The efficacy of a clustered group-based acceptance and commitment therapy for patients with chronic pain — a randomized controlled semi-crossover trial

Purpose The efficacy of Acceptance and Commitment Therapy (ACT) for chronic pain when provided as weekly sessions, is well documented. In scarcely populated areas, the traveling distance may be a barrier to weekly attendance. This study aimed to test the efficacy of a group-based ACT intervention, c...

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Main Authors: Lena Danielsson, Svein Bergvik, Are Hugo Pripp, Gunnvald Kvarstein
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Canadian Journal of Pain
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Online Access:https://www.tandfonline.com/doi/10.1080/24740527.2025.2515106
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author Lena Danielsson
Svein Bergvik
Are Hugo Pripp
Gunnvald Kvarstein
author_facet Lena Danielsson
Svein Bergvik
Are Hugo Pripp
Gunnvald Kvarstein
author_sort Lena Danielsson
collection DOAJ
description Purpose The efficacy of Acceptance and Commitment Therapy (ACT) for chronic pain when provided as weekly sessions, is well documented. In scarcely populated areas, the traveling distance may be a barrier to weekly attendance. This study aimed to test the efficacy of a group-based ACT intervention, clustered into three bouts of three consecutive days, separated by 4 weeks.Patients and methods A total of 122 patients, recruited from a university hospital pain clinic, were randomized to either a clustered ACT or Treatment As Usual (TAU) provided by the primary health care services. The study had a semi-crossover design. Group effects of ACT versus TAU were assessed 3 months after the start of ACT by using linear mixed models for repeated measures. Outcome measures included pain intensity, health-related quality of life, pain acceptance, catastrophizing, and psychological distress.Results A total of 81 patients completed the ACT intervention. No statistically significant effects were observed on the primary outcome variables, pain intensity and health-related quality of life. Significant group differences in favor of ACT were detected in pain acceptance (modified Cohen`s d = 0.32), including pain willingness (modified Cohen`s d = 0.30) and activity engagement (modified Cohen`s d = 0.23). The treatment effect remained at the 6- and 12-month follow-ups with a trend toward improvement.Conclusion A group-based ACT for chronic pain clustered into 3-day bouts may strengthen pain acceptance processes, including pain willingness and activity engagement. Reasons why the intervention did not affect pain intensity and health-related quality of life are discussed.
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spelling doaj-art-e7121df9a1d048ada4ee9b0ca0507f002025-08-20T03:16:01ZengTaylor & Francis GroupCanadian Journal of Pain2474-05272025-12-019110.1080/24740527.2025.2515106The efficacy of a clustered group-based acceptance and commitment therapy for patients with chronic pain — a randomized controlled semi-crossover trialLena Danielsson0Svein Bergvik1Are Hugo Pripp2Gunnvald Kvarstein3Department of Pain Management, Division of Surgical Medicine and Intensive Care, University Hospital of North Norway, Tromsø, NorwayDepartment of Psychology, UiT the Arctic University of Norway, Tromsø, NorwayOslo Centre of Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, NorwayDepartment of Pain Management, Division of Surgical Medicine and Intensive Care, University Hospital of North Norway, Tromsø, NorwayPurpose The efficacy of Acceptance and Commitment Therapy (ACT) for chronic pain when provided as weekly sessions, is well documented. In scarcely populated areas, the traveling distance may be a barrier to weekly attendance. This study aimed to test the efficacy of a group-based ACT intervention, clustered into three bouts of three consecutive days, separated by 4 weeks.Patients and methods A total of 122 patients, recruited from a university hospital pain clinic, were randomized to either a clustered ACT or Treatment As Usual (TAU) provided by the primary health care services. The study had a semi-crossover design. Group effects of ACT versus TAU were assessed 3 months after the start of ACT by using linear mixed models for repeated measures. Outcome measures included pain intensity, health-related quality of life, pain acceptance, catastrophizing, and psychological distress.Results A total of 81 patients completed the ACT intervention. No statistically significant effects were observed on the primary outcome variables, pain intensity and health-related quality of life. Significant group differences in favor of ACT were detected in pain acceptance (modified Cohen`s d = 0.32), including pain willingness (modified Cohen`s d = 0.30) and activity engagement (modified Cohen`s d = 0.23). The treatment effect remained at the 6- and 12-month follow-ups with a trend toward improvement.Conclusion A group-based ACT for chronic pain clustered into 3-day bouts may strengthen pain acceptance processes, including pain willingness and activity engagement. Reasons why the intervention did not affect pain intensity and health-related quality of life are discussed.https://www.tandfonline.com/doi/10.1080/24740527.2025.2515106Acceptance and commitment therapychronic paingroup interventionclustered interventionrandomized control trialSemi-crossover design
spellingShingle Lena Danielsson
Svein Bergvik
Are Hugo Pripp
Gunnvald Kvarstein
The efficacy of a clustered group-based acceptance and commitment therapy for patients with chronic pain — a randomized controlled semi-crossover trial
Canadian Journal of Pain
Acceptance and commitment therapy
chronic pain
group intervention
clustered intervention
randomized control trial
Semi-crossover design
title The efficacy of a clustered group-based acceptance and commitment therapy for patients with chronic pain — a randomized controlled semi-crossover trial
title_full The efficacy of a clustered group-based acceptance and commitment therapy for patients with chronic pain — a randomized controlled semi-crossover trial
title_fullStr The efficacy of a clustered group-based acceptance and commitment therapy for patients with chronic pain — a randomized controlled semi-crossover trial
title_full_unstemmed The efficacy of a clustered group-based acceptance and commitment therapy for patients with chronic pain — a randomized controlled semi-crossover trial
title_short The efficacy of a clustered group-based acceptance and commitment therapy for patients with chronic pain — a randomized controlled semi-crossover trial
title_sort efficacy of a clustered group based acceptance and commitment therapy for patients with chronic pain a randomized controlled semi crossover trial
topic Acceptance and commitment therapy
chronic pain
group intervention
clustered intervention
randomized control trial
Semi-crossover design
url https://www.tandfonline.com/doi/10.1080/24740527.2025.2515106
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