2014
DOI: 10.1016/j.jcbs.2014.04.003
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Acceptance and Commitment Therapy for chronic pain: A diary study of treatment process in relation to reliable change in disability

Abstract: In chronic pain treatment, a primary goal is reduced disability. It is often assumed that a central process by which disability reduction occurs is pain reduction. Conversely, approaches such as Acceptance and Commitment Therapy (ACT) posit that pain reduction is not necessary for reduced disability. Instead, disability reduction occurs when responses to pain are changed, such that as unsuccessful struggles for pain control decreases and engagement in personally-valued activities increases. Treatment outcome s… Show more

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Cited by 46 publications
(35 citation statements)
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“…Changes in pain acceptance during treatment were related to changes in emotional state, physical and psychosocial disability, and physical task persistence, with changes in pain acceptance accounting for unique variance in these outcomes beyond that accounted for by changes in pain intensity and catastrophic thinking (Vowles & McCracken, 2008). Overall increases in psychological flexibility mediated decreases in disability, depression, pain-related anxiety, number of medical visits, and the number of classes of prescribed analgesics resulting from interdisciplinary ACT treatment for chronic pain (Vowles et al, 2014). Further, recent analyses suggest that increases in pain acceptance, accompanied by increased engagement in values-driven behaviors (i.e, another core process of the contextual model) are related with statistically reliable reductions in disability (Vowles, Fink, Cohen, 2014).…”
Section: Discussionmentioning
confidence: 99%
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“…Changes in pain acceptance during treatment were related to changes in emotional state, physical and psychosocial disability, and physical task persistence, with changes in pain acceptance accounting for unique variance in these outcomes beyond that accounted for by changes in pain intensity and catastrophic thinking (Vowles & McCracken, 2008). Overall increases in psychological flexibility mediated decreases in disability, depression, pain-related anxiety, number of medical visits, and the number of classes of prescribed analgesics resulting from interdisciplinary ACT treatment for chronic pain (Vowles et al, 2014). Further, recent analyses suggest that increases in pain acceptance, accompanied by increased engagement in values-driven behaviors (i.e, another core process of the contextual model) are related with statistically reliable reductions in disability (Vowles, Fink, Cohen, 2014).…”
Section: Discussionmentioning
confidence: 99%
“…Overall increases in psychological flexibility mediated decreases in disability, depression, pain-related anxiety, number of medical visits, and the number of classes of prescribed analgesics resulting from interdisciplinary ACT treatment for chronic pain (Vowles et al, 2014). Further, recent analyses suggest that increases in pain acceptance, accompanied by increased engagement in values-driven behaviors (i.e, another core process of the contextual model) are related with statistically reliable reductions in disability (Vowles, Fink, Cohen, 2014). These findings point to potentially promising directions for focused study in veterans experiencing chronic pain and common co-occurring conditions.…”
Section: Discussionmentioning
confidence: 99%
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“…This is not the case with ACT as both experimental research findings, basic principles, and a therapeutic model are the basis for the design of ACT (38). So, proposed mechanisms appeared before the treatment designs, and a strategy of measuring mechanisms of action in trials and in routine practice has become common in ACT research and practice (32,33,39,40). Combined with this we have consistently followed a strategy to support this research by designing measures for relevant processes when they did not exist (41,42).…”
Section: Process and Mechanism In Actmentioning
confidence: 99%
“…A strong correlation between pain and disability leads many treatment approaches to focus on reducing pain, while psychological approaches focus on changing responses to chronic pain (22). Chronic pain is a major health problem that is associated with depression and other psychological disorders.…”
Section: Introductionmentioning
confidence: 99%