One persons mild pain could be debilitating for another. Chronic pain comes with even further complications for diagnosis and treatment, and affects a great many more than you may expect.
Dr Lauren Harrison is a pediatric pain psychologist and pain researcher at Stanford University School of Medicine. Her research on user-centered development of interventions for youth with chronic pain focuses on optimizing the development of digital tools when funds and technical knowledge are low.
Read the original article: https://doi.org/10.1136/bmjopen-2022-065997
Image Source: Adobe Stock Images / ChayTea
The following transcript is automatically generated
00:00:07 Will Mountford
Hello I’m will welcome to researchpod.
00:00:10 Will Mountford
Pain is a tricky thing to diagnose and treat. One person’s inconvenience could be debilitating for another. Chronic pain comes with even further complications and affects a great many more than you may expect.
00:00:23 Will Mountford
Doctor Lauren Harrison is a paediatric pain psychologist and pain researcher at Stanford University School of Medicine.
00:00:30 Will Mountford
Today we’re talking about her recent research and current trial focused on user centered development of digital graded exposure intervention for youth with chronic pain, with a specific focus on optimizing the development of digital tools. When funds and technical knowledge are low.
00:00:52 Will Mountford
Doctor Harrison. Hello.
00:00:54 Dr Lauren Harrisson
Hi, thank you so much for having me. My name is Lauren Harrison. I am a clinical psychologist by training and an instructor at Stanford University School of Medicine, where I hold mostly a research position but also work clinically in our pediatric pain rehab program.
00:01:13 Will Mountford
Could I ask a little bit in terms of the background of how you wound up in that kind of program? What about this field, drew you to this kind of research and how timely is your involvement in it?
00:01:23 Dr Lauren Harrisson
So I received my pH. D in clinical psychology from Eastern Michigan University, but prior to that did a Masters in clinical psychology down in Houston, TX, where I did a clinical rotation at Shriners Pediatric Burn Hospital. That was my first experience with pain, more of an acute pain setting.
00:01:44 Dr Lauren Harrisson
Obviously, but a lot of the principles that we use when supporting kids, working through chronic pain situations were present there as well. So things that we use to support comfort and coping distraction and then supporting parents and dealing with the distress of their child.
00:02:00 Dr Lauren Harrisson
Pain in my pH. D training. I did clinical rotations broadly with kids with a variety of chronic medical conditions and in a variety of intensive in patient consultation, liaison, and outpatient settings.
00:02:15 Dr Lauren Harrisson
Before moving on to my residency training at Kennedy Krieger Institute at Johns Hopkins School of Medicine, where I did primarily in patient rehabilitation services as the behavioral psychology provider. So.
00:02:30 Dr Lauren Harrisson
Working really closely with kids with chronic pain, but also spinal cord injury, brain injury, post ortho surgeries and working very collaboratively with the other rehabilitative services. So physical therapy, occupational therapy, speech and language, and just really, really enjoyed the collaborative nature of that work.
00:02:52 Dr Lauren Harrisson
Watching these kids get better, that’s one of my favorite things I think about working with children is that they’re so resilient. And after my residency training, I came out here to Stanford in 2018 to do a pain focused fellowship.
00:03:09 Dr Lauren Harrisson
And I’ve been here ever since.
00:03:15 Dr Lauren Harrisson
Oftentimes when I tell people that I work with kids with chronic pain, the response I get is kids have chronic pain and it’s actually a pretty pervasive problem. So one in four kids, it’s estimated, will experience chronic pain.
00:03:31 Dr Lauren Harrisson
And the impacts of this chronic pain on their daily lives are really far reaching. Kids are having difficulties attending school, participating in sports or other social events, engaging with friends and family.
00:03:44 Dr Lauren Harrisson
In addition to the physical experience of the pain, a lot of these kids are experiencing significant impact to their psychological and social functioning.
00:03:55 Dr Lauren Harrisson
And if left untreated, the pain can persist. Having chronic pain in childhood and adolescence is a really significant risk factor for having pain as an adult with societal costs exceeding $19.5 billion in the US each year alone, it’s a big number and I think when we think about the various domains that are impacted by chronic pain.
00:04:12 Will Mountford
That’s a big number.
00:04:20 Dr Lauren Harrisson
And the things that are driving them. So oftentimes, children will and adults present with a pain problem to 1st, their primary care physician who then let’s say they have ongoing stomach aches, might send them. And again we’re speaking in the United States healthcare system here. So they’ll send them to.
