Skip to main content
Top
Gepubliceerd in:

01-02-2015

Internet-based guided self-help intervention for chronic pain based on Acceptance and Commitment Therapy: A randomized controlled trial

Auteurs: Hester R. Trompetter, Ernst T. Bohlmeijer, Martine M. Veehof, Karlein M. G. Schreurs

Gepubliceerd in: Journal of Behavioral Medicine | Uitgave 1/2015

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

Acceptance-based psychological interventions can potentially minimize the burden of chronic pain. This randomized controlled trial evaluated an internet-delivered, guided self-help intervention based on Acceptance and Commitment Therapy (ACT). A total of 238 chronic pain sufferers from the general population were randomly allocated to either ACT (n = 82), an internet-based control condition Expressive Writing (n = 79) or a waiting list condition (n = 77). Participants completed measures at baseline, posttreatment (3 months) and at a 3-month follow-up. At follow-up, ACT participants had improved in pain interference in daily life (primary outcome) compared to participants in Expressive Writing (Cohen’s d = .47), but not compared to waiting list participants (p value = .11). Those who adhered to the ACT-intervention (48 %) did improve significantly compared to waiting list participants (d = .49). ACT-participants also showed superior improvement on depression, pain intensity, psychological inflexibility and pain catastrophizing (d: .28–.60). Significant clinical improvement was present. Especially, 28 % of ACT-participants showed general clinically relevant improvement in pain interference, as well as in pain intensity and depression (vs. Expressive Writing and waiting list 5 %). Given these findings, internet-based ACT programs may be a promising treatment modality for chronic pain.
Literatuur
go back to reference Bohlmeijer, E., ten Klooster, P. M., Fledderus, M., Veehof, M., & Baer, R. (2011). Psychometric properties of the five facet mindfulness questionnaire in depressed adults and development of a short form. Assessment, 18, 308–320. doi:10.1177/1073191111408231 PubMedCrossRef Bohlmeijer, E., ten Klooster, P. M., Fledderus, M., Veehof, M., & Baer, R. (2011). Psychometric properties of the five facet mindfulness questionnaire in depressed adults and development of a short form. Assessment, 18, 308–320. doi:10.​1177/​1073191111408231​ PubMedCrossRef
go back to reference Breivik, H., Collett, B., Ventafridda, V., Cohen, R., & Gallacher, D. (2006). Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment. European Journal of Pain (London, England), 10, 287–333. doi:10.1016/j.ejpain.2005.06.009 CrossRef Breivik, H., Collett, B., Ventafridda, V., Cohen, R., & Gallacher, D. (2006). Survey of chronic pain in Europe: Prevalence, impact on daily life, and treatment. European Journal of Pain (London, England), 10, 287–333. doi:10.​1016/​j.​ejpain.​2005.​06.​009 CrossRef
go back to reference Buhrman, M., Skoglund, A., Husell, J., Bergström, K., Gordh, T., Hursti, T., et al. (2013). Guided Internet-delivered acceptance and commitment therapy for chronic pain patients: A randomized controlled trial. Behaviour Research and Therapy,. doi:10.1016/j.brat.2013.02.010 PubMed Buhrman, M., Skoglund, A., Husell, J., Bergström, K., Gordh, T., Hursti, T., et al. (2013). Guided Internet-delivered acceptance and commitment therapy for chronic pain patients: A randomized controlled trial. Behaviour Research and Therapy,. doi:10.​1016/​j.​brat.​2013.​02.​010 PubMed
go back to reference Cho, S., McCracken, L. M., Heiby, E. M., Moon, D.-E., & Lee, J.-H. (2013). Pain acceptance-based coping in complex regional pain syndrome Type I: Daily relations with pain intensity, activity, and mood. Journal of Behavioral Medicine, 36, 531–538. doi:10.1007/s10865-012-9448-7 PubMedCrossRef Cho, S., McCracken, L. M., Heiby, E. M., Moon, D.-E., & Lee, J.-H. (2013). Pain acceptance-based coping in complex regional pain syndrome Type I: Daily relations with pain intensity, activity, and mood. Journal of Behavioral Medicine, 36, 531–538. doi:10.​1007/​s10865-012-9448-7 PubMedCrossRef
go back to reference Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). New York: Lawrence Erlbaum. Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). New York: Lawrence Erlbaum.
