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Acceptance and Commitment Therapy (ACT), Process-Based Therapy, and
Chronic Pain

Lance McCracken

18 Oct 2024

Introduction

Professor Lance McCracken will deliver a full-day workshop across two days -  Friday 18th and 25th October 2024 on acceptance and commitment therapy (ACT), process-based therapy, and chronic pain.

Content

Chronic pain is a difficult and common problem whether it be the primary problem or secondary to another primary medical or mental health problem.  It is a difficult problem for how overwhelming it can be for the person who experiences it and for those who try to help. The loss, uncertainty, threat, invalidation, and exclusion often experienced by the person with significant chronic pain can provoke strong emotional reactions for them. When we see people with chronic pain as a psychological treatment provider we see fear and avoidance, depression, anger, and also insomnia, health behaviour problems, a deeply disturbed sense of self, unhealthy social circumstances and more. What’s more is that we see these problems in unique combinations experienced by people who are also entirely unique. Faced with this potential complexity we need a treatment model, methods, and skills that are fit for purpose.  Acceptance and Commitment Therapy (ACT) and the psychological flexibility model provide a pretty good source for these.

The first controlled treatment trial of ACT that involved chronic pain was published in 2004, although it took another 10 years before there were 10 RCTs in total.  By now, 20 years later there are more than 30 RCTs and there are at least 5 meta-analyses devoted exclusively to ACT for chronic pain.  Results show positive outcomes, and still growing. ACT is recommended in national treatment guidelines and widely implemented. The point of this workshop is to very briefly look at ACT as an evidence-based approach that is both generally applicable, and has particular support in the treatment of chronic pain. The main point for most of the workshop is for participants to gain knowledge, learn theory and principles, and develop a set of skills that can be used in practice.

A way to think about Cognitive Behavioral Therapy approaches is that they mainly entail selected sets of methods or components. ACT can be thought about in that way too but this is not the best way to frame it. Delivering ACT is, in most simple terms, a process of determining desired outcomes, finding inflexibility processes that stand in the way of these outcomes, and addressing these with methods that increase flexibility. In this way ACT is inherently a prototype “process-based” therapy.  This workshop will define what this means and help participants develop ways to do this with the facets of psychological flexibility as the base.

Learning Objectives

In this workshop participants will learn to…

Summarise the current evidence for ACT in chronic pain.
Apply in a practical way the ACT model and principles in chronic pain and related conditions.
Identify behaviour patterns that reflect inflexibility and undermine effective functioning.
Use a complete set of methods for promoting each of the flexibility subprocesses in the model underlying ACT.

Training Modalities

Brief lecture
Method demonstrations
Experiential exercises
Role play

Key References

McCracken, L. M. (2024). Psychological flexibility, chronic pain, and health. Annual Review of Psychology, 75, 1-24. https://doi.lorg/10.1146/annurev-psych-020223-124335

McCracken, L. M. (2023). Personalized pain management: Is it time for process-based therapy for particular people with chronic pain? European Journal of Pain, 27, 1044–1055. https://doi.org/10.1002/ejp.2091

Lai, L., Liu, Y., McCracken, L. M., Li, Y., & Ren, Z. (2023). The efficacy of acceptance and commitment therapy for chronic pain: A three-level meta-analysis and a trial sequential analysis of randomized controlled trials. Behaviour Research and Therapy, 165, 104308. https://doi.org/10.1016/j.brat.2023.104308

About the presenter

Lance M McCracken is Professor and Head of Division in Clinical Psychology, Psychology Department, Uppsala University, Sweden, since 2018. He completed his PhD at West Virginia University and a post doctoral fellowship at Johns Hopkins. While working on his PhD and during his post doc he produced several of the early studies of the fear-avoidance model of chronic pain. He was employed at The University of Chicago, in Psychiatry and in Anesthesia and Critical Care from 1994 to 2000. During this time, he published the first study of chronic pain and psychological flexibility, the process model underlying Acceptance and Commitment Therapy (ACT), in 1998. He was Clinical Lead at the Bath Centre for Pain Services in the UK, beginning in 2000 until 2011. While in Bath he led in the organization of the first interdisciplinary pain management centre focused on ACT as the working model, including the program of research affiliated with the treatment provided there. He left that post to take up a post as Professor of Behavioral Medicine at King’s College London in 2011 and was there until 2018. While at King’s he and his colleagues published the first UK-based study of an online version of ACT for chronic pain. He now has more than 30 years of clinical and research experience mainly in psychological and interdisciplinary approaches to chronic pain and other long-term health conditions. He has over 300 scientific publications and his studies are highly cited, over 31,000 times (h = 90). 

Who should attend

This course is designed as an introduction or refresher of basic knowledge and skills in ACT for chronic pain. A general familiarity with CBT and prior exposure to ACT from teaching or reading will be necessary to benefit most from the workshop. Similarly, prior experience providing service to people with chronic pain, or secondarily with other chronic physical health conditions, will help participants integrate and apply learning of the model and skills. 

Low Intensity clinical contact hours survey - BABCP Low Intensity Special Interest Group

Please click below if you are interested in contributing to the survey.

 

The BACP Low Intensity SIG are interested in the impact of clinical contact hours on Low Intensity/Wellbeing Practitioner wellbeing. This questionnaire contains six multi-choice questions and a free text box for you to share your experiences. The answers to these questions will help the BABCP SIG plan how to meet CPD topics and other developments within the SIG.  The SIG hope to produce a write up of the answers to this questionnaire to be shared with SIG members and to be used in training.

View Survey

This FREE conference is for Psychological Wellbeing Practitioners working in Talking Therapies for Anxiety and Depression services and is brought to you by Bespoke Mental Health in collaboration with the NHS National PWP Leads Network.

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