ACT Psychotherapy for Anxiety/Depression of Chronic Pain

Last week, at the Annual European Congress of Rheumatology (EULAR) 2017, a group of researchers showed that Acceptance and Commitment Therapy (ACT) significantly reduced both anxiety and depression among participants suffering from chronic pain.1 ACT is an empirically studied psychotherapy that works to increase psychological flexibility within individuals as a means of working with symptoms they may be experiencing, instead of against them. ACT maintains that psychological “inflexibility” arises out of experiential avoidance, cognitive entanglement, and an attachment to a conceptualized self, among other non-productive psychological coping mechanisms.2 ACT attempts to gain increasing amounts of psychological flexibility by building a commitment to pursuing value and building value in certain life areas, and acknowledging and working with a natural desire to escape painful and troubling experiences.

Benefits of 8-week ACT Program

The study looked at the benefits of an 8-week program of group ACT with patients with persistent pain. Participants were all referred to the study by one of three consultant rheumatologists over a 5-year time period. Over 100 participants’ data was available for analysis retrospectively.  Measures of pain acceptance and activity level were assessed with the Chronic Pain Acceptance Questionnaire. The Hospital Anxiety and Depression Scale was used to assess psychological distress, and subjective self-efficacy was also reported individually.  These measures were taken at the onset of the study, upon completion, and at a 6-month follow-up.

ACT Valued for Decreasing Distress in Chronic Pain

The researchers reported that chronic pain participants who had scores at all 3 analytical time points showed significantly improved scores of depression, anxiety, self-efficacy, activity engagement and pain willingness. This supports previous evidence, since the mid 2000’s which has shown that ACT has value for decreasing distress in chronic pain patients when included in a pain rehabilitation program.

Sources:

1. Nealon Lennox N, O’Neill S, Hannigan A. Acceptance and commitment therapy: a retrospective study of outcomes from a hospital-based, group, pain rehabilitation programme in rheumatology services in the South-East of Ireland. EULAR 2017; Madrid: Abstract OP0140HPR

2.Harris, Russ (August 2006). “Embracing your demons: an overview of Acceptance and Commitment Therapy” (PDF). Psychotherapy in Australia. 12 (4): 2–8.

3. Dindo L, Van liew JR, Arch JJ. Acceptance and Commitment Therapy: A Transdiagnostic Behavioral Intervention for Mental Health and Medical Conditions. Neurotherapeutics. 2017

4. Copyright Image: <a href=’https://www.123rf.com/profile_christitze’>christitze / 123RF Stock Photo</a>


Node Smith, associate editor for NDNR, is a fifth year naturopathic medical student at NUNM, where he has been instrumental in maintaining a firm connection to the philosophy and heritage of naturopathic medicine amongst the next generation of docs. He helped found the first multi-generational experiential retreat, which brings elders, alumni, and students together for a weekend campout where naturopathic medicine and medical philosophy are experienced in nature. Three years ago he helped found the non-profit, Association for Naturopathic ReVitalization (ANR), for which he serves as the board chairman. ANR has a mission to inspire health practitioners to embody the naturopathic principles through experiential education. Node also has a firm belief that the next era of naturopathic medicine will see a resurgence of in-patient facilities which use fasting, earthing, hydrotherapy and homeopathy to bring people back from chronic diseases of modern living; he is involved in numerous conversations and projects to bring about this vision.

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