TREK (Transform, Restore, Empower, Knowledge) for Success

Single Session Behavioral Pain Management Classes: Standard of Care for Chronic Pain Patients With Demonstrated Feasibility and Acceptability

Empowered Relief™ is a single-session 2-hour pain relief skills class for acute/surgical and chronic pain that was developed by Beth Darnall at Stanford University. Multiple randomized trials provide efficacy evidence for Empowered Relief delivered across different patient populations and delivery formats. Cleveland Clinic has adopted Empowered Relief as a standard of care approach for all patients who have chronic pain as well as individuals who are preparing for spine surgery. The class is a foundational approach as part of TREK (Transform, Restore, Empower, Knowledge) for Success Programs. TREK classes are introductory pathways to more intensive group treatment programs focused on restoring function and reducing emotional suffering related to chronic pain.

Patient Engagement

High levels of engagement were demonstrated with 72% of all referred chronic pain patients completing the class and 52% of all surgical patients completing the class.

Class Acceptability and Utility

Immediately after the class, participants received an e-survey to assess their perceptions about the class, including satisfaction, perceived usefulness of information, and likelihood to use the skills learned; all items use a 10-point scale, where 1 is the lowest rating and 10 is the highest possible rating.

Spine Surgery Cohort (N = 107)

PHQ-9 = Patient Health Questionaire, PROMIS = Patient Reported Outcomes Measurement Information System.

Patients who took the class showed significant within-group improvement in PROMIS-GH Physical Health, PROMIS Fatigue, PROMIS Pain Interference, and PROMIS Social Role Satisfaction. Patients who completed the ER class had significant improvement in PHQ-9 scores while patients who did not complete the ER class did not have significant improvement.

Chronic Pain Cohort (N = 146)

PROMIS = Patient Reported Outcomes Measurement System.

Patients who took the class showed significant within-group improvements in Pain Catastrophizing, PROMIS Physical and Mental Health, Pain Interference, and Self-Efficacy for Managing Symptoms.