Effectiveness of a Positive Writing Intervention for Chronic Pain: A Randomized Trial

Ziemer, Kathryn Schaefer; Fuhrmann, Amy; Hoffman, Mary Ann

doi:10.1080/24708593.2017.1307893

Cited by 13 publications

(11 citation statements)

References 52 publications

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“…Additionally, one study found that self-compassion is a moderator of the affective and cognitive responses to a vignette-based social situation in a sample of participants with CP (Purdie & Morley, 2015). Another study found that self-compassion predicts changes in depression symptoms and illness intrusiveness in participants with CP (Ziemer, Fuhrmann, & Hoffman, 2017). Nevertheless, more studies on the role of self-compassion in CP are needed in order to unequivocally establish this psychological process as a relevant one in psychological interventions for CP.…”

Section: Introductionmentioning

confidence: 99%

Pain and Depressive Symptoms: Exploring Cognitive Fusion and Self-Compassion in a Moderated Mediation Model

Carvalho

Pinto‐Gouveia

Gillanders

et al. 2018

The Journal of Psychology

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The association between chronic pain (CP) and depression is complex, and influenced by several psychological processes. Cognitive fusion (i.e. being entangled with one´s internal experiences) and self-compassion (i.e. being touched by one´s suffering, with a motivation to alleviate it) have been hypothesized as relevant psychological processes in physical and mental health, but few studies have addressed them in CP, and none in a comprehensive model relating pain intensity and depressive symptoms. This study tests, in a moderated mediation model, the mediator role of cognitive fusion between pain intensity and depressive symptoms, and the moderator effect of self-compassion in this mediation. In a cross-sectional study, 231 female CP patients (Age: M = 48.51, SD = 10.89) responded online self-report measures. PROCESS, an SPSS macro for conducting path analysis modeling, was used to test the hypothesized model. The model explained 63% of depressive symptoms, and cognitive fusion mediates the association between pain intensity and depressive symptoms. Also, self-compassion moderates this mediation (regardless of self-compassion being low, moderate or high). Although pain intensity is a predictor of depressive symptoms, fusion with thinking in general mediates this association, this relationship is buffered when patients are able to respond to setbacks and perceived shortcomings with self-kindness and warmth. Clinical and theoretical implications are discussed.

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Section: Introductionmentioning

confidence: 99%

Pain and Depressive Symptoms: Exploring Cognitive Fusion and Self-Compassion in a Moderated Mediation Model

Carvalho

Pinto‐Gouveia

Gillanders

et al. 2018

The Journal of Psychology

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“…The attrition rate in the present study, while elevated ( n = 11/26; 42%), falls at the superior end of the range of rates reported for minimally monitored or guided Internet-based online self-compassion interventions in nonclinical samples (17% to 55%; Eriksson et al, 2018 ; Finlay-Jones et al, 2017 ; Halamová et al, 2018a ; Krieger et al, 2016 ; Sommers-Spijkerman et al, 2018 ). A lower attrition rate was found in Ziemer et al's (2015) study among chronic pain patients (22%), but the online writing program was half the duration of the current program and, perhaps more importantly, yielded no significant increase in self-compassion. No significant pre-treatment differences in the present investigation were found between study completers and non completers.…”

Section: Discussionmentioning

confidence: 52%

“…To date, the few studies that have evaluated the impact of Internet-based programs specifically targeting self-compassion have supported their use among the general population ( Finlay-Jones et al, 2017 ; Halamová et al, 2018a ; Krieger et al, 2016 ; Sommers-Spijkerman et al, 2018 ). To our knowledge, only one study of pain patients was conducted ( Ziemer et al, 2015 ). Ninety-three chronic pain patients were randomized to either a self-compassion or a self-efficacy 20-minute writing task performed online over three consecutive weeks.…”

Section: Introductionmentioning

confidence: 99%

“…In the self-compassionate writing condition, participants were instructed “ to think about what you would say to a friend in your position, or what a friend would say to you about your experiences with pain ”. They were also instructed to “ to make sure the writing provides you with what you need in order to feel understood and not alone in your experiences with pain ” (p. 145; Ziemer et al, 2015 ). Although there was no significant change in self-compassion in either group, when the groups were combined, increased self-compassion predicted decreased illness intrusiveness and depressive symptoms and increased pain acceptance.…”

Section: Introductionmentioning

confidence: 99%

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Increasing access to pain management: Feasibility of a self-compassion psychoeducational website using a minimally monitored delivery model

