Chronic pain has a significant impact on the physical and psychological functioning of those living with this condition. It is now recognized that Acceptance and Commitment Therapy (ACT) is an effective intervention in managing chronic pain; however, several barriers limit its accessibility. The current study aims to evaluate the effectiveness of an eight-week bibliotherapy-type self-administered psychological intervention with minimal therapeutic contact, based on ACT, in the management of chronic pain. This study is a randomized controlled trial with two groups (one experimental group and one wait-list control group). Participants will be randomly assigned to each condition and measures will be taken at pretest, posttest and three months following the intervention.
The purpose of this randomized controlled trial was to assess the effectiveness of an eight-week self-administered intervention program (bibliotherapy) based on Acceptance and Commitment Therapy with minimal therapeutic support in the management of chronic pain. This study was based on the following hypotheses. In comparison to the control group, from pre to post, the self-help program will: 1. significantly reduce pain-related disability (primary variable); 2. improve depressive symptoms related to CP (secondary variable); 3. increase the level of pain acceptance; 4. reduce psychological inflexibility linked to painful symptoms (process variables). It was also expected that: 5. the improvements would be maintained at three-month follow-up; 6. participants would have an overall impression of a positive change following the intervention.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
140
The intervention consisted of the book "Libérez-vous de la douleur par la méditation et l'ACT" (Dionne, 2014) and a participant workbook, along with two phone calls of approximately 15 minutes each and weekly e-mails presenting the week's content. Participants also had access to audio meditation exercises on the book's website (http://liberezvousdeladouleur.com/meditations/).
Change in Pain-related disability
Brief Pain Inventory (BPI; Interference subscale; Cleeland \& Ryan 1994; Poundja, Fikretoglu, Guay, \& Brunet 2007; Tyler, Jensen, Engel, \& Schwartz 2002)
Time frame: Change from week 1 to week 9
Change in Pain-related disability
Brief Pain Inventory (BPI; Interference subscale; Cleeland \& Ryan 1994; Poundja, Fikretoglu, Guay, \& Brunet 2007; Tyler, Jensen, Engel, \& Schwartz 2002)
Time frame: Change from week 9 and week 21 (ACT group only)
Change in Depressive symptoms
The Beck Depression Inventory (BDI - Short Form: Beck, Rial, \& Rickels 1974)
Time frame: Change from week 1 to week 9
Change in Depressive symptoms
The Beck Depression Inventory (BDI - Short Form: Beck, Rial, \& Rickels 1974)
Time frame: Change from week 9 and week 21 (ACT group only)
Change in Pain acceptance
Chronic Pain Acceptance Questionnaire (CPAQ-8: Fish, McGuire, Hogan, Morrison, \& Stewart 2010). The CPAQ-8 is an 8-item measure that evaluates acceptance of pain according to two sub-scales: activity engagement and pain willingness. Items are rated on a Likert scale from 0 = never true to 6 = always true. Total scores range from 0 to 48 and higher scores reflect greater acceptance of pain.
Time frame: Change from week 1 to week 9
Change in Pain acceptance
Chronic Pain Acceptance Questionnaire (CPAQ-8: Fish, McGuire, Hogan, Morrison, \& Stewart 2010). The CPAQ-8 is an 8-item measure that evaluates acceptance of pain according to two sub-scales: activity engagement and pain willingness. Items are rated on a Likert scale from 0 = never true to 6 = always true. Total scores range from 0 to 48 and higher scores reflect greater acceptance of pain.
Time frame: Change from week 9 and week 21 (ACT group only)
Change in Psychological inflexibility
Psychological Inflexibility in Pain Scale (PIPS; Wicksell, Lekander, et al. 2010). The PIPS is composed of 12 items that evaluate two dimensions: avoidance and cognitive fusion. Items are rated on a Likert scale from 1 = never true to 7 = always true, to evaluate the level of inflexibility associated to pain. Scores range from 12 to 84, with higher scores revealing greater psychological inflexibility.
Time frame: Change from week 1 to week 9
Change in Psychological inflexibility
Psychological Inflexibility in Pain Scale (PIPS; Wicksell, Lekander, et al. 2010). The PIPS is composed of 12 items that evaluate two dimensions: avoidance and cognitive fusion. Items are rated on a Likert scale from 1 = never true to 7 = always true, to evaluate the level of inflexibility associated to pain. Scores range from 12 to 84, with higher scores revealing greater psychological inflexibility.
Time frame: Change from week 9 and week 21 (ACT group only)
Participants' impression of change
Patient Global Impression of Change (PGIC: Guy et al. 1976)
Time frame: week 21
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