title: Internet-based guided self-help intervention for chronic pain based on Acceptance and Commitment Therapy: a randomized controlled trial.
abstract: Acceptance-based psychological interventions can potentially minimize the burden of chronic pain. This randomized controlled trial evaluated an internet-delivered, guided self-help intervention based on Acceptance and Commitment Therapy (ACT). A total of 238 chronic pain sufferers from the general population were randomly allocated to either ACT (n = 82), an internet-based control condition Expressive Writing (n = 79) or a waiting list condition (n = 77). Participants completed measures at baseline, posttreatment (3 months) and at a 3-month follow-up. At follow-up, ACT participants had improved in pain interference in daily life (primary outcome) compared to participants in Expressive Writing (Cohen's d = .47), but not compared to waiting list participants (p value = .11). Those who adhered to the ACT-intervention (48%) did improve significantly compared to waiting list participants (d = .49). ACT-participants also showed superior improvement on depression, pain intensity, psychological inflexibility and pain catastrophizing (d: .28-.60). Significant clinical improvement was present. Especially, 28% of ACT-participants showed general clinically relevant improvement in pain interference, as well as in pain intensity and depression (vs. Expressive Writing and waiting list 5%). Given these findings, internet-based ACT programs may be a promising treatment modality for chronic pain.
authors.affiliation: Department of Psychology, Health and Technology, Faculty of Behavioural Sciences, University of Twente, Cubicus B127a, Postbox 217, 7500 AE, Enschede, The Netherlands, h.r.trompetter@utwente.nl.
authors.forename: Hester R
authors.initials: HR
authors.lastname: Trompetter
authors.forename: Ernst T
authors.initials: ET
authors.lastname: Bohlmeijer
authors.forename: Martine M
authors.initials: MM
authors.lastname: Veehof
authors.forename: Karlein M G
authors.initials: KM
authors.lastname: Schreurs
mesh_terms: D064869:Acceptance and Commitment Therapy; D058443:Catastrophization / Q000150:complications / Q000628:therapy; D059350:Chronic Pain / Q000523:psychology* / Q000628:therapy*; D003863:Depression / Q000150:complications / Q000628:therapy; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D017060:Patient Satisfaction; D012648:Self Care / Q000523:psychology*; D013813:Therapy, Computer-Assisted; D016896:Treatment Outcome