go back to reference Crombez, G., Eccleston, C., Van Damme, S., Vlaeyen, J. W. S., & Karoly, P. (2012). Fear-avoidance model of chronic pain: The next generation. The Clinical Journal of Pain, 28(6), 475–483.PubMedCrossRef Crombez, G., Eccleston, C., Van Damme, S., Vlaeyen, J. W. S., & Karoly, P. (2012). Fear-avoidance model of chronic pain: The next generation. The Clinical Journal of Pain, 28(6), 475–483.PubMedCrossRef
go back to reference Dempster, A. P., Laird, N. M., & Rubin, D. B. (1977). Maximum likelihood for incomplete data via the EM algorithm. Journal of the Royal Statistical Society: Series B (Methodological), 39, 1–38. Dempster, A. P., Laird, N. M., & Rubin, D. B. (1977). Maximum likelihood for incomplete data via the EM algorithm. Journal of the Royal Statistical Society: Series B (Methodological), 39, 1–38.
go back to reference Donker, T., van Straten, A., Marks, I., & Cuijpers, P. (2009). A brief web-based screening questionnaire for common mental disorders: Development and validation. Journal of Medical Internet Research, 11, 19. doi:10.2196/jmir.1134 CrossRef Donker, T., van Straten, A., Marks, I., & Cuijpers, P. (2009). A brief web-based screening questionnaire for common mental disorders: Development and validation. Journal of Medical Internet Research, 11, 19. doi:10.​2196/​jmir.​1134 CrossRef
go back to reference Donkin, L., Christensen, H., Naismith, S. L., Neal, B., Hickie, I. B., & Glozier, N. (2011). A systematic review of the impact of adherence on the effectiveness of e-Therapies. Journal of Medical Internet Research, 13, e52.PubMedCentralPubMedCrossRef Donkin, L., Christensen, H., Naismith, S. L., Neal, B., Hickie, I. B., & Glozier, N. (2011). A systematic review of the impact of adherence on the effectiveness of e-Therapies. Journal of Medical Internet Research, 13, e52.PubMedCentralPubMedCrossRef
go back to reference Dworkin, R. H., Turk, D. C., Wyrwich, K. W., Beaton, D., Cleeland, C. S., Farrar, J. T., et al. (2008). Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT recommendations. The Journal of Pain: Official Journal of the American Pain Society, 9, 105–121. doi:10.1016/j.jpain.2007.09.005 CrossRef Dworkin, R. H., Turk, D. C., Wyrwich, K. W., Beaton, D., Cleeland, C. S., Farrar, J. T., et al. (2008). Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT recommendations. The Journal of Pain: Official Journal of the American Pain Society, 9, 105–121. doi:10.​1016/​j.​jpain.​2007.​09.​005 CrossRef
go back to reference Fledderus, M., Bohlmeijer, E. T., Pieterse, M. E., & Schreurs, K. M. G. (2012). Acceptance and commitment therapy as guided self-help for psychological distress and positive mental health: A randomized controlled trial. Psychological Medicine, 42, 485–495. doi:10.1017/S0033291711001206 PubMedCrossRef Fledderus, M., Bohlmeijer, E. T., Pieterse, M. E., & Schreurs, K. M. G. (2012). Acceptance and commitment therapy as guided self-help for psychological distress and positive mental health: A randomized controlled trial. Psychological Medicine, 42, 485–495. doi:10.​1017/​S003329171100120​6 PubMedCrossRef
go back to reference Hayes, S. C., Strosahl, K., & Wilson, K. G. (2012). Acceptance & commitment therapy: The process and practice of mindful change (2nd ed.). New York City: Guilford Press. Hayes, S. C., Strosahl, K., & Wilson, K. G. (2012). Acceptance & commitment therapy: The process and practice of mindful change (2nd ed.). New York City: Guilford Press.
