Virtual Coach-Guided Online Acceptance and Commitment Therapy for Chronic Pain: Pilot Feasibility Randomized...

Area of Science:

• Pain Management
• Digital Health Interventions
• Veteran Health

Background:

• Veterans experience disproportionately high rates of chronic pain, often with poor functional outcomes.
• Existing medical treatments for chronic pain are frequently insufficient, highlighting the need for nonmedical self-management strategies.
• Online platforms offer a scalable solution for delivering evidence-based pain self-management programs to veterans.

Purpose of the Study:

• To evaluate the feasibility and acceptability of the Veteran ACT for Chronic Pain (VACT-CP) online program.
• To compare VACT-CP to a waitlist and treatment as usual (WL+TAU) control group in a pilot randomized controlled trial.
• To explore preliminary effects on pain, mental health, functioning, and acceptance and commitment therapy (ACT) processes.

Main Methods:

• A pilot feasibility randomized controlled trial comparing VACT-CP to WL+TAU in veterans with chronic pain.
• Participants (N=42) were randomized to VACT-CP (n=20) or WL+TAU (n=22).
• Feasibility, usability, and acceptability were assessed via study procedures and participant feedback; secondary outcomes measured via self-report surveys at multiple time points.

Main Results:

• Study procedures demonstrated good feasibility regarding recruitment, enrollment, and completion.
• Participants found VACT-CP easy to use (System Usability Scale: mean 79.6) and reported high satisfaction.
• The VACT-CP group showed significant increases in chronic pain acceptance (P<.001) and decreases in depressive symptoms (P=.03).

Conclusions:

• The VACT-CP online program is feasible, usable, and acceptable for veterans with chronic pain.
• Initial results suggest VACT-CP may improve chronic pain acceptance and reduce depressive symptoms.
• A larger efficacy trial is warranted to confirm clinical outcomes.