Problem Area: Chronic or Persistent Pain
Treatment: Acceptance and Commitment Therapy for Chronic Pain
EST Status: Strong Research SupportStrong: Support from two well-designed studies conducted by independent investigators.
Modest: Support from one well-designed study or several adequately designed studies.
Controversial: Conflicting results, or claims regarding mechanisms are unsupported.
- Basic premise: By accepting and learning to live with pain, one can limit the control it exerts over his or her life.
- Essence of therapy: This therapy guides individuals to change their expectations from the elimination of pain to living as well as possible with pain. Through metaphors and experiential exercises, individuals learn the futility of control-oriented strategies and the benefits of acceptance-oriented strategies in response to negative internal experiences such as pain and discomfort. Individuals are encouraged to explore their personal values and set goals consistent with those values in order to improve overall quality of life and functioning.
- Length: approx. 8 sessions
Editors: Evan Forman, PhD; Joanna Kaye, BA
Note: The resources provided below are intended to supplement not replace foundational training in mental health treatment and evidence-based practice
Treatment Manuals / Outlines
- Life with Chronic Pain: Therapist Guide & Patient Workbook (Vowles & Sorrell)
- Acceptance and Commitment Therapy in the Treatment of Chronic Pain (Dahl & Lundgren; explanation and session example)
- ACT for Chronic Pain (McCracken)
Books Available for Purchase Through External Sites
- Acceptance and Commitment Therapy for Chronic Pain (Dahl et al.)
Measures, Handouts and Worksheets
- Valued Living Questionnaire
- Chronic Pain Values Inventory
- Chronic Pain Acceptance Questionnaire-Revised
- Psychological Inflexibility in Pain Scale
- Committed Action Questionnaire-18
- Committed Action Questionnaire-8
- Committed Action Questionnaire-8 with scoring instructions
- Living Beyond your Pain: Using Acceptance and Commitment Therapy to Ease Chronic Pain (Dahl, Lundgren, & Hayes)
Important Note: The books listed above are based on empirically-supported in-person treatments. They have not necessarily been evaluated empirically either by themselves or in conjunction with in-person treatment. We list them as a resource for clinicians who assign them as an adjunct to conducting in-person treatment.
- ACT Companion: The Happiness Trap App with Dr. Russ Harris (Berrick Psychology)
- A randomized, controlled trial of acceptance and commitment therapy and cognitive-behavioral therapy for chronic pain (Wetherell et al., 2011)
- Acceptance and commitment therapy and the treatment of persons at risk for long-term disability resulting from stress and pain symptoms: A preliminary randomized trial (Dahl, Wilson, & Nilsson, 2004)
- Acceptance-based treatment for persons with complex, long standing chronic pain: A preliminary analysis of treatment outcome in comparison to a waiting phase (McCracken, Vowles, & Eccleston, 2005)
- Acceptance and values-based action in chronic pain: A study of treatment effectiveness and process (Vowles & McCracken, 2008)
- Targeting acceptance, mindfulness, and values-based action in chronic pain: Findings of two preliminary trials of an outpatient group-based intervention (Vowles, Wetherell, & Sorrell, 2009)
- 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 (McCracken, Sato, & Taylor, 2013)
Meta-analyses and Systematic Reviews
- Acceptance-based interventions for the treatment of chronic pain: A systematic review and meta-analysis (Veehof et al., 2011)
Other Treatment Resources
- Comparison between an acceptance-based and a cognitive-control-based protocol for coping with pain (Gutiérrez et al., 2004)
- Acceptance and Commitment Therapy and Chronic Pain presentation (McCracken)
- A prospective analysis of pain and values-based action in patients with chronic pain (McCracken & Vowles, 2008)
- Patient functioning and catastrophizing in chronic pain: The mediating effects of acceptance (Vowles, McCracken, & Eccleston, 2008)
- The role of values in a contextual cognitive-behavioral approach to chronic pain (McCracken & Yang, 2006)
- Committed action: An application of the psychological flexibility model to activity patterns in chronic pain (McCracken, 2013)
- Further development in the assessment of psychological flexibility: A shortened Committed Action Questionnaire (CAQ-8; McCracken, Chilcot, & Norton, 2014)