title: The systematic implementation of acceptance & commitment therapy (ACT) in Dutch multidisciplinary chronic pain rehabilitation.
abstract: OBJECTIVE
  This study evaluates the implementation of Acceptance & Commitment Therapy (ACT) in Dutch chronic pain rehabilitation centers. Changes in multidisciplinary professionals' self-perceived competencies in working with ACT were evaluated and corroborated with patients' ratings of treatment adherence. To inform subsequent implementation efforts, relevant determinants of implementation success were monitored and the relationship with self-perceived competencies over time was explored.
  
  
  METHODS
  Data was gathered from 111 professionals, 9 managers and 79 patients using questionnaires at the start (T0), halfway (T1) and end (T2) of implementation, and at the end of treatment.
  
  
  RESULTS
  All professionals adhered to ACT, improved significantly in self-perceived competencies over time and rated competence in working with ACT ≥ adequate at T2. Determinants of success were evaluated extremely positive by professionals and management. Professionals' self-perceived competencies at T2 were most strongly related to ratings of more workload (b=-.43), and experienced difficulties in working with ACT (b=-.38) at T0 and T1.
  
  
  CONCLUSIONS
  Multidisciplinary chronic pain rehabilitation professionals rated their improvement in working with ACT positively during the implementation period. Impeding and facilitating factors were explored successfully.
  
  
  CONCLUSIONS
  A multi-faceted, long-term, educational, train-the-trainer approach may help to guide systematic changes in multidisciplinary treatment.
authors: Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands; Roessingh Research and Development, Telemedicine Group, Enschede, The Netherlands. Electronic address: h.r.trompetter@utwente.nl.
authors: Hester R
authors: HR
authors: Trompetter
authors: Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands; Roessingh Research and Development, Telemedicine Group, Enschede, The Netherlands.
authors: Karlein M G
authors: KM
authors: Schreurs
authors: Adelante Rehabilitation Centre, Hoensbroek, The Netherlands.
authors: Peter H T G
authors: PH
authors: Heuts
authors: Roessingh Research and Development, Telemedicine Group, Enschede, The Netherlands; Faculty of Engineering, Mathematics and Computer Science, University of Twente, Enschede, The Netherlands.
authors: Miriam M
authors: MM
authors: Vollenbroek-Hutten
mesh_terms: D064869:Acceptance and Commitment Therapy; D000328:Adult; D059350:Chronic Pain / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D002983:Clinical Competence; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D059408:Pain Management / Q000379:methods*; D010342:Patient Acceptance of Health Care; D010348:Patient Care Team; D011369:Professional-Patient Relations; D012047:Rehabilitation Centers; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
keywords: Acceptance & Commitment Therapy; Competence; Determinants; Implementation; Rehabilitation