Objective. Overall, the literature on the effectiveness of psychological treatments in general and those for fibromyalgia in particular has been dominated by research designs that focus on large groups and explore changes on average, so the treatment impact at the individual level remains unclear. In this quasi-experimental, replicated single-case design, we will test the feasibility and effectiveness of a brief acceptance and committed therapy intervention using ecological momentary assessment supported by technology. Methods. The sample comprised 7 patients (3 in the individual condition and 4 in the group condition) who received a brief, 5-week psychological treatment. Patient evolution was assessed one week prior to treatment onset and during the whole study with a smartphone app. Because ecological momentary assessment and the use of an app are not frequent practices in routine care, we also evaluated the feasibility of this assessment methodology (i.e., compliance with the app). Change was investigated with a nonoverlap of all pairs index. Outcomes were pain interference with sleep and social activities, fatigue, sadness, and pain intensity. Results. Patient change was not uniform across outcomes. Four patients (two in each condition) showed relatively moderate levels of change (approximately 60% nonoverlap in several outcomes). The remaining patients showed more modest improvements which affected a reduced number of outcomes. Based on nonoverlapping indices, there was no clear evidence in favor of any treatment format. Conclusions. An alternative design to large-scale trials, one that focuses on the individual change, exists and it can be implemented in pain research. The use of technology (e.g., smartphones) simplifies such designs by facilitating ecological momentary assessment. Based on our findings showing that changes were not homogeneous across patients or outcomes, more single-case designs and patient-centered analyses (e.g., responder and moderation analyses) are required.

中文翻译：

---

纤维肌痛的简短接受和承诺疗法：复制的单例设计的可行性和有效性。

目标。总体而言，有关一般心理治疗效果，尤其是针对纤维肌痛的心理治疗效果的文献，主要集中在大型人群并平均探讨变化的研究设计中，因此对个体水平的治疗效果尚不清楚。在这种准实验性，重复性单例设计中，我们将使用技术支持的生态瞬时评估来测试短暂接受和承诺治疗干预的可行性和有效性。方法。样本包括7位接受简短的5周心理治疗的患者（个人情况3例，团体情况4例）。在治疗开始前一周和整个研究过程中，使用智能手机应用程序评估了患者的发展情况。由于生态瞬时评估和使用应用程序在常规护理中并不常见，因此，我们还评估了这种评估方法的可行性（即遵守应用程序）。使用所有对的非重叠索引调查了变化。结果是疼痛干扰睡眠和社交活动，疲劳，悲伤和疼痛强度。结果。患者结局的变化并不统一。四名患者（每种情况中的两名）表现出相对中等的变化水平（几种结果中约60％无重叠）。其余患者表现出较适度的改善，从而减少了预后。基于非重叠指标，没有明确证据支持任何治疗形式。结论。存在着一种针对大型试验的替代设计，其着眼于个体变化，并且可以在疼痛研究中实施。技术（例如智能手机）的使用通过促进生态瞬时评估来简化此类设计。根据我们的发现表明患者或结果之间的变化不均匀，需要更多的单例设计和以患者为中心的分析（例如，响应者和中度分析）。