Background Acceptance and Commitment Therapy (ACT) is a form of cognitive behavioural therapy (CBT), which focuses on psychological flexibility and behavior change. ACT has been advocated for the treatment of Persistent Pain. A systematic review concluded that ACT is efficacious for enhancing physical functioning and decreasing distress amongst adults with chronic pain attending Pain Rehabilitation Programmes (Hann & McCracken 2014). A call was made for further studies to examine outcomes from more homogenous groups.
Objectives To assess the effects of an eight-week group ACT, Rheumatology based programme, for people with persistent pain, on pain acceptance, activity engagement, psychological distress and self-efficacy.
Methods Patients were referred to the programme by three Consultant Rheumatologists over a five-year period. Over one hundred patients' outcome measures were available for this retrospective study from a convenience sample. Consent had been sought routinely from patients who attended the ACT programme and ethical approval was granted from the Hospital Research Ethics Committee (REC) and Ulster University REC. Baseline measures were taken at assessment, on the final day of the programme and at the follow up six-month review. Data was analysed with One Way Repeated Measures ANOVA using SPSSv20. Effect sizes were calculated using Partial Eta Squared and interpreted using the guidelines proposed by Cohen (1998).
Results For those with scores at all three time points, mean depression scores, anxiety scores and self-efficacy scores were statistically significantly different over time. In addition, for those with activity engagement and pain willingness scores at all three time points, scores were statistically significantly different over time.
Conclusions The ACT Pain Rehabilitation Programme at University Hospital Waterford in Ireland has provided significant outcomes for reducing depression and anxiety amongst its participants as measured by the Hospital Anxiety and Depression Scale (HADS). Increases in self-efficacy were also found to be statistically significant. Increases in activity engagement & pain acceptance, as measured by the Chronic Pain Acceptance Questionnaire (CPAQ) also showed statistically significant increases. A number of limitations should be noted i.e. this was a retrospective study and depended on self report measures only. However, positive outcomes suggest ACT is a helpful intervention for people with persistent pain.
Hann, K.E.J., McCracken, L.M. (2014). A systematic review of randomized controlled trials of Acceptance and Commitment Therapy for adults with chronic pain: Outcome domains, design quality, and efficacy. Jounal of Contextual Behavioural Science 3, 217–222.
Disclosure of Interest None declared
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