Acceptance and Commitment Therapy Intervention for Individuals with Endometriosis and Persistent Pelvic Pain

In: CBT: Science Into Practice · 2025 · pp. 71–90 · doi:10.1007/978-3-031-98876-9_5 · W4414608461
book-chapter OA: green CC0 ⤵ 1 in-corpus citation
Full text JSON View on OpenAlex View at publisher
AI-generated summary by claude@2026-06+body, 2026-06-08

This paper explores the application of Acceptance and Commitment Therapy (ACT) for individuals experiencing persistent pelvic pain due to endometriosis, detailing its components, techniques, and therapist dialogues through a case study.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

AI-generated deep summary by claude@2026-06, 2026-06-10 · read from full text

The chapter discusses Acceptance and Commitment Therapy (ACT) for individuals with endometriosis-related persistent pelvic pain, framing endometriosis as a “whole of person” inflammatory condition associated with ongoing pain, reduced health-related quality of life, and psychological distress. Using the case of Maeve, a 29-year-old who reported symptoms since age 12, the authors provide an overview of ACT components, techniques, and therapist–client dialogue aimed at helping clients understand their experiences and reconnect with important life domains. A major limitation is that the text is presented as an applied clinical chapter with a single illustrative case rather than a controlled effectiveness study. This paper is centrally about endometriosis — specifically, it presents an ACT intervention approach for individuals with endometriosis and persistent pelvic pain.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Full text 11,156 characters · extracted from oa-doi-fallback · 2 sections · click to expand

Abstract

Endometriosis, a source of persistent pelvic pain, is an inflammatory disease where endometrium-like tissue is found outside the uterus, such as in the ovaries, intestines, bowel, and bladder. Symptoms of endometriosis include dysmenorrhea, dyspareunia, dysuria, dyschezia, heavy menstrual bleeding, gastric upset, and fatigue. Endometriosis is referred to as a ‘whole of person’ disease and is associated with persistent pain, lowered health-related quality of life, and psychological distress. Acceptance and Commitment Therapy (ACT) is an effective therapeutic approach for clients who wish to enhance their understanding of endometriosis-related experiences or their connection with important life domains. The chapter discusses the application of ACT for endometriosis with Maeve, a 29-year-old who has experienced endometriosis symptoms since the age of 12, providing the reader with an overview of key ACT components, techniques, and therapist dialogues. Leesa Van Niekerk & Suiyin Cheah are Joint First Authors. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

