New generation psychological treatments in chronic pain | The BMJ

A recent article in the British Medical Journal reviewed the latest evidence for the effectiveness of Acceptance and Commitment Therapy in chronic pain.


They reported favourable outcomes, saying,

“Chronic pain conditions are common and have a considerable impact on health and wellbeing. This impact can be reduced by cognitive behavioural 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 favouring 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”

Further, they commented,

“ACT is essentially a form of CBT that focuses on enhancing psychological flexibility as a process of change to produce outcomes. Psychological flexibility is a combination of acceptance, awareness, and behaviour change processes. It is the ability to be clear in, guided by, and persistent in taking action toward one’s goals and values, and aware of or sensitive to situations as they occur, without unproductive resistance or being dominated by feelings or thoughts. The psychological flexibility model has six inter-related processes or facets that can be represented as continuums ranging from inflexible to flexible, can be targeted separately, and combine to form the one unifying whole.”


At, we have a comprehensive guided program which deals with all aspects of how acceptance and commitment therapy can be applied to chronic pain.