Guided Internet-delivered Acceptance and Commitment Therapy for Chronic Pain Patients - Full Text View

Purpose

The aim of this study was to investigate if guided internet-delivered acceptance and commitment therapy (ACT)would help chronic pain patients.

Condition	Intervention
Chronic Pain	Behavioral: Guided internet-delivered acceptance and commitment therapy


Study Type:	Interventional
Study Design:	Allocation: Randomized Intervention Model: Parallel Assignment Masking: None (Open Label) Primary Purpose: Treatment
Official Title:	Guided Internet-delivered Acceptance and Commitment Therapy for Chronic Pain Patients: a Randomized Controlled Trial

Resource links provided by NLM:

MedlinePlus related topics: Chronic Pain

U.S. FDA Resources

Further study details as provided by Gerhard Andersson, Linkoeping University:

Primary Outcome Measures:

Chronic Pain Acceptance Questionnaire (CPAQ) [ Time Frame: One week pre- and post-treatment ]
CPAQ consists of 20 items divided into two subscales: activity engagement and pain willingness. Items are rated on a scale from 0 (never true) to 6 (always true). Higher scores denote greater activity engagement and pain willingness. Studies show acceptable reliability (α =.72-.92).

Secondary Outcome Measures:

Hospital and Anxiety Depression Scale (HADS) [ Time Frame: One week pre- and post- treatment ]
HADS contains 14 items and evaluates severity of symptoms of depression and anxiety without contamination of scores of physical symptomatology.
The Coping Strategies Questionnaire (CSQ) [ Time Frame: One week pre- and post- treatment ]
The CSQ contains 50 items divided into eight scales measuring different cognitive and behavioural coping strategies and has been widely used by chronic pain patients. The coping strategies scales are: diverting attention, re-interpreting pain sensations, coping self-statements, ignoring sensations, praying and hoping, catastrophizing and increased behavioral activities
Multidimensional Pain Inventory (MPI-S) [ Time Frame: One week pre- and post- treatment ]
The Swedish version of MPI (MPI-S) consists of 34 items divided into 8 scales. The first section addresses: Pain Severity, Interference, Life Control, Affective Distress and Support. The second section addresses the patient's perception of how significant others respond to their displays of pain: Punishing Responses, Solicitous Responses and Distracting Responses.
The Pain and Impairment Relationship Scale (PAIRS) [ Time Frame: One week pre- and post- treatment ]
PAIRS assess beliefs and attitudes associated with the experience of chronic pain and one's ability to function despite pain. It consists of 15 personal statements that reflect thoughts, attitudes and opinions about pain.
Quality of Life Inventory (QOLI) [ Time Frame: One week pre- and post- treatment ]
QOLI consists of 32 items for assessing life satisfaction. The assessment yields an overall score and profile in 16 areas of life; health, self-esteem, goals and values, money, work, play, learning, creativity, helping, love, friends, children, relatives, home, neighborhood, and community.


Enrollment:	76
Study Start Date:	February 2010
Study Completion Date:	December 2010
Primary Completion Date:	May 2010 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Experimental: Internet delivered ACT Internet delivered acceptance and commitment therapy (ACT), 7 weeks treatment	Behavioral: Guided internet-delivered acceptance and commitment therapy The treatment program consisted of seven sections and was based on ACT.The first part was about creative hopelessness and was followed in the next section by an introduction to willingness and to the process of acceptance of pain. Information and assignments about committed action and values were also part of the treatment program. Mindfulness exercises were a regular feature in the program. The last part was about how to maintain learned strategies but also an evaluation of the program.
Active Comparator: Online discussion forum Active wait-list condition. Were offered to participate in a moderated online discussion forum. After post-treatment assessment the control group were offered treatment.	Behavioral: Guided internet-delivered acceptance and commitment therapy The treatment program consisted of seven sections and was based on ACT.The first part was about creative hopelessness and was followed in the next section by an introduction to willingness and to the process of acceptance of pain. Information and assignments about committed action and values were also part of the treatment program. Mindfulness exercises were a regular feature in the program. The last part was about how to maintain learned strategies but also an evaluation of the program.

Arms

Assigned Interventions

Experimental: Internet delivered ACT

Internet delivered acceptance and commitment therapy (ACT), 7 weeks treatment

Behavioral: Guided internet-delivered acceptance and commitment therapy

The treatment program consisted of seven sections and was based on ACT.The first part was about creative hopelessness and was followed in the next section by an introduction to willingness and to the process of acceptance of pain. Information and assignments about committed action and values were also part of the treatment program. Mindfulness exercises were a regular feature in the program. The last part was about how to maintain learned strategies but also an evaluation of the program.

Active Comparator: Online discussion forum

Active wait-list condition. Were offered to participate in a moderated online discussion forum. After post-treatment assessment the control group were offered treatment.

Behavioral: Guided internet-delivered acceptance and commitment therapy

The treatment program consisted of seven sections and was based on ACT.The first part was about creative hopelessness and was followed in the next section by an introduction to willingness and to the process of acceptance of pain. Information and assignments about committed action and values were also part of the treatment program. Mindfulness exercises were a regular feature in the program. The last part was about how to maintain learned strategies but also an evaluation of the program.

Detailed Description:

The present study investigates internet-delivered ACT for persons with chronic pain. The use of internet as a delivery format for interventions could be a way of overcome many barriers (financial obstacles, reluctance to seek treatment and paucity of clinicians trained in ACT) that hinder persons with chronic pain to seek or receive adequate help. Persons were randomized to either treatment for 7 weeks or to a control group who were invited to participate in a moderated online discussion forum. Follow up data was collected six months after the treatment.

Eligibility

Information from the National Library of Medicine

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Ages Eligible for Study:	18 Years and older (Adult, Senior)
Sexes Eligible for Study:	All
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

that participants had undergone medical investigation (within one year)
had regular access to the internet
had functional impairment caused by chronic pain
had internet access

Exclusion Criteria:

ongoing medical investigations or treatment that could interfere with participation in the study, such as planned surgery and suffering from acute physical or psychological conditions
not fluent in the Swedish language

Contacts and Locations

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01603797

Sponsors and Collaborators

Gerhard Andersson

Investigators


Study Director:	Gerhard Andersson, Professor	Linkoeping University
Principal Investigator:	Monica Buhrman, MSc	Uppsala University
Study Chair:	Timo Hursti, PhD	Uppsala University
Study Chair:	Torsten Gordh, Professor	Uppsala University
Study Chair:	Tomas Furmark, Professor	Uppsala University
Study Chair:	Astrid Skoglund, MSc	Uppsala University
Study Chair:	Josefin Husell, MSc	Uppsala University
Study Chair:	Kristina Bergström, MSc	Uppsala University
Study Chair:	Nina Bendelin, MSc	Linkoeping University

More Information


Responsible Party:	Gerhard Andersson, Professor, Linkoeping University
ClinicalTrials.gov Identifier:	NCT01603797 History of Changes
Other Study ID Numbers:	smartaSIAMB_GA
First Submitted:	May 19, 2012
First Posted:	May 22, 2012
Last Update Posted:	October 3, 2012
Last Verified:	October 2012

Keywords provided by Gerhard Andersson, Linkoeping University:


internetdelivered CBT chronic pain acceptance and commitment therapy mindfulness guided self help

Additional relevant MeSH terms:


Chronic Pain Pain Neurologic Manifestations Nervous System Diseases Signs and Symptoms