Acceptance and commitment therapy

Acceptance and commitment therapy (ACT) is a psychological treatment for chronic neuropathic pain that does not seek to eliminate the pain itself, but rather to help patients live full and meaningful lives in the context of its presence. It helps to change the patient's relationship with their pain and develop skills and tools to cope with it in a more adaptive and functional way.

Acceptance and Commitment Therapy (ACT) is part of the contextual or third-generation psychological therapies focused on achieving what is called "Psychological Flexibility." This approach, in the context of chronic neuropathic pain, seeks to be able to manage and regulate the impact of pain on their daily lives. Rather than focusing on eliminating or controlling pain itself, therapy helps develop skills to live a full and meaningful life in the presence of persistent pain.

Clinical studies have supported the effectiveness of Acceptance and Commitment Therapy for chronic pain, being recognized by the American Psychological Association (APA) as an evidence-based treatment for coping with this type of pain. In addition, the NICE 2021 guideline for addressing chronic pain in adults recommends it as a treatment.

Acceptance and Commitment Therapy has proven to be effective in a wide variety of types of pain and application formats, reducing the intensity of pain, its interference with daily activities, depression, and anxiety, and improving quality of life.

Therapy focuses on:

  • Acceptance: Helps patients accept the presence of pain and other difficult private experiences without trying to avoid or control them. This involves learning to be present in the current moment and allowing painful sensations to coexist with other life experiences.
  • Defining Values: Helps patients identify and commit to personal values ​​that are important to them. This allows them to direct their actions toward goals and activities that are meaningful and satisfying in the presence of pain.
  • Mindfulness: Mindfulness is an integral part of ACT and is used to help patients develop full awareness of the present moment, including the physical sensations associated with pain, without automatically judging or reacting to them.
  • Committed Action: Patients learn, practice, and experience the favorable and useful consequences of carrying out activities and behaviors that give meaning to life in accordance with their personal values, even when they experience pain. This may involve measuring daily activities, setting clear limits, and practicing self-compassion.

Existing studies indicate that people with greater acceptance of pain report having less pain, less anxiety, less depression, less disability, a higher level of activity, and a better quality of life.

Acceptance and Commitment Therapy at Hospital del Mar

The ACT Therapy program is carried out in the Pain Unit and the Neuromodulation Unit of the Hospital del Mar, both online and in person. It consists of 10 sessions, each lasting 2 hours, with a frequency of one session per week. Up to 15 people can participate in each group.

Another possible modality is individual sessions before and after the intervention for patients who are going to be treated with invasive neuromodulation, with an individualized adapted program.