Community-based Acceptance and Commitment Therapy Programmes for rheumatic conditions: An acceptability and qualitative process evaluation study.

To examine the effects of a 1-day acceptance and commitment therapy (ACT) workshop on the mental health of clinically distressed health care employees, and to explore ACT's processes of change in a routine practice setting. A quasi-controlled design, with participants block allocated to an ACT intervention or waiting list control group based on self-referral date. Participants were 35 health care workers who had self-referred for the ACT workshop via a clinical support service for staff. Measures were completed by ACT and control group participants at pre-intervention and 3months post-intervention. Participants allocated to the waitlist condition went on to receive the ACT intervention and were also assessed 3months later. At 3months post-intervention, participants in the ACT group reported a significantly lower level of psychological distress compared to the control group (d=1.41). Across the 3-month evaluation period, clinically significant change was exhibited by 50% of ACT participants, compared to 0% in the control group. When the control group received the same ACT intervention, 69% went on to exhibit clinically significant change. The ACT intervention also resulted in significant improvements in psychological flexibility, defusion, and mindfulness skills, but did not significantly reduce the frequency of negative cognitions. Bootstrapped mediation analyses indicated that the reduction in distress in the ACT condition was primarily associated with an increase in mindfulness skills, especially observing and non-reactivity. These findings provide preliminary support for providing brief ACT interventions as part of routine clinical support services for distressed workers. A 1-day ACT workshop delivered in the context of a routine staff support service was effective for reducing psychological distress among health care workers. The brief nature of this group intervention means it may be particularly suitable for staff support and primary care mental health service settings. The findings indicate that the beneficial effects of an ACT workshop on distressed employees' mental health were linked to improvements in specific mindfulness skills. Study limitations include non-random allocation of participants to the ACT and control groups, and measurement of mediators and outcome at the same time point (3months post-intervention).

Introduction: Chronic joint pain is a problem for the majority of elderly. Psychosocial factors have a great impact on people with chronic pain. The acceptance of pain in people with chronic pain can increase their activity daily living, comfort, and quality of life. Acceptance And Commitment Therapy (ACT) is a form of psychotherapy which effective in the management of chronic pain. The objective of this study was to analyze the effect of ACT on improvement acceptance of chronic pain, comfort, and quality of life elderly with chronic joint pain. Method: This study was used a quasy experiment pre-post test control group design. Population were elderly who lived at UPT PSLU Jombang di Pare-Kediri. Sample were 32 respondents gotten by purposive sampling, divided into experiment and control group. Independent variable was ACT, and dependent variables were pain acceptance, comfort, and quality of life elderly with chronic joint pain. Data were collected by using questionnaire with CPAQ (pain acceptance), GCQ (comfort) and WHO-QOLBREF (Quality of Life). Data then analyzed by using Wilcoxon Signed Ranks Test, Mann Whitney U Test, Paired t test and Independent Samples t test with significance value of 0.05. Result: The results had showed that there was an influence ACT to improvement acceptance of chronic pain (p=0,003), comfort (p=0,008), and quality of life elderly with chronic joint pain (p=0,002). Discussion: ACT improved pain acceptance, comfort, and quality of life of elderly with joint chronic pain. Geriatric nurses should include psychosocial activities as a routine activities, as an effort to improve the quality of life. Beside that, the quality of nursing care for elderly can be improved.Keywords: ACT, pain acceptance, comfort, quality of life, elderly, chronic joint pain

Introduction: Chronic joint pain is a problem for the majority of elderly. Psychosocial factors have a great impact on people with chronic pain. The acceptance of pain in people with chronic pain can increase their activity daily living, comfort, and quality of life. Acceptance And Commitment Therapy (ACT) is a form of psychotherapy which effective in the management of chronic pain. The objective of this study was to analyze the effect of ACT on improvement acceptance of chronic pain, comfort, and quality of life elderly with chronic joint pain.Method: This study was used a quasy experiment pre-post test control group design. Population were elderly who lived at UPT PSLU Jombang di Pare-Kediri. Sample were 32 respondents gotten by purposive sampling, divided into experiment and control group. Independent variable was ACT, and dependent variables were pain acceptance, comfort, and quality of life elderly with chronic joint pain. Data were collected by using questionnaire with CPAQ (pain acceptance), GCQ (comfort) and WHO-QOLBREF (Quality of Life). Data then analyzed by using Wilcoxon Signed Ranks Test, Mann Whitney U Test, Paired t test and Independent Samples t test with significance value of 0.05.Result: The results had showed that there was an influence ACT to improvement acceptance of chronic pain (p=0,003), comfort (p=0,008), and quality of life elderly with chronic joint pain (p=0,002).Discussion: ACT improved pain acceptance, comfort, and quality of life of elderly with joint chronic pain. Geriatric nurses should include psychosocial activities as a routine activities, as an effort to improve the quality of life. Beside that, the quality of nursing care for elderly can be improved.