00:04:40 Dr Lauren Harrisson
By gastrointestinal doctor, who might run a bunch of tests and try a bunch of medications and not be able to figure it out, and then they might send them back to primary care. The patient still has pain. They might send them to internal medicine or another specialty provider. So usually by the time patients make it into our pain management.
00:05:01 Dr Lauren Harrisson
Clinic, they’ve been experiencing pain for many years and they’ve been to many, many, many medical providers. And so when we start to.
00:05:10 Dr Lauren Harrisson
Conceptualized chronic pain as a biopsychosocial problem in looking at mechanisms like pain related fear and avoidance as being drivers to impairment. We can then start to intervene.
00:05:25 Dr Lauren Harrisson
On those mechanisms through cognitive, behavioral and physical and rehabilitative therapies.
00:05:31 Will Mountford
I mean, it’s no wonder that they come to you with pain and fear and probably a lot of baggage and trauma along the way.
00:05:38 Dr Lauren Harrisson
Yes. Yeah. A lot of emotional distress. Not just in the children and teens, but in the caregivers as well.
00:05:45 Will Mountford
Well, to think about, you know, the two different, I suppose elements of your work when it comes to pain and working with children, how different is the experience of chronic pain and chronic pain management between adults?
00:05:59 Will Mountford
And then how is working with a child as a person, let alone from you know, the experiences they have, but as an individual different from working with an adult with any other health concern.
00:06:10 Dr Lauren Harrisson
In the work that we do with kids with chronic pain, we tend to really focus on function. There’s definitely space and effective medications and medical intervention.
00:06:20 Dr Lauren Harrisson
But usually the primary push for these kids is to get them back to school, get them back engaging with their families and their friends. A lot of the activities that they’ve stopped doing because.
00:06:31 Dr Lauren Harrisson
There is the pain present or there’s the fear that the activity will exacerbate the pain. So in the context of the work that I do clinically with kids with chronic pain is more focused on.
00:06:43 Dr Lauren Harrisson
Supporting them and returning to function trying to cope with and manage the pain, but really focusing on expanding their day-to-day activities and what they’re doing in the context of normal waking hours. And usually what we see is that pain decrease follows functional increase, so that tends to be our primary focus in treating chronic pain in kids.
00:07:05 Will Mountford
And when you talk about the nerve signals for pain where there or can be that the interventions to treat that is that, you know, physically intervene in the neurotransmitter signal or is that a more psychological approach to manage those signals and, you know, lessen them through whatever psychological conditioning rather than direct physiological intervention?
00:07:26 Dr Lauren Harrisson
There are interventions directly onto the nerves to try to cut those signals, and sometimes those are very effective and in the cases when they aren’t, we move more towards a physical rehabilitative approach with the psychological support to try to.
00:07:44 Dr Lauren Harrisson
Let’s say for example a child is having significant amount of pain in their foot post. Maybe there was a break. The break has healed, the pain remains. The pain might even be worse. So what we’re needing to do is get them to walk, even though everything that they’re conditioned to do, how they’re conditioned to respond to pain would be I can’t walk.
00:08:04 Dr Lauren Harrisson
So we need to get them engaging in those movements. The physical rehabilitation of walking. However, that sort of starts and builds up and then sort of the behavioral and the psychological support to be able to actually.
00:08:16 Dr Lauren Harrisson
Do that cope with doing that and then the mindset shift that’s required to say even though my body is telling me I’m in pain and this is dangerous.
00:08:25 Dr Lauren Harrisson
I know I’m safe and I need to push forward and engage in this exercise.
00:08:29 Dr Lauren Harrisson
And eventually know that the pain comes down.
00:08:32 Will Mountford
And what kind of rates of success do you see with that therapy?
00:08:36 Dr Lauren Harrisson
For the pain rehabilitation clinic, we’re seeing kids five days a week, typically 8:00 to 3:00. So working in a much more intensive setting with.
00:08:46 Dr Lauren Harrisson
And working interdisciplinary with physical therapy, occupational therapy, nursing, medicine.
00:08:53 Dr Lauren Harrisson
So we tend to see kids get better, but it’s a different treatment. It’s a more intensive treatment. We have kids in our program for up to 12 weeks. So it takes time and a lot of the kids will discharge from our program and still need some additional supports. But we’ll have made pretty significant functional improvements able to return to school.
