Mentalizing & InteRpersonal Recognition of Others’ Relational States (MIRROR): a patient-directed intervention for navigating clinical encounters in chronic pain

INTRODUCTION: Chronic pain can lead to challenges in social functioning that extend into healthcare. The Mentalizing & InteRpersonal Recognition of Others' Relational States (MIRROR) intervention was developed to support patients' relational and communication skills in healthcare by targeting mentalizing (the ability to understand mental states of oneself and others). This paper describes MIRROR and reports preliminary findings regarding feasibility and acceptability across two pain samples. METHODS: Eleven patients with chronic low back pain (cLBP, mean age 39.64 ± 16.37) and 12 patients with fibromyalgia (FM, mean age 38.83 ± 15.25) completed the four-session intervention. Questionnaires assessed session value and applicability, perceived benefit and generalization, and Perceived Efficacy in Patient-Physician Interactions (PEPPI). RESULTS: Session ratings reflected moderate-to-high value and applicability (mean over 4 sessions: cLBP 1.22 ± 0.46, FM 1.45 ± 0.46; scale: -2 to 2), and perceived benefit and generalization (mean cLBP 0.88 ± 0.77, FM 0.71 ± 0.58; scale: -2 to 2). Exploratory pre-post changes in PEPPI scores indicated a medium effect observed in cLBP (Hedges' g = 0.52) and a small effect in FM (Hedges' g = 0.10). Open-ended feedback supported acceptability and feasibility. CONCLUSIONS: MIRROR appears feasible and acceptable as an intervention engaging mentalizing methods for enhancing patients' ability to navigate clinical interactions. Further research should evaluate whether engaging mentalizing abilities improves subsequent healthcare communication and outcomes. CLINICAL TRIAL REGISTRATION: www.clinicaltrials.gov identifier is NCT06157866.