go back to reference Jensen, K. B., Kosek, E., Wicksell, R., Kemani, M., Olsson, G., Merle, J. V., et al. (2012). Cognitive Behavioral Therapy increases pain-evoked activation of the prefrontal cortex in patients with fibromyalgia. Pain, 153, 1495–1503. doi:10.1016/j.pain.2012.04.010 PubMedCrossRef Jensen, K. B., Kosek, E., Wicksell, R., Kemani, M., Olsson, G., Merle, J. V., et al. (2012). Cognitive Behavioral Therapy increases pain-evoked activation of the prefrontal cortex in patients with fibromyalgia. Pain, 153, 1495–1503. doi:10.​1016/​j.​pain.​2012.​04.​010 PubMedCrossRef
go back to reference Kelders, S. M., Kok, R. N., Ossebaard, H. C., & Gemert-Pijnen, J. E. W. C. (2012). Persuasive system design does matter: A systematic review of adherence to web-based interventions. Journal of Medical Internet Research, 14, e152.PubMedCentralPubMedCrossRef Kelders, S. M., Kok, R. N., Ossebaard, H. C., & Gemert-Pijnen, J. E. W. C. (2012). Persuasive system design does matter: A systematic review of adherence to web-based interventions. Journal of Medical Internet Research, 14, e152.PubMedCentralPubMedCrossRef
go back to reference Macea, D. D., Gajos, K., Daglia Calil, Y. A., & Fregni, F. (2010). The efficacy of web-based cognitive behavioral interventions for chronic pain: A systematic review and meta-analysis. The Journal of Pain: Official Journal of the American Pain Society, 11, 917–929. doi:10.1016/j.jpain.2010.06.005 CrossRef Macea, D. D., Gajos, K., Daglia Calil, Y. A., & Fregni, F. (2010). The efficacy of web-based cognitive behavioral interventions for chronic pain: A systematic review and meta-analysis. The Journal of Pain: Official Journal of the American Pain Society, 11, 917–929. doi:10.​1016/​j.​jpain.​2010.​06.​005 CrossRef
go back to reference McCracken, L. M., & Gutiérrez-Martínez, O. (2011). Processes of change in psychological flexibility in an interdisciplinary group-based treatment for chronic pain based on acceptance and commitment therapy. Behaviour Research and Therapy, 49, 267–274. doi:10.1016/j.brat.2011.02.004 PubMedCrossRef McCracken, L. M., & Gutiérrez-Martínez, O. (2011). Processes of change in psychological flexibility in an interdisciplinary group-based treatment for chronic pain based on acceptance and commitment therapy. Behaviour Research and Therapy, 49, 267–274. doi:10.​1016/​j.​brat.​2011.​02.​004 PubMedCrossRef
go back to reference McCracken, L. M., Sato, A., & Taylor, G. J. (2013). A trial of a brief group-based form of acceptance and commitment therapy (ACT) for chronic pain in general practice: Pilot outcome and process results. The Journal of Pain: Official Journal of the American Pain Society, 14, 1398–1406. doi:10.1016/j.jpain.2013.06.011 CrossRef McCracken, L. M., Sato, A., & Taylor, G. J. (2013). A trial of a brief group-based form of acceptance and commitment therapy (ACT) for chronic pain in general practice: Pilot outcome and process results. The Journal of Pain: Official Journal of the American Pain Society, 14, 1398–1406. doi:10.​1016/​j.​jpain.​2013.​06.​011 CrossRef
go back to reference McCracken, L. M., & Vowles, K. E. (2008). A prospective analysis of acceptance of pain and values-based action in patients with chronic pain. Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association, 27, 215–220. doi:10.1037/0278-6133.27.2.215 CrossRef McCracken, L. M., & Vowles, K. E. (2008). A prospective analysis of acceptance of pain and values-based action in patients with chronic pain. Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association, 27, 215–220. doi:10.​1037/​0278-6133.​27.​2.​215 CrossRef
go back to reference Pennebaker, J. W. (1997). Writing about emotional experiences as a therapeutic process. Psychological Science, 8, 162–166.CrossRef Pennebaker, J. W. (1997). Writing about emotional experiences as a therapeutic process. Psychological Science, 8, 162–166.CrossRef