References

Allaire, C., Bedaiwy, M. A., & Yong, P. J. (2023). Diagnosis and management of endometriosis. CMAJ, 195(10), E363–E371. Armour, M., Avery, J., Leonardi, M., Van Niekerk, L., Druitt, M. L., Parker, M. A., Girling, J. E., McKinnon, B., Mikocka-Walus, A., Ng, C. H. M., O’Hara, R., Ciccia, D., Stanley, K., & Evans, S. (2022). Lessons from implementing the Australian National Action Plan for Endometriosis. Reproduction and Fertility, 3(3), C29–C39. Armour, M., Ciccia, D., Yazdani, A., Rombauts, L., Niekerk, L. V., Schubert, R., & Abbott, J. (2023). Endometriosis research priorities in Australia. Australian and New Zealand Journal of Obstetrics and Gynaecology, 63(4), 594–598. Bernini, O., Tumminaro, G., Compare, L., Belviso, C., Conforti, V., & Berrocal Montiel, C. (2022). Incremental validity of acceptance over coping in predicting adjustment to endometriosis. Front Pain Res (Lausanne), 3, 928985. Bittelbrunn, C. C., de Fraga, R., Martins, C., Romano, R., Massaneiro, T., Mello, G. V. P., et al. (2023). Pelvic floor physical therapy and mindfulness: Approaches for chronic pelvic pain in women-a systematic review and meta-analysis. Archives of Gynecology and Obstetrics, 307, 663–672. Buhrman, M., Hällström, H., Fridén, A., Kettis Moden, E., Grahn, G., Carlfjord, M., et al. (2024). Guided internet-based acceptance and commitment therapy for provoked vestibulodynia: A randomized controlled trial. European Journal of Pain. Ciarrochi, J., Harris, R., & Bailey, A. (2015). The weight escape: Stop fad dieting, start losing weight and reshape your life using cutting-edge psychology. Hachette UK. Dowding, C., Mikocka-Walus, A., Skvarc, D., O’Shea, M., Olive, L., & Evans, S. (2024). Learning to cope with the reality of endometriosis: A mixed-methods analysis of psychological therapy in women with endometriosis. British Journal of Health Psychology. Engel, G. L. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196(4286), 129–136. Evans, S., Olive, L., Dober, M., Knowles, S., Fuller-Tyszkiewicz, M., Eric, O., et al. (2022). Acceptance commitment therapy (ACT) for psychological distress associated with inflammatory bowel disease (IBD): Protocol for a feasibility trial of the ACTforIBD programme. BMJ Open, 12(6), e060272. Hansen, K. E., Brandsborg, B., Kesmodel, U. S., Forman, A., Kold, M., Pristed, R., et al. (2023). Psychological interventions improve quality of life despite persistent pain in endometriosis: Results of a 3-armed randomized controlled trial. Quality of Life Research, 32, 1727–1744. Harris, R. (2007). Acceptance and commitment therapy (ACT) advanced workshop handout. Harris, R. (2017a). The “hands as thoughts & feelings” exercise. ACTMindfully. https://www.actmindfully.com.au/upimages/Hands_as_Thoughts_and_feelings_Exercise_-_2017_version.pdf Harris, R. (2017b). The choice point 2.0: A brief overview. ACTMindfully. Commitment therapy in drug-dependent https://www.actmindfully.com.au/free-stuff/worksheets-handouts-book-chapters Harris, R. (2019). ACT made simple: An easy-to-read primer on acceptance and commitment therapy. New Harbinger Publications. Harris, R. (2022). The happiness trap: How to stop struggling and start living. Shambhala Publications. Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behaviour Research and Therapy, 44(1), 1–25. Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy. Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and commitment therapy: The process and practice of mindful change (2nd ed.). Guilford Press. Hess Engström, A., Bohm-Starke, N., Kullinger, M., Hesselman, S., Högberg, U., Buhrman, M., & Skalkidou, A. (2022). Internet-based treatment for vulvodynia (EMBLA)–a randomized controlled study. The Journal of Sexual Medicine, 19(2), 319–330. Kabat-Zinn, J. (2018). Falling awake: How to practice mindfulness in everyday life. Hachette UK. Lamceva, J., Uljanovs, R., & Strumfa, I. (2023). The main theories on the pathogenesis of endometriosis. International Journal of Molecular Sciences, 24(5), 4254. Lehman, B. J., David, D. M., & Gruber, J. A. (2017). Rethinking the biopsychosocial model of health: Understanding health as a dynamic system. Social and Personality Psychology Compass, 11(8), e12328. Mace, C. (2007). Mindfulness in psychotherapy: An introduction. Advances in Psychiatric Treatment, 13(2), 147–154. Marinho, M. C. P., Magalhaes, T. F., Fernandes, L. F. C., Augusto, K. L., Brilhante, A. V. M., & Bezerra, L. (2018). Quality of life in women with endometriosis: An integrative review. Journal of Women’s Health (Larchmt), 27(3), 399–408. Mazalin, K., Evans, S., & Van Niekerk, L. (2024). A template thematic analysis of self-concept and self-compassion in people living with endometriosis: Analysis of qualitative survey responses. Journal of Advanced Nursing. McCracken, L. M., & Morley, S. (2014). The psychological flexibility model: A basis for integration and progress in psychological approaches to chronic pain management. Journal of