Acceptance and commitment therapy for fibromyalgia: A randomized controlled trial

Abstract

Background Recent developments within cognitive behavior therapy (CBT) have emphasized the utility of acceptance and mindfulness strategies, contrasting interventions focused on reduction or control of symptoms. A study of fMRI changes after CBT in females with fibromyalgia (FM) has been performed and results are presented elsewhere (under review). The aim of the present study was evaluate the effectiveness of Acceptance and Commitment Therapy (ACT)-based intervention for patient diagnosed with FM in comparison with a wait-list control Method Female patients aged 18–55 years, fulfilling the American College of Rheumatology classification criteria for FM, and with a weekly self-reported average pain intensity of >40 (VAS 0–100) were considered eligible for inclusion. Participants completed a set of questionnaires prior to treatment, immediately following the treatment and at follow 3–4 months post treatment. Primary outcome variable was pain disability (PDI). FIQ, SF36, SES, STAI, pain intensity, BDI, PIPS (psychological inflexibility in pain scale) were also used. The ACT-intervention consisted of twelve weekly group sessions, ten with psychologist and two with pain physician. Treatment was evaluated and mediation analyses were performed. Results Primary outcome measure (PDI): A significant improvement in pain disability for ACT in relation to the control condition, p < 0.001. Secondary outcome measures: ACT showed significant improvement in mental health quality of life, self-efficacy, depression, and anxiety. Consistent with hypotheses, ACT did not result in significant changes in either physical quality of life or pain intensity. Mediation analyses: A decrease in psychological inflexibility from pre to post assessments significantly mediated the improvement in pain disability. Conclusion The present study supports the utility of using a relatively brief ACT intervention in a group format for women diagnosed with fibromyalgia, and data suggests a mediating function on improvements in psychological flexibility.

Alliance Rupture Detection and Repair in Group Therapy: Using the Group Questionnaire--GQ

“…Thus, they cannot speak to the continuous assessment being advocated herein. Nevertheless, with the increased use of MBC, there is a small but growing number of published studies (Burlingame, Whitcomb, et al, 2018;Gallagher et al, 2014;Hornsey et al, 2012;Illing et al, 2011;Lo Coco et al, 2012;Norton & Kazantzis, 2016;Obeid et al, 2018;Olsson et al, 2012;Tasca et al, 2013) that use repeated assessment of both outcome and group process. Two of these studies (Burlingame, Whitcomb, et al, 2018;Obeid et al, 2018) continuously assessed both the therapeutic relationship and outcome on a session x session basis, finding that positive change in the therapeutic relationship predicted outcome improvement.…”