سالمندی فرایند زیستی است که تمام موجودات زنده از جمله انسان‌ها آن را تجربه می‌کنند، از این رو توجه خاص و پیشگیری از اختلالاتی نظیر باورهای غیرمنطقی و نگرش منفی به مرگ در سالمندی بسیار مهم است. بنابراین مطالعه حاضر با هدف تعیین اثربخشی درمان مبتنی بر تعهد و پذیرش بر باورهای غیرمنطقی و نگرش به مرگ سالمندان انجام شد. روش پژوهش نیمه آزمایشی با طرح پیش‌آزمون-پس‌آزمون با گروه کنترل بود.جامعه آماری پژوهش کلیه سالمندان شهر خرم آباد در سال 1399 بودند. حجم نمونه پژوهش شامل 30 نفر سالمند (60 تا 70 سال) بود که با روش نمونه‌گیری در دسترس و با توجه به ملاک‌های ورود و خروج مطالعه انتخاب شدند. گروه آزمایش مداخله آموزشی را در قالب هشت جلسه 90 دقیقه‌ای هفتگی دریافت نمودند. پرسش‌نامه‌های مورد استفاده در این پژوهش شامل پرسش‌نامه باورهای غیرمنطقی اهواز و نیمرخ نگرش به مرگ وونگ بود. داده‌ها با تحلیل کوواریانس تک متغیره، با استفاده از نرم‌افزارSPSS نسخه 22 مورد تجزیه و تحلیل قرار گرفتند. یافته‌ها نشان داد که بین گروه‌های آزمایش و کنترل در پس­آزمون از نظر باورهای غیرمنطقی و نگرش به مرگ تفاوت معنی‌داری وجود داشت (001/0>P). به عبارت دیگر درمان مبتنی بر تعهد و پذیرش باعث کاهش باورهای غیرمنطقی و نگرش منفی به مرگ شد. منطبق با یافته‌های پژوهش حاضر می‌توان درمان مبتنی بر تعهد و پذیرش را به عنوان یک روش کارا جهت کاهش باورهای غیرمنطقی و نگرش منفی به مرگ سالمندان پیشنهاد داد.

Introduction Insomnia is a common complaint for individuals with chronic pain. CBT-I as an intervention for these patients shows strong improvement in sleep but not consistently in pain outcomes. Current treatment approaches for chronic pain focus increasingly on acceptance-based interventions. Integrating ACT into a CBT-I group protocol has the potential to optimize both sleep and pain outcomes. Methods A hybrid CBT-I/ACT 6-session weekly group protocol for chronic pain and insomnia was developed and piloted. CBT-I components included sleep education, stimulus control, and sleep restriction. ACT components included cognitive defusion, self-as-context, present moment awareness, mindfulness, and values-guided behavioral activation. Pre-post measures assessing insomnia symptoms, sleep parameters based on sleep diary, sleep catastrophizing, pain catastrophizing, pain acceptance, beliefs about pain and sleep, depression, and anxiety were analyzed using frequency analyses and paired sample t-tests. Results Group participants (4) recruited from an outpatient pain management clinic were on average 57 years old, 100% female and 75% White. Post-treatment, patients reported significantly improved insomnia symptoms (ISI Mdiff=5.8, SDdiff=3.9, p < .05, ES=1.5), sleep efficiency (SE, Mdiff=16%, SDdiff= 10%, p = .05, ES=1.5), pain catastrophizing (PCS Mdiff=7.8, SDdiff=4.6, p < .05, ES=1.6), pain acceptance (CPAQ Mdiff=11.5, SDdiff=7.5, p = .05, ES=1.5), beliefs about the relationship between pain and sleep (PBAS Mdiff=2.3, SDdiff=1.3, p < .05, ES=1.8) and anxiety (GAD-7 Mdiff=3.3, SDdiff=2.1, p < .05, ES = 1.6). Conclusion Hybrid CBT-I/ACT group protocol for chronic pain and insomnia showed significant improvements in sleep and, more importantly, pain outcomes. This pilot study demonstrates the benefits of incorporating an ACT approach to optimize pain as well as sleep outcomes. Future efforts will continue to refine the CBT-I/ACT protocol in anticipation of conducting a dismantling study to determine the clinical benefits of adding an ACT framework to the CBT-I model. Support NA

