Sammendrag
Few studies exist on interventions delivered at home aiming to support self-management of chronic pain conditions following rehabilitation. We performed a randomized trial to study the efficacy of a smartphone delivered intervention based on acceptance and commitment therapy (ACT). After the follow up period the intervention group reported less catastrophizing and more activities engagement and willingness to experience pain compared to the control group six month after the intervention. The aim of this paper is to investigate the process; ie how the therapeutic elements are leading to positive results.
The follow-up intervention included one face-to-face session and four weeks of written communication via a smartphone. Participants filled out three diaries daily. The registered diaries were immediately available to a therapist who submitted daily a tailored written feedback based on ACT accessible on the phone.
48 women with chronic pain took part in the intervention group. 800 feedbacks were analysed and coded qualitatively. The outcome measures were Pain Catastrophizing Scale and Chronic Pain Acceptance Questionnaire.
Analysing the feedbacks qualitatively three groups of process codes were identified; five ACT process - categories, four motivation strategy categories and five communication strategy categories. The ACT-specific processes codes were: Values, Committed Action, Contact with present moment, Cognitive Defusion and Acceptance. The motivational strategy codes were Acceptance, Support, Encouragement and Suggestion. The communication strategy codes were affirmative, empathic supportive, create participation, creative communication, and information.
In this paper we will present analyses of the relationship between feedback content and valued actions and pain acceptance 6 month after the intervention.
We expect that the study will contribute to understanding of how value based and webbased written processes stimulate behavioural change.
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