Authors
1 Ph.D. Student in Clinical Psychology, Faculty of Humanities, Shahed University
2 shahed university
Abstract
The purpose of this study is to evaluate the effect of acceptance and commitment therapy for children with chronic pain on internalizing symptoms of 7 to 12 year-old children. In this quasi-experimental study, a number of children suffering from chronic pain were selected by available sampling method from specialty and subspecialty pediatric hospitals of Tehran (Such as Children's Mofid, Children's Medical Center, Hazrat Ali Asghar and Bahrami), in 2014. Then, among the children, 20 children who according to their parents were prepared to participate in this study and met the inclusion criteria, were selected and placed in the experimental group (n = 10) and control group (n = 10). The CHACT protocol applied on the experiment group, for 8 sessions. The Child Behavior Checklist (CBCL) was administered in both groups at the pre-test, post-test, first and second follow-up (Respectively, 1.5 and 5 months after treatment) and analyzed with MANCOVA analysis of variance. The results showed that the experimental group compared with the control group showed significant change in internalizing symptoms in multiple stages. These changes continued after the treatment, first and secondary follow-up. Generally, it can be said that this protocol can be used in clinical fields, especially in the area of improving the internalizing symptoms of children.
Keywords
فیضی، ژاله. مرادی، علیرضا. خواجه‌دلوئی، محمد و خادم، نیره. (1396). "کارآمدی درمان مبتنی بر پذیرش و تعهد بر اضطراب و افسردگی زنان باردار به وسیله لقاح خارج از رحمی". فصلنامه مطالعات روان‌شناسی بالینی، سال هفتم، شماره بیست و هفتم، 1-21.
قمیان، سهیلا و شعیری، محمدرضا. (1393). "طراحی مقدماتی پروتکل درمان مبتنی بر پذیرش و تعهد برای کودکان مبتلا به درد مزمن (CHACT) و بررسی تاثیر آن بر میزان انعطاف‌پذیری روان‌شناختی کودکان 7 تا 12 ساله نسبت به درد". مجله تحقیقات علوم رفتاری. 12(4)، 581-592.
مینایی، اصغر (1385). "انطباق و هنجاریابی سیاهه رفتاری کودک آخنباخ، پرسشنامه خودسنجی و فرم گزارش معلم"، پژوهش در حیطه کودکان استثنایی19، 6 (1)، 529-558.
نعیمی، ابراهیم و مظاهری، زهرا. (1396). "بررسی تاثیر مشاوره مبتنی بر پذیرش و تعهد (ACT) بر انطباق‌پذیری مسیر شغلی دانشجویان". فصلنامه مطالعات روان شناسی بالینی، سال هفتم، شماره بیست و هفتم، 161-180.
Allen, L. B. Tsao, J. C. I. Seidman, L. C. (2012). “A Unified, Transdiagnostic Treatment for Adolescents With Chronic Pain and Comorbid Anxiety and Depression”,Cognitive and Behavioral Practice, 19, 56-67.
Berquin, A. & Grisart, J. (2011). “To prescribe or not to prescribe. . . (in chronic pain. . . and elsewhere. . .)" , Annals of Physical and Rehabilitation Medicine , 54, 465–477.
Biglan, A. (1990). “A contextual approach to treating family distress. In Singer, G & Irvin, L. (Eds.), Supporting the family: Enabling a positive adjustment to children with disabilities (299–311)”. Baltimore: Paul H. Brookes.
Braams, B. R. Blechert, J. Boden, M. T. Gross, J. J. (2012). “The effects of acceptance and suppression on anticipation and receipt of painful Stimulation”, Journal of Behavior Therapy and Experimental Psychiatry. 43, 1014-1018.
Brattberg, G. (2004). “Do pain problems in young school children persist into early adulthood? A 13-year follow-up”, European Journal of Pain , 8, 187–199.
Carrascoso, L. & Francisco, J. (1999). “Acceptance and commitment therapy (ACT) in panic disorder with agoraphobia: A case study”, Psicothema, 11, 1–12.
