One of the treatment modalities used at the Las Vegas Recovery Center is Acceptance and Commitment Therapy for chronic pain. Abbreviated as “ACT”, the therapy is based on the principle that all humans experience certain emotions, thoughts, memories and physical sensations that are unpleasant. Problems are caused by trying to avoid or alter the actual experience. This is especially true when resisting or avoiding feelings that arise from the pain, which causes more pain. ACT differs from traditional cognitive behavioral therapy (CBT) in that rather than trying to teach people to better control their thoughts, feelings, sensations, memories and other private events, ACT teaches them to simply notice, accept, and embrace them, especially previously unwanted ones. Mindfulness techniques such as meditation are especially helpful when it comes to noticing and accepting thoughts. There is no right or wrong way to approach one’s thoughts when it comes to pain recovery, but some modalities are more successful that others, depending on a person’s unique psychological orientation. That’s one reason we insist on creating an individualized treatment plan for each of our clients.
Mindful Awareness Plays a Role in Acceptance and Commitment Therapy for Chronic Pain
Acceptance and Commitment Therapy for chronic pain promotes mindful awareness by helping one separate thought from troublesome feelings associated with thought. This is the acceptance part of ACT and is a tool that is well known as part of 12 step programs. It involves surrender rather than a futile attempt to control the uncontrollable (which is, in Buddhist terms, what “attachment” is). This therapy helps the individual get in touch with a transcendent sense of self known as “self-as-context”—the self that is always there observing and experiencing and yet distinct from one’s thoughts, feelings, sensations, memories and ego. The goal of ACT is also to help the individual clarify his or her personal values and take action on them, bringing more vitality and meaning to life in the process. The commitment part of ACT comes from making a commitment to clarify personal values and then behaving in accordance with them.
Empirical Evidence for Acceptance and Commitment Therapy for Chronic Pain
There has been a recent increase in the number of studies being conducted on ACT as a pain reliever, and research does show that Acceptance and Commitment Theory is often effective for chronic pain. The empirical evidence notes marked improvements in depression, pain related anxiety, physical disability, and the ability to stand upright. Positive outcomes in a recent study included decreased medical visits, as well as less intensity of pain. Studies have also shown that acceptance correlates with greater activity and sense of well-being. Additional research is in process and may reveal even more concrete evidence for the efficacy of ACT. As with any therapy, there is a possibility that ACT will not be effective for every person. The challenge with Acceptance and Commitment Therapy for chronic pain is being willing to accept whatever level of pain exists, even though pain may not lessen through the course of therapy. While focusing on one treatment modality is probably most effective, it is sometimes necessary to combine protocols, techniques and modalities in order to address each person’s individual needs and design customized treatment plans.