Treatment for Chronic Pain for Adults in the Seventh and Eighth Decades of Life: A Preliminary Study of Acceptance and Commitment Therapy (ACT)

Objective. The purpose of this study was to examine results for older adults attending treatment based on Acceptance and Commitment Therapy (ACT) for chronic pain. Both clinical outcome and treatment process variables were examined. Subjects. Participants were 40 adults with chronic pain age 60 and older selected from a larger consecutive sample of 470 adults of any age. The mean age for the smaller study sample was 64.3 years, most were women, 62.5%, and they had longstanding (median 171 months) and highly disabling pain. Intervention. The treatment consisted of 3 or 4 weeks of residential treatment delivered by a team of psychologists, physiotherapists, occupational therapists, nurses, and physicians. It was designed to increase daily functioning not by decreasing pain, but by increasing psychological flexibility. This includes the ability to change or persist with behavior in a practical, accepting, open, aware, values-directed, and committed fashion. Results. Participants showed significant improvements in physical disability, psychosocial disability, and depression at posttreatment and at a 3-month follow-up. They also showed significant increases in components of psychological flexibility. In secondary correlation analyses measures of psychological flexibility were significantly correlated with key outcome measures. Conclusion. To our knowledge, this is the first study of ACT for chronic pain specifically looking at older adults, and preliminary results are promising.