Journal of Anesthesiology and Pain

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Ebadi Z, Mousavi Bakhsh S H, Azhdari S. Comparison of the Effectiveness of Positive Psychotherapy and Acceptance and Commitment Therapy on Pain Anxiety, Pain Catastrophizing, and Psychological Well-Being in Patients with Chronic Headache in Hamedan. JAP 2026; 17 (2) :58-69
URL: http://jap.iums.ac.ir/article-1-5830-en.html

Chronic headache is one of the most common painful neurological disorders and has detrimental effects on patients’ quality of life. Given the limitations of pharmacological treatments and the need for more comprehensive approaches, the present study was conducted with the aim of comparing the effectiveness of positive psychotherapy (PPT) and acceptance and commitment therapy (ACT) on pain anxiety, pain catastrophizing, and psychological well-being in patients with chronic headache.

Methods:

The present study was an experimental investigation with a pretest-posttest design and a three-month follow-up conducted on 60 patients with chronic headache based on the ICHD-3 criteria, who were selected through convenience sampling from specialized clinics in the city of Hamadan. The participants were randomly assigned to three groups: PPT (n = 20), ACT (n = 20), and a control group (no intervention) (n = 20). The PPT and ACT groups each received 8 weekly sessions, lasting 90 minutes per session. The assessment instruments included the Pain Anxiety Questionnaire, the Pain Catastrophizing Scale, and the Psychological Well-Being Questionnaire, which were administered at three time points: pretest, posttest, and three-month follow-up. The data were analyzed using multivariate analysis of covariance (MANCOVA) and the Sidak test. Data analysis was performed using SPSS version 26.

Results:

The results showed that in both the PPT and ACT groups, there was a significant decrease in the mean scores of pain anxiety and pain catastrophizing, as well as a significant increase in psychological well-being at the posttest and follow-up stages compared with the control group (p < 0.001). In addition, no significant difference was observed between the effectiveness of the two approaches, PPT and ACT, on the studied variables (p > 0.05), although the improvement trend in both treatment groups was stable.

Conclusion:

Both positive psychotherapy and acceptance and commitment therapy were effective in reducing pain anxiety and pain catastrophizing and in improving psychological well-being in patients with chronic headache. These findings indicate that focusing on individual strengths and the positive aspects of life (PPT), as well as accepting unpleasant internal experiences and committing to personal values (ACT), can both be used as complementary interventions alongside standard treatments for chronic headache. Given the absence of a significant difference between the two approaches, the choice between them may be based on the patient’s and therapist’s preferences, as well as the specific characteristics of each individual.