Journal of Behavioral Medicine

, Volume 38, Issue 1, pp 66–80 | Cite as

Internet-based guided self-help intervention for chronic pain based on Acceptance and Commitment Therapy: A randomized controlled trial

  • Hester R. Trompetter
  • Ernst T. Bohlmeijer
  • Martine M. Veehof
  • Karlein M. G. Schreurs


Acceptance-based psychological interventions can potentially minimize the burden of chronic pain. This randomized controlled trial evaluated an internet-delivered, guided self-help intervention based on Acceptance and Commitment Therapy (ACT). A total of 238 chronic pain sufferers from the general population were randomly allocated to either ACT (n = 82), an internet-based control condition Expressive Writing (n = 79) or a waiting list condition (n = 77). Participants completed measures at baseline, posttreatment (3 months) and at a 3-month follow-up. At follow-up, ACT participants had improved in pain interference in daily life (primary outcome) compared to participants in Expressive Writing (Cohen’s d = .47), but not compared to waiting list participants (p value = .11). Those who adhered to the ACT-intervention (48 %) did improve significantly compared to waiting list participants (d = .49). ACT-participants also showed superior improvement on depression, pain intensity, psychological inflexibility and pain catastrophizing (d: .28–.60). Significant clinical improvement was present. Especially, 28 % of ACT-participants showed general clinically relevant improvement in pain interference, as well as in pain intensity and depression (vs. Expressive Writing and waiting list 5 %). Given these findings, internet-based ACT programs may be a promising treatment modality for chronic pain.


Chronic pain Acceptance RCT ACT Internet-based intervention Pain interference 



Funding for this study was provided by the Innovation Fund Health Insurers (Innovatiefonds Zorgverzekeraars). The study protocol was approved by the Dutch Medical-Ethical Review Board (METC, trial number NL38622.044.11), which operates under the Dutch Central Committee for Research involving human participants (CCMO). The study has been registered in the Dutch Trial Register (Nederlands Trialregister), the primary trial register for clinical trials in the Netherlands (trial number NTR3659).

Conflict of Interest

Authors Hester R. Trompetter, Ernst T. Bohlmeijer, Martine M. Veehof and Karlein M. G. Schreurs declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Hester R. Trompetter
    • 1
    • 2
  • Ernst T. Bohlmeijer
    • 1
  • Martine M. Veehof
    • 1
  • Karlein M. G. Schreurs
    • 1
    • 2
  1. 1.Department of Psychology, Health and Technology, Faculty of Behavioural SciencesUniversity of TwenteEnschedeThe Netherlands
  2. 2.Roessingh Research and DevelopmentEnschedeThe Netherlands

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