Acceptance and Related Processes in Adjustment to Chronic Pain

Thompson, Miles; McCracken, Lance M.

doi:10.1007/s11916-010-0170-2

Cited by 77 publications

(65 citation statements)

References 34 publications

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“…Our results indicate that there is need for more systematic focus on acceptance in the psychological assessment before treatment in this population. This is well in line with research in chronic pain: improving acceptance is considered as more important than other coping strategies to achieve treatment success [59][60][61][62][63][64]. It may well be that a more explicit focus on acceptance will also prove beneficial for patients with chronic fatigue syndrome.…”

Section: Discussionsupporting

confidence: 71%

Cognitive behavior therapy in patients with chronic fatigue syndrome: The role of illness acceptance and neuroticism

Poppe

Petrovic

Vogelaers

et al. 2013

Journal of Psychosomatic Research

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Number of words: 4560 Number of tables: 3Running head: CBT and chronic fatigue syndrome Key Words: chronic fatigue syndrome, cognitive behaviour therapy, acceptance, healthrelated quality of life, neuroticism. 2 AbstractObjective. Increasing the quality of life (QoL) of patients with chronic fatigue is challenging because recovery is seldom achieved. Therefore, it is important to identify processes that improve QoL. This study examined the extent of improvement related to cognitive behaviour group therapy (CBT), and whether improvement is affected by initial levels of acceptance and neuroticism.Methods. Eighty CFS patients followed CBT, and self-reported (pre-post design) on mental and physical QoL (MQoL and PQoL), fatigue, acceptance, neuroticism. The extent of improvement was analyzed using t-tests, effect sizes, and clinically significant change criteria.Whether acceptance and neuroticism at baseline predicted changes, was analyzed by means of correlation and regression analyses. Results. Significant improvement was found for all variables. The effect size for MQoL andPQoL was small; for acceptance and fatigue moderate. About 20% (MQoL) to 40% (fatigue) of the participants clinically improved.Pre-treatment level of acceptance was negatively correlated with changes in MQoL, not with PQoL changes. Neuroticism pre-treatment was positively related with MQoL changes.Regression analysis showed an effect of acceptance on changes in MQoL beyond the effect of neuroticism. Conclusions:Although CBT is an evidence-based treatment, the sizes of the effects are often small regarding QoL. Our study also revealed small effect sizes. Our study showed that patient characteristics at baseline were significantly associated with MQoL outcome; indicating that CFS patients with high neuroticism or with a low acceptance show more improvement in MQoL. We propose to specifically target acceptance and neuroticism before treatment in order to maximize clinical relevance.3

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Section: Discussionsupporting

confidence: 71%

Cognitive behavior therapy in patients with chronic fatigue syndrome: The role of illness acceptance and neuroticism

Poppe

Petrovic

Vogelaers

et al. 2013

Journal of Psychosomatic Research

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“…These therapies construct acceptance as moving towards goals that define self alongside a 'willingness to continue to actively experience pain along with related thoughts and feeling' (p. 145). 404 Although moving towards self-defining goals is integral to ACT, acceptance might mean different things to different patients (and their clinicians). For example, for some the term 'acceptance' might imply giving up 404,405 and this may have an impact on their willingness to engage in ACT.…”

Section: Accepting Pain and Redefining My Selfmentioning

confidence: 99%

“…404 Although moving towards self-defining goals is integral to ACT, acceptance might mean different things to different patients (and their clinicians). For example, for some the term 'acceptance' might imply giving up 404,405 and this may have an impact on their willingness to engage in ACT. Qualitative research exploring the meaning of acceptance for both patients and clinicians might help us to understand the efficacy of these approaches.…”

Section: Accepting Pain and Redefining My Selfmentioning

confidence: 99%

A meta-ethnography of patients’ experience of chronic non-malignant musculoskeletal pain