go back to reference Pollard, C. A. (1984). Preliminary validity study of the Pain Disability Index. Motor Skills, 59, 974.CrossRef Pollard, C. A. (1984). Preliminary validity study of the Pain Disability Index. Motor Skills, 59, 974.CrossRef
go back to reference Schreurs, K. M. G., & Hulsbergen, M. (2012). Leven met Pijn: Praktijkboek voor behandelaars. [Living with Pain: Therapist manual]. Amsterdam: Boom. Schreurs, K. M. G., & Hulsbergen, M. (2012). Leven met Pijn: Praktijkboek voor behandelaars. [Living with Pain: Therapist manual]. Amsterdam: Boom.
go back to reference Sheehan, D. V., Lecrubier, Y., Amorim, P., Janav, J., Weiller, E., Hergueta, T., et al. (1998). The mini-international neuropsychiatric interview (MINI): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59, 22–33.PubMed Sheehan, D. V., Lecrubier, Y., Amorim, P., Janav, J., Weiller, E., Hergueta, T., et al. (1998). The mini-international neuropsychiatric interview (MINI): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59, 22–33.PubMed
go back to reference Sullivan, M. J. L., Biishop, S. R., & Pivik, J. (1995). The Pain Catastrophizing Scale: Development and validation. Psychological Assessment, 7, 524.CrossRef Sullivan, M. J. L., Biishop, S. R., & Pivik, J. (1995). The Pain Catastrophizing Scale: Development and validation. Psychological Assessment, 7, 524.CrossRef
go back to reference Thorsell, J., Finnes, A., Dahl, J., Lundgren, T., Gybrant, M., Gordh, T., et al. (2011). A comparative study of 2 manual-based self-help interventions, acceptance and commitment therapy and applied relaxation, for persons with chronic pain. The Clinical Journal of Pain, 27, 716–723. doi:10.1097/AJP.0b013e318219a933 PubMedCrossRef Thorsell, J., Finnes, A., Dahl, J., Lundgren, T., Gybrant, M., Gordh, T., et al. (2011). A comparative study of 2 manual-based self-help interventions, acceptance and commitment therapy and applied relaxation, for persons with chronic pain. The Clinical Journal of Pain, 27, 716–723. doi:10.​1097/​AJP.​0b013e318219a933​ PubMedCrossRef
go back to reference Trompetter, H. R., Bohlmeijer, E. T., Van Baalen, B., Kleen, M., Koke, A., Reneman, M. F., et al. (2014). The Psychological Inflexibility in Pain Scale (PIPS): Exploration of psychometric properties in a heterogeneous chronic pain sample. European journal of psychological assessment, 1–7. doi:10.1027/1015-5759/a000191 Trompetter, H. R., Bohlmeijer, E. T., Van Baalen, B., Kleen, M., Koke, A., Reneman, M. F., et al. (2014). The Psychological Inflexibility in Pain Scale (PIPS): Exploration of psychometric properties in a heterogeneous chronic pain sample. European journal of psychological assessment, 1–7. doi:10.​1027/​1015-5759/​a000191
go back to reference Trompetter, H. R., ten Klooster, P. M., Schreurs, K. M. G., Fledderus, M., Westerhof, G. J., & Bohlmeijer, E. T. (2013). Measuring values and committed action with the Engaged Living Scale (ELS): Psychometric evaluation in a nonclinical and chronic pain sample. Psychological Assessment,. doi:10.1037/a0033813 PubMed Trompetter, H. R., ten Klooster, P. M., Schreurs, K. M. G., Fledderus, M., Westerhof, G. J., & Bohlmeijer, E. T. (2013). Measuring values and committed action with the Engaged Living Scale (ELS): Psychometric evaluation in a nonclinical and chronic pain sample. Psychological Assessment,. doi:10.​1037/​a0033813 PubMed
go back to reference Veehof, M. M., Schreurs, K. M. G., Hulsbergen, M., & Bohlmeijer, E. T. (2010). Leven met pijn. De kunst van het aanvaarden [Living with Pain. The art of acceptance] (Boom.). Amsterdam. Veehof, M. M., Schreurs, K. M. G., Hulsbergen, M., & Bohlmeijer, E. T. (2010). Leven met pijn. De kunst van het aanvaarden [Living with Pain. The art of acceptance] (Boom.). Amsterdam.
