Examining Fidelity of Web-based Acceptance and Commitment Interventions for Women with Chronic Widespread Pain


  • Andrea Aparecida Goncalves Nes Assistant professor and PhD student at Oslo and Akershus University College (OAUC)
  • Espen Andreas Brembo
  • Sandra van Dulmen
  • Ólöf Birna Kristjánsdóttir
  • Rikard Wicksell
  • Hilde Eide




Chronic Widespread Pain, Acceptance and Commitment Therapy, M- health, Internet, Treatment Fidelity


Objectives. To examine the protocol adherence to the theoretical background of Acceptance and Commitment Therapy (ACT) in a RCT of a web-based intervention including e-diaries and written personalized feedback delivered via smartphone for persons with chronic widespread pain.Methods. The data consisted of 790 written feedback. A qualitative descriptive design on how ACT and other therapeutic processes were used in the feedback which was applied. The analysis was done with a feedback coding scheme developed employing a combination of an inductive and deductive approach.Results. The coded feedback messages reflected five of the six main ACT processes in addition to communication and motivation strategies. The degree of inter-rater reliability between the researchers coding the feedback, measured by Cohen’s kappa, was 0.790.Conclusions. Based on the level of adherence to ACT-principles the treatment integrity can be judged as high. The developed coding scheme can serve as a basis for coding written therapeutic feedback and thereby serve as a tool for a reliable assessment of the treatment fidelity in ACT based interventions delivered by internet.Practice Implications. Internet-delivered psychological interventions to support people with chronic conditions are increasingly common. Such interventions can be seen as person-centered therapeutic approaches. This study indicates that ACT can reliably be delivered in a written web-based format.   

Author Biography

Andrea Aparecida Goncalves Nes, Assistant professor and PhD student at Oslo and Akershus University College (OAUC)

Institute of Nursing


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