Canadian researchers writing in The Journal of Pain reported that fibromyalgia (FM) patients participating in online acceptance and commitment therapy (ACT) and treatment as usual (TAU) showed significant improvement in primary disease outcomes, such as depression, pain, sleep and pain acceptance, compared with TAU alone.
Acceptance and commitment therapy is a newer intervention within cognitive-behavioral therapy that relies on mindfulness and acceptance strategies. In contrast with traditional interventions, ACT aims to facilitate the development of psychological flexibility through six interrelated processes: acceptance, contact with the present moment, cognitive diffusion, self as context, connecting with personal values, and willingness and commitment.
In several randomized controlled studies, ACT has been shown to reduce the negative impact of FM on function. The researchers from the University of Manitoba sought to evaluate, for the first time, the efficacy of an online ACT protocol for FM. They hypothesized that subjects treated with online ACT and TAU would improve significantly on the primary measures of FM compared to TAU control group.
Sixty-seven participants with fibromyalgia were randomly assigned to an ACT and TAU protocol or a TAU control group. Study subjects completed the Fibromyalgia Impact Questionnaire and a battery of self-report measures to assess disease impact.
Results showed that online ACT significantly reduced FM impact relative to TAU, and 70 percent of online ACT participants were classified as treatment responders. The authors concluded their study shows that individuals with FM may benefit from online ACT with minimal additional monitoring.
"This study is important for two reasons. One, it provides evidence that ACT, a newer treatment approach that promotes psychological flexibility and valued living, can be particularly helpful or people with chronic pain conditions such as FM, for which sustained symptom reduction tends be less obtainable; and two, it suggests a method of delivering ACT to many people with FM who may otherwise not be able to obtain help due to limited access to trained clinicians and treatment centers, or prohibitive costs, " said Gregg Tkachuk, PhD, CPsych., assistant professor, Dept. of Clinical Health Psychology, Max Rady College of Medicine, University of Manitoba.