A new European study has found that Acceptance and Commitment Therapy, a form of cognitive-behavioral therapy (CBT) and mindfulness, provided a significant reduction in self-reported depression and anxiety among individuals with rheumatoid arthritis.
Acceptance and Commitment Therapy focuses on psychological flexibility and behavior change. The approach provided significant reduction in self-reported depression and anxiety among patients participating in a pain rehabilitation program.
This treatment also resulted in significant increases in self-efficacy, activity engagement and pain acceptance. Self-efficacy is an important concept as it reflects the belief by an individual that they can effectively self-manage their condition.
To assess the potential benefits of an 8-week program of group Acceptance and Commitment Therapy (ACT) in people with persistent pain, measures of pain acceptance and activity engagement were taken using the Chronic Pain Acceptance Questionnaire.
Measures of psychological distress using the Hospital Anxiety and Depression Scale and self-efficacy were also taken at assessment, on the final day of the program, and at the follow up six-month review.
For those chronic pain patients with scores at all three time points, there were statistically significant improvements in all parameters between baseline and at six-months follow-up, including the change in mean score of depression, anxiety, self-efficacy, activity engagement and pain willingness (p<0.001).
“To further validate the role of ACT in the treatment of chronic pain, specifically in a rheumatology context, a randomized controlled clinical trial that includes measures of physical and social functioning within a Rheumatology service would be desirable,” said lead author Dr. Noirin Nealon Lennox from Ulster University in Northern Ireland.
ACT is a form of CBT that includes a specific therapeutic process referred to as “psychological flexibility.”
ACT focuses on behavior change consistent with patients’ core values rather than targeting symptom reduction alone. Evidence for this approach to the treatment of chronic pain has been mounting since the mid 2000’s.
A previous systematic review had concluded that ACT is efficacious for enhancing physical function and decreasing distress among adults with chronic pain attending a pain rehabilitation program.
In this study, patients were referred into the ACT program by three consultant rheumatologists over a five-year period. More than 100 patients’ outcome measures were available for a retrospective analysis.