Interdisciplinary Musculoskeletal Pain Assessment and Community Treatment Service, Haywood Hospital, Stoke-on-Trent PCT, Burslem, Stoke-on-Trent, UK.
Behav Res Ther. 2011 Nov;49(11):748-55. doi: 10.1016/j.brat.2011.08.002. Epub 2011 Aug 16.
Recent developments in CBT emphasize the promotion of psychological flexibility to improve daily functioning for people with a wide range of health conditions. In particular, one of these approaches, Acceptance and Commitment Therapy (ACT), has been studied for treatment of chronic pain. While trials have provided good support for treatment effectiveness through follow-ups of as long as seven months, the longer-term impact is not known. The present study of 108 participants with chronic pain examined outcomes three years after treatment completion and included analyses of two key treatment processes, acceptance of pain and values-based action. Overall, results indicated significant improvements in emotional and physical functioning relative to the start of treatment, as well as good maintenance of treatment gains relative to an earlier follow-up assessment. Effect size statistics were generally medium or large. At the three-year follow-up, 64.8% of patients had reliably improved in at least one key domain. Improvements in acceptance of pain and values-based action were associated with improvements in outcome measures. A "treatment responder" analysis, using variables collected at pre-treatment and shorter term follow-up, failed to identify any salient predictors of response. This study adds to the growing literature supporting the effectiveness of ACT for chronic pain and yields evidence for both statistical and clinical significance of improvements over a three-year period.
最近 CBT 的发展强调了促进心理灵活性，以改善各种健康状况人群的日常功能。特别是，这些方法之一，接受与承诺疗法（ACT），已经被用于治疗慢性疼痛。虽然试验通过长达七个月的随访为治疗效果提供了很好的支持，但长期影响尚不清楚。本研究对 108 名慢性疼痛患者进行了治疗完成三年后的随访，分析了两个关键的治疗过程，即对疼痛的接受和基于价值的行动。总体而言，结果表明与治疗开始相比，在情感和身体功能方面有显著改善，与早期随访评估相比，治疗效果也得到了很好的维持。效果大小统计数据通常为中等或较大。在三年的随访中，至少有一个关键领域有 64.8%的患者得到了可靠改善。对疼痛和基于价值的行动的接受程度的改善与结果测量的改善相关。使用治疗前和短期随访收集的变量进行的“治疗反应者”分析未能确定任何显著的反应预测因素。这项研究增加了支持 ACT 治疗慢性疼痛有效性的文献，并为三年内的统计学和临床意义的改善提供了证据。
