Acceptance and values-based action in chronic pain: A study of treatment effectiveness and process.

TLDR

Cognitive behavioral therapy is shifting toward process‑oriented, functional, contextual approaches distinct from earlier models. This study examined the effectiveness of acceptance and commitment therapy for chronic pain and the roles of acceptance and values‑based action. The study involved 171 completers of an interdisciplinary program, with 66.7 % completing a 3‑month follow‑up. Results showed significant, medium‑to‑large improvements in pain, depression, anxiety, disability, medical visits, work status, and physical performance, with 75.4 % of patients improving in at least one domain and gains in acceptance and values‑based action linked to these outcomes.

Abstract

Developing approaches within cognitive behavioral therapy are increasingly process-oriented and based on a functional and contextual framework that differs from the focus of earlier work. The present study investigated the effectiveness of acceptance and commitment therapy (S. C. Hayes, K. Strosahl, & K. G. Wilson, 1999) in the treatment of chronic pain and also examined 2 processes from this model, acceptance and values-based action. Participants included 171 completers of an interdisciplinary treatment program, 66.7% of whom completed a 3-month follow-up assessment as well. Results indicated significant improvements for pain, depression, pain-related anxiety, disability, medical visits, work status, and physical performance. Effect size statistics were uniformly medium or larger. According to reliable change analyses, 75.4% of patients demonstrated improvement in at least one key domain. Both acceptance of pain and values-based action improved, and increases in these processes were associated with improvements in the primary outcome domains.