## KarunaHOME Fear Avoidance Belief Training (FABT)

#### At Home for Workers’ Compensation Patients

### KarunaHOME Program Benefits

- Decrease fear avoidance beliefs, improve function
- Decrease medication usage
- Decrease medical utilization for high medical utilizers, decreasing open claim time and moving patient to MMI more quickly

### KarunaHOME Program Features

- Fear Avoidance Belief Training recommended in MTUS Chronic Pain Guidelines
- Behavioral health coaches trained in motivational interviewing
- Opioid-sparing, evidence-based pain neuroscience education program
- Digital health tools to track patient progress

## The KarunaHOME Patient Journey

#### The KarunaHOME Patient Experience

Patients perform KarunaHOME sessions and activities at home, while progress data is sent back to their providers.

#### Pre-Program: Getting Started

Patient meets with a clinician (either in person or over video chat) to determine a plan of care for Fear Avoidance Belief Training (FABT).

Once authorized, the KarunaHOME Kit, including our proprietary FABT device and an educational workbook, is sent to the patient’s house.

#### Weeks 1-2: Training and Coaching Begin

Training and coaching begin. The patient meets with his or her coach once per week to set and review goals, complete FABT activities, and review educational materials. All sessions are completed virtually from the comfort of the patient’s home.

#### Weeks 3-10: Program Continues

Patient continues FABT activities and exercises. Patient meets with their KarunaHOME coach once per week to review progress, refine goals, and work towards unlearning their chronic pain. Coaches provide support and accountability throughout the program.

Provider is able to track patient progress through a dedicated Provider Portal.

#### Weeks 11-12: Real World Application

Patient’s pain coach will provide support and actionable steps to help them transition their progress to the real world. Patient continues to perform FABT exercises.

#### End of Program: Device Return

After completing the 12-week program, patients return the KarunaHOME FABT device to Karuna using a prepaid label (included in program cost).

Coaches continue to check in with their patients regularly after the end of the program to ensure they are making continued progress in regaining function and getting back to work.

## Research

#### Selected Fear Avoidance Beliefs Training (FABT) Research

Fear Avoidance Beliefs are associated with disability, reduced function, and impairment in chronic pain patients. FABT has demonstrated improvements in disability, function, impairment, and return to work in chronic pain patients.

| **DESCRIPTION** | **TITLE** | **DESIGN** |
|----------------|-----------|------------|
| [The Effect of a Fear-Avoidance–Based Physical Therapy Intervention for Patients With Acute Low Back Pain: Results of a Randomized Clinical Trial](https://pubmed.ncbi.nlm.nih.gov/14652471/) | Fear Avoidance Beliefs Training improves disability and pain intensity in patient’s low back pain | Randomized Controlled Trial |
| [Ten weeks of physical-cognitive-mindfulness training reduces fear-avoidance beliefs about work-related activity: Randomized controlled trial](https://pubmed.ncbi.nlm.nih.gov/27559939/) | Fear Avoidance Beliefs Training significantly improved work related fear avoidance beliefs in workers with chronic pain | Randomized Controlled Trial |
| [High Fear-Avoiders of Physical Activity Benefit From an Exercise Program for Patients With Back Pain](https://pubmed.ncbi.nlm.nih.gov/15167652/) | Patients with high fear avoidance benefit from functional rehabilitation programs that include Fear Avoidance Beliefs Training | Comparative Study |
| [A randomized controlled trial of exposure in vivo for patients with spinal pain reporting fear of work-related activities](https://pubmed.ncbi.nlm.nih.gov/18155934/) | Chronic low back pain patients with reduced function demonstrated superior benefits over treatment as usual on function, fear, and pain | Randomized Controlled Trial |
| [Preventing progression to chronicity in first onset, subacute low back pain: an exploratory study](https://pubmed.ncbi.nlm.nih.gov/19345767/) | Early Fear Avoidance Training prevents the onset of chronic pain | Exploratory Study |
| [Fear-Avoidance Behavior and Anticipation of Pain in Patients With Chronic Low Back Pain: A Randomized Controlled Study](https://pubmed.ncbi.nlm.nih.gov/15102230/) | Function in chronic pain patients is significantly reduced in patients with high Fear Avoidance Beliefs | Randomized Controlled Trial |
| [Fear avoidance beliefs as a predictor for long-term sick leave, disability and pain in patients with chronic low back pain](https://pubmed.ncbi.nlm.nih.gov/30509231/) | High fear avoidance beliefs is associated with sustained impairments in returning to work in chronic pain patients | Randomized Controlled Trial |
| [Manual Therapy, Therapeutic Patient Education, and Therapeutic Exercise, an Effective Multimodal Treatment of Nonspecific Chronic Neck Pain: A Randomized Controlled Trial](https://pubmed.ncbi.nlm.nih.gov/25888653/) | Therapeutic patient education | Randomized Controlled Trial |

### “This product stood out from all the other treatments I’ve had…it has improved me the most. Everything else was more of a bandaid.”

## Our Evidence-Based Approach

#### Our integrative program helps people address pain from multiple angles. It is founded on the “biopsychosocial” approach to fear-avoidance beliefs-based pain management, which has been clinically shown to support lasting outcomes.

Our coaching curriculum and proprietary FABT software fuse neuroplastic pain education paired with movement and relaxation exercises designed to mirror the type of activities you engage in on a daily basis in work, at home, and in life. The 12-week multi-disciplinary program is safe, non-invasive, and hyper-personalized.