Online Acceptance and Commitment Therapy (ACT) interventions for chronic pain: A systematic literature review

D L van de Graaf, H R Trompetter, T Smeets, F Mols, D L van de Graaf, H R Trompetter, T Smeets, F Mols

Abstract

Background: We systematically reviewed all literature concerning online Acceptance and Commitment Therapy (ACT) interventions for chronic pain to evaluate their (1) ACT content, (2) design characteristics, (3) design rationales, and (4) adherence.

Material and methods: A systematic search was performed on July 9th, 2020 in; PubMed, PsycINFO, CINAHL, and Web of Science. Search terms related to: Acceptance and Commitment Therapy, chronic pain, and eHealth. Extracted data concerned ACT content, design characteristics, adherence, and design rationales.

Results: 20 articles, in which 14 interventions were described, met all inclusion criteria. Adherence and design rationales were described to a limited extent in the included studies. In total, the majority provided an overview of the included ACT processes. In 10 articles it was described that the intervention was delivered via a dedicated website (n = 10), which was sometimes combined with an app (n = 3). Guidance was included in most studies (n = 19). Studies including RCT's (n = 8) reported online ACT interventions to be effective.

Conclusion: Online ACT interventions for chronic pain have been shown to be effective and have generally been constructed in line with ACT theory. However, the majority of studies does not provide information about the choices to optimize the fit between task, technology, and user. Considerations behind the choices for intervention features as well as design rationales could help to optimize future online ACT interventions. Additionally, consistent attention should be paid to measurement and operationalization of adherence, since this is a crucial link between content, design and effectiveness.

Keywords: Acceptance and Commitment Therapy; Chronic pain; Online intervention; eHealth.

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

© 2021 The Authors. Published by Elsevier B.V.

Figures

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Fig. 1
PRISMA flow diagram.

