Background: Long-term non-malignant pain is a major health problem causing substantial suffering for the patients and a challenge for the health services. Studies have reported promising results of Acceptance and commitment therapy (ACT) as a treatment of long-term pain.

Aims:The aims of this stydy was to explore user experiences, practice and lived significance of patients participating in ACT treatment of pain and pain-related health issues.

Methods: Eight adults aged 24-68 (3 men and 5 women) with long-term pain following a group-based ACT treatment.
All had participated in a three-month group-based program including three gatherings lasting three days each time, plus a three month follow up. 
After completing the program, they were invited to an individual semi-structured in-depth interview. 
The analysis was based on systematic text condensation by Malterud, and the phenomenological approach described by Giorgi. 

Results: Three major themes emerged in the analyses; the fight against the pain, cure and control over their health condition, and the pain-related implications on the self. How the patients´described these themes could be understood as two different groups of approaching their health related challenges:“The Accepting approach” (TAA) and “The Fighting approach” (TFA).  

Conclusion:The results of this study demonstrates the differences in patients´ illness perception and how this may relate to their approach and ways of coping with their pain. 
Psychological flexibility, as seen in The Accepting approach, could ease the adjustment into a new life with long-term pain.
Psychological inflexibility as seen in The Fighting approach, may lead to a maintained focus on the pain, and perceiving their struggle with living with long-term pain as hopeless.

FIGHTING OR ACCEPTING LONG-TERM PAIN - A QUALITATIVE STUDY ON ACCEPTANCE AND COMMITMENT THERAPY (ACT) IN TREATMENT OF LONG-TERM PAIN