Articlehybrid2016

A Comprehensive Examination of Changes in Psychological Flexibility Following Acceptance and Commitment Therapy for Chronic Pain

Whitney Scott · Katie E. J. Hann · Lance M. McCracken

111 citations0/0 files storedJournal of Contemporary Psychotherapy

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Mindfulness and Compassion Interventions Musculoskeletal pain and rehabilitation Psychotherapy Techniques and Applications

Abstract

Acceptance and commitment therapy (ACT) for chronic pain aims to improve patient functioning by fostering greater psychological flexibility. While promising, ACT treatment process research in the context of chronic pain so far has only focused on a few of the processes of psychological flexibility. Therefore, this study aimed to more comprehensively examine changes in processes of psychological flexibility following an ACT-based treatment for chronic pain, and to examine change in these processes in relation to improvements in patient functioning. Individuals with chronic pain attending an interdisciplinary ACT-based rehabilitation program completed measures of pain, functioning, depression, pain acceptance, cognitive fusion, decentering, and committed action at pre- and post-treatment and during a nine-month follow-up. Significant improvements were observed from pre- to post-treatment and pre-treatment to follow-up on each of the treatment outcome and process variables. Regression analyses indicated that change in psychological flexibility processes cumulatively explained 6-27 % of the variance in changes in functioning and depression over both assessment periods, even after controlling for changes in pain intensity. Further research is needed to maximize the effectiveness of ACT for chronic pain, and to determine whether larger improvements in the processes of psychological flexibility under study will produce better patient outcomes, as predicted by the psychological flexibility model.

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References

2001The PHQ-9 1992The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection.2005Acceptance and Commitment Therapy: Model, processes and outcomes 2011Cochrane Database of Systematic Reviews 2003Core outcome domains for chronic pain clinical trials: IMMPACT recommendations 2011Acceptance and Commitment Therapy and Contextual Behavioral Science: Examining the Progress of a Distinctive Model of Behavioral and Cognitive Therapy 1990Interpersonal process in cognitive therapy 2013The Development and Initial Validation of the Cognitive Fusion Questionnaire

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2017Change in “Self-as-Context” (“Perspective-Taking”) Occurs in Acceptance and Commitment Therapy for People With Chronic Pain and Is Associated With Improved Functioning 2021Decentering as a core component in the psychological treatment and prevention of youth anxiety and depression: a narrative review and insight report 2025Individual‐Level Effects of a Digital Behavioural Treatment for Chronic Pain: Proof‐of‐Concept of a Single‐Case Experimental Design Study 2024Personality systems interactions theory: an integrative framework complementing the study of the motivational and volitional dynamics underlying adjustment to chronic pain

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