2015 EST Status: Treatment pending re-evaluation Very strong: High-quality evidence that treatment improves symptoms and functional outcomes at post-treatment and follow-up; little risk of harm; requires reasonable amount of resources; effective in non-research settings

Strong: Moderate- to high-quality evidence that treatment improves symptoms OR functional outcomes; not a high risk of harm; reasonable use of resources

Weak: Low or very low-quality evidence that treatment produces clinically meaningful effects on symptoms or functional outcomes; Gains from the treatment may not warrant resources involved

Insufficient Evidence: No meta-analytic study could be identified

Insufficient Evidence: Existing meta-analyses are not of sufficient quality

Treatment pending re-evaluation

1998 EST Status: Strong Research Support Strong: Support from two well-designed studies conducted by independent investigators.

Modest: Support from one well-designed study or several adequately designed studies.

Controversial: Conflicting results, or claims regarding mechanisms are unsupported.

Brief Summary

• Basic premise: By accepting and learning to live with pain, one can limit the control it exerts over his or her life.
• Essence of therapy: This therapy guides individuals to change their expectations from the elimination of pain to living as well as possible with pain. Through metaphors and experiential exercises, individuals learn the futility of control-oriented strategies and the benefits of acceptance-oriented strategies in response to negative internal experiences such as pain and discomfort. Individuals are encouraged to explore their personal values and set goals consistent with those values in order to improve overall quality of life and functioning.
• Length: approx. 8 sessions

Treatment Resources

Editors: Evan Forman, PhD; Joanna Kaye, BA

Note: The resources provided below are intended to supplement not replace foundational training in mental health treatment and evidence-based practice

Treatment Manuals / Outlines

Treatment Manuals

• Life with Chronic Pain: Therapist Guide & Patient Workbook (Vowles & Sorrell)
• Acceptance and Commitment Therapy in the Treatment of Chronic Pain (Dahl & Lundgren; explanation and session example)
• ACT for Chronic Pain (McCracken)

Books Available for Purchase Through External Sites

• Acceptance and Commitment Therapy for Chronic Pain (Dahl et al.)

Measures, Handouts and Worksheets

• Valued Living Questionnaire
• Chronic Pain Values Inventory
• Chronic Pain Acceptance Questionnaire-Revised
• Psychological Inflexibility in Pain Scale
• Committed Action Questionnaire-18
• Committed Action Questionnaire-8
• Committed Action Questionnaire-8 with scoring instructions

 

Self-help Books

• Living Beyond your Pain: Using Acceptance and Commitment Therapy to Ease Chronic Pain (Dahl, Lundgren, & Hayes)

Important Note: The books listed above are based on empirically-supported in-person treatments. They have not necessarily been evaluated empirically either by themselves or in conjunction with in-person treatment. We list them as a resource for clinicians who assign them as an adjunct to conducting in-person treatment.

Smartphone Apps

• ACT Companion: The Happiness Trap App with Dr. Russ Harris (Berrick Psychology)
• 2Morrow Health for Chronic Pain (2Morrow Health)

Clinical Trials

• A randomized, controlled trial of acceptance and commitment therapy and cognitive-behavioral therapy for chronic pain (Wetherell et al., 2011)
• Acceptance and commitment therapy and the treatment of persons at risk for long-term disability resulting from stress and pain symptoms: A preliminary randomized trial (Dahl, Wilson, & Nilsson, 2004)
• Acceptance-based treatment for persons with complex, long standing chronic pain: A preliminary analysis of treatment outcome in comparison to a waiting phase (McCracken, Vowles, & Eccleston, 2005)
• Acceptance and values-based action in chronic pain: A study of treatment effectiveness and process (Vowles & McCracken, 2008)
• Targeting acceptance, mindfulness, and values-based action in chronic pain: Findings of two preliminary trials of an outpatient group-based intervention (Vowles, Wetherell, & Sorrell, 2009)
• A trial of a brief group-based form of acceptance and commitment therapy (ACT) for chronic pain in general practice: Pilot outcome and process results (McCracken, Sato, & Taylor, 2013)

 

 

Meta-analyses and Systematic Reviews

• Acceptance-based interventions for the treatment of chronic pain: A systematic review and meta-analysis (Veehof et al., 2011)

• A systematic review of randomized controlled trials of acceptance and commitment therapy for adults with chronic pain: Outcome domains, design quality, and efficacy (Hann & McCracken, 2014)

 

 

Other Treatment Resources

• Comparison between an acceptance-based and a cognitive-control-based protocol for coping with pain (Gutiérrez et al., 2004)
• Acceptance and Commitment Therapy and Chronic Pain presentation (McCracken)
• A prospective analysis of pain and values-based action in patients with chronic pain (McCracken & Vowles, 2008)
• Patient functioning and catastrophizing in chronic pain: The mediating effects of acceptance (Vowles, McCracken, & Eccleston, 2008)
• The role of values in a contextual cognitive-behavioral approach to chronic pain (McCracken & Yang, 2006)
• Committed action: An application of the psychological flexibility model to activity patterns in chronic pain (McCracken, 2013)
• Further development in the assessment of psychological flexibility: A shortened Committed Action Questionnaire (CAQ-8; McCracken, Chilcot, & Norton, 2014)