Utilizing Group Acceptance and Commitment Therapy (ACT) to Address Chronic Pain, Coping, and Functioning for Patients With Chiari Malformation: A Case Example

• Published in: Professional psychology, research and practice research and practice, 2019-10, Vol.50 (5), p.296-306
• Main Authors: Holmes, Samantha C., Gonzalez, Alejandra, Allen, Philip A., Johnson, Dawn M.
• Format: Article
• Language: English
• Subjects: Acceptance; Acceptance and Commitment Therapy; Chronic Pain; Coping; Coping Behavior; Drugs; Female; Group therapy; Headache; Human; Male; Mental disorders; Pain; Pain Management; Psychotherapy; Surgery; Symptoms; Treatment Planning; Treatment Withholding
• ISSN: 0735-7028; 1939-1323
• DOI: 10.1037/pro0000247

Individuals with Chiari malformation (CM) often experience of a host of symptoms that severely impact their functioning, ranging from chronic headache pain to neurocognitive impairment and psychological disorders. Currently available treatment options for this population include decompression surgery and medication pain management, which each come with their own limitations. A group-based acceptance and commitment therapy (ACT) approach is proposed as a less-invasive treatment option to improve functioning and coping with chronic pain and other symptoms associated with CM. ACT is widely used by clinicians in the treatment of patients with chronic pain and may help address some of the limitations with currently available treatment options for CM. This article details some of the unique challenges faced by individuals with CM, discusses research on the use of ACT for the treatment of chronic pain and headache, and examines its potential use with this population. We illustrate a case example of a weekly ACT group that was executed for patients with CM. Examples of the content covered in the group for each of the 6 core processes in ACT (i.e., defusion, acceptance, contacting the present moment, self-as-context, values, and committed action) are included, highlighting salient components and adaptations made for this population. The goal of this article is to examine the use of a psychotherapeutic approach to improve functioning and coping with chronic pain and other symptoms associated with CM. Further, the article underscores the need for research on psychotherapy approaches for the treatment of individuals with CM. Public Significance Statement Chiari malformation (CM) is a serious medical condition for which the current front-line treatments (i.e., surgery, medication pain management) have considerable limitations. The current paper provides preliminary support for a noninvasive alternative treatment by describing a case example of an acceptance and commitment therapy (ACT) group for patients with CM.