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 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.

A Four-Session Acceptance and Commitment Therapy Based Intervention for Depressive Symptoms Delivered by Masters Degree Level Psychology Students: A Preliminary Study

2013 ◽  
Vol 43 (3) ◽  
pp. 360-373 ◽  
Author(s):  
Aino Kohtala ◽  
Raimo Lappalainen ◽  
Laura Savonen ◽  
Elina Timo ◽  
Asko Tolvanen
Keyword(s):  
Depressive Symptoms ◽  
Acceptance And Commitment Therapy ◽  
Well Being ◽  
Psychology Students ◽  
Waiting List ◽  
Long Term Effects ◽  
Average Decrease ◽  
Commitment Therapy ◽  
Acceptance And Commitment

Background:Depressive symptoms are one of the main reasons for seeking psychological help. Shorter interventions using briefly trained therapists could offer a solution to the ever-rising need for early and easily applicable psychological treatments.Aims:The current study examines the effectiveness of a four-session Acceptance and Commitment Therapy (ACT) based treatment for self-reported depressive symptoms administered by Masters level psychology students.Method:This paper reports the effectiveness of a brief intervention compared to a waiting list control (WLC) group. Participants were randomized into two groups: ACT (n= 28) and waiting list (n= 29). Long-term effects were examined using a 6-month follow-up.Results:The treatment group's level of depressive symptoms (Beck Depression Inventory) decreased by an average of 47%, compared to an average decrease of 4% in the WLC group. Changes in psychological well-being in the ACT group were better throughout, and treatment outcomes were maintained after 6 months. The posttreatment “between-group” and follow-up “with-in group” effect sizes (Cohen'sd) were large to medium for depressive symptoms and psychological flexibility.Conclusions:The results support the brief ACT-based intervention for sub-clinical depressive symptoms when treatment was conducted by briefly trained psychology students. It also contributes to the growing body of evidence on brief ACT-based treatments and inexperienced therapists.

Neuropsychological Functioning and Treatment Outcomes in Acceptance and Commitment Therapy for Chronic Pain

2018 ◽  
Vol 19 (8) ◽  
pp. 852-861
Author(s):  
Matthew Scott Herbert ◽  
Niloofar Afari ◽  
J.B. Robinson ◽  
Andrew Listvinsky ◽  
Mark W. Bondi ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Treatment Outcomes ◽  
Acceptance And Commitment Therapy ◽  
Neuropsychological Functioning ◽  
Commitment Therapy ◽  
Acceptance And Commitment
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