Acceptance and commitment therapy (ACT) to manage pain for people with Crohn’s

What the researchers will look at?

Up to 7 in 10 people with Crohn’s have long-standing pain. Pain stops many people from doing the things they enjoy and greatly reduces their quality of life. Treatments available now aim to reduce the severity of pain and include: 

• medicines such as painkillers 
• talking therapies such as cognitive-behavioural therapy (CBT). 

But for many people pain remains after these treatments, even when gut symptoms are well controlled. 

Acceptance and Commitment Therapy (ACT) is a talking therapy that starts by accepting that pain will not go away quickly. It encourages the person to focus on positive activities that they value, even when significant pain continues. It is a group-based therapy that allows people to share their lived experiences of ongoing pain and learn new strategies to manage this from each other. 

ACT has been found to be effective in improving quality of life in people with long-standing pain in other conditions. This is the first study to explore this approach in people with Crohn’s disease. 

The study will involve 48 people with Crohn’s and long-standing tummy pain. They will have group sessions of 90 minutes once a week led by an experienced psychologist, along with weekly homework tasks. Half the group will also receive usual care from their IBD team, but no specific pain treatment. Participants will complete questionnaires before, during and after treatment and take part in an interview to discuss their experience of ACT.  

What the researchers think this could this mean for people with Crohn’s?

Researchers hope that this therapy will help people with Crohn’s to do more despite the pain, such as returning to work sooner after a flare-up. It may also improve symptoms including depression, anxiety and fatigue.  Based on the findings of this study the researchers will design a larger trial and include people with Ulcerative Colitis. 

Acceptance and Commitment Therapy could offer a new approach to treatment of ongoing pain that will improve quality of life for people with Crohn’s and Colitis.    

Who is leading this research: Dr Wladyslawa Czuber-Dochan, King’s College London 
Our funding: £117,378.26 
Duration: 24 months 
Official title of application: Managing pain in people with Crohn's Disease: Feasibility Testing of an Acceptance and Commitment Group Therapy intervention.