Acceptance and Values-Based Treatment of Adolescents With Chronic Pain: Outcomes and Their Relationship to Acceptance

• Published in: Journal of pediatric psychology Vol. 38; no. 1; pp. 72 - 81
• Main Authors: Gauntlett-Gilbert, Jeremy, Connell, Hannah, Clinch, Jacqui, McCracken, Lance M.
• Format: Journal Article
• Language: English
• Published: Atlanta, GA Oxford University Press 01.01.2013
• Subjects: Activities of Daily Living - psychology; Adaptation, Psychological; Adolescent; Adult and adolescent clinical studies; Anxiety - psychology; Behavior; Behavior therapy. Cognitive therapy; Biological and medical sciences; Catastrophization - psychology; Child; Child clinical studies; Chronic Pain - psychology; Chronic Pain - therapy; Depression; Female; Humans; Male; Medical sciences; Mood disorders; Pain Management; Pain Measurement; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychotherapy - methods; Surveys and Questionnaires; Treatment Outcome; Treatments; Young Adult; Human; Mood disorder; Handicap; Acceptance; Cognitive therapy; chronic pain; adolescents; Depression; cognitive-behavioral therapy; School attendance; Disability; Chronic; Pain; Treatment; Adolescent; Value; Behavior therapy
• ISSN: 0146-8693; 1465-735X; 1465-735X
• DOI: 10.1093/jpepsy/jss098

Psychological treatments for pediatric chronic pain are moderately effective. However, there have been few studies of the psychological processes associated with treatment response. This study examines the effects of Acceptance and Commitment Therapy (ACT) treatment on a severely disabled group of adolescents with chronic pain, examining relationships between outcome and acceptance. 98 adolescents with pain, mean age 15.6 years, underwent an uncontrolled trial of 3-week residential ACT treatment. Adolescents improved in self-reported functioning and objective physical performance at 3-month follow-up. They were less anxious and catastrophic, attended school more regularly, and used health care facilities less often. Most positive treatment outcomes were associated with improvements in acceptance. An intensive ACT-based pain rehabilitation course was an effective treatment for disabled adolescents with chronic pain. Its results were theoretically consistent--improvements were associated with changes in acceptance and were achieved without pain control or cognitive restructuring techniques.