(PS13-A14) Acceptability of a Remotely Delivered, Brief Acceptance and Commitment Therapy Group for Women Veterans with Chronic Pelvic Pain

Background:  Chronic pelvic pain (CPP) is a debilitating pain condition that disproportionately affects women veterans (30% vs. 16% of nonveteran women vs. 3% of men; Cichowski et al., 2018). CPP is associated with functional disability and psychosocial distress (such as depression and anxiety; Dobie et al., 2004, Maguen et al., 2010). While little is known about women veterans’ treatment experiences with CPP in Veterans Health Administration (VHA) facilities, they are generally dissatisfied with pain management programs (Driscoll et al., 2018). Because dissatisfaction can lead to disengagement from care, it is likely that their CPP symptoms go under- or untreated. We developed and piloted a remotely-delivered, brief (3-session) Acceptance and Commitment Therapy (ACT) group treatment tailored for women veterans with CPP. This study qualitatively describes the acceptability of the brief ACT group for women Veterans with CPP.

Method: Women veterans with CPP and pain-related distress were invited to participate in a small feasibility study to test a brief ACT group treatment. Eight participants (mean age = 50 years old, 50% self-identified as Black or Hispanic) agreed to engage in a brief qualitative interview about their experiences in the ACT treatment. Interview questions centered on treatment acceptability, its perceived clinical impact, and suggestions for improvement. They received $30 for completing the interview. Interviews were analyzed by two independent coders using thematic analysis.

Findings: All eight women veterans felt the ACT group was beneficial. Four major themes related to acceptability emerged from thematic analysis: 1) The treatment helped to normalize and validate women veterans’ pelvic pain experiences, 2) The brief format and use of telehealth increased accessibility to treatment, 3) The patient workbook supported women veterans’ continued use of learned skills, and 4) Interacting with peers positively shifted participant’s perspectives on how to live with pelvic pain. Suggested improvements included adding classes to facilitate greater connection with peers and deeper discussions about pelvic pain experiences. All women veterans would recommend the group to other women veterans experiencing CPP as well as including their family and friends as a way of increasing their empathy, support, and understanding towards them.

Conclusion: Overall, woman veterans indicated that a brief, remotely-delivered ACT group for CPP was acceptable to their needs in terms of modality, structure, and content. Moreover, this treatment increased their feelings of validation and support by female peers with CPP. Patient feedback will inform future treatment modifications to improve the relevance and impact of this intervention in future clinical trials.