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

J Consult Clin Psychol. 2008 Jun;76(3):397-407. doi: 10.1037/0022-006X.76.3.397.

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.

MeSH terms

  • Chronic Disease
  • Cognitive Behavioral Therapy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Pain / diagnosis
  • Pain Management*
  • Pain Measurement
  • Surveys and Questionnaires
  • Treatment Outcome