Highlights
- •ACT improves primary headache-related disability and functioning
- •ACT leads to increases in headache sufferers’ quality of life
Abstract
Prevention of headaches via avoidance of triggers remains the main behavioral treatment
suggestion for headache management despite trigger avoidance resulting in increases
in potency, lifestyle restrictions, internal locus of control decreases, pain exacerbation
and maintenance. New approaches, such as Acceptance and Commitment Therapy (ACT),
instead emphasize acceptance and valued living as alternatives to avoidance. Though
ACT is an empirically supported treatment for chronic pain, there is limited evidence
for headache management while preliminary outcome studies are afflicted with methodological
limitations. This study compared an ACT-based group headache-specific intervention
to wait-list control, in a randomized clinical trial, on disability, distress, medical
utilization, functioning, and quality of life. Ninety-four individuals with primary
headache (84% women; Mage = 43 years; 87.35% migraine diagnosis) were randomized into
2 groups (47 in each). Assessments occurred: before, immediately after, and at 3 months
following treatment end. Only the ACT group was additionally assessed at 6- and 12-month
follow-up. Results (intent to treat analyses corroborated by linear mixed model analyses)
showed substantial improvements in favor of ACT compared to control, on disability,
quality of life, functional status, and depression at 3-, 6-, and 12-month follow-up.
Improvements were maintained in the ACT group at 6- and 12-month follow-up. At 3-month
follow-up, clinical improvement occurred in headache-related disability (63%) and
65% in quality of life in ACT versus 37% and 35% in control. These findings offer
new evidence for the utility and efficacy of ACT in localized pain conditions and
yields evidence for both statistical and clinical improvements over a years’ period.
Perspective
An Acceptance and Commitment Therapy approach focusing on acceptance and values-based
activities was found to improve disability, functioning, and quality of life among
patients with primary headaches.
Keywords
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Article info
Publication history
Published online: July 16, 2020
Accepted:
June 14,
2020
Received in revised form:
May 7,
2020
Received:
September 5,
2019
Footnotes
Funding: This work was part of a larger project supported by the European Union Structural Funds and National Funds [K3_01_06] via the collaborative program between Greece and Cyprus to Maria Karekla, PhD, Principal investigator.
Conflict of interest: All authors declare that they have no conflicts of interest.
Trial registration: Clinical trials.gov registry (NCT02734992).
Identification
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© 2020 by United States Association for the Study of Pain, Inc.
