Exercise and Acceptance and Commitment Therapy for Chronic Pain: A Case Series with One‐Year Follow‐Up

2020 ◽  
Vol 18 (1) ◽  
pp. 64-73 ◽  
Author(s):  
Máire‐Bríd Casey ◽  
Niamh Cotter ◽  
Caoimhe Kelly ◽  
Lisa Mc Elchar ◽  
Cian Dunne ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Acceptance And Commitment Therapy ◽  
Case Series ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
One Year

scholarly journals MECHANISM OF ACTION: AGE DIFFERENCES IN RESPONSE TO ACCEPTANCE AND COMMITMENT THERAPY FOR CHRONIC PAIN

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S809-S809
Author(s):  
Julie L Wetherell ◽  
Matthew Herbert ◽  
Niloofar Afari
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Acceptance And Commitment Therapy ◽  
Behavioral Therapy ◽  
Pain Interference ◽  
Younger Adults ◽  
Pain Acceptance ◽  
Commitment Therapy ◽  
Acceptance And Commitment

Abstract A recent randomized comparison of Acceptance and Commitment Therapy (ACT) vs. Cognitive-Behavioral Therapy for chronic pain found a clear age interaction effect, such that older adults benefitted more from ACT. In a subsequent study comparing ACT delivered in person to ACT delivered via telehealth to a sample of veterans (N=128, mean age 51.9, SD 13.3, range 25-89), we found no significant age by modality interactions, suggesting that older veterans responded as well as younger people did to telehealth delivery. Consistent with our previous findings, we found a trend for older adults to experience greater reduction in pain interference (p = .051) and significantly greater reduction in pain severity (p = .001) than younger adults following ACT. In younger veterans, change in pain acceptance from baseline to posttreatment was related to change in pain interference from baseline to 6-month follow-up (r = -.38), but change in pain interference from baseline to posttreatment was not related to change in pain acceptance from baseline to follow-up (r = .14), suggesting that, consistent with the ACT model, increased pain acceptance at posttreatment was related to reduced pain interference at follow-up. By contrast, in older veterans, both correlations were significant and of comparable magnitude (rs = -.43 and -.46, respectively), providing no support for the idea that change in pain acceptance drove change in pain interference. Overall, our findings suggest that ACT may work better in older adults with chronic pain than in younger adults, but via a different mechanism.

Internet-Delivered Acceptance and Commitment Therapy for Adolescents with Chronic Pain and Their Parents: A Nonrandomized Pilot Trial

2020 ◽  
Vol 45 (9) ◽  
pp. 990-1004
Author(s):  
Vendela Zetterqvist ◽  
Charlotte Gentili ◽  
Jenny Rickardsson ◽  
Isabel Sörensen ◽  
Rikard K Wicksell
Keyword(s):  
Chronic Pain ◽  
Acceptance And Commitment Therapy ◽  
Psychological Treatment ◽  
Pilot Trial ◽  
Evidence Base ◽  
Recruitment Rate ◽  
Outcome Evaluation ◽  
Commitment Therapy ◽  
Acceptance And Commitment

Abstract Background Acceptance and Commitment Therapy (ACT) is an empirically supported treatment for chronic pain in adults. There is also a small but growing evidence base of ACT for pediatric chronic pain. However, because of limited access to psychological treatment for pain, and geographical distances from pain facilities, many patients will not receive such treatment. Objective The aim of the study was to evaluate the feasibility and preliminary effects of an internet-delivered ACT for adolescents with chronic pain, and their parents. Methods In this nonrandomized pilot study 28 self-recruited adolescents, aged 13–17 years, received 8 weeks of internet-delivered ACT, while outcomes were assessed at pre-, posttreatment, and at follow-up (17–25 weeks). Parents of the adolescents received an 8-week internet-delivered parental program, and their outcomes were assessed at the same timepoints. Both treatments were guided by a therapist experienced in ACT and chronic pain. Results Some threats to feasibility were identified such as slow recruitment rate, low compliance and a delay in completion of follow-up assessments. Preliminary outcome evaluation showed that adolescents showed a large significant improvement on their main outcome (pain interference, d = 1.09), and parents a medium improvement on their main outcome, pain reactivity (d = 0.70). Improvements were also seen in adolescents’ depressive symptoms and insomnia severity. Conclusion The preliminary results of internet-delivered ACT are promising with regards to improvements in adolescent and parent outcome. Measures to improve feasibility are needed prior to conducting a larger randomized trial.

