Advanced Journal of Management, Humanity and Social Science

The Effectiveness of Acceptance and Commitment Therapy on Reducing Depression and Increasing Quality of Life in Patients with Chronic Pain

Document Type : Original Article

Author

Ali Emami

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

10.5281/zenodo.22830874
Abstract
Chronic pain is a prevalent and disabling health condition that is frequently accompanied by depression, emotional distress, functional impairment, and reduced quality of life. Acceptance and Commitment Therapy (ACT) has emerged as a contextual behavioral intervention designed to improve psychological flexibility, facilitate acceptance of unpleasant internal experiences, and promote engagement in personally meaningful activities despite pain. The present systematic review and meta-analytic synthesis examined the effectiveness of ACT in reducing depressive symptoms and improving quality of life among adults with chronic pain. Published randomized controlled trials and previous systematic reviews and meta-analyses investigating ACT for chronic pain were considered. The evidence indicates that ACT produces clinically meaningful improvements in psychological and quality-of-life outcomes compared with usual care, waiting-list conditions, and, in some studies, active psychological interventions. Across a three-level meta-analysis involving 33 randomized controlled trials and 2,293 participants, ACT demonstrated significant effects on depression (Hedges' g = 0.43) and quality of life (g = 0.45) immediately after treatment. Similar effects were observed at follow-up, with pooled effects of g = 0.43 for depression and g = 0.43 for quality of life. Another meta-analysis of 21 trials involving 1,962 participants reported a standardized mean difference of −0.74 for depression and 0.43 for quality of life, favoring ACT. These findings suggest that ACT may be particularly valuable because it does not require pain elimination as a prerequisite for recovery. Instead, it targets psychological flexibility, acceptance, values-based behavior, and meaningful engagement. Overall, ACT appears to be an effective psychological intervention for reducing depression and enhancing quality of life in people living with chronic pain, although heterogeneity in intervention format, diagnosis, comparator condition, treatment duration, and follow-up period should be considered when interpreting the evidence.

Graphical Abstract

The Effectiveness of Acceptance and Commitment Therapy on Reducing Depression and Increasing Quality of Life in Patients with Chronic Pain

Keywords

Acceptance and Commitment Therapy
Chronic Pain
Depression
Quality of Life
Psychological Flexibility
Subjects
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Advanced Journal of Management, Humanity and Social Science
Volume 2, Issue 4
July 2026
Pages 350-360

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