Sanabria-Mazo, J. P., Colomer-Carbonell, A., Borràs, X., Castaño-Asins, J. R., McCracken, L. M., Montero-Marin, J., ... & Luciano, J. V. (2023). Efficacy of videoconference group Acceptance and Commitment Therapy (ACT) and Behavioral Activation Therapy for Depression (BATD) for chronic low back pain (CLBP) plus comorbid depressive symptoms: A randomized controlled trial (IMPACT study). The Journal of Pain, 24(8), 1522–1540. DOI: 10.1016/j.jpain.2023.04.008
This study examined the efficacy of adding a remote, synchronous, group, videoconference-based form of acceptance and commitment therapy (ACT) or behavioral activation therapy for depression (BATD) to treatment-as-usual (TAU) in 234 patients with chronic low back pain (CLBP) plus comorbid depressive symptoms. Participants were randomly assigned to ACT, BATD, or TAU. Compared to TAU, ACT produced a significant reduction in pain interference at posttreatment (d = .64) and at follow-up (d = .73). BATD was only superior to TAU at follow-up (d = .66). A significant reduction in pain catastrophizing was reported by patients assigned to ACT and BATD at posttreatment (d = .45 and d = .59, respectively) and at follow-up (d = .59, in both) compared to TAU. Stress was significantly reduced at posttreatment by ACT in comparison to TAU (d = .69). No significant between-group differences were found in depressive or anxiety symptoms. Clinically relevant number needed to treat (NNT) values for reduction in pain interference were obtained at posttreatment (ACT vs TAU = 4) and at follow-up (ACT vs TAU = 3; BATD vs TAU = 5). In both active therapies, improvements in pain interference at follow-up were significantly related to improvements at posttreatment in psychological flexibility. These findings suggest that new forms of cognitive-behavioral therapy are clinically useful in improving pain interference and pain catastrophizing. Further research on evidence-based change processes is required to understand the therapeutic needs of patients with chronic pain and comorbid conditions.
Sanabria-Mazo, J.P., Rodríguez-Freire, C., Gallego, A., Feliu-Soler, A., Suso-Ribera, C., García-Palacios, A., Hayes, S. C., Hofmann, S. G., Ciarrochi, J., McCracken, L. M., & Luciano, J. V. (2026). Acceptance and Commitment Therapy in Chronic Low Back Pain and Comorbid Depression: A Single-Case Study with Idiographic Network Analysis. International Journal of Cognitive Behavioral Therapyl, 19, 1-32. DOI: 10.1007/s41811-025-00268-x
Secondary Analysis
Medina, S., Forero, C. G., Sanabria-Mazo, J. P., Rodríguez-Freire, C., Navarrete, J., O'Daly, O. G., Howard, M. A. & Luciano, J. V. (2025). Baseline Functional Connectivity of the Mesolimbic, Salience, and Sensorimotor Systems Predicts Responses to Psychological Therapies for Chronic Low Back Pain With Comorbid Depression: A Functional MRI Study. Brain and Behavior, 15, e70380. DOI: 10.1002/brb3.70380
Idiographic analyses
Sanabria-Mazo, J. P., Giné-Vázquez, I., Cristobal-Narváez, P., Suso-Ribera, C., García-Palacios, A., McCracken, L. M., … Luciano, J. V. (2025). Relationship between outcomes and processes in patients with chronic low back pain plus depressive symptoms: Idiographic analyses within a randomized controlled trial. Psychotherapy Research, 35(6), 1001–1016. DOI: 10.1080/10503307.2024.2382429
Economic evaluation
Sanabria-Mazo, J. P., D’Amico, F., Cardeñosa, E., Ferrer-Forés, M., Edo, S., Borràs, X., McCracken, L. M., Feliu-Soler, A., Sanz, A., & Luciano, J. V. (2024). Economic evaluation of videoconference group acceptance and commitment therapy and behavioral activation therapy for depression versus usual care among adults with chronic low back pain plus comorbid depressive symptoms. The Journal of Pain, 25(7), 104472. DOI: 10.1016/j.jpain.2024.01.337
Qualitative study
Sanabria-Mazo, J.P., Colomer-Carbonell, A., Gandara-Urrutia, N., Pérez-Sutil, J.M., Noboa-Rocamora, G., Fernández-Vázquez, Ó., Val-Mariano, G., Fontana-McNally, M., Cardona-Ros, G., Feliu-Soler, A., McCracken, L.M., Edo, S., Sanz, A., & Luciano, J.V. (2023). Experiences of patients with chronic low back pain plus comorbid depressive symptoms in a videoconference group acceptance and commitment therapy or behavioral activation treatment for depression: a qualitative study. Disability and Rehabilitation, 46(21), 5052–5063. DOI: 10.1080/09638288.2023.2298265