Instructions for using the Patient’s Toolkit in Group Visits

Authors: Jason Kroening-Roche and Mark Stephens

Purpose of the Toolkit Journal

The Life Beyond Pain Toolkit and Personal Journal is a structured workbook that supports patients throughout the 10-week group visit program. It is designed to:

1. Reinforce session content
   Patients engage more actively with videos, discussions, and handouts by reflecting on what they have learned and how it applies to their lives.
2. Support weekly goal setting and practice
   After each session, patients identify practical steps they would like to try during the week.
3. Track progress over time
   Patients reflect on what they worked on and what progress they made, helping them recognize change across the program.

The Toolkit functions as a central element of the care process, linking education, personal reflection, and behavior change.

Session 1 (Week 1): Establishing the Baseline

Help patients describe their current situation and define a starting point for the program.

• Allow approximately 10–15 minutes for patients to complete:
  • “My Personal Home Page”
• Introduce this page as:
  • A way to describe current pain and its impact
  • A place to reflect on past experiences that may relate to pain
  • An opportunity to identify what patients hope to gain from the program
• Encourage patients to revisit this page during the program to notice changes over time

This baseline helps patients develop insight into their starting point and recognize progress as the program continues.

Sessions 2–9: Weekly Workflow

During or Immediately After Each Session

• Invite patients to complete the top section of the Session Review page:
  • “What did I learn…”
  • “What did I enjoy…”
  • “How can I use what I have learned…”
• Provide time within the session when possible, or encourage completion shortly after the session
• Reinforce that:
  • There are no right or wrong answers
  • Even small insights can be meaningful

Between Sessions

Encourage patients to apply what they have learned in ways that feel manageable.

• Encourage patients to:
  • Try one or two small, practical changes based on the session
  • Use handouts and mind-body practices as guides
• Emphasize:
  • Small steps are appropriate
  • Progress may be gradual
• Acknowledge that:
  • Some weeks may feel more productive than others
  • All efforts contribute to the overall process

Before the Next Session

Support reflection on effort and progress.

• Encourage patients to complete the bottom section of the Session Review page (“Progress”) before the next session:
  • “What have I worked on…”
  • “What would I like to share…”
  • “What am I planning to do next…”
• At the start of each session:
  • Briefly check in on completion
  • Use patient reflections to support discussion, when appropriate
• Recognize and reinforce:
  • Effort
  • Attempts to apply new strategies
  • Any progress, including small changes

Role of Videos and Handouts

• In most sessions, the video is viewed during the group visit
• Patients may revisit videos:
  • For review
  • If they missed a session
• Handouts:
  • Highlight key concepts
  • Offer practical suggestions
  • Serve as a reference between sessions

This approach aligns with the patient instructions in the Toolkit .

Session 10: Transition to Ongoing Care

Support patients in identifying a next step beyond the structured program.

• Invite patients to complete:
  • “My Final Review” and Lifestyle Goal section
• Guide patients in defining a:
  • 3–6 week Lifestyle Goal that is:
    • Meaningful to them
    • Realistic
    • Clearly stated
• This goal can be:
  • Entered into the medical record
  • Used to guide follow-up contacts

Provider Role Summary

Providers play a key role in supporting engagement with the Toolkit by:

• Introducing the purpose of the journal and how it fits into the program
• Allowing time in Session 1 for baseline reflection
• Encouraging completion of:
  • The Session Review (top section) after each session
  • The Progress section (bottom section) before the next session
• Supporting patients in setting and working toward small, meaningful goals
• Recognizing effort and progress throughout the program
• Helping patients define a Lifestyle Goal in Session 10 and connecting it to follow-up care

Key Principle

The Toolkit supports a consistent process:

Learn → Plan → Practice → Reflect → Continue

A supportive, flexible approach—highlighting effort, encouraging participation, and recognizing progress—helps patients engage with this process and apply it to their daily lives.

Download the booklet.