Workshop Outline

Chronic pain is a difficult and common problem whether it be the primary problem or secondary to another primary medical or mental health problem.  It is a difficult problem for how overwhelming it can be for the person who experiences it and for those who try to help. The loss, uncertainty, threat, invalidation, and exclusion often experienced by the person with significant chronic pain can provoke strong emotional reactions for them. When we see people with chronic pain as a psychological treatment provider we see fear and avoidance, depression, anger, and also insomnia, health behaviour problems, a deeply disturbed sense of self, unhealthy social circumstances, substance abuse, and more. What’s more is that we see these problems in unique combinations experienced by people who are also entirely unique. Faced with this potential complexity we need a treatment model, methods, and skills that are fit for purpose.  Acceptance and Commitment Therapy (ACT) and the psychological flexibility model provide a pretty good source for these.

The first controlled treatment trial of ACT that involved chronic pain was published in 2004, although it took another 10 years before there were 10 RCTs in total.  By now, 20 years later there are more than 30 RCTs and there are at least 5 meta-analyses devoted exclusively to ACT for chronic pain.  Results show positive outcomes, and still growing. ACT is recommended in national treatment guidelines and widely implemented. The point of this workshop is to very briefly look at ACT as an evidence-based approach that is both generally applicable, and has particular support in the treatment of chronic pain. The main point for most of the workshop is for participants to gain knowledge, learn theory and principles, and develop a set of skills that can be used in practice.

A way to think about Cognitive Behavioral Therapy approaches is that they mainly entail selected sets of methods or components. ACT can be thought about in that way too but this is not the best way to frame it. Delivering ACT is, in most simple terms, a process of determining desired outcomes, finding inflexibility processes that stand in the way of these outcomes, and addressing these with methods that increase flexibility. In this way ACT is inherently a prototype “process-based” therapy.  This workshop will define what this means and help participants develop ways to do this with the facets of psychological flexibility as the base.