title: Can a psychologically based treatment help people to live with chronic pain when they are seeking a procedure to reduce it?
abstract: OBJECTIVE
  At present, the potential benefits of psychologically oriented approaches to pain management for patients waiting to undergo medical interventions, such as neuromodulation, remain unclear. Therefore, this study aimed to examine the results of an interdisciplinary treatment based on principles of Acceptance and Commitment Therapy (ACT) delivered to a group of patients being considered for a neuromodulation procedure.
  
  
  METHODS
  Participants were 86 adults with chronic pain. All were referrals to a 2-week, interdisciplinary, residential pain management course for people being considered for a later neuromodulation procedure. Patients completed standard self-report measures of outcome and treatment process at the beginning and end of the 2-week treatment. Data on progression on the neuromodulation pathway were extracted from medical records.
  
  
  RESULTS
  After the 2-week ACT-based interdisciplinary treatment, the majority of patients showed a clinically significant improvement on pain, depression, physical functioning, social functioning, and pain acceptance. Regression analyses indicated that change in pain acceptance related to improvements in depression, mental health, physical function, and social function. Results with regard to the trial of neuromodulation revealed that patients who did not proceed to the trial at their physician's request (n = 13) reported significantly worse depression and mental health, and lower levels of pain acceptance and committed action following the 2-week program compared with those who went for the trial.
  
  
  CONCLUSIONS
  People seeking medical interventions to reduce pain appear able to benefit from an interdisciplinary treatment aimed to improve daily functioning and mental health through increased psychological flexibility.
authors.affiliation: Psychology Department, Institute of Psychiatry, King's College London, London, UK; Input Pain Management, Guy's and St Thomas NHS Foundation Trust, London, UK.
authors.forename: Lance M
authors.initials: LM
authors.lastname: McCracken
authors.forename: Megan
authors.initials: M
authors.lastname: Davies
authors.forename: Whitney
authors.initials: W
authors.lastname: Scott
authors.forename: Mery
authors.initials: M
authors.lastname: Paroli
authors.forename: Stephany
authors.initials: S
authors.lastname: Harris
authors.forename: Karen
authors.initials: K
authors.lastname: Sanderson
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D059350:Chronic Pain / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods* / Q000523:psychology*; D010147:Pain Measurement / Q000379:methods / Q000523:psychology; D016896:Treatment Outcome
keywords: Acceptance and Commitment Therapy; Chronic Pain; Cognitive Behavioral Therapy; Neuromodulation; Spinal Cord Stimulation