As non-pharmacological alternatives, psychosocial treatments have been recommended for chronic pain management. One such treatment is Acceptance and Commitment Therapy (ACT). ACT is a cognitive behavior therapy based on Relational Frame Theory, a comprehensive theory about language and cognition. This treatment intends to help patients identify values ("what is truly meaningful to them") and to set goals and take action according to their values. ACT has research support in the treatment of several mental health problems. Moreover patients are taught mindfulness skills to increase acceptance of pain, thoughts and feelings so that these will have less impact on functioning and action. Among patients with chronic pain, several small clinical trials have shown that ACT is more effective than other treatments in terms of increasing function and improving mental health. ACT in combination with mindfulness training has not been tested so far. Further methodologically robust trials are required. This study will therefore examine whether ACT is more effective for chronic pain than an education program, and whether adding daily mindfulness training will improve the outcome, in a large sample of patients from four multidisciplinary pain centers.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
667
Acceptance and commitment therapy (ACT) sessions, lead by 2 qualified therapists, using a manual based on Steven Hayes et al 1999 that was adapted to group therapy and includes all the dynamic processes of ACT.
mindfulness exercises introduced in the ACT sessions. In addition daily home meditation exercises based on the program developed by Kabat-Zinn 2005 and with help of audio recordings.
Self-management education program. Information given by a qualified health professional on pain and symptom management, stress, sleep, eating habits, mental health problems. Group discussions about thoughts and experiences. communication skills and physical activity
Haukeland universitetssykehus
Bergen, Norway
Oslo universitetssykehus
Oslo, Norway
Norges arktiske universitet
Tromsø, Norway
St Olavs Hospital
Trondheim, Norway
pain intensity measured by the Norwegian Brief Pain Inventory (BPI)
the Brief Pain Inventory includes four 0-10 numerical rating scales: for 'pain now', and for 'least pain', 'worst pain', and 'average pain' during the last 24 hours, with 0 = no pain to 10 = pain as bad as you can imagine. A pain severity index is calculated by adding the scores on the pain severity items
Time frame: 44 weeks after end of treatment
pain intensity measured by the Norwegian Brief Pain Inventory (BPI)
the Brief Pain Inventory includes four 0-10 numerical rating scales: for 'pain now', and for 'least pain', 'worst pain', and 'average pain' during the last 24 hours, with 0 = no pain to 10 = pain as bad as you can imagine. A pain severity index is calculated by adding the scores on the pain severity items
Time frame: 8 weeks after end of treatment
pain intensity measured by the Norwegian Brief Pain Inventory (BPI)
the Brief Pain Inventory includes four 0-10 numerical rating scales: for 'pain now', and for 'least pain', 'worst pain', and 'average pain' during the last 24 hours, with 0 = no pain to 10 = pain as bad as you can imagine. A pain severity index is calculated by adding the scores on the pain severity items
Time frame: 24 weeks after end of treatment
pain intensity measured by the Norwegian Brief Pain Inventory (BPI)
the Brief Pain Inventory includes four 0-10 numerical rating scales: for 'pain now', and for 'least pain', 'worst pain', and 'average pain' during the last 24 hours, with 0 = no pain to 10 = pain as bad as you can imagine. A pain severity index is calculated by adding the scores on the pain severity items
Time frame: 3 years after end of treatment
physical function
according to the SF-36 Health Survey
Time frame: 8 weeks after end of treatment
physical function
according to the SF-36 Health Survey
Time frame: 24 weeks after end of treatment
physical function
according to the SF-36 Health Survey
Time frame: 44 weeks after end of treatment
physical function
according to the SF-36 Health Survey
Time frame: 3 years after end of treatment
mental health
according to the SF-36 Health Survey
Time frame: 8 weeks after end of treatment
mental health
according to the SF-36 Health Survey
Time frame: 24 weeks after end of treatment
mental health
according to the SF-36 Health Survey
Time frame: 44 weeks after end of treatment
mental health
according to the SF-36 Health Survey
Time frame: 3 years after end of treatment
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