Clinical effectiveness of an internet-delivered Acceptance and Commitment Therapy (ACT) intervention for chronic pain

Abstract

Background Internet-delivered psychological interventions have the potential to overcome environmental and economic barriers in the provision of evidence-based psychological treatment for people living with chronic pain. While the use of internet-delivered cognitive-behavioural therapy programmes has been consistently shown to have small-to-moderate effects in the management of chronic pain, there is a dearth of research regarding the effectiveness of online Acceptance and Commitment Therapy (ACT) programmes for this population. The current study compared the clinical-effectiveness of an online ACT intervention with a waitlist control condition in the management of pain-related functional interference among people with chronic pain. Methods Participants n= 240 with non-malignant pain of at least 3 months’ duration were randomised to one of two study conditions. The experimental group (n=70) underwent an eight-session internet-delivered ACT programme over an 8-week period. The waitlist control group was offered the ACT intervention after a 3-month follow-up period. The primary outcome was pain-related functional interference. Secondary outcomes included: pain intensity, depression, global impression of change, acceptance of chronic pain and quality of life. Participants were assessed pre-intervention, post-intervention and at 3-month follow-up. Results Between groups ANCOVA analyses revealed a significant effect of the intervention on pain severity, activity engagement, and pain-specific cognitive anxiety over time. Conclusions Findings provide preliminary support for the clinical effectiveness of an 8-week internet-delivered ACT intervention for reducing pain-related functional interference among people with chronic pain. Further research comparing the clinical and cost-effectiveness of online versus face-to-face ACT programmes is warranted.