Chronic pain: third wave case conceptualizations

Kevin E. Vowles*

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapter


The three “waves” of behavioral therapy have each considered chronic pain as a relevant and treatable clinical problem. These treatments have a longstanding and well-established evidence base. As the prime example of a third wave behavioral treatment, acceptance and commitment therapy (ACT) for chronic pain seeks to enhance willingness to have chronic pain in the service of engaging in personally meaningful activity. Several studies have examined willingness to have pain (e.g., pain acceptance) in the service of engagement in meaningful activity (e.g., values-based action) and there is strong support for their relevance in those who are living with chronic pain. Treatments using the ACT model have been successful at improving pain acceptance, values-based action, emotional distress, physical ability, healthcare utilization, and engagement in role functioning up through follow-ups of as long as 3 years. As with the other behavioral treatments from preceding waves, ACT for chronic pain seeks to reduce the deleterious effects of pain on functioning. That being said, ACT is distinctive from the previous two behavioral waves with regard to its view of cognition as an important and relevant, but not uniquely causal, aspect of human behavior and in its specification that increasing engagement in valued activities is the principal goal of intervention.

Original languageEnglish
Title of host publicationBehavior therapy. First, second, and third waves
EditorsWilliam O'Donohue, Akihiko Masuda
PublisherSpringer International Publishing AG
Number of pages23
ISBN (Electronic)9783031116773
ISBN (Print)9783031116766
Publication statusPublished - 18 Oct 2022

Bibliographical note

Publisher Copyright:
© Springer Nature Switzerland AG 2022.


  • Acceptance and commitment therapy
  • Chronic pain
  • Cognitive behavior therapy for chronic pain
  • Third wave treatments

ASJC Scopus subject areas

  • Psychology(all)


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