Acceptance and Commitment Therapy for chronic pain on functioning: A systematic review of randomized controlled trials

Neurosci Biobehav Rev. 2021 Dec:131:59-76. doi: 10.1016/j.neubiorev.2021.09.022. Epub 2021 Sep 15.


Chronic pain is a worldwide health problem, Acceptance and Commitment Therapy (ACT) is regarded as one of the promising interventions. ACT aims to help chronic pain patients to create space for pursuing valued life activities in spite of pain. This systematic review of randomized controlled trials (RCTs) examined the efficacy of ACT on functioning for chronic pain. Literature search was performed among seven databases, and 12 RCTs were retrieved. The revised Cochrane risk of bias tool (RoB 2.0) was employed to assess the quality of the 12 RCTs, of which 10 were rated as "low risks", and 2 as "some concerns". Effect sizes of single RCTs and the pooled effect sizes of meta analyses were all rated by Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Low to moderate evidence showed that ACT played a positive immediate role in functioning for patients with chronic pain; however, it is inconsistent whether the effect can be sustained. More RCTs are warranted within specific chronic pain conditions.

Keywords: Acceptance and Commitment Therapy; Chronic pain; Functioning; Meta analysis; Randomized controlled trial; Systematic review.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Acceptance and Commitment Therapy*
  • Chronic Disease
  • Chronic Pain* / therapy
  • Humans
  • Randomized Controlled Trials as Topic