Cioffi, D. & Holloway, J. (1993). “Delayed cost of suppressed pain”, Journal of Personality and Social Psychology, 64, 274–82.
Clark, D. M.. Ball, S. Pape, D. (1991). “An experimental investigation of thought suppression”, Behaviour Research and Therapy, 29, 253–257.
Dahl, J. Wilson, K. G. Luciano, C. Hayes, S. C. (2005). “Acceptance and commitment therapy for chronic pain”. Reno, NV: Context Press.
Geiser, D. (1992). “A comparison of acceptance-based and control-focused interventions in a chronic pain treatment center”, Unpublished doctoral dissertation, University of Nevada, Reno.
Gold, D. B. & Wegner, D. M. (1995),“Origins of ruminative thought: Trauma, incompleteness, nondisclosure, and suppression”, Journal of Applied Social Psychology, 25, 1245–1261.
Gross, J. J. & Levenson, R.W. (1997). “Hiding feelings: The acute effects of inhibiting negative and positive emotion”. Journal of Abnormal Psychology, 106, 95–103.
Hayes, S. C. (2004). “Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies”. Behavior Therapy, 35(4), 639-665.
Hayes, S. C. (1987). “A contextual approach to therapeutic change. In N. Jacobson (Ed.), Psychotherapists in clinical practice: Cognitive and behavioral perspectives (pp. 327–387)”. New York: The Guilford Press.
Hayes, S. C. Bissett, R. T. Korn, Z. Zettle, R. D. Rosenfarb, I. S. Cooper, L. D. Grundt, A. M. (1999).“The impact of acceptance versus control rationales on pain tolerance”. The Psychological Record, 49, 33–47.
Huggins, J. L. Bonn-Miller, M. O. Oser, M. L. (2012). “Pain anxiety, acceptance, and outcomes among individuals with HIV and chronic pain: A preliminary investigation”, Behaviour Research and Therapy , 50, 72-78.
Huguet, A. Eccleston, C. Miró, J. Gauntlett-Gilbert, J. (2009). “Young people making sense of pain: Cognitive appraisal, function, and pain in 8–16 year old children”, European Journal of Pain , 13, 751–759.
Johnston, M. Foster, M. Shennan, J. Starkey, N. Johnson, A. (2010). “The Effectiveness of an acceptance and commitment therapy self-help intervention for chronic pain”. Clinical Journal of Pain,.26(5), 393-402.
Kashikar-Zuck, S. Flowers, S. R. Claar, R. L. ( 2011). “Clinical utility and validity of the Functional Disability Inventory among a multicenter sample of youth with chronic pain”, PAIN, 152, 1600–1607.
Korn, Z. (1997). “Effects of acceptance/commitment and cognitive behavioral interventions on pain tolerance”. Unpublished doctoral dissertation, Hofstra University.
Kranz, D. Bollinger, A. Nilges, P. (2010). “Chronic pain acceptance and affective well-being: A coping perspective”, European Journal of Pain, 14, 1021–1025.
Kratz, A. L. Davis, M. C. Zautra, A. J. (2007). “Pain acceptance moderates the relation between pain and affect in chronic pain patients”. Annals of Behavioral Medicine,33, 291–301.
Lethem, J. Slade, P. D. Troup, J. D. Bentley, G. (1983). “Outline of a fear-avoidance model of exaggerated pain perceptioneI”, Behaviour Research and Therapy, 21(4), 401-408.
Lunde, L. H. & Nordhus, I. H. (2009). “Combining acceptance and commitment therapy and cognitive behavioral therapy for the treatment of chronic pain in older adults”. Clinical Case Studies, 8(4), 296-308.
Marx, B. P. Sloan, D. M. (2002). “The role of emotion in the psychological functioning of adult survivors of childhood sexual abuse”. Behavior Therapy, 33, 563–577.
McCracken, L. M. Eccleston, C. Bell, L.(2005). “Clinical assessment of behavioral coping responses: results from a brief inventory”, European Journal of Pain, 9(1), 69-78.