Toye

Seers

Allcock

et al. 2013

Health Services and Delivery Research

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Health Services and Delivery ResearchISSN 2050-4349 (Print) ISSN 2050-4357 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full HS&DR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hsdr. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Services and Delivery Research journalReports are published in Health Services and Delivery Research (HS&DR) if (1) they have resulted from work for the HS&DR programme or programmes which preceded the HS&DR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. HS&DR programmeThe Health Services and Delivery Research (HS&DR) programme, part of the National Institute for Health Research (NIHR), was established to fund a broad range of research. It combines the strengths and contributions of two previous NIHR research programmes: the Health Services Research (HSR) programme and the Service Delivery and Organisation (SDO) programme, which were merged in January 2012.The HS&DR programme aims to produce rigorous and relevant evidence on the quality, access and organisation of health services including costs and outcomes, as well as research on implementation. The programme will enhance the strategic focus on research that matters to the NHS and is keen to support ambitious evaluative research to improve health services.For more information about the HS&DR programme please visit the website: www.netscc.ac.uk/hsdr/ This reportThe research reported in this issue of the journal was funded by the HS&DR programme or one of its proceeding programmes as project number 09/2001/09. The contractual start date was in October 2010. The final report began editorial review in November 2012 and was accepted for publication in February 2013. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HS&DR editors and production house have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Department of Health. If there are verbatim quotations included in this publication the views and opinions expressed by the interviewees are those of the interviewees and do not necessarily reflect those of the authors, those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Department of Health. Published b...

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“…Aside from specific pain and life management strategies, the program covered aspects of mindfulness, clarification of values, defusion techniques, committed action, and self-ascontext components. These core elements relate to the six ACT processes, which together represent psychological flexibility [31]. Homework exercises based on the protocol used in Vowles et al [1] were set for patients to complete between sessions.…”

Section: Group Intervention Programmentioning

confidence: 99%

Changes in Acceptance in a Low-Intensity, Group-Based Acceptance and Commitment Therapy (ACT) Chronic Pain Intervention

et al. 2015

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BackgroundAcceptance and commitment therapy has shown to be effective in chronic pain rehabilitation, and acceptance has been shown to be a key process of change. The influence of treatment dose on acceptance is not clear, and in particular, the effectiveness of a non-intensive treatment (<20 h) in a tertiary pain clinic is required. PurposeThe purpose of the study was to assess the effectiveness of a low-intensity, acceptance and commitment therapy (ACT) group program for chronic pain. The study sought to compare, at both groups and individual patient levels, changes in acceptance with changes observed in previous ACT studies. Methods Seventy-one individuals with chronic pain commenced a 9-week ACT-based group program at an outpatient chronic pain service. In addition to acceptance, outcomes included the following: pain catastrophizing, depression, anxiety, quality of life, and pain-related anxiety. To compare the current findings with previous research, effect sizes from seven studies were aggregated using the random-effects model to calculate benchmarks. Reliable change indices (RCIs) were applied to assess change on an individual patient-level. ResultsThe ACT intervention achieved a statistically significant increase in acceptance and medium effect size (d=0.54) at a group level. Change in acceptance was of a similar magnitude to that found in previous ACT studies that examined interventions with similar treatment hours (<20 h). Results across other outcome measures demonstrated small to medium effect sizes (d=0.01 to 0.48, mean=0.26). Reliable improvement in acceptance occurred in approximately one-third (37.2, 90 % CI) of patients. Approximately three-quarters (74.3, 90 % CI) demonstrated reliable change in at least one of the outcome measures. ConclusionsThe low-intensity, group-based ACT intervention was effective at a group level and showed a similar magnitude of change in acceptance to previous ACT studies employing low-intensity interventions. Three-quarters of patients reported reliable change on at least one outcome measure.

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Acceptance and Related Processes in Adjustment to Chronic Pain

Cited by 77 publications

References 34 publications

Cognitive behavior therapy in patients with chronic fatigue syndrome: The role of illness acceptance and neuroticism

Cognitive behavior therapy in patients with chronic fatigue syndrome: The role of illness acceptance and neuroticism

A meta-ethnography of patients’ experience of chronic non-malignant musculoskeletal pain

Changes in Acceptance in a Low-Intensity, Group-Based Acceptance and Commitment Therapy (ACT) Chronic Pain Intervention

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