go back to reference Vowles, K. E., McCracken, L. M., & Eccleston, C. (2007). Processes of change in treatment for chronic pain: The contributions of pain, acceptance, and catastrophizing. European Journal of Pain (London, England), 11, 779–787. doi:10.1016/j.ejpain.2006.12.007 CrossRef Vowles, K. E., McCracken, L. M., & Eccleston, C. (2007). Processes of change in treatment for chronic pain: The contributions of pain, acceptance, and catastrophizing. European Journal of Pain (London, England), 11, 779–787. doi:10.​1016/​j.​ejpain.​2006.​12.​007 CrossRef
go back to reference Vowles, K. E., McCracken, L. M., & O’Brien, J. Z. (2011). Acceptance and values-based action in chronic pain: A three-year follow-up analysis of treatment effectiveness and process. Behaviour Research and Therapy, 49, 748–755.PubMedCrossRef Vowles, K. E., McCracken, L. M., & O’Brien, J. Z. (2011). Acceptance and values-based action in chronic pain: A three-year follow-up analysis of treatment effectiveness and process. Behaviour Research and Therapy, 49, 748–755.PubMedCrossRef
go back to reference Vowles, K. E., Witkiewitz, K., Sowden, G., & Ashworth, J. (2014). Acceptance and commitment therapy for chronic pain: Evidence of mediation and clinically significant change following an abbreviated interdisciplinary program of rehabilitation. The Journal of Pain: Official Journal of the American Pain Society, 15, 101–113. doi:10.1016/j.jpain.2013.10.002 CrossRef Vowles, K. E., Witkiewitz, K., Sowden, G., & Ashworth, J. (2014). Acceptance and commitment therapy for chronic pain: Evidence of mediation and clinically significant change following an abbreviated interdisciplinary program of rehabilitation. The Journal of Pain: Official Journal of the American Pain Society, 15, 101–113. doi:10.​1016/​j.​jpain.​2013.​10.​002 CrossRef
go back to reference Wetherell, J. L., Afari, N., Rutledge, T., Sorrell, J. T., Stoddard, J. A., & Petkus, A. J. (2011). A randomized, controlled trial of acceptance and commitment therapy and cognitive-behavioral therapy for chronic pain. Pain, 152, 2098–2107. doi:10.1016/j.pain.2011.05.016 PubMedCrossRef Wetherell, J. L., Afari, N., Rutledge, T., Sorrell, J. T., Stoddard, J. A., & Petkus, A. J. (2011). A randomized, controlled trial of acceptance and commitment therapy and cognitive-behavioral therapy for chronic pain. Pain, 152, 2098–2107. doi:10.​1016/​j.​pain.​2011.​05.​016 PubMedCrossRef
go back to reference Wicksell, R. K., Ahlqvist, J., Bring, A., Melin, L., & Olsson, G. L. (2008). Can exposure and acceptance strategies improve functioning and life satisfaction in people with chronic pain and whiplash-associated disorders (WAD)? A randomized controlled trial. Cognitive Behaviour Therapy, 37, 169–182. doi:10.1080/16506070802078970 PubMedCrossRef Wicksell, R. K., Ahlqvist, J., Bring, A., Melin, L., & Olsson, G. L. (2008). Can exposure and acceptance strategies improve functioning and life satisfaction in people with chronic pain and whiplash-associated disorders (WAD)? A randomized controlled trial. Cognitive Behaviour Therapy, 37, 169–182. doi:10.​1080/​1650607080207897​0 PubMedCrossRef
