Abstract
There is an emerging body of evidence regarding interdisciplinary acceptance and commitment
therapy in the rehabilitative treatment of chronic pain. This study evaluated the
reliability and clinical significance of change following an open trial that was briefer
than that examined in previous work. In addition, the possible mediating effect of
psychological flexibility, which is theorized to underlie the acceptance and commitment
therapy model, was examined. Participants included 117 completers of an interdisciplinary
program of rehabilitation for chronic pain. Assessment took place at treatment onset
and conclusion, and at a 3-month follow-up when 78 patients (66.7%) provided data.
At the 3-month follow-up, 46.2% of patients achieved clinically significant change,
and 58.9% achieved reliable change, in at least 1 key measure of functioning (depression,
pain anxiety, and disability). Changes in measures of psychological flexibility significantly
mediated changes in disability, depression, pain-related anxiety, number of medical
visits, and the number of classes of prescribed analgesics. These results add to the
growing body of evidence supporting interdisciplinary acceptance and commitment therapy
for chronic pain, particularly with regard to the clinical significance of an abbreviated
course of treatment. Further, improvements appear to be mediated by changes in the
processes specified within the theoretical model.
Perspective
Outcomes of an abbreviated interdisciplinary treatment for chronic pain based on a
particular theoretical model are presented. Analyses indicated that improvements at
follow-up mediated change in the theorized treatment process. Clinically significant
change was indicated in just under half of participants. These data may be helpful
to clinicians and researchers interested in intervention approaches and mechanisms
of change.
Key words
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Article info
Publication history
Accepted:
October 7,
2013
Received in revised form:
September 3,
2013
Received:
July 12,
2013
Footnotes
The authors have no funding source or conflict of interest to declare.
Identification
Copyright
© 2014 American Pain Society. Published by Elsevier Inc. All rights reserved.