BackgroundBipolar disorder is a chronic and disabling psychiatric condition, characterised by recurrent episodes of mania, hypomania and depression. It places a heavy burden on sufferers and families, with high societal and healthcare costs. Many service users with a diagnosis of bipolar disorder also experience prominent psychotic symptoms, with differential diagnoses of schizoaffective disorder, and relapses characterised by repeated manic psychotic episodes and grandiosity. Such presentations require specific adaptations to standard bipolar disorder interventions in order to address their psychosis, alongside mood regulation, with a particular emphasis on impulsivity, irritability, disinhibition and elation. The Balancing ACT study aims to evaluate an innovative group intervention combining Acceptance and Commitment Therapy and psychoeducation approaches (ACT/PE) with individuals experiencing bipolar disorder and/or symptoms within community psychosis services.MethodsThe Balancing ACT study is a randomised controlled trial comparing Balancing ACT groups (ACT/PE) plus routine care to routine care alone. Balancing ACT (ACT/PE) comprises ten group sessions, each lasting 2 hours, delivered weekly. The primary outcome is psychological wellbeing; secondary outcomes are mental health relapses (measured by service use averages for the 12 months pre baseline and 3 months post baseline). We will also measure mood, distress, recovery and psychological change processes. Participants will be randomised in a 1:1 ratio, after baseline assessment. Outcomes will be assessed by trained assessors blind to treatment condition at 0, 10 and 14 weeks. Recruitment began in April 2017 and is on-going until the end of October 2017.DiscussionThe Balancing ACT study will contribute to the currently limited evidence base for psychological interventions for people experiencing bipolar disorder and/or symptoms in the context of community psychosis services.Trial registrationISRCTN73327972. Registered on 27 March 2017. Balancing ACT: evaluating the effectiveness of psychoeducation and Acceptance and Commitment Therapy (ACT) groups for people with bipolar disorder.

Purpose: The primary objective of this study is to compare the effectiveness of Spiritual Therapy and Acceptance and Commitment Therapy (ACT) on illness-related worries in patients with fibromyalgia syndrome. Methodology: The research method employed is quasi-experimental (pre-test, post-test with a control group). The research tools include spiritual therapy and acceptance and commitment therapy packages, as well as the Illness Worry Questionnaire, which consists of 23 items. The content validity for the entire scale was 0.95. The statistical population included patients diagnosed with fibromyalgia (referred to the clinic in Tehran in 2024). A total of 36 participants were selected through purposive sampling and were randomly assigned to two experimental groups (12 in the Spiritual Therapy group and 12 in the Acceptance and Commitment Therapy group) and one control group (12 participants). For hypothesis testing, analysis of covariance (ANCOVA) was used, and SPSS version 23 software was employed. Findings: The research findings, based on the pairwise comparison of post-test mean scores of worry, among the ACT group, the Spiritual Therapy group, and the control group, indicate that the significance level for all groups is (sig<0.05). Therefore, the difference between the mean scores is statistically significant, and the research hypothesis is accepted with 95% confidence. Conclusion: Given that the effect size (η²>0.36) is significant, both Acceptance and Commitment Therapy (ACT) and Spiritual Therapy have a strong impact on reducing illness-related worries in patients with fibromyalgia syndrome. Furthermore, Spiritual Therapy is more effective in reducing worries than Acceptance and Commitment Therapy.

Objective: The aim of the present study was to compare the effectiveness of Cognitive-Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) on job burnout and psychological well-being among nurses. Methods and Materials: The research method was quasi-experimental, employing a pre-test, post-test, follow-up design with a control group. The statistical population of this study included all female nurses of Hazrat Rasoul Akram Hospital in Tehran in the spring of 2023, from which 45 individuals were selected using purposive sampling and were randomly assigned to two intervention groups and one control group. The research instruments included the Maslach Burnout Inventory (Maslach et al., 1996) and the Ryff Psychological Well-being Scale - Short Form (Ryff, 1989). After conducting 8 sessions of Cognitive-Behavioral Therapy and 8 sessions of Acceptance and Commitment Therapy for the intervention groups, the data were analyzed using SPSS software version 24. Findings: Cognitive-Behavioral Therapy and Acceptance and Commitment Therapy had significant effects on job burnout and psychological well-being in the intervention groups (P < 0.01), and the differences in the mean scores of job burnout and psychological well-being among the Cognitive-Behavioral Therapy groups, Acceptance and Commitment Therapy groups, and the control group were statistically significant (P < 0.01). Conclusion: The results indicated that both Cognitive-Behavioral Therapy and Acceptance and Commitment Therapy are effective in improving job burnout and psychological well-being among nurses. It is recommended that healthcare administrators and specialists conduct empowerment programs with a Cognitive-Behavioral or Acceptance and Commitment approach.

