Acceptance and Commitment Therapy for the Treatment of Chronic Pain and Coexisting Depression: A Single-Case Study

Abstract

Pain resulting from chronic medical conditions (CMCs) can create debilitating effects globally across domains of functioning in the lives of those it impacts. There currently remain no treatment options to eliminate associated pain entirely, leaving care efforts often to manage the disabling effects and consequential depression. Acceptance and commitment therapy (ACT) has recently been introduced as an alternative treatment approach, emphasizing the commitment to engage in actions that contribute to a fulfilling life even in the face of disability through the fostering of psychological flexibility. For patients who do not respond to traditional psychological approaches, ACT may offer a sensible substitute. This single-case study delineates ACT for chronic pain and comorbid depression using standardized and patient-centered outcome measures across areas of general symptom functioning, therapeutic processes, and flexibility surrounding pain associated with CMCs. Clinical significance and reliable change were calculated using the reliable change index, in conjunction with patient-reported behavioral engagement and subjective assessment. Results indicate significant improvement across areas of depression, psychological flexibility, and flexibility in relating to pain endured from CMCs. The patient reported perceived improvement in quality of life and no longer viewed herself as a “professional patient.” This case study illustrates the potential of shifting from restraining and extinguishing symptoms to fostering a stance of willingness to reengage in a valued life while continuing to live with CMCs.