McCracken, L. M. & Eccleston, C. (2005). “A prospective study of acceptance of pain and patient functioning with chronic pain”. Pain, 118, 164–169.
McCracken, L. M. MacKichan, F. Eccleston, C. (2007). “Contextual cognitive-behavioral therapy for severely disabled chronic pain sufferers: effectiveness and clinically significant change”. European Journal of Pain, 11(3), 314-22.
McCracken, L. M. & Yang, S. (2006). “The role of values in a contextual cognitive-behavioral approach to chronic pain”, Pain, 123, 137–145.
McCracken, L. M. (2005). “Social context and acceptance of chronic pain: the role of solicitous and punishing responses”, Pain , 113, 155–159.
McCracken, L. M. Carson, J. W. Eccleston, C. Keefe, F. J. (2004). “Acceptance and change in the context of chronic pain”, Pain , 109, 4–7.
McCracken, L. M. Gauntlett-Gilbert, J. & Eccleston, C. (2010). “Acceptance of pain in adolescents with chronic pain: Validation of an adapted assessment instrument and preliminary correlation analyses”. European Journal of Pain, 14, 316-320.
McCracken, L, M. Vowles, K. E. Eccleston, C. (2005). “Acceptance based treatment for persons with complex, long standing chronic pain: A preliminary analysis of treatment outcome in comparison to a waiting phase”. Behaviour Research and Therapy, 43, 1335–1346.
Mikkelsson, M. Sourander, A. Piha, J. Salminen, J. J. (1997). “Psychiatric symptoms in preadolescents with musculoskeletal pain and fibromyalgia”. Pediatrics, 100, 220–227.
Mikkelsson, M. Sourander, A. Salminen, J. J. Kautiainen, H. (1998). “Contributing factors to the persistence of musculoskeletal pain in preadolescents: a prospective 1-year follow-up study”, Pain, 77(1), 67– 72.
Mikkelsson, M. Sourander, A. Salminen, J. J. Kautiainen, H. Piha, J. (1999). “Widespread pain and neck pain in school children. A prospective one-year follow-up study”. Acta Paediatrica,, 88(10),1119–1124.
Palermo, T. M. Riley, C. A. Mitchell, B. A. (2008). “Daily Functioning and Quality of Life in Children With Sickle Cell Disease Pain: Relationship With Family and Neighborhood Socioeconomic Distress”, The Journal of Pain, 9(9), 833-840.
Pielech, M. Vowles, K. E. Wicksell, R. (2017). “Acceptance and ommitment Therapy for Pediatric Chronic Pain: Theory and Application”. Children, 4, 10.
Roche, B. Forsyth, J. P. Maher, E. (2007). “The Impact of Demand Characteristics on Brief Acceptance- and Control-Based Interventions for Pain Tolerance”, Cognitive and Behavioral Practice , 14, 381–393.
Romano, J. M. & Turner, J. A. (1985). “Chronic pain and depression; does the evidence support a relationship?”, Psychological Bulletin, 97, 18–34.
Schutze, R. Rees, C. Preece, M. Schutze, M. Low. (2010). “mindfulness predicts pain catastrophizing in a fear-avoidance model of chronic pain”. Pain, 148(1), 120-127.
Shaw, W. S. Linton, S. J. Pransky, G. (2006). “Reducing sickness absence from work due to low back pain: how well do intervention strategies match modifiable risk factors?”, Journal of Occupational rehabilitation, 16, 591–605.
Strigo, I. A. Simmons, A. N. Matthews, S. C. Craig, A. D. Paulus, M. P. (2008). “Major depressive disorder is associated with altered functional brain response during anticipation and processing of heat pain”. Archives of General Psychiatry, 65, 1275–1284.
Sullivan, M. J. L. Rouse, D. Bishop, S. Johnston, S. (1997). “Thought suppression, catastrophizing, and pain”. Cognitive Therapy and Research, 21, 555–568.