scholarly journals Values-based action in fibromyalgia: results from a randomized pilot of acceptance and commitment therapy

2013 ◽  
Vol 1 (3) ◽  
pp. 34 ◽  
Author(s):  
Jennifer L. Steiner ◽  
Leah Bogusch ◽  
Silvia M. Bigatti
Keyword(s):  
Chronic Pain ◽  
Acceptance And Commitment Therapy ◽  
Intimate Relationships ◽  
Education Group ◽  
Nonrestorative Sleep ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Differential Pattern ◽  
Changes Over Time

Fibromyalgia Syndrome (FMS) is a chronic pain condition characterized by pain, fatigue, and nonrestorative sleep. The disruptive symptoms of FMS are associated with reductions in quality of life related to family, intimate relationships, and work. The present study was part of a randomized pilot study of an 8-week Acceptance and Commitment Therapy (ACT) intervention compared to education in a sample of 28 women with FMS. The Chronic Pain Values Inventory was administered at baseline, postintervention, and 12 week follow-up. Both groups showed significant improvements in family success, which were maintained at follow-up. Groups showed a differential pattern of success in work. The ACT group demonstrated significant, maintained improvements in success in intimate relationships, while the education group reported no changes over time. Findings suggest that both interventions may lead to improvements in valued living; however different interventions may be best suited for certain valued domains. The results of this study indicate that FMS patients are able to improve their success in family and intimate relationships and losses in these areas are not necessarily permanent.

scholarly journals Acceptance and Commitment Therapy for Chronic Pain: Does Post-traumatic Stress Disorder Influence Treatment Outcomes?

Pain Medicine ◽  
2019 ◽  
Vol 20 (9) ◽  
pp. 1728-1736 ◽  
Author(s):  
Matthew S Herbert ◽  
Anne L Malaktaris ◽  
Cara Dochat ◽  
Michael L Thomas ◽  
Julie Loebach Wetherell ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Depressive Symptoms ◽  
Treatment Outcomes ◽  
Acceptance And Commitment Therapy ◽  
Traumatic Stress ◽  
Post Traumatic Stress ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Post Traumatic

AbstractObjectiveThe aim of this study was to determine whether post-traumatic stress disorder (PTSD) moderates treatment outcomes in Acceptance and Commitment Therapy for chronic pain.DesignLongitudinal.SettingVeterans Affairs San Diego Healthcare System.SubjectsA total of 126 veterans with chronic pain participating in an Acceptance and Commitment Therapy intervention for chronic pain. A structured clinical interview was used at baseline to designate PTSD-positive (N = 43) and -negative groups (N = 83).MethodsLinear mixed-effects models to determine whether PTSD moderated change in pain interference, pain severity, pain acceptance, depressive symptoms, or pain-related anxiety at post-treatment and six-month follow-up.ResultsParticipants with co-occurring PTSD reported greater pain interference, pain severity, depressive symptoms, and pain-related anxiety at baseline. PTSD status did not moderate treatment effects post-treatment. Rather, there were significant improvements on all study measures across groups (P < 0.001). PTSD status moderated change in depressive symptoms at six-month follow-up (P < 0.05). Specifically, participants with chronic pain alone demonstrated improvement in depressive symptoms compared with pretreatment levels, whereas participants with PTSD regressed to pretreatment levels.ConclusionsPTSD status did not significantly affect treatment outcomes, with the exception of depressive symptoms at six-month follow-up. Overall, Acceptance and Commitment Therapy for chronic pain appears helpful for improving outcomes among veterans with co-occurring PTSD; however, veterans with co-occurring PTSD may experience fewer long-term gains compared with those with chronic pain alone.

