| Abstract: Behavioral treatments for chronic pain have amassed an impressive and progressive record of success. As with any area of clinical science, challenges and shortcomings have also been identified. These include difficulties in maintaining clinical effectiveness from clinical trials into large scale implementation efforts, unclear identification of specific intervention components that are clearly linked to improved adaptive outcomes, and lack of clarity with regard to the necessary and active ingredients of effective treatment. Overall, these problems highlight the practical difficulty of translating research into practice. They also helpfully illuminate several potential avenues for improvement, including the need for: (1) a precise delineation of what constitutes treatment success and differentiates it from treatment failure, (2) lucidity in the specification of processes by which treatment is hypothesized to work followed by explicit tests of these hypotheses, and (3) methods to promote the generalization and continuance of within-treatment adaptive behavioral changes to the non-treatment environment. This presentation will describe Acceptance and Commitment Therapy (ACT) as one potential model that can aid in helpfully progressing down these avenues. In particular, the potential for augmenting patient behavior that displays an open, accepting, and non-struggling response to pain will be highlighted, as this area perhaps differs most markedly from other approaches where a primary focus may be on better management of pain and distress. Furthermore, the importance of identifying important and meaningful areas of living to pursue with pain present will be evaluated, as this has the potential to naturally promote generalization and longevity of treatment gains. Based on the data presented, it seems feasible for individuals with complex and potentially disabling pain to respond to that pain with acceptance and willingness, choose important areas of living that are of personal relevance, and take effective action to improve quality of life. Importantly, these responses are possible when pain is low, but crucially also when pain is elevated or even at its maximum. |