[CHRONIC: A didactically constructed clinical vignette illustrating a digital multimodal self-help program for
Gentian Bunjaku1, Tanja Zimmermann1
1Klinik für Psychosomatik und Psychotherapie, Medizinische Hochschule Hannover, Hannover, Germany.
Objective:
The aim of this article is to provide a conceptual description and clinical illustration of CHRONIC, a web-based multimodal program, by means of a didactically constructed clinical vignette.
Methods:
We present a clinically typical course of a 47-year-old woman with chronic pain disorder (F45.41), long-standing back and leg pain, pronounced avoidance and protective behavior, and marked restrictions in meaningful activities. CHRONIC is accessed via a browser and provides weekly unlocked video modules with in-session interactive exercises (auto-pause), worksheets, and structured home practice. Mindfulness exercises are provided as audio (up to ~15 minutes), and three physiotherapy units are embedded within the module flow (posture in daily life, dose-adaptable whole-body exercises, safe gait and stance). Brief weekly assessments (past 7 days) are displayed on the dashboard as line graphs of sum scores from selected MPI-D subscales. Written feedback is delivered in-app and via email.
Clinical Illustration:
The vignette illustrates how psychoeducation (biopsychosocial model and vicious cycle of pain), acceptance and defusion strategies, and values-based goal setting can be translated into everyday action while gradually increasing pain-adapted physical activation. Over the 12-week course, the vignette illustrates a possible course toward personally meaningful goals with reduced avoidance and excessive guarding.
Conclusions:
This didactically constructed vignette illustrates the intended clinical application and conceptual structure of CHRONIC. The article is hypothesis-generating and does not allow conclusions regarding effectiveness, implementation success, or comparative utility in routine care.
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