The mediating role of acceptance in multidisciplinary cognitive behavioral therapy for chronic pain
| Autor: | Marcelo Rivano Fischer, Sophia Åkerblom, Lance M. McCracken, Sean Perrin |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Mediation (statistics) Psychotherapist Adolescent multilevel structural equation modeling medicine.medical_treatment Mediation Acceptance Psychological Flexibility CBT Pain Acceptance and commitment therapy Structural equation modeling Young Adult Social support Surveys and Questionnaires medicine Humans Pain Measurement Retrospective Studies Cognitive Behavioral Therapy Depression business.industry Mechanism (biology) Chronic pain Flexibility (personality) Middle Aged medicine.disease Acceptance and commitment therapy (ACT) Cognitive behavioral therapy cognitive behavioural therapy (CBT) Treatment Outcome Anesthesiology and Pain Medicine Neurology Female Neurology (clinical) Chronic Pain business chronic pain mediator Clinical psychology acceptance |
| Zdroj: | Åkerblom, S, Perrin, S, Rivano Fischer, M & McCracken, L 2015, ' The mediating role of acceptance in multidisciplinary cognitive behavioral therapy for chronic pain ', JOURNAL OF PAIN, vol. 16, no. 7, 3066, pp. 606-615 . https://doi.org/10.1016/j.jpain.2015.03.007 Journal of Pain; 16(7), pp 606-615 (2015) |
| ISSN: | 1526-5900 |
| DOI: | 10.1016/j.jpain.2015.03.007 |
| Popis: | Cognitive Behavioral Therapy (CBT) is the most frequently delivered psychological intervention for adults with chronic pain. The treatment yields modest effect sizes and the mechanisms of action remain understudied and unclear. Efforts are needed to identify treatment mediators that could be used to refine CBT and improve outcomes. The primary aim of this study is to investigate whether pain-related acceptance, from the psychological flexibility model, mediates changes in outcome over time in a CBT-based treatment program. This includes comparing how this variable relates to three other variables posited as potential mediators in standard CBT: life-control, affective distress, and social support. Participants attended a five-week outpatient multidisciplinary program with self-report data collected at assessment, post-treatment, and at 12-month follow-up. Multilevel structural equation modeling was used to test for mediation in relation to three outcomes: pain interference, pain intensity, and depression. Results indicate that effect sizes for the treatment were within the ranges reported in the CBT for pain literature. Pain-related acceptance was not related to pain intensity, which is in line with past empirical evidence and the treatment objectives in Acceptance and Commitment Therapy (ACT). Otherwise, pain-related acceptance was the strongest mediator across the different indices of outcome. Accumulating results like these suggest that acceptance of pain may be a general mechanism by which CBT-based treatments achieve improvements in functioning. More specific targeting of pain-related acceptance in treatment may lead to further improvements in outcome. Potential mediators of outcome in a CBT-based treatment for adult chronic pain were investigated using multilevel structural equation modeling. The results highlight the role of pain-related acceptance as an important treatment process even when not explicitly targeted during treatment. These data may help clinicians and researchers better understand processes of change and improve the choice and development of treatment methods. |
| Databáze: | OpenAIRE |
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