Basque

Talbot

French³

2021

Internet Interventions

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Self-compassion has been associated with several positive pain-related outcomes. However, little is known about the impact of targeting self-compassion on pain management. This study assesses the feasibility of a self-compassion psychoeducation website among adults with chronic pain using a minimally monitored delivery model. Participants (N = 26) were recruited online and a single group pre-test and post-test design with a 3-month follow-up was used. The intervention was a 6-week program comprised of a video, writing exercises, guided meditations and automated emails. Feasibility outcome measures were grouped into the following categories: study engagement (ease of recruitment, attrition, adherence, satisfaction), pain vulnerability variables (intensity, interference, catastrophizing, mood) and protective pain variables (self-compassion, resilience and acceptance). Challenges pertaining to uptake were encountered. Attrition was higher ( n = 11/26; 42%) and adherence to the full treatment protocol lower ( n = 6/26; 23%) than expected. Treatment satisfaction was high with nearly all study completers (93%) reporting that they would recommend the program to a friend. Intent-to-treat mixed effects models showed a significant and large increase of self-compassion ( d = 0.92) and a significant impact on several outcome variables ( ds from 0.24 to 1.15) with most gains either maintained or increased at follow-up. The recruitment strategy may have negatively impacted participant engagement. Methodological modifications are proposed to improve the feasibility of the program. Minimally monitored web-based programs targeting self-compassion may benefit adults with chronic pain who may have limited access to traditional psychological services or who prefer online-based interventions.

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“…Recently, some studies suggested that ACT interventions also promote self-compassion ( Yadavaia et al, 2014 ; Luoma and Platt, 2015 ), a non-judgmental and mindful approach to one’s pain and suffering ( Neff, 2003 ), which presents known links with pain regulation systems, such as heart-rate variability ( Rockliff et al, 2008 ), and oxytocin-endorphin systems ( Rockliff et al, 2011 ). Self-compassion has been the focus of growing attention in CP due to its protective role against depressive symptomatology in this condition ( Carvalho et al, 2019 ), its negative association with pain disability ( Wren et al, 2016 ), and the promising results showing the positive effects of compassion-based interventions in CP ( Chapin et al, 2014 ; Ziemer et al, 2015 ; Parry and Malpus, 2017 ; Gooding et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of an ACT and Compassion-Based eHealth Program for Self-Management of Chronic Pain (iACTwithPain): Study Protocol for a Randomized Controlled Trial

et al. 2021

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BackgroundChronic pain (CP) has serious medical and social consequences and leads to economic burden that threatens the sustainability of healthcare services. Thus, optimized management of pain tools to support CP patients in adjusting to their condition and improving their quality of life is timely. Although acceptance and commitment therapy (ACT) is considered an evidence-based psychological approach for CP, evidence for the efficacy of online-delivered ACT for CP is still scarce. At the same time, studies suggest that self-compassion mediates the change in disability and psychopathological symptoms in ACT interventions for CP, although self-compassion is not a specific target in ACT. Thus, an explicit focus on self-compassion might increase the efficacy of ACT interventions for CP, although this hypothesis has not been tested. This study aims to develop an eHealth ACT and compassion-based self-management intervention for CP, the iACTwithPain, and to compare its efficacy in improving health outcomes to a similar ACT-only intervention and a medical TAU group.MethodsThe eHealth platform that will host the interventions will be developed using a flat design identity and will be interactive. The iACTwithPain intervention will comprise eight weekly self-management sessions and will be developed taking into consideration the psychological flexibility model applied to CP, with the addition of explicit compassion-based components. To analyze whether the iACTwithPain intervention will present superiority in improving CP’s impact and related health markers over the two other conditions, this study will follow an RCT design with three arms. CP patients will be recruited through direct contact with patient associations and healthcare services and a national press release in Portugal. Outcome measurement will be conducted at baseline, post-intervention and at 3- and 6-month follow-ups. The interventions’ acceptability will also be assessed.DiscussionThe iACTwithPain intervention is expected to improve CP patients’ psychosocial functioning, quality of life, and empowerment, by promoting adaptive disease management and regulation of pain-related internal experiences. Results will contribute to a better understanding on the pertinence of adding compassion elements to ACT for CP and to reach an optimized intervention for CP.Clinical Trial RegistrationThis trial has been registered at ClinicalTrials.Gov (NCT04200183; 16 December 2019; https://clinicaltrials.gov/ct2/show/NCT04200183). The current manuscript comprises the first version of this clinical trial’s protocol.

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Effectiveness of a Positive Writing Intervention for Chronic Pain: A Randomized Trial

Cited by 13 publications

References 52 publications

Pain and Depressive Symptoms: Exploring Cognitive Fusion and Self-Compassion in a Moderated Mediation Model

Pain and Depressive Symptoms: Exploring Cognitive Fusion and Self-Compassion in a Moderated Mediation Model

Increasing access to pain management: Feasibility of a self-compassion psychoeducational website using a minimally monitored delivery model

Efficacy of an ACT and Compassion-Based eHealth Program for Self-Management of Chronic Pain (iACTwithPain): Study Protocol for a Randomized Controlled Trial

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