The feasibility and acceptability of a brief Acceptance and Commitment Therapy (ACT) group intervention for people with psychosis: The ‘ACT for life’ study

We compared the incremental effects of adding acceptance and commitment therapy (ACT) to pharmacological treatment as usual (TAU) in a sample of patients with high frequency episodic migraine without aura (HFEM), assessing impact on a spectrum of measures across multiple domains. Patients with HFEM are at risk of developing chronic migraine and medication overuse headache. ACT has been shown to be effective for the treatment of various chronic pain conditions, but little attention has been given to its therapeutic value in the management of recurring headaches. In this single-blind (masking for outcome assessor), open-label, randomized clinical trial, 35 patients with HFEM, with a monthly headache frequency ranging from 9 to 14days, were recruited at the headache center of C. Besta Neurological Institute and randomized to either TAU (patient education and pharmacological prophylaxis; n=17) or TAU+ACT (n=18). Patients assigned to the combined treatment arm additionally received six 90-min weekly group sessions of ACT therapy and two supplementary "booster" sessions. All patients were on a stable course of prophylactic medication in the 3months prior to initiating either treatment. Monthly headache frequency served as the primary outcome measure, with all other data collected being considered as secondary measures (medication intake, disability, headache impact, anxiety and depression, catastrophizing, allodynia, cognitive inflexibility, pain acceptance, mindful attention and awareness). A total of 35 patients were enrolled: 17 randomized to TAU, of whom three dropped out, and 18 to TAU+ACT (no dropouts in this group). Headache frequency and medication intake decreased in both groups over 12months, with patients in the TAU+ACT group showing statistically significant reduction earlier, that is, by month 3. Headache frequency was reduced by 3.3days (95% CI: 1.4 to 5.2) among those randomized to ACT+TAU, whereas it increased by 0.7days (95% CI: -2.7 to 1.3) among those randomized to TAU only (p=0.007, partial η2 =0.21), the difference being 4days (95% CI: 1.2 to 6.8). Medication intake was reduced by 4.1 intakes (95% CI: 2.0 to 6.3) among those randomized to ACT+TAU and by 0.4 intakes (95% CI: -1.8 to 2.5) among those randomized to TAU only (p=0.016; partial η2 =0.17), the difference being 3.8 intakes (95% CI: 0.7 to 6.8). At 6 and 12months, the variations were not different between the two groups for headache frequency and medication intake. The opposite was found for measures of headache impact and pain acceptance, where the differences over time favored patients allocated to TAU. Both groups improved with regard to measures of disability, anxiety and depression, catastrophizing, and cognitive inflexibility, whereas measures of allodynia and pain acceptance were stable over time. Our preliminary findings indicate that supplementing TAU with ACT can enhance the main clinical outcomes, namely headache frequency and medication intake of patients with HFEM.

Acceptance and commitment therapy has shown to be effective in chronic pain rehabilitation, and acceptance has been shown to be a key process of change. The influence of treatment dose on acceptance is not clear, and in particular, the effectiveness of a non-intensive treatment (<20 h) in a tertiary pain clinic is required. The purpose of the study was to assess the effectiveness of a low-intensity, acceptance and commitment therapy (ACT) group program for chronic pain. The study sought to compare, at both groups and individual patient levels, changes in acceptance with changes observed in previous ACT studies. Seventy-one individuals with chronic pain commenced a 9-week ACT-based group program at an outpatient chronic pain service. In addition to acceptance, outcomes included the following: pain catastrophizing, depression, anxiety, quality of life, and pain-related anxiety. To compare the current findings with previous research, effect sizes from seven studies were aggregated using the random-effects model to calculate benchmarks. Reliable change indices (RCIs) were applied to assess change on an individual patient-level. The ACT intervention achieved a statistically significant increase in acceptance and medium effect size (d = 0.54) at a group level. Change in acceptance was of a similar magnitude to that found in previous ACT studies that examined interventions with similar treatment hours (<20 h). Results across other outcome measures demonstrated small to medium effect sizes (d = 0.01 to 0.48, mean = 0.26). Reliable improvement in acceptance occurred in approximately one-third (37.2, 90% CI) of patients. Approximately three-quarters (74.3, 90% CI) demonstrated reliable change in at least one of the outcome measures. The low-intensity, group-based ACT intervention was effective at a group level and showed a similar magnitude of change in acceptance to previous ACT studies employing low-intensity interventions. Three-quarters of patients reported reliable change on at least one outcome measure.