00:09:13 Dr Lauren Harrisson
That was the plan returning to daily activities, engaging with the.
00:09:18 Will Mountford
How much of A barrier to accessing care and to recovery is the intensity of having to be in the clinic for those you know, days of the week to be travelling all the time, the pressure on the families that puts on them like wait lists to get there, the monetary demands of it, you know, everything outside of the care that impacts successful care.
00:09:41 Dr Lauren Harrisson
They’re high. I think the burden on families to come into these programs is high. Parents are taking off work. Sometimes families are relocating temporarily into hospital based housing services.
00:09:55 Dr Lauren Harrisson
And it’s typically not only one caregiver and one child that makes up the family unit, I think.
00:10:04 Dr Lauren Harrisson
The impact of pain is far reaching beyond the domains that are impacted for the child so far reaching on the family unit, and I think that.
00:10:15 Dr Lauren Harrisson
In addition to access to care barriers, insurance barriers, it’s a high cost, high demanding intervention.
00:10:24 Dr Lauren Harrisson
With digital health, we have this unprecedented opportunity to increase access to care and there’s certainly been a lot of work and government grant dollars put forth to support the development of digital tools, digital interventions. I think where we still have a lot of room to grow.
00:10:46 Dr Lauren Harrisson
In assessing how do we increase engagement and usability with these tools, the work that’s been done, at least in pediatric chronic pain space, shows that outcomes of the digital tools that exist are pretty similar to outcomes for in person interventions.
00:11:06 Dr Lauren Harrisson
So when we think about treating kids with chronic pain, the gold standard of care is cognitive behavioral therapy. So that’s an intervention delivered by a psychologist or psychological provider where we’re targeting the child’s thoughts and emotions around them.
00:11:24 Dr Lauren Harrisson
Saying and their behaviors how they’re either behaving or engaging or not in relation to their pain. And so we’re using the broad cognitive behavioral therapy interventions and really tailoring them to chronic pain. And so we see changes, we see improvements but with cognitive behavioral therapy being a broad intervention that’s targeting.
00:11:46 Dr Lauren Harrisson
Several different domains, sometimes all at the same time. It’s hard to really suss out what mechanistically is driving the change or not driving the change, and so there’s been this push to really dive into specific mechanisms of these behavioral interventions to try to see.
00:12:05 Dr Lauren Harrisson
Can we isolate A mechanism or figure out what isn’t contributing to improvement or might be taking away from improvement to see if we can enhance these treatment outcomes? Exposure is a long standing behavioral intervention that is most often used to treat people with really significant anxiety disorders.
00:12:26 Dr Lauren Harrisson
So the idea is when we have a stimulus that we’re afraid.
00:12:30 Dr Lauren Harrisson
Of we tend to avoid it because our body is conditioned to avoid things that we’re fearful of. So with exposure therapy, we are supporting people engaging in the things that they’re having in fear response to that.
00:12:45 Dr Lauren Harrisson
Has caused avoidance that is now non functional, so the same principles of that.
00:12:50 Dr Lauren Harrisson
Are being applied to chronic pain. The work first started in adults with back pain trying to get these adults to engage in these movements that they weren’t engaging to due to the presence of pain or the fear that engaging in that movement would cause pain to increase.
00:13:07 Dr Lauren Harrisson
So it’s targeting not only the physical movements of the exposure, but also the cognitions and the appraisals and how we are interpreting what pain means. When I first came to Stanford as a fellow, my clinical position was on a clinical trial examining A graded exposure intervention in kids with chronic pain.
00:13:29 Dr Lauren Harrisson
So my primary mentor at the time, Doctor Laura Simons, had adapted the graded exposure treatment that was being done in adults for kids, and that intervention is called get.
00:13:39 Dr Lauren Harrisson
Living and we examined that intervention in A2 arm randomized controlled trial against the current gold standard. So cognitive behavioral therapy for chronic pain and physical therapy for chronic pain. The graded exposure intervention in the context of the clinical trial was delivered jointly by a pain psychologist and a physical therapist.
00:14:00 Dr Lauren Harrisson
So in both arms, we had both disciplines, but the core components of the intervention are different. So in the exposure intervention, there’s focus on.
00:14:10 Dr Lauren Harrisson
And the cycle of pain and avoidance, how that incorporates aspects of parents and family functioning. So how parents, appraisals and behaviors around pain can contribute to a child’s appraisals and behaviors around pain, how they’re emotionally responding, how they’re behaviorally responding to the pain and to each other. We do a lot of.
