# Acceptance and commitment therapy in rehabilitation for chronic pain and fatigue: a qualitative interview study with patients

## TL;DR

This study explores how patients with chronic pain and fatigue experience a rehabilitation program based on acceptance and commitment therapy (ACT), highlighting both benefits and areas for improvement.

## Contribution

The study provides qualitative insights into how ACT-based rehabilitation impacts patients' emotional and psychological experiences in a group setting.

## Key findings

- Participants felt a sense of community and shared understanding helped reduce feelings of loneliness and failure.
- Increased self-compassion and self-awareness were valued outcomes of the ACT program.
- Some participants found the sharing practices uncomfortable and felt the program had limited benefits for them.

## Abstract

To shed a nuanced light on the experiences of taking part in a rehabilitation programme using acceptance and commitment therapy (ACT) for people living with persistent pain and fatigue.

The ACT intervention, designed by the Pain Clinic of a University Hospital, consisted of six four-hour sessions, each for four groups of 6–8 participants, given over the course of four months. An interdisciplinary research team thematically analysed 13 post-programme individual interviews with people aged 21 to 54 with different symptoms and diagnoses using systematic text condensation.

Participants reported that while illness had led to feelings of loneliness, loss and failure, participating in a safe and supportive group setting led to a nurturing sense of shared community, understanding and learning. Increased self-awareness, self-acceptance and self-compassion were valued outcomes of the programme. Most felt that they had acquired new tools, such as exercises, practices and altered ways of thinking. A few participants were uncomfortable with the sharing practices and felt that the programme brought few benefits for them.

The study indicates the value of a sense of community and experiencing illness as a shared human condition. Learning to see oneself as worthy of self-compassion, suggested in the literature as key to pain rehabilitation, was connected to group validation and ACT-specific sessions. Information, exercises and sharing practices could have been even better targeted and tailored to individual participants.