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A randomized, controlled trial of acceptance and commitment therapy and cognitive-behavioral therapy for chronic pain
Julie Loebach Wetherell1, Niloofar Afari, Thomas Rutledge
1VA San Diego Healthcare System, 3350 La Jolla Village Drive, Dept. 111N-1, San Diego, CA 92161, USA Department of Psychiatry, University of California, San Diego, 9500 Gilman Dr., Dept. 9111N-1, La Jolla, CA 92093-9111, USA Stanford University Medical Center, Department of Anesthesia, Division of Pain Management, 430 Broadway St., Pavilion C, MC 6343, Redwood City, CA 94063-3132, USA Alliant International University, 10455 Pomerado Rd., San Diego, CA, 92131, USA SDSU/UCSD Joint Doctoral Program in Clinical Psychology, 6363 Alvarado Ct., Suite 103, San Diego, CA 92120-4913 USA Washington University, Department of Psychology, Campus Box 1125, One Brookings Drive, St. Louis, MO 63130-4899, USA.
Abstract:
Individuals reporting chronic, nonmalignant pain for at least 6 months (N=114) were randomly assigned to 8 weekly group sessions of acceptance and commitment therapy (ACT) or cognitive-behavioral therapy (CBT) after a 4-6 week pretreatment period and were assessed after treatment and at 6-month follow-up. The protocols were designed for use in a primary care rather than specialty pain clinic setting. All participants remained stable on other pain and mood treatments over the course of the intervention. ACT participants improved on pain interference, depression, and pain-related anxiety; there were no significant differences in improvement between the treatment conditions on any outcome variables. Although there were no differences in attrition between the groups, ACT participants who completed treatment reported significantly higher levels of satisfaction than did CBT participants. These findings suggest that ACT is an effective and acceptable adjunct intervention for patients with chronic pain.
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