The Effectiveness of ACT and DBT-Based Interventions with and without Exercise on Pain Outcomes and Desire for Treatment in Substance-Dependent Patients with Chronic Pain

Background: Managing chronic pain outcomes and addressing the desire for addiction treatment can be crucial for recovery from substance dependence and chronic pain. Objectives: This study aimed to control pain outcomes and enhance the desire for treatment using interventions based on acceptance and commitment therapy (ACT), Dialectical Behavior Therapy (DBT), and physical exercise. Methods: This quasi-experimental study employed a pre-test-post-test design with a two-month follow-up period and included a control group. Seventy-five voluntary patients undergoing addiction treatment in 2021 at Taban, Hayate Pak, and Omid addiction treatment centers in Zahedan with chronic pain participated. Participants were selected through purposive sampling and randomly assigned to five groups (ACT and DBT groups with and without exercise, and a control group). Data were collected using the Pain Outcomes Questionnaire-VA (POQ-VA) (Clark, Gironda, & Young, 2003) and the Stages of Change Readiness and Treatment Eagerness scale (SOCRATES) (Miller & Tonigan, 1996). Acceptance and Commitment Therapy intervention (eight sessions), DBT intervention (eight sessions), and aerobic exercise (24 sessions) were conducted only for the intervention groups over two months. Data were analyzed using repeated measures analysis of variance (ANOVA) and Bonferroni's post hoc test with SPSS-26 software at a significance level of 0.05 (P < 0.05). Results: Repeated measures ANOVA revealed significant changes for ACT and DBT interventions with and without exercise in the intragroup effect (time) for pain outcomes and the desire for treatment across the pre-intervention, post-intervention, and follow-up stages (P ≤ 0.001), as well as for time-group interaction (P ≤ 0.001). Furthermore, the three groups exhibited significant differences in pain outcomes and the desire for treatment across the three evaluation stages (P ≤ 0.01). Notably, compared to other interventions, ACT intervention with exercise was more effective in managing pain outcomes and enhancing the desire for treatment (P ≤ 0.001). Conclusions: The findings suggest that ACT intervention with exercise, while controlling pain outcomes and increasing the desire for treatment, can contribute to successful addiction cessation and serve as an effective intervention in healthcare settings.