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Efficacy and Cost-effectiveness of Acceptance and Commitment Therapy and Applied Relaxation for Longstanding Pain A Randomized Controlled Trial
Karolinska University Hospital, Sweden; Karolinska Institute, Sweden.
Karolinska University Hospital, Sweden; Karolinska Institute, Sweden.
Karolinska Institute, Sweden; Stockholm University, Sweden.
Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
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2015 (English)In: The Clinical Journal of Pain, ISSN 0749-8047, E-ISSN 1536-5409, Vol. 31, no 11, 1004-1016 p.Article in journal (Refereed) Published
Abstract [en]

Background and Objectives:To date, few studies have compared Acceptance and Commitment Therapy (ACT) for longstanding pain with established treatments. Only 1 study has evaluated the cost-effectiveness of ACT. The aim of the current study was to evaluate the efficacy and cost-effectiveness of ACT and applied relaxation (AR) for adults with unspecific, longstanding pain.Materials and Methods:On the basis of the inclusion criteria 60 consecutive patients received 12 weekly group sessions of ACT or AR. Data were collected pretreatment, midtreatment, and posttreatment, as well as at 3- and 6-month follow-up. Growth curve modeling was used to analyze treatment effects on pain disability, pain intensity, health-related quality of life (physical domain), anxiety, depression, and acceptance.Results:Significant improvements were seen across conditions (pretreatment to follow-up assessment) on all outcome measures. Pain disability decreased significantly in ACT relative to AR from preassessment to postassessment. A corresponding decrease in pain disability was seen in AR between postassessment and 6-month follow-up. Pain acceptance increased only in ACT, and this effect was maintained at 6-month follow-up. Approximately 20% of the participants achieved clinically significant change after treatment. Health economic analyses showed that ACT was more cost-effective than AR at post and 3-month follow-up assessment, but not at 6-month follow-up.Discussion:More studies investigating moderators and mediators of change are needed. The present study is one of few that have evaluated the cost-effectiveness of ACT and AR and compared ACT with an established behavioral intervention, and the results provide additional support for behavioral interventions for longstanding pain.

Place, publisher, year, edition, pages
LIPPINCOTT WILLIAMS and WILKINS , 2015. Vol. 31, no 11, 1004-1016 p.
Keyword [en]
acceptance and commitment therapy (ACT); applied relaxation (AR); chronic pain; cost-effectiveness
National Category
Basic Medicine
Identifiers
URN: urn:nbn:se:liu:diva-123065DOI: 10.1097/AJP.0000000000000203ISI: 000364089900010PubMedID: 25585272OAI: oai:DiVA.org:liu-123065DiVA: diva2:876595
Note

Funding Agencies|Department of Psychology at the Karolinska University Hospital, Stockholm, Sweden

Available from: 2015-12-04 Created: 2015-12-03 Last updated: 2015-12-04

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