OUTCOMES AND PROCESSES OF PSYCHOLOGICAL FLEXIBILITY DURING ACCEPTANCE AND COMMITMENT THERAPY (ACT), GROUP BASED TREATMENT FOR PATIENTS WITH CHRONIC PAIN IN A RHEUMATOLOGY CONTEXT
Nóirín Lennox, Prof Siobhán O Neill1, Prof Ailish Hannigan2, Helen Rooney3, Dr Alexander Fraser2 3 and Dr Joseph Devlin3
1.Department of Psychology Ulster University, 2. Graduate Entry Medical School, University of Limerick, 3. Rheumatology Services Croom, University Hospital Limerick.
ACT (pronounced as one word) is a type of Cognitive Behavioural Therapy that promotes a therapeutic process known as “Psychological Flexibility”. A key feature of this therapy in the context of chronic pain is that it focuses on behaviour change rather than symptom reduction only.
This was a prospective study, which aimed to design, implement and evaluate ACT based, group, interdisciplinary, rehabilitation programmes for people with chronic pain attending rheumatology services. Specifically it aimed to conduct an outcome evaluation of 10 ACT and exercise programmes and to examine the mechanisms of its impact.
Data was collected at three time points; at assessment, on the last day of the interventions and at a 6-month review date following completion of the programme. Four self-report measures and two objective measures were used for the primary outcomes. To examine the processes of psychological flexibility, a further four validated measures were included at each time point. Paired t-tests and repeated measures ANOVA were used to test differences between time points.
Results showed statistically significant improvements across all the primary outcome measures except for pain. Improvements made during the eight-week programmes were maintained at follow up for all the measures. In addition statistically significant improvements were made in all four process measures and these were maintained at follow up.
To the authors knowledge these are the first trials, examining ACT for chronic pain in a rheumatology context only. As such they add to the existing evidence for the effectiveness of Acceptance and Commitment Therapy for chronic pain.