New generation psychological treatments in chronic pain

Article


McCracken, L., Yu, L. and Vowles, K. 2022. New generation psychological treatments in chronic pain. British Medical Journal. 376. https://doi.org/10.1136/bmj-2021-057212
TypeArticle
TitleNew generation psychological treatments in chronic pain
AuthorsMcCracken, L., Yu, L. and Vowles, K.
Abstract

Chronic pain conditions are common and have a considerable impact on health and wellbeing. This impact can be reduced by cognitive behavioral therapy (CBT), the most commonly applied
psychological approach to chronic pain. At the same time, CBT continues to develop, and now includes what is sometimes called “third wave” CBT. In this review, we examine the evidence for application of acceptance and commitment therapy (ACT), a principal example of this new wave or latest generation of treatment approaches, in people with chronic pain.

We identified 25 randomized controlled trials of ACT for adults with chronic pain. Across the included trials, small to large effect sizes favoring ACT were reported for key outcomes including pain interference, disability, depression, and quality of life. Evidence from three studies provided some support for the cost effectiveness of ACT for chronic pain. Evidence also supported the mediating role of theoretically consistent processes of change (psychological flexibility) in relation to treatment outcomes. Investigation of moderators and predictors of outcomes was limited and inconsistent.

In future, a greater focus on process based treatments is recommended. This should include continued identification of evidence based processes of change, and research methods more suited to understanding the experience and needs of individual people.

Sustainable Development Goals3 Good health and well-being
Middlesex University ThemeHealth & Wellbeing
PublisherBMJ Publishing Group Ltd
JournalBritish Medical Journal
ISSN0959-535X
Electronic1756-1833
Publication dates
Print28 Feb 2022
Publication process dates
Deposited21 Jun 2024
Output statusPublished
Digital Object Identifier (DOI)https://doi.org/10.1136/bmj-2021-057212
Web of Science identifierWOS:000795903200010
LanguageEnglish
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