00:14:30 Dr Lauren Harrisson
Values based goal setting. So rather than setting arbitrary goals that might be important in the day-to-day life of a child, we’re asking them really specifically like what is important to you. What do you want your life to look like outside of the context and pain? And we try to set.
00:14:46 Dr Lauren Harrisson
Goals related to that. And then we look at their physical movements and what they are and aren’t able to do and set some activity goals around that.
00:14:57 Dr Lauren Harrisson
The meat of the intervention is getting them to engage in these activity exposure.
00:15:06 Dr Lauren Harrisson
So the clinical trial that we ran took about 2 1/2 years and.
00:15:12 Dr Lauren Harrisson
A significant portion of that happened in the context of COVID.
00:15:16 Dr Lauren Harrisson
But what we saw essentially is no differences in the outcomes between the interventions, so the exposure intervention.
00:15:26 Dr Lauren Harrisson
Function just as well as the current gold standard of care patients improved in expected directions regardless of the intervention. We also saw no differences in improvement for those patients who received the treatment in person or virtually due to the pandemic.
00:15:43 Dr Lauren Harrisson
But that study, and I think the context of the pandemic, really sort of set the stage for us to try.
00:15:49 Dr Lauren Harrisson
To see if we could create a version different from like an hour session on telehealth, which is still burdensome, albeit less so than presenting to the clinic. But to see if there’s a way to modify the exposure intervention into a more self-guided self-paced digital format.
00:16:09 Dr Lauren Harrisson
And I think diving into that work and being connected with mentors and collaborators who have been doing work in this space for a long time, it sort of sparked all these questions about we have.
00:16:24 Dr Lauren Harrisson
A lot of effort and energy, time and money that’s being put into the development of.
00:16:28 Dr Lauren Harrisson
Digital tools but.
00:16:31 Dr Lauren Harrisson
Like about 28% actually make it into healthcare. So there’s a significant amount of research waste when it comes to these digital interventions.
00:16:41 Dr Lauren Harrisson
And in working closely with my collaborator, so my mentor, doctor Laura Simons, Doctor Richard Wicksell, who’s at Karolinska Institute in Stockholm, Sweden, you know, we started talking about how do we be a bit flexible in our methodologies, maybe pull in some other methodologies that have been.
00:17:01 Dr Lauren Harrisson
Used in other psychological research spaces for many, many years, and also consider how are these tools being developed in industry? There’s a model that we have been basing our most recent work off of. It’s the M health, agile development and life cycle model.
00:17:21 Dr Lauren Harrisson
Which really seeks to provide a framework to take what’s being done in academia and what’s being done in industry and.
00:17:29 Dr Lauren Harrisson
Essentially, marry them together, so integrating the rapid iterative development process used in industry with empirically driven behavior change theories of academia to engage end users in the development process to produce a digital tool that is meeting their needs and contexts.
00:17:50 Dr Lauren Harrisson
Empirically driven and can be widely disseminated.
00:17:56 Dr Lauren Harrisson
In developing the digital version of the graded exposure intervention, we tried to really take that approach. So I would say our top priorities have been to engage end users. So in this case, teens with chronic pain in all aspects of the development process to take a really agile and iterative.
00:18:17 Dr Lauren Harrisson
Approach to the development process.
00:18:20 Dr Lauren Harrisson
And to try to do it relatively quick.
00:18:23 Dr Lauren Harrisson
Which is a challenge in academia, particularly when you’re working in digital technology spaces, because we don’t tend to have a ton of money to put into these interventions or to partner with people who know how to build really effective and enticing digital tools.
00:18:40 Will Mountford
How does a clinician get into software and apps? Or how does an app developer get contacted about some medical work rather than, you know, another version of Angry Birds or something?
00:18:51 Dr Lauren Harrisson
Yeah, that’s a big.
00:18:53 Dr Lauren Harrisson
Question and gap in the digital intervention development that’s happening in the context of academia.
00:19:00 Dr Lauren Harrisson
We had this idea to develop a.
00:19:03 Dr Lauren Harrisson
Digital version of this intervention and.
00:19:07 Dr Lauren Harrisson
It’s, so to speak.
00:19:07 Dr Lauren Harrisson
Like looking around the room of like who’s done something similar and what have they built their intervention?