References

    1. Bandura A., Walters R. Social Learning Theory. 1977. p. 1.
    1. Barker R. 2003. The Social Work Dictionary.
    1. Bell L.V., Cornish P., Flusk D., Garland S.N., Rash J.A. The INternet ThERapy for deprESsion trial (INTEREST): protocol for a patient-preference, randomised controlled feasibility trial comparing iACT, iCBT and attention control among individuals with comorbid chronic pain and depression. BMJ Open. 2020;10 doi: 10.1136/bmjopen-2019-033350.
    1. Bendelin N., Björkdahl P., Risell M., Nelson K.Z., Gerdle B., Andersson G., Buhrman M. Patients’ experiences of internet-based acceptance and commitment therapy for chronic pain: a qualitative study. BMC Musculoskelet. Disord. 2020;21:212. doi: 10.1186/s12891-020-03198-1.
    1. Bendelin N., Gerdle B., Andersson G. Internet-delivered aftercare following multimodal rehabilitation program for chronic pain: a qualitative feasibility study. J. Pain Res. 2018;11:1715–1728. doi: 10.2147/JPR.S157939.
    1. Bender J.L., Radhakrishnan A., Diorio C., Englesakis M., Jadad A.R. Can pain be managed through the Internet? A systematic review of randomized controlled trials. Pain. 2011;152:1740–1750. doi: 10.1016/j.pain.2011.02.012.
    1. Bennett S.D., Cuijpers P., Ebert D.D., McKenzie Smith M., Coughtrey A.E., Heyman I., Manzotti G., Shafran R. Practitioner review:unguided and guided self-help interventions for common mental health disorders in children and adolescents: a systematic review and meta-analysis. J. Child Psychol. Psychiatry. 2019;60:828–847. doi: 10.1111/jcpp.13010.
    1. Børøsund E., Mirkovic J., Clark M.M., Ehlers S.L., Andrykowski M.A., Bergland A., Westeng M., Nes L.S. A stress management app intervention for cancer survivors: design, development, and usability testing. J. Med. Internet Res. 2018;20 doi: 10.2196/formative.9954.
    1. Breivik H., Collett B., Ventafridda V., Cohen R., Gallacher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. European journal of pain. 2006;10(4):287–333.
    1. Breivik H., Eisenberg E., O’Brien T. The individual and societal burden of chronic pain in Europe: the case for strategic prioritisation and action to improve knowledge and availability of appropriate care. BMC Public Health. 2013;13 doi: 10.1186/1471-2458-13-1229.
    1. Buhrman M., Gordh T., Andersson G. Internet interventions for chronic pain including headache: a systematic review. Internet Interv. 2016;4:17–34. doi: 10.1016/j.invent.2015.12.001.
    1. Buhrman M., Skoglund A., Husell J., Bergström K., Gordh T., Hursti T., Bendelin N., Furmark T., Andersson G. Guided internet-delivered acceptance and commitment therapy for chronic pain patients: a randomized controlled trial. Behav. Res. Ther. 2013;51:307–315. doi: 10.1016/j.brat.2013.02.010.
    1. Claes N. 2016. Pain in Context: The Effect of Goal Competition on Pain-related Fear and Avoidance.
    1. Claes N., Crombez G., Pain J.V.- U., 2015. Pain-avoidance versus reward-seeking: an experimental investigation. Pain. 2015;156:1449–1457.
    1. Daft R.L., Lengel R.H. Texas A&M University College of Business Administration; 1983.
    1. Daniel H.C., Narewska J., Serpell M., Hoggart B., Johnson R., Rice A.S.C. Comparison of psychological and physical function in neuropathic pain and nociceptive pain: implications for cognitive behavioral pain management programs. Eur. J. Pain. 2008;12:731–741. doi: 10.1016/j.ejpain.2007.11.006.
    1. Davis F.D. Perceived usefulness, perceived ease of use, and user acceptance of information technology. MIS Q. 1989:319–340.
    1. Donkin L., Christensen H., Naismith S.L., Neal B., Hickie I.B., Glozier N. A systematic review of the impact of adherence on the effectiveness of e-therapies. Journal of medical Internet research. 2011;13(3):e52.
