Efficacy of videoconference group acceptance and commitment therapy (ACT) and behavioral activation therapy for depression (BATD) for chronic low back pain (CLBP) plus comorbid depressive symptoms : a randomized controlled trial (IMPACT Study)
Sanabria-Mazo, Juan P. (Parc Sanitari Sant Joan de Déu)
Colomer-Carbonell, Ariadna (Parc Sanitari Sant Joan de Déu)
Borràs, Xavier (Universitat Autònoma de Barcelona)
Castaño Asins, Juan Ramon (Hospital del Mar (Barcelona, Catalunya))
McCracken, Lance M (Uppsala Universitet)
Montero-Marin, Jesus (Parc Sanitari Sant Joan de Déu)
Pérez-Aranda, Adrián (Universitat Autònoma de Barcelona. Departament de Psicologia Clínica i de la Salut)
Edo Izquierdo, Sílvia (Universitat Autònoma de Barcelona. Departament de Psicologia Bàsica, Evolutiva i de l'Educació)
Sanz Ruiz, Antoni (Universitat Autònoma de Barcelona. Departament de Psicologia Bàsica, Evolutiva i de l'Educació)
Feliu-Soler, Albert (Universitat Autònoma de Barcelona. Departament de Psicologia Clínica i de la Salut)
Luciano, Juan V (Universitat Autònoma de Barcelona. Departament de Psicologia Clínica i de la Salut)

Date:	2023
Abstract:	This study examined the efficacy of adding a remote, synchronous, group, videoconference-based form of acceptance and commitment therapy (ACT) or behavioral activation therapy for depression (BATD) to treatment-as-usual (TAU) in 234 patients with chronic low back pain (CLBP) plus comorbid depressive symptoms. Participants were randomly assigned to ACT, BATD, or TAU. Compared to TAU, ACT produced a significant reduction in pain interference at posttreatment (d = . 64) and at follow-up (d = . 73). BATD was only superior to TAU at follow-up (d = . 66). A significant reduction in pain catastrophizing was reported by patients assigned to ACT and BATD at posttreatment (d = . 45 and d = . 59, respectively) and at follow-up (d = . 59, in both) compared to TAU. Stress was significantly reduced at posttreatment by ACT in comparison to TAU (d = . 69). No significant between-group differences were found in depressive or anxiety symptoms. Clinically relevant number needed to treat (NNT) values for reduction in pain interference were obtained at posttreatment (ACT vs TAU = 4) and at follow-up (ACT vs TAU = 3; BATD vs TAU = 5). In both active therapies, improvements in pain interference at follow-up were significantly related to improvements at posttreatment in psychological flexibility. These findings suggest that new forms of cognitive-behavioral therapy are clinically useful in improving pain interference and pain catastrophizing. Further research on evidence-based change processes is required to understand the therapeutic needs of patients with chronic pain and comorbid conditions.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Chronic low back ; Pain depression acceptance and commitment ; Therapy behavioral activation ; Ehealth
Published in:	The Journal of Pain, Vol. 24 Núm. 8 (2023) , p. 1522-1540, ISSN 1526-5900

DOI: doi.org/10.1016/j.jpain.2023.04.008

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