A Prospective Examination of Acceptance at a CBT-based Interdisciplinary Chronic Pain Management Program

Abstract

Aims/Objectives: Acceptance of chronic pain is related to active patient engagement in valued aspects of life. This study sought
to prospectively evaluate acceptance and patient functioning in a Cognitive Behavioural Therapy (CBT) - based chronic pain
management program.
Methods: Participants in this study were 184 consecutive adult patients with heterogeneous pain admitted to a interdisciplinary
four-week Chronic Pain Management Program (CPMP) who completed self-report questionnaires at admission and discharge.
Measures examined pain perception, psychological/emotional and social aspects of patient experience with chronic pain. Acceptance
was evaluated by the Chronic Pain Acceptance Questionnaire (CPAQ).1
Results: Patients showed all-round improvement after program completion. Consistent with other studies, higher acceptance
scores at admission were associated with more overall positive change at discharge. In addition, greater increase in acceptance
scores at discharge was also associated with greater improvement in other variables. However, no significant change was shown
in the Pain Willingness subscale of the CPAQ.
Discussion: This study provides a new understanding of the relationship of acceptance of chronic pain with patient functioning
in a CBT-oriented pain management program. Results suggest that engaging in activity regardless of pain is an important
program goal. This is directly measured by the Activity Engagement component of the CPAQ, which increases following participation
in a CBT-based CPMP. Study findings also differ from some previous research and suggest that Pain Willingness may
be a poor predictor of patient functioning.
Limitations: Results were obtained from patients at an interdisciplinary program and may not be generalized to the entire chronic
pain population. Also, these results only demonstrate associations between acceptance and other variables, not causality. In addition,
patients in this study served as their own controls (admission-discharge) thus the study lacks a true control group.
Conclusion: This study extends previous research by contributing needed prospective data on the relationship between acceptance
and patient functioning.