    1. Eccleston C., Hearn L., Williams A. Psychological therapies for the management of chronic neuropathic pain in adults. Cochrane Database Syst. Rev. 2015 doi: 10.1002/14651858.CD011259.pub2.
    1. Eccleston C., Williams A., Morley S. Psychological therapies for the management of chronic pain (excluding headache) in adults. Cochrane Database Syst. Rev. 2009:2.
    1. Eysenbach G. Issues in evaluating health websites in an internet-based randomized controlled trial. J. Med. Internet Res. 2002;4 doi: 10.2196/jmir.4.3.e17.
    1. Fledderus M., Schreurs K.M., Bohlmeijer E.T., Vollenbroek-Hutten M.M. Development and pilotevaluation of an onlinerelapse-preventionprogrambased on acceptance and commitmenttherapy for chronicpainpatients. JMIR Hum. Factors. 2015;2 doi: 10.2196/humanfactors.3302.
    1. Gainsbury S., Blaszczynski A. Online self-guided interventions for the treatment of problem gambling. Int. Gambl. Stud. 2011;11:289–308. doi: 10.1080/14459795.2011.617764.
    1. Gentili C., Zetterqvist V., Rickardsson J., Holmström L., Simons L.E., Wicksell R.K. ACTsmart - development and feasibility of digital acceptance and commitmenttherapy for adults with chronic pain. NPJ Digit. Med. 2020;3:20. doi: 10.1038/s41746-020-0228-4.
    1. Goodhue D.L., Thompson R.L. Task-technology fit and individual performance. MIS Q. 1995;19:213–236.
    1. Graham C.D., Gouick J., Krahé C., Gillanders D. A systematic review of the use of acceptance and commitmenttherapy (ACT) in chronic disease and long-term conditions. Clin. Psychol. Rev. 2016;46:46–58. doi: 10.1016/j.cpr.2016.04.009.
    1. Han J.Y. Transaction logfile analysis in health communication research: challenges and opportunities. Patient Educ. Couns. 2011;82:307–312. doi: 10.1016/j.pec.2010.12.018.
    1. Harvie D.S., Moseley G.L., Hillier S.L., Meulders A. Classical conditioningdifferencesassociatedwithchronicpain:asystematicreview. J. Pain. 2017 doi: 10.1016/j.jpain.2017.02.430.
    1. Hayes S., Mogan H., Dowd H., Doherty E., O’Higgins S., Gabhainn S.N., MacNeela P., Murphy A.W., Kropmans T., O’Neill C., Newell J., McGuire B.E. Comparing the clinical-effectiveness and cost-effectiveness of an internet-delivered acceptance and commitmenttherapy (ACT) intervention with a waiting list control among adults with chronic pain: study protocol for a randomised controlled trial. BMJ Open. 2014;4 doi: 10.1136/bmjopen-2014-005092.
    1. Hayes S.C., Luoma J., Bond F.W., Masuda A., Lillis J. Acceptance and commitment therapy: model, processes and outcomes. Behav. Res. Ther. 2006;44:1–25.
    1. Hayes S.C., Strosahl K.D., Wilson K.G. 2012. Acceptance and Commitment Therapy: The Process and Practice of Mindful Change.
    1. Heber E., Ebert D.D., Lehr D., Cuijpers P., Berking M., Nobis S., Riper H. The benefit of web-andcomputer-basedinterventions for stress:asystematicreview and meta-analysis. J. Med. Internet Res. 2017;19 doi: 10.2196/jmir.5774.
    1. Héroux M., Watt M., McGuire K.A., Berardi J.M. A personalized, multi-platform nutrition, exercise, and lifestyle coaching program: a pilot in women. Internet Interv. 2017;7:16–22. doi: 10.1016/j.invent.2016.12.002.
    1. Horvath K.J., Bauermeister J.A. eHealth literacy and intervention tailoring impacts the acceptability of a HIV/STI testing intervention and sexual decision making among young gay and bisexual men. AIDS Educ. Prev. 2017;29:14–23. doi: 10.1521/aeap.2017.29.1.14.
    1. Hughes L.S., Clark J., Colclough J.A., Dale E., McMillan D. Acceptance and commitmenttherapy (ACT) for chronicpain. Clin. J. Pain. 2017;33:552–568. doi: 10.1097/AJP.0000000000000425.
