| 1. |
|
|
| 2. |
|
|
| 3. |
- Bendelin, Nina, et al.
(författare)
-
Patients' experiences of internet-based Acceptance and commitment therapy for chronic pain : a qualitative study
- 2020
-
Ingår i: BMC Musculoskeletal Disorders. - : BMC. - 1471-2474. ; 21
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Chronic pain is a globally widespread condition with complex clusters of symptoms within a heterogeneous patient group. Internet-delivered Acceptance and Commitment Therapy (IACT) has shown promising results in the treatment of chronic pain. How IACT is experienced by patients is less well known. Qualitative studies of patients' experiences are needed to further understand factors behind both engagement and negative effects. The aim of this study was to explore how IACT was experienced by chronic pain patients who had participated in a controlled trial.Methods: Through an open and exploratory approach this study aimed to investigate how IACT was experienced when delivered as a guided self-help program to persons with chronic pain. Eleven participants were interviewed over telephone after completing IACT.Results: Qualitative analysis based on grounded theory resulted in 2 core categories and 8 subcategories. In treatment: Physical and cognitive restraints, Time and deadline, Therapist contact, and Self-confrontation. After treatment: Attitude to pain, Image of pain, Control or Command, and Acting with pain. Individual differences as well as specific conditions of the treatment may explain variations in how the treatment was approached, experienced and what consequences it led to. Therapist guidance and deadlines for homework play complex roles in relation to autonomy and change.Conclusions: Adjusting treatment content and format based on participants' characteristics, such as expectations, motivation and restraints, might positively affect engagement, autonomy and change. Further research on attrition and negative effects of treatment might clarify what enables chronic pain patients to benefit from IACT.
|
|
| 4. |
- Buhrman, Monica, 1974-, et al.
(författare)
-
Controlled trial of Internet-based treatment with telephone support for chronic back pain
- 2004
-
Ingår i: Pain. - : Ovid Technologies (Wolters Kluwer Health). - 0304-3959 .- 1872-6623. ; 111:3, s. 368-377
-
Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to investigate the effects of an Internet-based cognitive-behavioral intervention with telephone support for chronic back pain. Participants who met the criteria for chronic back pain (N=56) were randomly assigned to either an Internet-based cognitive behavioral self-help treatment or to a waiting-list control condition. The study period lasted 8 weeks and consisted of 1 week of self-monitoring prior to the intervention, 6 weeks of intervention, and 1 week of post-intervention assessment. Treatment consisted of education, cognitive skill acquisition, behavioral rehearsal, generalization and maintenance. The dropout rate was 9% (N=5). Results showed statistically significant improvements in catastrophizing, control over pain and ability to decrease pain. Some improvement was found in both the control group and the treatment group. A follow-up of 3 months after treatment termination was completed in 92% (N=47) of the participants who completed the treatment intervention. Follow-up results showed that some improvement was maintained. Findings indicate that Internet-based self-help with telephone support, based on established psychological treatment methods, holds promise as an effective approach for treating disability in association with pain.
|
|
| 5. |
- Buhrman, Monica, 1974-
(författare)
-
Guided Internet-Based Cognitive Behaviour Therapy for Chronic Pain
- 2012
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Chronic pain is a one of the most common causes of disability and sick leave. Psychological factors play a central role in the experience of pain and are important in the management of pain. However, for many people with chronic pain CBT is not available. There is a need to develop alternative ways to deliver treatments that reach more individuals with chronic pain. Internet-based treatments have been shown to be effective for several disorders and recent research suggests that internet-based CBT for chronic pain can be effective. The present thesis included four randomized controlled studies with the aim of evaluating whether guided internet-based treatments based on CBT can help individuals with chronic pain regarding psychological variables.Study I investigated the effects of an internet-based CBT intervention with telephone support for chronic back pain. The study showed reductions in some variables assessed. Study II investigated the effects of an internet-based CBT intervention for chronic back pain without telephone support and with a live structured interview before inclusion. It was found that the treatment can reduce some of the distress associated with chronic pain.Study III investigated the effects of a guided internet-delivered CBT as a secondary intervention. Participants were patients who had previously completed multidisciplinary treatment at a pain management unit. Results showed that the internet-based treatment can be a feasible option for persons with residual problems after completed pain rehabilitation. Effects remained at six-month follow-up. Study IV focused on the effect of a guided internet-delivered acceptance and commitment therapy (ACT) for persons with chronic pain. Results suggest that an internet-delivered ACT treatment can help persons with chronic pain. Effects remained at six-month follow-up.In conclusion, guided internet-based CBT can decrease distress associated with chronic pain.
|
|
| 6. |
- Buhrman, Monica, 1974-, et al.
