Vowles Kevin E, McCracken Lance M
Centre for Pain Research, School for Health, University of Bath.
J Consult Clin Psychol. 2008 Jun;76(3):397-407. doi: 10.1037/0022-006X.76.3.397.
Developing approaches within cognitive behavioral therapy are increasingly process-oriented and based on a functional and contextual framework that differs from the focus of earlier work. The present study investigated the effectiveness of acceptance and commitment therapy (S. C. Hayes, K. Strosahl, & K. G. Wilson, 1999) in the treatment of chronic pain and also examined 2 processes from this model, acceptance and values-based action. Participants included 171 completers of an interdisciplinary treatment program, 66.7% of whom completed a 3-month follow-up assessment as well. Results indicated significant improvements for pain, depression, pain-related anxiety, disability, medical visits, work status, and physical performance. Effect size statistics were uniformly medium or larger. According to reliable change analyses, 75.4% of patients demonstrated improvement in at least one key domain. Both acceptance of pain and values-based action improved, and increases in these processes were associated with improvements in the primary outcome domains.
认知行为疗法中不断发展的方法越来越以过程为导向，且基于一个与早期工作重点不同的功能和情境框架。本研究调查了接纳与承诺疗法（S.C.海斯、K.斯特罗萨尔和K.G.威尔逊，1999年）在治疗慢性疼痛方面的有效性，同时还检验了该模型中的两个过程，即接纳和基于价值观的行动。参与者包括171名跨学科治疗项目的完成者，其中66.7%的人还完成了为期3个月的随访评估。结果表明，在疼痛、抑郁、与疼痛相关的焦虑、残疾、就诊次数、工作状态和身体表现方面有显著改善。效应量统计结果均为中等或更大。根据可靠变化分析，75.4%的患者在至少一个关键领域有改善。对疼痛的接纳和基于价值观的行动都有所改善，这些过程的增加与主要结果领域的改善相关。
