The systematic implementation of Acceptance & Commitment Therapy (ACT) in Dutch multidisciplinary chronic pain rehabilitation

• Published in: Patient education and counseling 2014-08, Vol.96 (2), p.249-255
• Main Authors: Trompetter, Hester R, Schreurs, Karlein M.G, Heuts, Peter H.T.G, Vollenbroek-Hutten, Miriam M
• Format: Article
• Language: English
• Subjects: Acceptance; Acceptance & Commitment Therapy; Acceptance and Commitment Therapy; Adherence; Adult; Chronic pain; Chronic Pain - complications; Chronic Pain - psychology; Chronic Pain - rehabilitation; Clinical Competence; Competence; Determinants; Female; Humans; Implementation; Internal Medicine; Male; Middle Aged; Netherlands; Nursing; Pain Management - methods; Patient Acceptance of Health Care; Patient Care Team; Professional-Patient Relations; Rehabilitation; Rehabilitation Centers; Surveys and Questionnaires; Treatment Outcome; Workloads; Young Adult
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/j.pec.2014.05.019

Abstract Objective This study evaluates the implementation of Acceptance & Commitment Therapy (ACT) in Dutch chronic pain rehabilitation centers. Changes in multidisciplinary professionals’ self-perceived competencies in working with ACT were evaluated and corroborated with patients’ ratings of treatment adherence. To inform subsequent implementation efforts, relevant determinants of implementation success were monitored and the relationship with self-perceived competencies over time was explored. Methods Data was gathered from 111 professionals, 9 managers and 79 patients using questionnaires at the start (T0), halfway (T1) and end (T2) of implementation, and at the end of treatment. Results All professionals adhered to ACT, improved significantly in self-perceived competencies over time and rated competence in working with ACT ≥ adequate at T2. Determinants of success were evaluated extremely positive by professionals and management. Professionals’ self-perceived competencies at T2 were most strongly related to ratings of more workload ( b = −.43), and experienced difficulties in working with ACT ( b = −.38) at T0 and T1. Conclusion Multidisciplinary chronic pain rehabilitation professionals rated their improvement in working with ACT positively during the implementation period. Impeding and facilitating factors were explored successfully. Practice implications A multi-faceted, long-term, educational, train-the-trainer approach may help to guide systematic changes in multidisciplinary treatment.