Psychological therapy for chronic pain

One of the biggest problems facing healthcare today is the issue of chronic pain. Patients who have tried numerous interventions over the years, but have yet to find adequate pain relief, and they will often present to healthcare providers asking, “What’s next? What can you do for me now?“. Managing chronic pain often requires a multidisciplinary approach as treatment might need to combine medication, physical therapy, occupational therapy, psychological counselling, relaxation techniques, and lifestyle modifications. This can be extremely frustrating for clients who just want to ‘get better’.

How ACT can help manage chronic pain

This is where acceptance and commitment therapy (ACT) can play a vital role. ACT helps reorient people with pain towards the ultimate goals of treatment – reestablishing meaningful living, quality of life, through values-based living or committed action. ACT demonstrates significant benefits for chronic pain, including reductions in pain interference, disability, and depression, as well as improved quality of life. There is also solid evidence to suggest that ACT is at least comparable with more traditional psychotherapies such as CBT, but with stronger support for its specified processes of change. See our ACT for chronic pain – systematic review for more about this.

The difficulty is that when a client presents with chronic pain symptoms, they can often be quite sceptical about how psychological therapy can help them. As such, accelerating your training and understanding of chronic pain can be invaluable. We are pleased to have expert ACT trainer Kevin E Vowles joining us soon for a live online training session: Working with chronic pain: Using acceptance, mindfulness and values

Throughout his career, Kevin has dedicated himself almost exclusively to the field of chronic pain. He has played a pivotal role in developing and adapting acceptance and commitment therapy as a treatment approach for this intricate condition. The American Psychological Association’s Division of Clinical Psychology has cited Kevin’s work, recognising ACT for chronic pain as an intervention supported by extensive research – the highest possible designation.

One of the principal ways that ACT fits into the problem of chronic pain is it helps reorient people with pain a bit towards the ultimate goals of treatment,” Kevin explains. “My hope is that by the end of the 12 hours or so that we spend together, the people who take this workshop will not only have an idea of how to start this with the next person with chronic pain that they see, but also have an understanding of theoretically how the model works to support this patient progress towards that journey.”.

A quick tip to help set targets for a chronic pain client

One of Kevin’s top tips can be seen in our recent ‘expert tip’ video ‘ACT for chronic pain – setting targets’:

To get a sense of potential treatment targets and values-based areas to focus on clinically, he often asks patients a simple question: “If this treatment worked for you and things were back on track in your life, what would I see you doing on a day when treatment was working?”

The responses typically reveal discrete behavioural events related to the patient’s relationships, responsibilities, and activities that they are missing due to their illness. In the example  Kevin provides, the client wanted to spend time with his wife, get up in the morning, make her a cup of coffee, help get his children off to school and then do something useful like mowing the lawn or doing the dishes. From this, Kevin explains how he can deduce some of the clients broad values domains. He reflects back to him, “so it sounds like your relationship with your wife, your relationship with your kids, taking care of them and also kind of doing some productive activity around the home matters to you”. This can then become the signposts that both Kevin and the patient can check in on throughout their treatment process to gauge if intervention is truly working.

By reorienting chronic pain patients towards values-based living and committed action, ACT can help these individuals regain a sense of purpose and quality of life, despite the persistent nature of their physical discomfort. This integrated approach to pain management represents a key step forward in addressing one of the most prevalent and challenging problems in modern healthcare.

Upcoming live training

Working with chronic pain featured image
12 hours (12 CE credits)
Working with chronic pain

Kevin E Vowles, PhD

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ACT for relationships featured image
3 hours (3 CE credits)
ACT for relationships

Dr Russ Harris

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Mastering ACT featured image
Two 3 hour sessions (6 CE credits)
Mastering ACT

Robyn Walser

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