A new approach to Cognitive Behavioral Therapy (CBT) may work wonders for individuals suffering from chronic pain. According to research reported in The Journal of Pain, a combination of Acceptance and Commitment therapy (ACT) and psychological flexibility may assist greatly in the healing process for these patients.
Acceptance and Commitment Therapy (ACT) is based on the psychological flexibility model, which includes a therapeutic process known as “self-as-context” (SAC)—a process that involves acting as an observer of one’s own psychological experiences.
“Psychological flexibility is the ability to be more aware, more focused on goals and more engaged. Another aspect of psychological flexibility pertinent to chronic pain, and supported by SAC, is called committed action, which involves goal-directed, flexible persistence,” said co-author Lance M. McCracken, Professor of Behavioral Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London. “For pain management, ACT is an approach based on the psychological flexibility model and focuses on building effective patterns of behavior change rather than symptom reduction.”
For this study, 412 adults referred to a pain management center at Guy’s and St. Thomas’ Hospital in London completed measures of treatment processes, such as SAC and committed action, and outcomes, including pain-related interference, work and social adjustment, and depression before treatment, upon treatment completion and after nine months.
Ultimately, scores from all measures significantly improved after treatment and were maintained at a nine-month follow-up. The ACT-oriented treatment was associated with improved SAC as well as improved functioning. In turn, this was associated with changes in pain-related interference, work and social adjustment, and depression.
“Greater psychological flexibility is associated with less pain-related anxiety and avoidance, less depression, less physical and psycho-social disability and other measures of patient function,” said McCracken. “Based on studies of forms of CBT that did not include ACT, acceptance of pain, one component of psychological flexibility, may be a general mechanism by which CBT treatments achieve improvements in functioning, and more specific targeting of pain-related acceptance may lead to further improvement is CBT outcomes.”