00:19:11 Dr Lauren Harrisson
On we spent.
00:19:14 Dr Lauren Harrisson
A lot of time at the beginning trying to figure out what is the best platform to build this on.
00:19:21 Dr Lauren Harrisson
The tools that we have available to us are not going to be exciting visually. Oftentimes they’re pretty basic, but they’ve been widely used in studying the preliminary efficacy of interventions and the feasibility of people using them. So we initially opted to use a platform that’s been widely used to study.
00:19:43 Dr Lauren Harrisson
Behavioral interventions in youth and adults and sort of making that decision. I think what’s really important in academia when we think about trying to speed up our process.
00:19:54 Dr Lauren Harrisson
It’s these decision points when it would be very easy to get hung up on on or you got to find the perfect platformer knowing we don’t have this much money or we have these limited technological skills. Like what do we do and and that is daunting. I could speak from experience, but we kind of got to this place where we have this established platform.
00:20:16 Dr Lauren Harrisson
So making that decision allowed us to tailor and tweak the content from the in person intervention, get it into a platform and get it in front of kids with chronic pain and let them tell us.
00:20:29 Dr Lauren Harrisson
What they think.
00:20:30 Dr Lauren Harrisson
So we ran 2 cycles of those interviews in the initial platform.
00:20:36 Dr Lauren Harrisson
And got to a place where essentially the kids were like, we understand the purpose of this intervention, the content is clear. We like.
00:20:45 Dr Lauren Harrisson
The platform is very boring.
00:20:48 Dr Lauren Harrisson
They had a lot of ideas for how it should look and the things that.
00:20:51 Dr Lauren Harrisson
00:20:52 Dr Lauren Harrisson
Have then again as a research team, we’re back in the Uncharted territory of, OK.
00:20:58 Dr Lauren Harrisson
Now, what do we do?
00:20:59 Dr Lauren Harrisson
The primary focus of this project was to have it be developed and designed based on the user feedback. I remember a point in time where we sort of stepped back and we were like, OK, well we can.
00:21:16 Dr Lauren Harrisson
Go forward with what feels certain and known, which would be to continue with this platform. There were a few modifications that could have been made. A lot of the things that we were asking for could have been made, but they would have.
00:21:30 Dr Lauren Harrisson
Been very, very.
00:21:31 Dr Lauren Harrisson
Very expensive and taken a long time like over a year.
00:21:36 Dr Lauren Harrisson
We needed to.
00:21:37 Dr Lauren Harrisson
Move quicker than that. That was also one.
00:21:39 Dr Lauren Harrisson
Of our big.
00:21:39 Dr Lauren Harrisson
Goals was to not spend years and years and years and years developing and then years and years and years testing this tool so that by the time it’s ready to be integrated into healthcare, it’s.
00:21:51 Dr Lauren Harrisson
Then totally obsolete so.
00:21:55 Dr Lauren Harrisson
We had a couple of weeks where we then just started reaching out to freelance software developers and app developers.
00:22:02 Dr Lauren Harrisson
Talked with a couple of colleagues who have partnered with industry and quickly realized that that was not going to be an option. Again, we don’t have a lot of money to develop this tool and when I say not a lot of money, I mean like $30,000.
00:22:18 Dr Lauren Harrisson
In total for the project in talking to freelancers, we started paying attention to the websites and platforms that they were commonly using, so we have no code, lower cost platforms that a lot of the freelancers were saying. I would build this on that platform. I build this on this platform and.
00:22:39 Dr Lauren Harrisson
My research coordinator, Sarah Webster and I one day were like, why don’t we just see how easy it?
00:22:44 Dr Lauren Harrisson
Would be to build one of these websites.
00:22:47 Dr Lauren Harrisson
So we just decided to try and see what would be available to us again with very limited money, very, very limited technology. But could we build something that was good enough, would meet the needs of the teens, the things that they were saying they would need in order to engage with this daily?
00:23:09 Dr Lauren Harrisson
That would allow us to then be able to test.
00:23:13 Dr Lauren Harrisson
What is the feasibility of an intervention like this? What is the likelihood of engagement? What’s getting in the way of non engagement and then to test the efficacy of the content? So we’re in the last phase of refining that intervention when we finish this round of interviews, we’ll finalize things and then prep for.
00:23:34 Dr Lauren Harrisson
The second part of the trial, which is to examine.