Pain, 15(3), 221–234. McCracken, L. M., Yu, L., & Vowles, K. E. (2022). New generation psychological treatments in chronic pain. BMJ, 376. Melis, I., Litta, P., Nappi, L., Agus, M., Melis, G. B., & Angioni, S. (2015). Sexual function in women with deep endometriosis: Correlation with quality of life, intensity of pain, depression, anxiety, and body image. International Journal of Sexual Health, 27(2), 175–185. Miller, W. R., C’de Baca, J., Matthews, D. B., & Wilbourne, P. L. (2001). Personal values card sort. University of New Mexico. Qian, X., & Zhang, J. (2024). Mindfulness-based interventions on psychological comorbidities in patients with inflammatory bowel disease: A systematic review and Meta-analysis. Actas Españolas de Psiquiatría, 52, 571–582. Rees, M., Kiemle, G., & Slade, P. (2022). Psychological variables and quality of life in women with endometriosis. Journal of Psychosomatic Obstetrics & Gynecology, 43(1), 58–65. Saulsman, L., & Nathan, P. (2012). Facing your feelings: Learning to tolerate distress. Centre for Clinical Interventions. Smout, M. (2012). Acceptance and commitment therapy: Pathways for general practitioners. Australian Family Physician, 41(9), 672–676. Sullivan-Myers, C., Sherman, K. A., Beath, A. P., Cooper, M. J. W., & Duckworth, T. J. (2023). Body image, self-compassion, and sexual distress in individuals living with endometriosis. Journal of Psychosomatic Research, 167, 111197. Teasdale, J., Williams, M., & Segal, Z. (2013). The mindful way workbook: An 8-week program to free yourself from depression and emotional distress. Guilford Publications. Tighe, J., Nicholas, J., Shand, F., & Christensen, H. (2018). Efficacy of acceptance and commitment therapy in reducing suicidal ideation and deliberate self-harm: Systematic review. JMIR Mental Health, 5(2), e10732. Tomassetti, C., Johnson, N. P., Petrozza, J., Abrao, M. S., Einarsson, J. I., et al. (2021). An international terminology for endometriosis, 2021. Human Reproduction Open, 2021(4), hoab029. Trindade, I. A., Guiomar, R., Carvalho, S. A., Duarte, J., Lapa, T., Menezes, P., Nogueira, M. R., Patrão, B., Pinto-Gouveia, J., & Castilho, P. (2021). Efficacy of online-based acceptance and commitment therapy for chronic pain: A systematic review and meta-analysis. The Journal of Pain, 22(11), 1328–1342. Van Niekerk, L., Johnstone, L., & Matthewson, M. (2022a). Health-related quality of life in endometriosis: The influence of endometriosis-related symptom presence and distress. Journal of Health Psychology, 27(14), 3121–3135. Van Niekerk, L., Johnstone, L., & Matthewson, M. (2022b). Predictors of self-compassion in endometriosis: The role of psychological health and endometriosis symptom burden. Human Reproduction, 37(2), 264–273. Van Niekerk, L., Steains, E., & Matthewson, M. (2022c). Correlates of health-related quality of life: The influence of endometriosis, body image and psychological wellbeing. Journal of Psychosomatic Research, 161, 110993. Van Niekerk, L., Weaver-Pirie, B., & Matthewson, M. (2019). Psychological interventions for endometriosis-related symptoms: A systematic review with narrative data synthesis. Archives of Women’s Mental Health, 22(6), 723–735. Wang, Y., Li, B., Zhou, Y., Wang, Y., Han, X., Zhang, S., He, Z., & Ouyang, L. (2021). Does endometriosis disturb mental health and quality of life? A systematic review and meta-analysis. Gynecologic and Obstetric Investigation, 86(4), 315–335. Wilkin, K., Evans, S., Van Niekerk, L., Romano, D., Fuller-Tyszkiewicz, M., Knowles, S., et al. (2024). Moving towards acceptance and values: A qualitative study of ACTforIBD compared to IBD psychoeducation. Journal of Clinical Psychology in Medical Settings, 1–13. Yu, L., Scott, W., & McCracken, L. M. (2020). Change in fatigue in acceptance and commitment therapy-based treatment for chronic pain and its association with enhanced psychological flexibility. European Journal of Pain, 24(1), 234–247. Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2025 The Author(s), under exclusive license to Springer Nature Switzerland AG About this chapter Cite this chapter Van Niekerk, L., Cheah, S., Mikocka-Walus, A., Mertens, B., Evans, S. (2025). Acceptance and Commitment Therapy Intervention for Individuals with Endometriosis and Persistent Pelvic Pain. In: Payne, L.A. (eds) Psychosocial Interventions for Chronic Pain in Women and Girls. CBT: Science Into Practice. Springer, Cham. https://doi.org/10.1007/978-3-031-98876-9_5 Download citation DOI: https://doi.org/10.1007/978-3-031-98876-9_5 Published: Publisher Name: Springer, Cham Print ISBN: 978-3-031-98875-2 Online ISBN: 978-3-031-98876-9 eBook Packages: Behavioral Science and PsychologyBehavioral Science and Psychology (R0)

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

endometriosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (38)

Cited by (1)

Source provenance

openalex
last seen: 2026-06-04T00:00:01.174412+00:00
License: CC0 · commercial use OK