    1. Johansson R., Andersson G. Internet-based psychological treatments for depression. Expert. Rev. Neurother. 2012;12:861–870. doi: 10.1586/ern.12.63.
    1. Kelders S.M., Kok R.N., Ossebaard H.C., Ewc J., Gemert-Pijnen V. Persuasive systemdesigndoesmatter:asystematicreview of adherence to web-basedinterventions. J. Med. Internet Res. 2012;14 doi: 10.2196/jmir.2104.
    1. Kerns R., Burns J., Shulman M. Can we improve cognitive–behavioral therapy for chronic back pain treatment engagement and adherence? A controlled trial of tailored versus standard therapy. Health Psychol. 2014;33:938.
    1. Kioskli K., Scott W., Winkley K., Godfrey E., McCracken L.M. Online acceptance and commitmenttherapy for people with painfuldiabeticneuropathy in the United Kingdom: asingle-armfeasibilitytrial. Pain Med. 2020;21:2777–2788. doi: 10.1093/pm/pnaa110.
    1. Kioskli K., Winkley K., McCracken L.M. Might psychological flexibility processes and acceptance and commitmenttherapy (ACT) apply in adults with painful diabetic neuropathy? A cross-sectional survey. J. Context. Behav. Sci. 2019;13:66–73. doi: 10.1016/j.jcbs.2019.07.002.
    1. Knoerl R., Smith E.M.L., Barton D.L., Williams D.A., Holden J.E., Krauss J.C., LaVasseur B. Self-guided online cognitive behavioral strategies for chemotherapy-induced peripheral neuropathy: a multicenter, pilot, randomized, wait-list controlled trial. J. Pain. 2018;19:382–394. doi: 10.1016/j.jpain.2017.11.009.
    1. Laugesen J.D. 2013. Adoption of Electronic Personal Health Records by Chronic Disease Patients: Integrating Protection Motivation Theory and Task-technology Fit. (Doctoral dissertation)
    1. Lee Younghwa, Kozar Kenneth A., Larsen Kai R.T., Lee Younghwa, Kozar K.A., Lee Y., Kozar K.A., Larsen K.R.T. The technologyacceptancemodel:past,present, and future. Commun. Assoc. Inf. Syst. 2003;12:752–780. doi: 10.17705/1CAIS.01250.
    1. Lin J., Klatt L.-I., McCracken L.M., Baumeister H. Psychological flexibility mediates the effect of an online-based acceptance and commitment therapy for chronic pain: an investigation of change processes. Pain. 2018;159:663–672. doi: 10.1097/j.pain.0000000000001134.
    1. Lin J., Paganini S., Sander L., Lüking M., Ebert D.D., Buhrman M., Andersson G., Baumeister H. An internet-based intervention for chronic pain: a three-arm randomized controlled study of the effectiveness of guided and unguided acceptance and commitment therapy. Dtsch. Arztebl. Int. 2017;114:681–688.
    1. Macea D.D., Gajos K., Daglia Calil Y.A., Fregni F. The efficacy of web-based cognitive behavioral interventions for chronic pain: a systematic review and meta-analysis. J. Pain. 2010;11:917–929. doi: 10.1016/j.jpain.2010.06.005.
    1. Marangunić N., Granić A. Technology acceptance model: a literature review from 1986 to 2013. Univers. Access Inf. Soc. 2015;14:81–95. doi: 10.1007/s10209-014-0348-1.
    1. Meulders A., Jans A., Pain J.V.- U., 2015. Differences in pain-related fear acquisition and generalization: an experimental study comparing patients with fibromyalgia and healthy controls. Pain. 2015;156:108–122.
    1. Moher D., Liberati A., Tetzlaff J., Altman D.G., Altman D., Antes G., Atkins D., Barbour V., Barrowman N., Berlin J.A., Clark J., Clarke M., Cook D., D’Amico R., Deeks J.J., Devereaux P.J., Dickersin K., Egger M., Ernst E., Gøtzsche P.C., Grimshaw J., Guyatt G., Higgins J., Ioannidis J.P.A., Kleijnen J., Lang T., Magrini N., McNamee D., Moja L., Mulrow C., Napoli M., Oxman A., Pham B., Rennie D., Sampson M., Schulz K.F., Shekelle P.G., Tovey D., Tugwell P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6 doi: 10.1371/journal.pmed.1000097.
    1. Nicholson B. Differential diagnosis: nociceptive and neuropathic pain. Am. J. Manag. Care. 2006;12:S256–S262.