00:23:39 Dr Lauren Harrisson
Feasibility and preliminary efficacy of the intervention and we’re planning to launch that on a small sample of participants. So we proposed N of 20. We’re incorporating A methodology called single case Experimental design, which has long been used in behavioral research and is starting to be integrated into.
00:24:00 Dr Lauren Harrisson
The behavioral health space.
00:24:02 Dr Lauren Harrisson
But essentially, with this methodology, you’re looking at changes within the individual at repeated time points over the course of the intervention. And so we’re able to see at the individual patient level when and where are they having changes or improvements and when are they not. And instead of needing to wait until the trial is complete.
00:24:24 Dr Lauren Harrisson
With single case experimental design, we’re able to examine the data.
00:24:30 Dr Lauren Harrisson
In real time, so we can change and make adjustments to what is being done in the context of our intervention. The next steps for us are really trying to look at implementation and adaptation into healthcare. So our next steps are to engage three clinics in our children’s healthcare system where patients with chronic pain.
00:24:51 Dr Lauren Harrisson
And to present so our pediatric pain management clinic, a sports and orthopedic medicine clinic and a rheumatology.
00:24:59 Dr Lauren Harrisson
And really take sort of a service design approach to assessing implementation and adaptation. Essentially what this means is we’ll have a period of time of observing workflow in each of those clinics, conducting interviews and focus groups with various providers in those clinics. So it might be a medical physician.
00:25:19 Dr Lauren Harrisson
Psychologist, a social worker, a nurse. Anybody who’s having touch points with patients where they might be delivering or following up on status or recommendation.
00:25:30 Dr Lauren Harrisson
And then trying to.
00:25:33 Dr Lauren Harrisson
Understand how this digital tool would potentially be implemented into their workflow, so trying to assess those pieces. The pieces that I think are really important for adoption and implementation of these tools before then launching a larger multi site trial. The hope there is that we’re.
00:25:53 Dr Lauren Harrisson
Answering all of the questions that we would be left with at the end of a multi site trial had we just moved right into it.
00:26:00 Will Mountford
Would you say that app development and mobile health technologies is for everyone, either from, you know, the peer and professional side or from the patient side of what they are getting out of it?
00:26:12 Dr Lauren Harrisson
I would definitely say.
00:26:13 Dr Lauren Harrisson
For both researchers and clinicians and patients are different strokes for different folks. As a clinical researcher using the knowledge that I have of how things work in a clinical space provides additional insights for how we develop things from a research perspective.
00:26:32 Dr Lauren Harrisson
As opposed to being somebody who’s isolated in either environment without an understanding of.
00:26:38 Dr Lauren Harrisson
You know the logistical barriers.
00:26:41 Dr Lauren Harrisson
And for patients and for families, it’s there’s going to be some kids that are really going to like the idea of a self-guided app and.
00:26:47 Dr Lauren Harrisson
Some kids who aren’t the big goal in developing this tool is to try to create something that will meet the needs of the people that will use it and will engage with it and will benefit from it.
00:27:02 Will Mountford
If there’s any patients or clinicians who think that they might have candidates that could be eligible for enrollment in either this stage or further development, what should people do? Having heard this and where can they find out more?
00:27:15 Dr Lauren Harrisson
I mean, anyone who’s working in this space in the digital intervention development space, I would be happy to connect with one of my big goals in this podcast and some of the work that we’re about to publish is being very transparent about our process and trying to shift how we approach.
00:27:35 Dr Lauren Harrisson
The development of these digital tools in early stages within academia.
00:27:40 Dr Lauren Harrisson
So, recognizing that there are like low cost, no code technical solutions that are accessible and allowing us as researchers in.
00:27:49 Dr Lauren Harrisson
The field of digital intervention development to move forward beyond those barriers, I think where the field used to get a bit stuck. So being a bit flexible and creative, my hope is to share.
00:28:01 Dr Lauren Harrisson
Our process and to collaborate with others who are interested in or pursuing similar.
00:28:07 Dr Lauren Harrisson
Work if there are teens with chronic pain who are wanting to get involved, we’re always looking for people with lived experiences to act as advisors and consultants and partners in our research. So anyone who’s interested in reaching out. You can find me on Twitter or via e-mail as well.
00:28:27 Will Mountford
Thank you so much for your time today and fingers crossed we get to hear more from you soon again.
00:28:31 Dr Lauren Harrisson
Thank you so much, will.