go back to reference Wicksell, R. K., Kemani, M., Jensen, K., Kosek, E., Kadetoff, D., Sorjonen, K., et al. (2013b). Acceptance and commitment therapy for fibromyalgia: A randomized controlled trial. European Journal of Pain (London, England), 17, 599–611.CrossRef Wicksell, R. K., Kemani, M., Jensen, K., Kosek, E., Kadetoff, D., Sorjonen, K., et al. (2013b). Acceptance and commitment therapy for fibromyalgia: A randomized controlled trial. European Journal of Pain (London, England), 17, 599–611.CrossRef
go back to reference Wicksell, R. K., Lekander, M., Sorjonen, K., & Olsson, G. L. (2010a). The Psychological Inflexibility in Pain Scale (PIPS)—statistical properties and model fit of an instrument to assess change processes in pain related disability. European Journal of Pain (London, England), 14, 771.e1–771.e14. doi:10.1016/j.ejpain.2009.11.015 Wicksell, R. K., Lekander, M., Sorjonen, K., & Olsson, G. L. (2010a). The Psychological Inflexibility in Pain Scale (PIPS)—statistical properties and model fit of an instrument to assess change processes in pain related disability. European Journal of Pain (London, England), 14, 771.e1–771.e14. doi:10.​1016/​j.​ejpain.​2009.​11.​015
go back to reference Wicksell, R. K., Olsson, G. L., & Hayes, S. C. (2010b). Psychological flexibility as a mediator of improvement in acceptance and commitment therapy for patients with chronic pain following whiplash. European Journal of Pain (London, England), 14, 1059.e1–1059.e11. doi:10.1016/j.ejpain.2010.05.001 Wicksell, R. K., Olsson, G. L., & Hayes, S. C. (2010b). Psychological flexibility as a mediator of improvement in acceptance and commitment therapy for patients with chronic pain following whiplash. European Journal of Pain (London, England), 14, 1059.e1–1059.e11. doi:10.​1016/​j.​ejpain.​2010.​05.​001
go back to reference Williams, A. C. D. C., Eccleston, C., & Morley, S. (2013). Psychological therapies for the management of chronic pain (excluding headache) in adults (Review). Cochrane Database of Systematic Reviews, (2). doi:10.1002/14651858.CD007407.pub2 Williams, A. C. D. C., Eccleston, C., & Morley, S. (2013). Psychological therapies for the management of chronic pain (excluding headache) in adults (Review). Cochrane Database of Systematic Reviews, (2). doi:10.​1002/​14651858.​CD007407.​pub2
go back to reference Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361–370.PubMedCrossRef Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361–370.PubMedCrossRef
Metagegevens
Titel
Internet-based guided self-help intervention for chronic pain based on Acceptance and Commitment Therapy: A randomized controlled trial
Auteurs
Hester R. Trompetter
Ernst T. Bohlmeijer
Martine M. Veehof
Karlein M. G. Schreurs
Publicatiedatum
01-02-2015
Uitgeverij
Springer US
Gepubliceerd in
Journal of Behavioral Medicine / Uitgave 1/2015
Print ISSN: 0160-7715
Elektronisch ISSN: 1573-3521
DOI
https://doi.org/10.1007/s10865-014-9579-0