Thompson, R. W. Arnkoff, D. B. Glass, C. R. (2011). “Conceptualizing mindfulness and acceptance as components of psychological resilience to trauma. [Research Support, Non-U.S. Gov’t Review]”, Trauma, violence & abuse, 12(4), 220-235.
Turk, D. C. Okifuji, A. Scharff, L. (1995). “Chronic pain and depression: role of perceived impact and perceived control in different age cohorts”. Pain, 61, 93–101.
Twohig, M. P. (2012). “The Basics of Acceptance and Commitment Therapy”, Cognitive and Behavioral Practice, 19, 499-507.
Vowles, K. E. McCracken, L. M. Eccleston, C. (2007). “Processes of behavior change in interdisciplinary treatment of chronic pain: Contributions of pain intensity, catastrophizing, and acceptance”. European Journal of Pain, 11, 779–787.
Vowles, K. E. McNeil, D. W. (2007). “Effects of Pain Acceptance and Pain Control Strategies on Physical Impairment in Individuals With Chronic Low Back Pain”, Behavior Therapy , 38, 412–425.
Vowles, K. E. Wetherell, J. L. Sorrell, J. T. (2009). “Targeting Acceptance, Mindfulness, and Values-Based Action in Chronic Pain: Findings of Two Preliminary Trials of an Outpatient Group-Based Intervention”, Cognitive and Behavioral Practice, 16, 49–58.
Walker, L. S. Smith, C. A. Garber, J. Claar, R. L. (2005). “Testing a model of pain appraisal and coping in children with chronic abdominal pain”. Health Psychology, 24, 364–374.
Wegner, D. M. Schneider, D. J. Carter, S. R. White, T. L.(1987). “Paradoxical effects of thought suppression”. Journal of Personality and Social Psychology , 53, 5–13.
Wetherell, J. L. Afari, N. Rutledge, T. Sorrell, J. T. Stoddard, J. A. Petkus, A. J. Solomon, B. C. Lehman. D. H. Liu, L. Lang, A. J. (2011). “A randomized, controlled trial of acceptance and commitment therapy and cognitive-behavioral therapy for chronic pain”, PAIN, 152, 2098–2107.
Wicksell, R. K. Melin, L. Olsson, G. L. (2007). “Exposure and acceptance in the rehabilitation of adolescents with idiopathic chronic pain – A pilot study”, European Journal of Pain, 11, 267–274.
Wicksell, R. K.. Ahlqvist, J. Bring, A. Melin, L. Olsson, G. L. (2008). “Can exposure strategies improve functioning and life satisfaction in people with chronic pain and whiplash-associated disorders (WAD)? A randomized controlled trial”. Cognitive Behavioral Therapy, 37(3), 169–182.
Wicksell, R. K. Olsson, G. L. Hayes, S. C. (2011). “Mediators of change in Acceptance and Commitment Therapy for pediatric chronic pain”, PAIN, 152, 2792–2801.
Wicksell, R. K. (2009). “Exposure and Acceptance in Patients with Chronic Debilitating Pain - A Behavior Therapy Model to Improve Functioning and Quality of Life”, Doctoral Thesis, Karolinska University, Stockholm, Sweden.
Wicksell, R. K. Melin, L. Lekander, M. (2009). “Evaluating the effectiveness of exposure and acceptance strategies to improve functioning and quality of life in longstanding pediatric pain – A randomized controlled trial”, PAIN , 141, 248–257.
Zettle, R. D. (2003). “Acceptance and commitment therapy (ACT) vs. systematic desensitization in treatment of mathematics anxiety”. Psychological Record, 53, 197–215.
Zettle, R. D. (1984). “Cognitive therapy of depression: A conceptual and empirical analysis of component and process issues”. Unpublished doctoral dissertation, University of North Carolina, Greensboro.
Zettle, R. D. Raines, J. C. (1989). “Group cognitive and contextual therapies in treatment of depression”. Journal of Clinical Psychology, 45, 438–445.
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