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Treatment Outcomes and Mechanisms for an ACT ‐Based 10‐Week Interdisciplinary Chronic Pain Rehabilitation Program
Author(s) -
Craner Julia R.,
Lake Eric S.,
Bancroft Kimberly A.,
George Logan L.
Publication year - 2020
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/papr.12824
Subject(s) - pain catastrophizing , biopsychosocial model , mood , medicine , chronic pain , rehabilitation , physical therapy , acceptance and commitment therapy , anxiety , clinical psychology , psychiatry , intervention (counseling)
Abstract Background Interdisciplinary pain rehabilitation programs are an evidence‐based biopsychosocial treatment approach for chronic pain. The purpose of the current study is to assess outcomes for a 10‐week interdisciplinary, acceptance and commitment therapy ( ACT )‐based, outpatient treatment model and to evaluate the relationship between psychological process variables (ie, pain catastrophizing, pain acceptance, pain self‐efficacy) and treatment outcomes. Methods 137 adults with chronic pain completed an interdisciplinary pain rehabilitation program. Measures of pain, pain interference, health‐related quality of life, anxiety, depressed mood, insomnia, pain catastrophizing, pain acceptance, and pain self‐efficacy were completed at admission and discharge. Data were also collected on demographic and clinical variables, including opioid use. Results Results indicated significant changes in all measures at program discharge compared to admission. Opioid doses were also reduced. Results of within‐subjects meditational analyses indicated that pain catastrophizing accounted for a significant portion of the treatment effect for pain severity, pain interference, and depressed mood. Pain acceptance was a mediator for change in depressed mood, whereas pain self‐efficacy was a mediator for pain interference outcomes. Conclusions This study supports a 10‐week, ACT ‐based treatment model for interdisciplinary chronic pain rehabilitation. In addition, pain catastrophizing, pain acceptance, and pain self‐efficacy were each found to be mechanisms by which individuals achieve successful treatment outcomes. This research provides further support for interdisciplinary rehabilitation approaches for chronic pain.