Chronic Pain Clinical Trial
Official title:
Managing Chronic Pain Through Self-Help: A Randomized Controlled Trial Comparing Guided Self-Help Programs Based on Acceptance and Commitment Therapy (ACT) to Education
Chronic pain has a significant impact on the physical and emotional functioning of those
living with this condition. It is now recognized that Acceptance and Commitment Therapy (ACT)
is an effective treatment in managing chronic pain; however, several barriers limit its
accessibility. Therefore, self-help versions of ACT are promising because they offer a
cost-effective treatment option that usually require little support from a therapist, and can
be widely accessed.
The current study aims to evaluate the effectiveness of predominantly self-help ACT
interventions (web-based and bibliotherapy programs) in comparison to an education
intervention among adults living with chronic pain.
The current study was a randomized controlled trial (RCT) with two experimental groups and an
active control group. The first experimental group received access to an internet platform
with videos, interactive content and exercises based on ACT. The second experimental group
received a copy of a self-help book based on ACT for chronic pain and had access to this
book's website which includes audio mindfulness exercises. The third group consisted of an
active control group, in which participants received pamphlet style pdf documents of
education for pain (without any ACT components) as well as related practical exercises.
This study aimed to evaluate the effectiveness of a web-based ACT intervention program with
minimal therapeutic contact, compared to an ACT-based bibliotherapy and a pain education
program (active control group) among adults with chronic pain. Participants were randomly
assigned to each group. We hypothesized that:
1. both ACT interventions would lead to significant reductions in pain-related disability
(primary variable), greater than the control group (education), and that the web-based
program would lead to greater reductions in disability than the bibliotherapy group;
2. both ACT interventions would lead to significant improvements in quality of life
(secondary variable), greater than the control group (education), and that the web-based
program would lead to greater improvements in quality of life than the bibliotherapy
group;
3. both ACT interventions would lead to significant reductions in anxiety and depressive
symptoms (secondary variables), greater than the control group (education), and that the
web-based program would lead to greater reductions in anxiety and depressive symptoms
than the bibliotherapy group;
4. Improvements on primary (pain-related disability) and secondary variables (quality of
life, anxiety/depressive symptoms) for the ACT groups will be maintained at 3 and 6
months and will remain superior to the control group (education);
5. Participants from both ACT groups would have a positive impressions of change following
the intervention (as measured by the PGIC scale).
- Some of the questionnaires described in the following section were administered and
will be subject to subsequent analyses examining patient trajectories of change and
profiles of patients who respond well or not to these treatment modalities.
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