    1. Paganini S., Lin J., Kählke F., Buntrock C., Leiding D., Ebert D.D., Baumeister H. A guided and unguided internet- and mobile-based intervention for chronic pain: health economic evaluation alongside a randomised controlled trial. BMJ Open. 2019;9 doi: 10.1136/bmjopen-2018-023390.
    1. Palermo T.M., Eccleston C., Lewandowski A.S., de C. Williams A.C., Morley S. Randomized controlled trials of psychological therapies for management of chronic pain in children and adolescents: an updated meta-analytic review. Pain. 2010;148:387–397. doi: 10.1016/j.pain.2009.10.004.
    1. Polomano R.C., Droog N., Purinton M.C.P., Cohen A.S. Social support web-based resources for patients with chronic pain. J. Pain Palliat. Care Pharmacother. 2007;21:49–55. doi: 10.1080/J354v21n03_09.
    1. Probst T., Baumeister H., McCracken L.M., Lin J. Baseline psychologicalinflexibilitymoderates the outcomepaininterference in a randomizedcontrolledtrial on internet-basedacceptance and commitmenttherapy for chronicpain. J. Clin. Med. 2018;8:24. doi: 10.3390/jcm8010024.
    1. Richards D., Richardson T. Computer-based psychological treatments for depression: a systematic review and meta-analysis. Clin. Psychol. Rev. 2012;32:329–342. doi: 10.1016/j.cpr.2012.02.004.
    1. Rickardsson J., Zetterqvist V., Gentili C., Andersson E., Holmström L., Lekander M., Persson M., Persson J., Ljótsson B., Wicksell R.K. Internet-delivered acceptance and commitment therapy (iACT) for chronic pain-feasibility and preliminary effects in clinical and self-referred patients. mHealth. 2020;6:27. doi: 10.21037/mhealth.2020.02.02.
    1. Rotter J. Johnson Reprint Corporation; 1954. Social Learning and Clinical Psychology.
    1. Schmidt M., Cheng L., Raj S., Wade S. Formative design and evaluation of a responsive eHealth/mHealth intervention for positivefamilyadaptationfollowingpediatrictraumaticbraininjury. J. Form. Des. Learn. 2020;1–19 doi: 10.1007/s41686-020-00049-z.
    1. Scott W., Chilcot J., Guildford B., Daly-Eichenhardt A., McCracken L.M. Feasibility randomized-controlled trial of online acceptance and commitmenttherapy for patients with complex chronic pain in the United Kingdom. Eur. J. Pain. 2018;22:1473–1484. doi: 10.1002/ejp.1236.
    1. Scott W., Hann K.E.J., McCracken L.M. A comprehensiveexamination of changes in psychologicalflexibilityfollowingacceptance and commitmenttherapy for chronicpain. J. Contemp. Psychother. 2016;46:139–148. doi: 10.1007/s10879-016-9328-5.
    1. Sieverink F., Kelders S.M., Gemert-Pijnen V. Clarifying the concept of adherence to ehealth technology: systematic review on when usage becomes adherence. J. Med. Internet Res. 2017 doi: 10.2196/jmir.8578.
    1. Simister H.D., Tkachuk G.A., Shay B.L., Vincent N., Pear J.J., Skrabek R.Q. Randomized controlledtrial of onlineacceptance and commitmenttherapy for fibromyalgia. J. Pain. 2018;19:741–753. doi: 10.1016/j.jpain.2018.02.004.
    1. Simpson P.A., Mars T., Esteves J.E. A systematic review of randomised controlled trials using acceptance and commitment therapy as an intervention in the management of non-malignant, chronic pain in adults. Int. J. Osteopath. Med. 2017;24:18–31. doi: 10.1016/j.ijosm.2017.03.001.
    1. Slattery B.W., O’Connor L.L., Haugh S., Barrett K., Francis K., Dwyer C.P., O’Higgins S., Caes L., Egan J., McGuire B.E. Investigating the effectiveness of an online acceptance and commitment therapy (ACT) intervention versus a waiting list control condition on pain interference and quality of life in adults with chronic pain and multimorbidity: protocol for a randomised co. BMJ Open. 2019;9 doi: 10.1136/bmjopen-2016-012671.
