Patients’ experiences of internet-based Acceptance and commitment therapy for chronic pain: a qualitative study
Open accessAbstract
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. Trial registration: clinicaltrials.gov (NCT01603797). Registered 22 May 2012. Retrospectively registered.
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ACT promoting acceptance, mindfulness, and committed action to living in alignment with values may improve QoL and decrease psychological distress by helping those who receive the therapy better manage uncomfortable or negative emotions, thoughts, and experiences; accept them without judgment; and move forward to valued living.
“ACT promoting acceptance, mindfulness, and committed action to living in alignment with values may improve QoL and decrease psychological distress by helping those who receive the therapy better manage uncomfortable or negative emotions, thoughts, and experiences; accept them without judgment; and move forward to valued living [54,55].”
From Efficacy of Internet-Based Acceptance and Commitment Therapy for Depressive Symptoms, Anxiety, Stress, Psychological Distress, and Quality of Life: Systematic Review and Meta-analysis. (2022) · cites this paper as [54]
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Babadağ, B. (2020) · Ağrı - The Journal of The Turkish Society of Algology · doi:10.14744/agri.2020.02212
“” [33] In another qualitative study conducted by Rutberg and Öhrling [34] which examined the experiences of women with migraine, it was stated that women take painkillers to cope with the pain thinking they do not have any alternative.”
Lindegaard, T., Kashoush, F., Holm, S., Halaj, A., Berg, M., & Andersson, G. (2021) · Figshare · doi:10.6084/m9.figshare.14728316
Self-citationNevelikova, M., Zlámal, F., Dosbaba, F., Su, J. J., & Baťalík, L. (2026) · Hong Kong Physiotherapy Journal · doi:10.1142/s1013702526500022
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Semonella, M., Rapelli, G., Rodighiero, C., Luca, A. D., Andersson, G., Buhrman, M., Donisi, V., Landi, G., Manna, C., Pasini, I., et al. (2026) · Internet Interventions · doi:10.1016/j.invent.2026.100972
“…as acceptable, empowering, and applicable to everyday pain management, particularly when interventions combine structured self-help content with therapist guidance, experiential exercises, and flexible access to materials (Bendelin et al., 2020; Main et al., 2025; Rickardsson et al., 2020).”
Self-citationSemonella, M., Luca, A. D., Rodighiero, C., Andersson, G., Buhrman, M., Donisi, V., Usubini, A. G., Landi, G., Manna, C., Pasini, I., et al. (2026) · Frontiers in Psychology · doi:10.3389/fpsyg.2026.1813251
Self-citation
- Authors
- Bendelin, N., Björkdahl, P., Risell, M., Nelson, K. Z., Gerdle, B., Andersson, G., & Buhrman, M.
- Affiliations
- Linköping University (SE)
- Uppsala University (SE)
- Corresponding author
- Bendelin, Nina
- Venue
- BMC Musculoskeletal Disorders
- Published
- 2020-04-06
- Volume
- 21
- Issue
- 1
- Pages
- 212-212
- ISSN
- 1471-2474 (ISSN-L)
- PMC
- PMC7137329
- OpenAlex
- W3014193525
- Cited by
- 33
- References
- 51
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 4 · 2023: 7 · 2022: 6 · 2021: 8 · 2020: 1
- FWCI
- 2.20
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Musculoskeletal Disorders (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- KTH Publication Database DiVA (KTH Royal Institute of Technology) (submittedVersion, other-oa)
- Uppsala University Publications (Uppsala University) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- County Council of Östergötland (SC-2019-00155-39)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Keywords
- chronic pain, patient experience, guided self-help, treatment engagement, autonomy, therapist contact, pain attitudes, treatment discontinuation
- MeSH terms
- Internet-Based Intervention, Adult, Aged, Aged, 80 and over, Female, Humans, Interviews as Topic, Male, Middle Aged, Motivation, Telephone, Treatment Outcome, Qualitative Research, Chronic Pain, Acceptance and Commitment Therapy
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