Table 1

Overview of the content of the sessions in both intervention groups

Overview of the content of the sessions
Perceived injustice-targeted PNE + MI	Session (duration)	Biomedically-focused pain education
PNE adapted to BCSs discussing: Pain as a fire alarm Characteristics of acute versus chronic pain How does acute pain arise in the nervous system? How does pain become chronic? Explaining the importance of long-term instead of short-term treatment options Introduction of perceived injustice as a possible sustaining factor for pain and central nervous system sensitisation Introduction to the logbook + change talk questions to prepare at home: ‘What would you like to see different in your current situation?’ ‘Why do you think you need to change?’ ‘What will happen if you don't change?’ ‘What will have changed when you complete this treatment programme?’ ‘What would be the benefits of changing the way you deal with the pain?’ ‘What would your life be like in 3 years if you changed your way of dealing with the pain?’ ‘Why do you think others are concerned about your pain experience?’	Online session (1 hour)	Differences between the characteristics of nociceptive pain, neuropathic pain and central sensitisation Pain as a fire alarm Characteristics of acute versus chronic pain Oncological causes of pain after breast cancer: (1) cancer itself/metastases from it resulting in nerve pain, bone pain or oncological ulcer or (2) the cancer treatment (radiotherapy, surgery/operation, chemotherapy, hormone therapy and general consequences of cancer treatment) Introduction to the logbook + questions to prepare at home: ‘Which symptoms do you recognise in yourself per treatment that we have discussed?’ ‘Do you have any other symptoms that cause you pain?’ ‘How did you feel about pain before the online session?’ ‘What has changed about the way you look at your pain after watching the online session?’
Summary of the online PNE session	Information leaflet	Summary of the online biomedically-focused pain education session
Completing the anamnesis in addition to the biopsychosocial baseline assessments Discussing the online PNE (short recapitulation) and information leaflet to define the behavioural stage of change of the participant Using MI based on the phase of behavioural change Defining and discussing sustaining factors for pain such as perceived injustice, anger, (pain) acceptance and frustrations Reviewing the logbook	1st one-to-one session (45 min)	Completing the anamnesis in addition to the biomedical baseline assessments Discussing responses to the online education and information leaflet Discussing the relationship between the treatment, symptoms and limitations in daily life Types of pain medication based on the WHO classification and side effects Reviewing the logbook
Continuing motivational interviewing based on the phase of behavioural change Defining life goals and restarting valued occupations by improving the predefined sustaining factors for pain and central sensitisation Reviewing the logbook	2nd one-to-one session (45 min)	Discussing other treatment possibilities instead of pain medication Defining goals to overcome the tissue damage to improve symptoms and limitations in daily life Reviewing the logbook
Further defining life goals and restarting valued occupations Supporting self-management based on motivational interviewing techniques in the planning phase Reviewing the logbook	3rd one-to-one session (45 min)	Supporting self-management, ‘What can you do yourself?’ Reviewing the logbook

BCSs, breast cancer survivors; MI, motivational interviewing; min, minutes; PNE, pain neuroscience education; WHO, World Health Organization.