    1. Spek V., Cuijpers P., Nycklícek I., Riper H., Keyzer J., Pop V. Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis. Psychol. Med. 2007;37:319–328. doi: 10.1017/S0033291706008944.
    1. Spijkerman M.P.J., Pots W.T.M., Bohlmeijer E.T. Effectiveness of online mindfulness-based interventions in improving mental health: a review and meta-analysis of randomised controlled trials. Clin. Psychol. Rev. 2016 doi: 10.1016/j.cpr.2016.03.009.
    1. Stinson J.N., Lalloo C., Phd B., Harris Msc L., Isaac L., Campbell Bsc F., Frca M.D., Brown S., Frcpc M.D., Ruskin D., Cpsych P., Gordon A., Galonski M., Bscn R.N., Pink L.R., Mn R.N., Buckley Ba N., Henry J.L., White Ba M., Karim A., Ma B.A. iCanCope with PainTM: user-centred design of a web-and mobile-based self-management program for youth with chronic pain based on identified health care needs. Pain Res. Manag. 2014:19.
    1. Sullivan M., Langford D.J., Davies P.S., Tran C., Vilardaga R., Cheung G., Yoo D., McReynolds J., Lober W.B., Tauben D., Vowles K.E. A controlledpilottrial of PainTracker self-manager, a web-basedplatformcombinedwithpatientcoaching, to supportpatients’self-management of chronicpain. J. Pain. 2018;19:996–1005. doi: 10.1016/j.jpain.2018.03.009.
    1. Trompetter H.R., Bohlmeijer E.T., Fox J.P., Schreurs K.M.G. Psychological flexibility and catastrophizing as associated change mechanisms during online Acceptance & Commitment Therapy for chronic pain. Behav. Res. Ther. 2015;74:50–59. doi: 10.1016/j.brat.2015.09.001.
    1. Trompetter H.R., Bohlmeijer E.T., Lamers S.M.A., Schreurs K.M.G. Positive psychologicalwellbeingisrequired for onlineself-helpacceptance and commitmenttherapy for chronicpain to be effective. Front. Psychol. 2016;7:353. doi: 10.3389/fpsyg.2016.00353.
    1. Trompetter H.R., Bohlmeijer E.T., Veehof M.M., Schreurs K.M.G. Internet-based guided self-help intervention for chronic pain based on acceptance and commitmenttherapy:a randomized controlled trial. J. Behav. Med. 2015;38:66–80. doi: 10.1007/s10865-014-9579-0.
    1. Turk D.C., Wilson H.D., Cahana A. Treatment of chronic non-cancer pain. Lancet. 2011;377:2226–2235. doi: 10.1016/S0140-6736(11)60402-9.
    1. Van Den Berg S.W., Peters E.J., Kraaijeveld J.F., Gielissen M.F.M., Prins J.B. Usage of a generic web-based self-management intervention for breast cancer survivors: substudy analysis of the BREATH trial. J. Med. Internet Res. 2013;15 doi: 10.2196/jmir.2566.
    1. Veehof M.M., Trompetter H.R., Bohlmeijer E.T., Schreurs K.M.G. Acceptance-and mindfulness-based interventions for the treatment of chronic pain: a meta-analytic review. Cogn. Behav. Ther. 2016;45:5–31. doi: 10.1080/16506073.2015.1098724.
    1. Vilardaga R., Davies P.S., Vowles K.E., Sullivan M.D. Theoretical grounds of paintrackerselfmanager:anacceptance and commitmenttherapy digital intervention for patients with chronic pain. J. Contextual Behav. Sci. 2020;15:172–180. doi: 10.1016/j.jcbs.2020.01.001.
    1. Vlaeyen J.W.S., Crombez G., Linton S.J. The fear-avoidance model of pain. Pain. 2016;157:1588–1589. doi: 10.1097/j.pain.0000000000000574.
    1. Wangberg S.C., Bergmo T.S., Johnsen J.-A.K. Adherence in internet-based interventions. Patient Prefer. Adherence. 2008;2:57–65.
    1. Williams A., Eccleston C., Morley S. Psychological therapies for the management of chronic pain (excluding headache) in adults (Review) Cochrane Database Syst. Rev. 2019 doi: 10.1002/14651858.CD007407.pub3.
    1. Yang S.-Y., Moss-Morris R., McCracken L.M. iACT-CEL: afeasibilitytrial of a face-to-face and internet-basedacceptance and commitmenttherapyintervention for chronicpain in Singapore. Pain Res. Treat. 2017;2017:6916915. doi: 10.1155/2017/6916915.

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