Chronic Pain
Conditions
Keywords
internetdelivered CBT, chronic pain, acceptance and commitment therapy, mindfulness, guided self help
Brief summary
The aim of this study was to investigate if guided internet-delivered acceptance and commitment therapy (ACT)would help chronic pain patients.
Detailed description
The present study investigates internet-delivered ACT for persons with chronic pain. The use of internet as a delivery format for interventions could be a way of overcome many barriers (financial obstacles, reluctance to seek treatment and paucity of clinicians trained in ACT) that hinder persons with chronic pain to seek or receive adequate help. Persons were randomized to either treatment for 7 weeks or to a control group who were invited to participate in a moderated online discussion forum. Follow up data was collected six months after the treatment.
Interventions
BEHAVIORALGuided internet-delivered acceptance and commitment therapy
The treatment program consisted of seven sections and was based on ACT.The first part was about creative hopelessness and was followed in the next section by an introduction to willingness and to the process of acceptance of pain. Information and assignments about committed action and values were also part of the treatment program. Mindfulness exercises were a regular feature in the program. The last part was about how to maintain learned strategies but also an evaluation of the program.
Sponsors
Gerhard Andersson
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* that participants had undergone medical investigation (within one year) * had regular access to the internet * had functional impairment caused by chronic pain * had internet access
Exclusion criteria
* ongoing medical investigations or treatment that could interfere with participation in the study, such as planned surgery and suffering from acute physical or psychological conditions * not fluent in the Swedish language
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Chronic Pain Acceptance Questionnaire (CPAQ) | One week pre- and post-treatment | CPAQ consists of 20 items divided into two subscales: activity engagement and pain willingness. Items are rated on a scale from 0 (never true) to 6 (always true). Higher scores denote greater activity engagement and pain willingness. Studies show acceptable reliability (α =.72-.92). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Hospital and Anxiety Depression Scale (HADS) | One week pre- and post- treatment | HADS contains 14 items and evaluates severity of symptoms of depression and anxiety without contamination of scores of physical symptomatology. |
| The Coping Strategies Questionnaire (CSQ) | One week pre- and post- treatment | The CSQ contains 50 items divided into eight scales measuring different cognitive and behavioural coping strategies and has been widely used by chronic pain patients. The coping strategies scales are: diverting attention, re-interpreting pain sensations, coping self-statements, ignoring sensations, praying and hoping, catastrophizing and increased behavioral activities |
| Multidimensional Pain Inventory (MPI-S) | One week pre- and post- treatment | The Swedish version of MPI (MPI-S) consists of 34 items divided into 8 scales. The first section addresses: Pain Severity, Interference, Life Control, Affective Distress and Support. The second section addresses the patient's perception of how significant others respond to their displays of pain: Punishing Responses, Solicitous Responses and Distracting Responses. |
| The Pain and Impairment Relationship Scale (PAIRS) | One week pre- and post- treatment | PAIRS assess beliefs and attitudes associated with the experience of chronic pain and one's ability to function despite pain. It consists of 15 personal statements that reflect thoughts, attitudes and opinions about pain. |
| Quality of Life Inventory (QOLI) | One week pre- and post- treatment | QOLI consists of 32 items for assessing life satisfaction. The assessment yields an overall score and profile in 16 areas of life; health, self-esteem, goals and values, money, work, play, learning, creativity, helping, love, friends, children, relatives, home, neighborhood, and community. |
Outcome results
None listed