scholarly journals iACT-CEL: A Feasibility Trial of a Face-to-Face and Internet-Based Acceptance and Commitment Therapy Intervention for Chronic Pain in Singapore

2017 ◽  
Vol 2017 ◽  
pp. 1-14 ◽  
Author(s):  
Su-Yin Yang ◽  
Rona Moss-Morris ◽  
Lance M. McCracken
Keyword(s):  
Chronic Pain ◽  
Acceptance And Commitment Therapy ◽  
Feasibility Trial ◽  
Meaningful Improvement ◽  
Face To Face ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Moderate Effect Size ◽  
Assessment Time

Psychological interventions are increasingly utilising online or mobile phone based platforms to deliver treatment, including that for people with chronic pain. The aims of this study were to develop an adapted form of Acceptance and Commitment Therapy (ACT) for chronic pain in Singapore and to test the feasibility of elements of this treatment delivered via the internet and email. Methods. Thirty-three participants recruited from a tertiary pain management clinic and via the clinic website participated in this program over a period of five weeks with a 3-month follow-up. Treatment outcomes were assessed at three assessment time points. Results. 90.9% of participants completed the program, with 81.8% reporting high treatment satisfaction. Significant changes in depression, t=3.08, p=0.002 (baseline to posttreatment), t=3.28, p=0.001 (baseline to follow-up), and pain intensity, t=2.15, p=0.03 (baseline to follow-up) were found. Mainly small effect sizes (d=0.09–0.39) with a moderate effect size (d=0.51) for depression were found at posttreatment. Clinically meaningful improvement in at least one outcome was demonstrated in 75.8% of participants. Conclusions. An adaptation of ACT for people with chronic pain in Singapore appears promising. Optimal treatment design and more effective ways to target outcomes and processes measured here are required.

Acceptance and commitment therapy (ACT)-enhanced communication skills: development and evaluation of a novel training programme

2021 ◽  
pp. bmjspcare-2020-002786
Author(s):  
Nicholas J Hulbert-Williams ◽  
Lee Hulbert-Williams ◽  
Pandora Patterson ◽  
Sahil Suleman ◽  
Lesley Howells
Keyword(s):  
Clinical Practice ◽  
Acceptance And Commitment Therapy ◽  
Cancer Care ◽  
Psychological Flexibility ◽  
Training Programme ◽  
Free Text ◽  
Evaluation Data ◽  
Commitment Therapy ◽  
Acceptance And Commitment

BackgroundPsychological suffering is ubiquitous with cancer and frequently presents as an unmet supportive care need. In clinical practice, distress-related needs are often addressed by nurses and non-psychologist allied healthcare professionals who may have limited training in psychological therapeutic frameworks, particularly more recently developed interventions such as Acceptance and Commitment Therapy (ACT).AimsWe developed a single-day training programme for professionals working in supportive and palliative cancer care settings to change the nature of clinical communication about psychological distress and suffering towards an ACT-consistent approach.MethodWe report on experiences of training delivery, and evaluation data about training satisfaction and intention to apply the training to clinical practice, from three training iterations in British and Australian, government-funded and charitable sectors. One hundred and sixteen cancer care professionals participated in the training. Evaluation data were collected from 53 participants (at either 2-week or 3-month follow-ups, or both) using self-report survey, including both quantitative and free-text questions.ResultsAt 2 week follow-up, 73% of trainees rating our course as having relevance to their work, and at 3 month follow-up, 46% agreed that they were better placed to provide improved clinical services. Qualitative feedback supported the inclusion of experiential learning and theoretical explanations underpinning ACT techniques. Undertaking this training did not significantly increase trainees’ stress levels, nor did implementation of this new way of working negatively affect staff well-being. Positive, ACT-consistent, changes in communication behaviours and attitudes were reported, however there was a lack of significant change in psychological flexibility.DiscussionAcceptability and applicability of this training to supportive and palliative healthcare is positive. The lack of change in psychological flexibility suggests a potential need for more experiential content in the training programme. Logistical challenges in one training group suggests the need for more robust train-the-trainer models moving forward.

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