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CompletedNCT03924687Updated Apr 23, 2019

Evaluating the Effectiveness of an ACT-Based Bibliotherapy Intervention Among Adults Living With Chronic Pain

An interventional study of Acceptance and Commitment Therapy (ACT) bibliotherapy for chronic pain in Chronic Pain, sponsored by Université du Québec à Trois-Rivières. Completed. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2019-04-23.

Sponsored by Université du Québec à Trois-Rivières · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Registered 3 years after the study started (first participant enrolled Mar 2016, registered Apr 2019).
Phase
Not applicable
Study type
Interventional
Enrollment
140
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

Chronic pain has a significant impact on the physical and psychological functioning of those living with this condition. It is now recognized that Acceptance and Commitment Therapy (ACT) is an effective intervention in managing chronic pain; however, several barriers limit its accessibility.

The current study aims to evaluate the effectiveness of an eight-week bibliotherapy-type self-administered psychological intervention with minimal therapeutic contact, based on ACT, in the management of chronic pain.

This study is a randomized controlled trial with two groups (one experimental group and one wait-list control group). Participants will be randomly assigned to each condition and measures will be taken at pretest, posttest and three months following the intervention.

Read the detailed description

The purpose of this randomized controlled trial was to assess the effectiveness of an eight-week self-administered intervention program (bibliotherapy) based on Acceptance and Commitment Therapy with minimal therapeutic support in the management of chronic pain.

This study was based on the following hypotheses. In comparison to the control group, from pre to post, the self-help program will:

  1. significantly reduce pain-related disability (primary variable);
  2. improve depressive symptoms related to CP (secondary variable);
  3. increase the level of pain acceptance;

  4. reduce psychological inflexibility linked to painful symptoms (process variables).

    It was also expected that:

  5. the improvements would be maintained at three-month follow-up;
  6. participants would have an overall impression of a positive change following the intervention.
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Conditions studied

  • Chronic Pain

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Keywords

  • chronic pain
  • Acceptance or Commitment Therapy (ACT)
  • self-help
  • pain-related disability
  • psychological inflexibility
  • depression
  • pain acceptance
  • bibliotherapy
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In context

Chronic Pain

2,930 studies on the registry are indexed under Chronic Pain; 701 are open to participants now.

This study's enrollment of 140 is above the median of 60 across 2,161 interventional studies indexed under Chronic Pain.

Browse Chronic Pain studies →

Lead sponsor

Université du Québec à Trois-Rivières is the lead sponsor of 40 studies on the registry; 8 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • being 18 years of age or older
  • having suffered from daily pain for more than three months
  • having reading and writing abilities in French equivalent or superior to grade 8
  • having access to Internet at home and having a valid e-mail address
  • not having previously completed an ACT-type psychotherapy, not having practiced mindfulness meditation regularly and not having read a bibliotherapy on ACT for pain
  • having stable medication for at least one month, if applicable.

Exclusion criteria

Exclusion Criteria:

-

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
140 participants (actual)

Study arms

  • Experimental
    ACT group

    ACT group: participants receiving the 8-week bibliotherapy intervention based on Acceptance and Commitment Therapy

    Behavioral: Acceptance and Commitment Therapy (ACT) bibliotherapy for chronic pain

  • No intervention
    control group

    Wait-list control condition: participants placed on a wait-list (and receiving the intervention following the 9 week duration of the intervention)

Interventions

  • BehavioralAcceptance and Commitment Therapy (ACT) bibliotherapy for chronic pain

    The intervention consisted of the book "Libérez-vous de la douleur par la méditation et l'ACT" (Dionne, 2014) and a participant workbook, along with two phone calls of approximately 15 minutes each and weekly e-mails presenting the week's content. Participants also had access to audio meditation exercises on the book's website (http://liberezvousdeladouleur.com/meditations/).

06

What researchers measure

Primary outcomes

  1. Change in Pain-related disability

    Brief Pain Inventory (BPI; Interference subscale; Cleeland \& Ryan 1994; Poundja, Fikretoglu, Guay, \& Brunet 2007; Tyler, Jensen, Engel, \& Schwartz 2002)

    Time frame: Change from week 1 to week 9

  2. Change in Pain-related disability

    Brief Pain Inventory (BPI; Interference subscale; Cleeland \& Ryan 1994; Poundja, Fikretoglu, Guay, \& Brunet 2007; Tyler, Jensen, Engel, \& Schwartz 2002)

    Time frame: Change from week 9 and week 21 (ACT group only)

Secondary outcomes

  1. Change in Depressive symptoms

    The Beck Depression Inventory (BDI - Short Form: Beck, Rial, \& Rickels 1974)

    Time frame: Change from week 1 to week 9

  2. Change in Depressive symptoms

    The Beck Depression Inventory (BDI - Short Form: Beck, Rial, \& Rickels 1974)

    Time frame: Change from week 9 and week 21 (ACT group only)

  3. Change in Pain acceptance

    Chronic Pain Acceptance Questionnaire (CPAQ-8: Fish, McGuire, Hogan, Morrison, \& Stewart 2010). The CPAQ-8 is an 8-item measure that evaluates acceptance of pain according to two sub-scales: activity engagement and pain willingness. Items are rated on a Likert scale from 0 = never true to 6 = always true. Total scores range from 0 to 48 and higher scores reflect greater acceptance of pain.

