Footstep 2


If your patient (and you) acknowledge that persistent pain cannot be cured or ‘made to go away’ then together you can focus on the things that can be influenced. This is acceptance – it is not giving up.

Acceptance will help your patient to shift attention from what cannot be changed to what can be changed.

You can raise the concept of acceptance and offer support to your patient. Here are some ideas of how you could do this:

  • Offer stories of others who have been through this process
  • Acknowledge the loss and bereavement linked to living with pain
  • Introduce the possibility of using techniques like mindfulness or meditation
  • Explain how they could shift their mindset from “Why have I got pain?” to “What do I want to do each day?”
  • Encourage the patient to explain the concept of acceptance to family and friends
  • Acknowledge they may need to support with managing mood disorders such as anxiety, anger or depression

Pain and Me - a story of acceptance

‘This video is my personal interpretation of my research on Acceptance and Commitment Therapy for chronic pain. It took me a long time to understand that acceptance was not the same as giving up or losing hope, but instead I’ve come to see it as a conscious decision to completely engage with life, including pain.’

Professor Tamar Pincus

with thanks to the Royal Holloway University of London, Psychology Department

Action to take

  • Print off the booklet or send the patient a link to any of the resources below and then invite them to share with you one thing they found of value at their next consultation. This can provide a valuable starting point for acceptance.

Resources for your patient

Bus Journey tool

This tool is a metaphor tool and can help people understand that the pain is part of them and their life at present. How you take control of the pain, help retrain the brain is really helpful. This is about learning ways to self manage pain by:

  • Letting the person decide where they want to put the pain on their bus now, rather than the driving seat and the steering wheel. The pain has arrived unwanted on the bus, like an unwanted passenger. This passenger is not at present going to get off the bus. However, they can be managed and placed anywhere on the bus.
  • Helping the person to decide what is the new direction of the bus journey, route, new stops and new passengers and which passengers they want on the bus from their family, friends and clinical team, social prescribers etc.
  • Helping them set rewarding, paced goals and focus on their priorities for change.

Your Journey with Pain – booklet

Patients can self complete this booklet. It uses a bus metaphor and is a great way for patients to start on their journey of acceptance and where they want to focus their lives despite the pain. From Live Well with Pain

This short animation also uses the bus metaphor and can be really helpful to understand the positive aspects of acceptance:

Passengers On A Bus - an Acceptance & Commitment Therapy (ACT) Metaphor

Tame the Beast

Leading neuroscientist Lorimer Moseley and colleagues have created a valued resource that explains and guides people’s journey to acceptance and living well with pain – focusing on dealing with the pain (the beast) and the self.



Very useful short video on ACT – Acceptance and Commitment Therapy – and its six key principles:



Summary of key points

  • Acceptance is key to moving on with self-care – be careful not to collude with false expectations!
  • You can raise the concept of acceptance and offer support

Quick links