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Randomized Controlled Trial of Online Acceptance and Commitment Therapy for Fibromyalgia
Authors:Heather D Simister  Gregg A Tkachuk  Barbara L Shay  Norah Vincent  Joseph J Pear  Ryan Q Skrabek
Abstract:In this study, 67 participants (95% female) with fibromyalgia (FM) were randomly assigned to an online acceptance and commitment therapy (online ACT)?and?treatment as usual (TAU; ACT + TAU) protocol or a TAU control condition. Online ACT?+?TAU participants were asked to complete 7 modules over an 8-week period. Assessments were completed at pre-treatment, post-treatment, and 3-month follow-up periods and included measures of FM impact (primary outcome), depression, pain, sleep, 6-minute walk, sit to stand, pain acceptance (primary process variable), mindfulness, cognitive fusion, valued living, kinesiophobia, and pain catastrophizing. The results indicated that online ACT?+?TAU participants significantly improved in FM impact, relative to TAU (P?<.001), with large between condition effect sizes at post-treatment (1.26) and follow-up (1.59). Increases in pain acceptance significantly mediated these improvements (P?=?.005). Significant improvements in favor of online ACT?+?TAU were also found on measures of depression (P?=?.02), pain (P?=?.01), and kinesiophobia (P?=?.001). Although preliminary, this study highlights the potential for online ACT to be an efficacious, accessible, and cost-effective treatment for people with FM and other chronic pain conditions.

Perspective

Online ACT reduced FM impact relative to a TAU control condition in this randomized controlled trial. Reductions in FM impact were mediated by improvements in pain acceptance. Online ACT appears to be a promising intervention for FM.
Keywords:Fibromyalgia  online acceptance and commitment therapy  randomized controlled trial  mediational analysis  psychological flexibility model
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