ACT includes aspects of mindfulness therapy and cognitive behavioral therapy. Both Drs. Meyer and Samsi have had success in getting patients to separate suffering from pain.
“The results of treatment often surprise people,” Dr. Samsi said, describing an exercise in which patients are asked to write down their greatest pain-related fears and then hold the paper up close to their face. “At that distance, it is the only thing they can see. As they move the paper away from their faces, they begin to see the rest of the room. That is what ACT is, getting some distance from the pain.”
The VHA study findings reinforce the importance of chronic pain acceptance, and suggest that ACT may be a promising technique for pain management. The authors would like to see larger studies using ACT to treat conditions such as PTSD and substance abuse along with pain. Future research may also reveal more about how the findings from these trauma-exposed veterans may relate to the general population of people with chronic pain and other comorbid conditions.1
ACT in Primary Care
“Primary care providers could measure chronic pain acceptance using the [CPAQ] questionnaire. There are 20 brief questions with good predictive validity. Patients who are struggling with pain and acceptance could benefit from a referral for ACT from an experienced mental health provider,” Dr. Meyer suggested, recommending https://contextualscience.org/ as a resource for finding certified ACT therapists.
“Chronic pain acceptance can be learned, and it can help. ACT is an evidenced-based treatment that is time-limited and has broad support in the literature. Primary care providers should know about it, and consider referring patients for ACT if they are struggling with chronic pain,” Dr. Samsi concluded.
1. Behav Res Ther. 2015 Oct;73:25-32. doi: 10.1016/j.brat.2015.07.003. Epub 2015 Jul 15.
2. European Journal of Pain, General psychological acceptance and chronic pain: There is more to accept than the pain itself, http://www.ednf.org/images/stories/pdfs_medical/2009_09/2009_McCracken_European-Journal-of-Pain.pdf