(författare)
-
Guided internet-delivered acceptance and commitment therapy for chronic pain patients: A randomized controlled trial
- 2013
-
Ingår i: Behaviour Research and Therapy. - : Elsevier. - 0005-7967 .- 1873-622X. ; 51:6, s. 307-315
-
Tidskriftsartikel (refereegranskat)abstract
- Acceptance and commitment therapy (ACT) interventions for persons with chronic pain have recently received empirical support. ACT focuses on reducing the disabling influences of pain through targeting ineffective control strategies and teaches people to stay in contact with unpleasant emotions, sensations, and thoughts. The aim of the present study was to investigate the effect of a guided internet-delivered ACT intervention for persons with chronic pain. A total of 76 patients with chronic pain were included in the study and randomized to either treatment for 7 weeks or to a control group that participated in a moderated online discussion forum. Intent-to-treat analyses showed significant increases regarding activity engagement and pain willingness. Measurements were provided with the primary outcome variable Chronic Pain Acceptance Questionnaire which was in favour of the treatment group. Reductions were found on other measures of pain-related distress, anxiety and depressive symptoms. A six month follow-up showed maintenance of improvements. We conclude that an acceptance based internet-delivered treatment can be effective for persons with chronic pain.
|
|
| 7. |
- Buhrman, Monica, 1974-, et al.
(författare)
-
Guided Internet-delivered cognitive behavioural therapy for chronic pain patients who have residual symptoms after rehabilitation treatment: Randomized controlled trial
- 2013
-
Ingår i: European Journal of Pain. - : Elsevier. - 1090-3801 .- 1532-2149. ; 17:5, s. 753-765
-
Tidskriftsartikel (refereegranskat)abstract
- Background Chronic pain can be treated with cognitive behavioural therapy delivered in multidisciplinary settings. However, relapse is likely, and there is a need for cost-effective secondary interventions for persons with residual problems after rehabilitation. The aim of the present study was to investigate the effects of a guided Internet-delivered cognitive behavioural intervention for patients who had completed multidisciplinary treatment at a pain management unit. Methods A total of 72 persons with residual pain problems were included in the study and were randomized to either treatment for 8 weeks or to a control group who were invited to participate in a moderated online discussion forum. The participants had different chronic pain conditions, and a majority were women (72%). Twenty-two percent of the participants dropped out of the study before the post-treatment assessment. Results Intent-to-treat analyses demonstrated differences on the catastrophizing subscale of the Coping Strategies Questionnaire (Cohens d=0.70), in favour of the treatment group but a small within-group effect. Differences were also found on other measures of pain-related distress, anxiety and depressive symptoms. A 6-month follow-up exhibited maintenance of improvements. Conclusions We conclude that Internet-delivered treatment can be partly effective for persons with residual problems after completed pain rehabilitation.
|
|
| 8. |
- Buhrman, Monica, 1974-
(författare)
-
ICBT for chronic pain
- 2012
-
Ingår i: ICB for chronic pain.
-
Konferensbidrag (refereegranskat)
|
|
| 9. |
|
|
| 10. |
- Buhrman, Monica, 1974-, et al.
(författare)
-
Internet interventions for chronic pain including headache: A systematic review
- 2016
-
Ingår i: Internet Interventions. - : Elsevier BV. - 2214-7829. ; 4, s. 17-34
-
Tidskriftsartikel (refereegranskat)abstract
- Chronic pain is a major health problem and behavioral based treatments have been shown to be effective. However, the availability of these kinds of treatments is scarce and internet-based treatments have been shown to be promising in this area. The objective of the present systematic review is to evaluate internet-based interventions for persons with chronic pain. The specific aims are to do an updated review with a broad inclusion of different chronic pain diagnoses and to assess disability and pain and also measures of catastrophizing, depression and anxiety. A systematic search identified 891 studies and 22 trials were selected as eligible for review. Two of the selected trials included children/youth and five included individuals with chronic headache and/or migraine. The most frequently measured domain reflected in the primary outcomes was interference/disability, followed by catastrophizing. Result across the studies showed a number of beneficial effects. Twelve trials reported significant effects on disability/interference outcomes and pain intensity. Positive effects were also found on psychological variable such as catastrophizing, depression and anxiety. Several studies (n = 12) were assessed to have an unclear level of risk bias. The attrition levels ranged from 4% to 54% where the headache trials had the highest drop-out levels. However, findings suggest that internet-based treatments based on cognitive behavioural therapy (CBT) are efficacious measured with different outcome variables. Results are in line with trials in clinical settings. Meta-analytic statistics were calculated for interference/disability, pain intensity, catastrophizing and mood ratings. Results showed that the effect size for interference/disability was Hedge's g = − 0.39, for pain intensity Hedge's g = − 0.33, for catastrophizing Hedge's g = − 0.49 and for mood variables (depression) Hedge's g = − 0.26.
|
|