    Time frame: Change from week 1 to week 9

  4. Change in Pain acceptance

    Chronic Pain Acceptance Questionnaire (CPAQ-8: Fish, McGuire, Hogan, Morrison, \& Stewart 2010). The CPAQ-8 is an 8-item measure that evaluates acceptance of pain according to two sub-scales: activity engagement and pain willingness. Items are rated on a Likert scale from 0 = never true to 6 = always true. Total scores range from 0 to 48 and higher scores reflect greater acceptance of pain.

    Time frame: Change from week 9 and week 21 (ACT group only)

  5. Change in Psychological inflexibility

    Psychological Inflexibility in Pain Scale (PIPS; Wicksell, Lekander, et al. 2010). The PIPS is composed of 12 items that evaluate two dimensions: avoidance and cognitive fusion. Items are rated on a Likert scale from 1 = never true to 7 = always true, to evaluate the level of inflexibility associated to pain. Scores range from 12 to 84, with higher scores revealing greater psychological inflexibility.

    Time frame: Change from week 1 to week 9

  6. Change in Psychological inflexibility

    Psychological Inflexibility in Pain Scale (PIPS; Wicksell, Lekander, et al. 2010). The PIPS is composed of 12 items that evaluate two dimensions: avoidance and cognitive fusion. Items are rated on a Likert scale from 1 = never true to 7 = always true, to evaluate the level of inflexibility associated to pain. Scores range from 12 to 84, with higher scores revealing greater psychological inflexibility.

    Time frame: Change from week 9 and week 21 (ACT group only)

  7. Participants' impression of change

    Patient Global Impression of Change (PGIC: Guy et al. 1976)

    Time frame: week 21

07

Study locations

No study locations are listed for this record.

08

References and documents

Publications

  • Hann, K. E. J., & McCracken, L. M. (2014). A systematic review of randomized controlled trials of Acceptance and Commitment Therapy for adults with chronic pain: Outcome domains, design quality, and efficacy. Journal of Contextual Behavioral Science, 3(4), 217-227. http://dx.doi.org/http://dx.doi.org/10.1016/j.jcbs.2014.10.001
  • Hughes LS, Clark J, Colclough JA, Dale E, McMillan D. Acceptance and Commitment Therapy (ACT) for Chronic Pain: A Systematic Review and Meta-Analyses. Clin J Pain. 2017 Jun;33(6):552-568. doi: 10.1097/AJP.0000000000000425. PubMed 27479642 ↗
  • Boulanger, A., Charbonneau, C., Choinière, M., Laliberté, J., & St-Hilaire, F. (2015). Renforcer les services de première ligne, développer les connaissances et les compétences des patients et des professionnels de la santé afin de mieux prévenir et traiter la douleur chronique.
  • Hogg MN, Gibson S, Helou A, DeGabriele J, Farrell MJ. Waiting in pain: a systematic investigation into the provision of persistent pain services in Australia. Med J Aust. 2012 Apr 2;196(6):386-90. doi: 10.5694/mja12.10140. PubMed 22471539 ↗
  • Jamison RN, Gintner L, Rogers JF, Fairchild DG. Disease management for chronic pain: barriers of program implementation with primary care physicians. Pain Med. 2002 Jun;3(2):92-101. doi: 10.1046/j.1526-4637.2002.02022.x. PubMed 15102155 ↗
  • Hayes, S. C., Strosahl, K. D., & Wilson, K., G. (2012). Acceptance and commitment therapy : the process and practice of mindful change (2nd ed.). New York: Guilford Press.
  • Veillette J, Martel ME, Dionne F. A randomized controlled trial evaluating the effectiveness of an acceptance and commitment therapy-based bibliotherapy intervention among adults living with chronic pain. Can J Pain. 2019 Nov 26;3(1):209-225. doi: 10.1080/24740527.2019.1678113. eCollection 2019. PubMed 35005411 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 23, 2019, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT03924687
Lead sponsor
Université du Québec à Trois-Rivières
Responsible party
Dr. Frédérick Dionne, Ph.D. (Associate Professor, Université du Québec à Trois-Rivières) — Principal investigator
First posted
Apr 23, 2019
Start date
Mar 28, 2016
Primary completion
Aug 2016
Completion
Aug 2016
Last update
Apr 23, 2019

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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