Online Acceptance and Commitment Therapy (ACT) interventions for chronic pain: A systematic literature review

Objective:Breast cancer is the most common cancer in women worldwide. Many of these patients suffer from multiple psychological symptoms. The present study aimed to investigate the impact of acceptance and commitment therapy (ACT) on depression, pain acceptance, and psychological flexibility in married women with breast cancer.Methods:The present study was a pre- and post-test clinical trial with intervention and control groups. The research population consisted of women with breast cancer referred to the Ayatollah Yasrebi and Shahid Beheshti Hospitals in Kashan in 2018. Through a purposive sampling method, 40 women were selected and randomly divided into two groups, namely, intervention (n = 20) and control (n = 20). The applied tools included the Depression, Anxiety and Stress Scale (DASS-21), Chronic Pain Acceptance Questionnaire 8 (CPAQ-8), and Acceptance and Action Questionnaire - II (AAQ-II). Data were analyzed by SPSS 16 using descriptive statistics and analysis of variance (ANOVA).Results:The results showed that ACT treatment significantly reduced the mean scores of depression compared to the control group (F = 107.72, p < 0.001). The mean scores of pain acceptance (F = 9.58, p < 0.05) and psychological flexibility (F = 10.61, p < 0 .05) significantly increased in comparison with the control group.Conclusion:ACT can be considered as an effective therapeutic approach to reduce depression and increase pain acceptance and psychological flexibility in women with breast cancer. These changes appear to be due to improved acceptance of thoughts and feelings associated with cancer and increased psychological flexibility, which is the primary goal of ACT treatment.Clinical trial registration:Iranian Registry of Clinical Trials (IRCT), IRCT20190518043620N1.

Objective To investigate the effect of acceptance and commitment therapy intervention on middle-aged and elderly patients with postherpetic neuralgia. Methods A convenient sampling method was used to select 70 middle-aged and elderly patients with postherpetic neuralgia who visited the pain department of a tertiary ClassⅢ Grade A hospital in Taiyuan, Shanxi Province from January to June 2019. They were divided into observation group and control group, 35 cases in each group. The control group continued to use conventional psychological nursing intervention, and the observation group performed acceptance commitment therapy intervention on the patients. The Chinese version of the Chronic Pain Acceptance Questionnaire-8 (CPAQ-8) , the simplified Mc Gill Pain Questionnaire (SF-MPQ) , and the Hospital Anxiety and Depression Scale (HADS) were used to conduct questionnaire surveys before and after intervention to assess pain acceptance, pain severity, and anxiety and depression. Results Before the intervention, there were no significant differences in CPAQ-8, SF-MPQ and HADS scores between the two groups (P>0.05) . After the intervention, the CPAQ-8 score of the observation group was higher than that of the control group, and the scores of SF-MPQ and HADS were lower than those of the control group. The differences between the two groups were statistically significant (P<0.05) . Conclusions Admission commitment therapy can effectively improve the degree of pain acceptance and reduce the pain in middle-aged and elderly patients with postherpetic neuralgia, and it can improve the anxiety and depression caused by pain. It is worthy of clinical promotion. Key words: Herpes zoster; Neuralgia; Anxiety; Depression; Acceptance and commitment therapy

One of the most important mental health issues in students is shyness. Considering adverse consequences of shyness in students’ lives, this study aimed to determine the efficacy of acceptance and commitment group therapy on the shyness of Zanjan High School female students. The research method was semi-experimental and based on the pretest-posttest control group design, with follow-up after one month. The sample included 38 participants who were selected by a multi-stage cluster sampling method and placed randomly in the experimental and control groups. At first, at the same time and in the same conditions, all the students responded to the Stanford Shyness Questionnaire (SSS; Zimbardo, Personal Communication, 1981). Then,the acceptance and commitment group therapy was performed for the experimental group in eight sessions; the control group received no intervention. In the end, both groups were evaluated by posttest, and then they were tracked after an interval of one month. In order to analyze data, the covariance analysis was applied. Findings showed that the acceptance and commitment therapy was meaningfully effective in decreasing shyness in the experimental group (p<0.01) and after one month, no significant changes were found in the results. These findings show that group acceptance and commitment therapy is an effective treatment for shyness in high school female students.