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The Effectiveness of an Acceptance and Commitment Therapy Self-help Intervention for Chronic Pain

Johnston, Marnie MSocSci/PGDip Clin Psych*; Foster, Mary PhD*; Shennan, Jeannette MSocSci/PGDip Clin Psych; Starkey, Nicola J. PhD*; Johnson, Anders MD, PhD

The Clinical Journal of Pain: June 2010 - Volume 26 - Issue 5 - p 393-402
doi: 10.1097/AJP.0b013e3181cf59ce
Original Articles

Objective To evaluate the effectiveness of an Acceptance Commitment Therapy based self-help book for people with chronic pain.

Method This was a randomized 2 group study design. Over a 6-week period, 6 participants read the self-help book and completed exercises from it with weekly telephone support whereas 8 others formed a wait-list control group. Subsequently, 5 of the wait-list participants completed the intervention. Participants completed preintervention and postintervention questionnaires for acceptance, values illness, quality of life, satisfaction with life, depression, anxiety, and pain. Initial outcome data were collected for 8 control participants and 6 intervention participants. Including the wait-list controls, a total of 11 participants completed preintervention and postintervention measures. Whilst completing the self-help intervention, each week participants' rated the content of the book according to reading level and usefulness, and their comprehension of the content was also assessed.

Results Compared with controls, participants who completed the book showed improved quality of life and decreased anxiety. When data from all the treatment participants were pooled, those who completed the intervention showed statistically significant improvements (with large effect sizes) for acceptance, quality of life, satisfaction with life, and values illness. Medium effect sizes were found for improvements in pain ratings.

Conclusions These findings support the hypothesis that using the self-help book, with minimal therapist contact adds value to the lives of people who experience chronic pain.

*Department of Psychology, Faculty of Arts and Social Sciences, The University of Waikato

Waikato Hospital Pain Clinic, Waikato District Health Board, Private Bag, Hamilton, New Zealand

Reprints: Nicola J. Starkey, PhD, Department of Psychology, Faculty of Arts and Social Sciences, The University of Waikato, Private Bag, Hamilton, New Zealand (e-mail:

Received for publication September 17, 2009; revised October 22, 2009; accepted November 29, 2009

© 2010 Lippincott Williams & Wilkins, Inc.