LBP Learning Collaborative Meeting Summary

Date: June 11, 2026

Attendees

Present for most or all of the meeting:

• Jason Kroening-Roche
• Charles
• Mark Stephens
• Kira
• Jenny
• Kristin
• Nick (joined later)

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Summary

The meeting began with a brief mindfulness exercise led by Jason, followed by personal check-ins. The discussion focused on three major themes:

1. Performance and attendance in the Life Beyond Pain groups
2. Use and future development of the patient journal
3. Post-program follow-up and long-term integration of learning

Overall, participants felt the groups were having a significant positive impact on patients despite lower-than-expected attendance in some cohorts.

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Group Attendance and Patient Impact

Several facilitators noted that attendance had declined in recent sessions at Richmond, Gabriel Park, and other sites. Rather than viewing this as a failure, the group emphasized that smaller groups often resulted in deeper discussions and meaningful patient engagement.

Mark shared feedback from former Richmond participants, reporting that patients consistently expressed gratitude and described the program as highly impactful. Several patients credited facilitators with helping change their lives and improve their relationship with chronic pain.

Jenny reported that one patient described the weekly session as the highlight of her week and looked forward to attending each Wednesday. Facilitators repeatedly observed that life circumstances—not dissatisfaction with the program—were the primary reason for missed sessions.

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Facilitator Reflections

Kira discussed the challenge of leading yoga sessions for participants with widely varying physical abilities. She found it difficult to accommodate patients with very limited mobility while keeping the experience meaningful for everyone. Despite her concerns, she remained optimistic and interested in refining her approach.

Kristin reflected on the “noise” that facilitators experience during groups:

• Managing time
• Redirecting discussions
• Wondering whether content is landing
• Managing expectations about patient outcomes
• Balancing structure with presence

Jason described facilitation itself as a mindfulness practice, requiring continual return to the present moment and trust in the process.

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Patient Journal Discussion

A substantial portion of the meeting focused on the Life Beyond Pain Journal. Facilitators reported mixed use among patients:

• Some patients actively use the journal for goals and reflections.
• Others rarely engage with it.
• No one wanted the journal to feel like homework.

Key ideas discussed:

• Frame the journal as an invitation rather than an assignment.
• Use it to support reflection and integration.
• Encourage patients to connect group learning to their daily lives.
• Consider having participants write briefly during Session 1 and Session 10 to establish the habit.

Mark emphasized that the journal’s long-term purpose is to help patients continue self-management after the formal 10-week program ends.

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Follow-Up Visits and Integration

The group discussed a surprising finding from prior cohorts: relatively few patients requested ongoing follow-up visits after completing the program.

Rather than offering frequent scheduled follow-ups, the group explored a new model:

• Recommend at least one follow-up visit within a month of program completion.
• Focus the visit on “integration” rather than accountability.
• Explore what remains meaningful, useful, or “alive” for patients after the program ends.
• Use the visit to discuss continuing growth and lifestyle changes.

Kira introduced a phrase that resonated strongly with the group:

“Did you find an access point to change?”

Jason specifically noted interest in incorporating that language into future materials and manuals.

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Proposed Journal Enhancements

Mark presented several draft additions for Version 2 of the journal:

1. Feelings Wheel

Include an emotion wheel directly in the journal rather than as a separate handout. Copyright considerations may require creation of a custom version.

2. Life Circle / Life Box Exercise

A visual exercise showing pain occupying a larger portion of life initially and a smaller proportion later as life expands around the pain.

3. Wellness Assessment Wheel

A self-rating tool covering:

• Sleep
• Movement
• Mood
• Stress
• Social connection
• Nutrition
• Daily function
• Pain impact

Patients would periodically score themselves and track progress.

4. Post-Program Reflection Pages

Additional pages allowing patients to continue journaling after the 10-week program ends, including:

• Progress toward goals
• Ongoing reflections
• Future plans and priorities.

Kristin recommended applying health-literacy principles to ensure the journal remains accessible to patients with varying educational backgrounds.

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Additional Feedback from Nick

After joining late, Nick reported:

• Groups have generally been well received.
• Attendance remains a concern.
• Patients use the feelings wheel regularly.
• Additional chair yoga scripts, videos, and embodiment resources would be helpful.
• Acupuncture implementation has gone well overall.
• Journal use varies considerably among participants.

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Key Decisions / Action Items

1. Continue refining journal Version 2.
2. Explore inclusion of a custom feelings wheel.
3. Add the Life Circle/Life Box exercise.
4. Continue development of the eight-domain wellness wheel.
5. Consider adding EFT, mindfulness, qigong, and embodiment practice appendices.
6. Shift follow-up messaging toward integration rather than accountability.
7. Encourage at least one post-program follow-up visit for all participants.
8. Schedule additional consultation regarding journal design and health literacy review.