A comparative study of 2 manual-based self-help interventions, acceptance and commitment therapy and applied relaxation, for persons with chronic pain

Clin J Pain. 2011 Oct;27(8):716-23. doi: 10.1097/AJP.0b013e318219a933.


Objective: The aim of this study was to compare 2 self-help-based interventions; a coping-oriented approach, applied relaxation (AR) and an acceptance-oriented approach, acceptance and commitment therapy (ACT), for persons with chronic pain.

Method: This study is a randomized control trial (N=90) with a mixed between-within participants design with repeated measures. Interventions in both conditions comprised an initial face-to-face session, a 7-week manual-based self-help intervention including weekly therapist telephone support and a concluding face-to-face session. Outcome measures included satisfaction with life, depression, anxiety, acceptance of chronic pain, level of function, and pain intensity. Effects were measured at preintervention and postintervention and at 6 and 12 months after the end of intervention.

Results: The results show that the ACT condition increased their level of acceptance significantly compared with the AR condition. There was also a marginally significant interaction effect regarding satisfaction with life in which the ACT condition had improved in comparison to the AR condition. Further, the ACT condition reported a higher level of function and decreased pain intensity compared with the AR condition. Both conditions improved significantly regarding depression and anxiety.

Conclusions: A manual-based self-help intervention with weekly therapist support in an ACT format adds value to the treatment repertoire for persons suffering with chronic pain.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adaptation, Psychological
  • Adult
  • Anxiety / etiology
  • Behavior Therapy / methods*
  • Chi-Square Distribution
  • Chronic Pain / psychology*
  • Chronic Pain / rehabilitation*
  • Depression / etiology
  • Double-Blind Method
  • Female
  • Follow-Up Studies
  • Health Behavior
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement / methods
  • Relaxation / physiology*
  • Self Care*
  • Telephone
  • Time Factors
  • Treatment Outcome