Living with pain is a reality for approximately one in five people in the Netherlands. If medication does not help, then psychological treatment may be used. An example is Acceptance and Commitment Therapy (ACT), which is primarily based on accepting pain. Hester Trompetter, a doctoral degree candidate at the UT, was the first person in the Netherlands to carry out research - in collaboration with Roessingh Research and Development - into the effectiveness of ACT as an online form of self-help treatment. "The results are very promising," says Trompetter. "About one third of the patients felt better after following the nine-week online 'Living with pain' course."
Central to the doctoral research carried out by Trompetter was the evaluation of the possible effectiveness of ACT as an online form of treatment. "There are advantages to offering treatment via the internet," explains Trompetter. "These include lower costs and time efficiency, for both patients and practitioners." Trompetter followed 82 Dutch people who were suffering chronic pain. The people in the group were offered the nine-week 'Living with Pain' course. The control group was made up of two groups with the same number of people. Three months on from the end of the course, one third of those who had taken the 'Living with Pain' course felt better. Specifically, they were experiencing less pain and fewer symptoms of depression and had fewer problems when going about their daily business (housekeeping tasks, work or social activities, for example).
What works for whom?
The group that showed improvement was made up of those people who, at the beginning of the course, reported a high level of positive well-being. This is characterised by people having objectives in life, good social relationships, control over their own environment and self-acceptance, among other things. "The results show that we can offer online pain treatment in an effective way, but not to everyone," comments Trompetter. "I think the results are realistic because I don't think that following a course of serious psychological treatment, such as this course, is for everyone. It is a good idea for there to be advance screening using a questionnaire designed to assess 'well-being'."
Train the trainer
In addition to looking into online forms of treatment, Trompetter also examined the ACT training given to practitioner teams at nine Dutch rehabilitation centres. A total of 160 professionals were involved, working as doctors, occupational therapists, physiotherapists, social workers and rehabilitation doctors. "The 'train the trainer' concept was applied," explains Trompetter. "The first 'leader team' followed the full six-day course about ACT. They then trained the teams made up of their colleagues. One year after the start of the training course, the professionals felt adequately capable of working with ACT. The patients, too, were very positive about how the treatment was administered."
More information
Dr Hester Trompetter's doctoral research was carried out as part of the research of the Institute for Innovation and Governance Studies at the Faculty of Behavioural, Management and Social Sciences, University of Twente in collaboration with Roessingh Research and Development. The doctoral thesis entitled 'ACT with Pain' is available on request. Hester Trompetter obtained her doctoral degree on 11 September 2014. Her thesis supervisors were Prof. K.M.G. Schreurs and Prof. E.T. Bohlmeijer.
