Acceptance And Commitment Therapy Intervention Research Articles

Prescription drug, healthcare utilization, and lost earnings cost of behavioral interventions for fear of cancer recurrence in breast cancer survivors.

e24095 Background: Breast cancer survivors experience distress due to the fear of cancer recurrence. Acceptance and commitment therapy (ACT) and cognitive behavioral therapy (CBT) can treat the fear of cancer recurrence. However, no study has applied economic evaluation methods to estimate ACT and CBT behavioral intervention costs for breast cancer survivors. Methods: 384 adult stage I-IIIA breast cancer survivors with fear of cancer recurrence were randomly assigned to either the ACT (n = 128), CBT (n = 128), or enhanced usual care (EUC, n = 128) groups. Through micro-costing, we assessed the societal perspective cost of behavioral interventions using 2022 dollars. Per-capita drug costs, healthcare utilization, and lost productivity were calculated using participant survey data. Drug costs were estimated using Micromedex’s Red Book wholesale unit price. The 2022 Medicare Physician Fee Schedule for Indiana estimated healthcare utilization costs from outpatient, inpatient, and emergency visits. Lost productivity costs included work loss, productivity loss, and unpaid work loss, valued by Indiana's mean hourly wage. We assessed the cost differences between baseline (T1) and after the 6-week intervention period (T2). We evaluated between-group differences with Bonferroni's tests for each pairwise group comparison and within-group differences with a paired t-test at a p-value of < 0.05. Results: The mean total per-capita cost change from T1 to T2 in the ACT, CBT, and EUC groups was -$563, -$1622, and -$981, respectively (Table 1). This cost reduction stemmed from drug and healthcare utilization. There was no significant between-group difference in total cost at T1 or T2 and no significant between-group or within-group cost change from T1 to T2. Conclusions: Our cost estimates will be updated at 6 and 12 months of intervention and combined with changes in quality of life and mental health metrics to assess the cost-effectiveness of ACT and CBT for fear of breast cancer recurrence. Clinical trial information: NCT05364450 . [Table: see text]

A pilot randomised controlled trial of acceptance and commitment therapy for medication decision-making and quality of life in women with breast cancer: The ACTION trial.

Non-adherence to adjuvant endocrine therapy (AET) in women with breast cancer is common and associated with medication side-effects and distress. We co-designed an Acceptance and Commitment Therapy intervention (ACTION) to enhance medication decision-making and quality of life (QoL). We undertook a pilot trial of ACTION to inform the feasibility of a phase III trial, and to examine intervention acceptability. This was a multi-site, exploratory, two-arm, individually randomised external pilot trial. Women with early breast cancer prescribed AET were randomised (1:1) to receive usual care (UC) or UC+ACTION. The ACTION intervention comprised a remotely delivered one-to-one ACT session followed by three group sessions delivered by clinical psychologists, alongside a website containing ideas for the self-management of side effects. Of the 480 women screened for eligibility, 260 (54.2%) were approached and 79 (30.4%) randomised. 71 (89.9%) women provided data at 3-month and 70 (88.6%) at 6-month 40 women were randomised to receive UC+ACTION and 32 (80.0%) completed the intervention. Most (75.0%) accessed the website at least once. ACTION was acceptable to participants (Borkovec & Nau Scale: mean=7.8 [SD=2.7] out of 10). Signals of effectiveness in favour of the UC+ACTION arm were observed for medication adherence (Adherence Starts with Knowledge questionnaire-12), QoL (work and social adjustment scale), health-related QoL (functional assessment of cancer therapy[FACT] general and FACT-ES-19/23), distress (generalised anxiety disorder -7, patient health questionnaire-9) and psychological flexibility (valuing questionnaire). The ACTION intervention was acceptable to patients. There were promising signals for effectiveness on primary and secondary outcomes. A phase III randomised controlled trial is feasible. ISRCTN12027752.

Brief online acceptance and commitment therapy for adults with type 1 diabetes: a pilot study.

Recognizing the pivotal role of psychosocial factors in triggering and maintaining Type 1 Diabetes Mellitus (T1DM), the integration of psychoeducational and psychotherapeutic interventions is associated with comprehensive management of the disease. This study aimed to evaluate the impact of a four-week online individual Acceptance and Commitment Therapy (ACT) intervention in mitigating diabetes-associated stress, fostering diabetes acceptance, enhancing the patient-doctor relationship, and promoting psychological flexibility in adults diagnosed with T1DM. Employing a single-arm trial design with mixed methodology, thirteen participants (Mage = 39.04, SDage =13.74) engaged in the intervention and completed self-report measures before and after the intervention. Quantitative analysis with the Wilcoxon signed-rank test indicated a statistically significant difference in diabetes-associated stress, diabetes acceptance, and psychological flexibility pre- and post-intervention. Notably, stress levels and psychological inflexibility diminished, while psychological flexibility and diabetes acceptance improved. However, the patient-doctor relationship did not exhibit a significant change. Furthermore, narrative feedback obtained from participants reflected overall satisfaction with the intervention. These preliminary findings contribute to the expanding body of literature supporting the affirmative influence of ACT interventions on individuals with T1DM.

Increasing Older Adults' Social Connectedness: Development and Implementation of a Web-Assisted Acceptance and Commitment Therapy-Based Intervention.

Abstract In this article, we will provide a rationale for a web-assisted acceptance and commitment therapy (ACT) approach to loneliness among older adults, drawing upon theories from the literature on adult development and aging, emotion regulation, and loneliness. The intervention program was developed using the principles of ACT, which is a cognitive behavioral approach and unified model of human behavior change and psychological growth. The ACT intervention focuses on developing nonjudgmental present-focused awareness of internal experiences (thoughts, emotions, and memories) through strategies such as acceptance and mindfulness rather than directly modifying or removing them per se. The ACT intervention appears well-suited to assist older adults in coping with the challenges of aging, as the focus is on an individual’s willingness to sit with internal experiences out of one’s control (ie, acceptance), stepping back from negative or critical thoughts and developing greater kindness toward oneself (ie, defusion), discerning what is most important to one’s true self (ie, values), and building larger patterns of effective action based on such values (ie, committed action). The ACT intervention was developed as a resource for older adults who are socially isolated or having difficulty with social connectedness. Eight modules comprise the web-assisted ACT intervention program, which includes reading materials, video clips, and activities. Each module is followed by a summary, a homework assignment, a short quiz to assess learning, and a moderated discussion with a coach. The intervention program begins with reconnecting participants with their values. The goal of the ACT intervention program is to foster flexibility in a participant’s behavior so they can behave consistently with their chosen values, rather than becoming locked into a pattern of behavior that is driven by avoiding distress or discomfort. The ACT intervention approach is both novel and innovative, as it is based on ACT and leverages a behavioral health web platform that is flexible and inclusive in its design. The ACT intervention aims to help older adults become more socially connected, less lonely, and more satisfied with their relationships with other people. The emphasis that ACT places on values and living life in accordance with one’s values renders it an approach ideally suited to older adults. Finally, recommendations for future research regarding this approach to addressing loneliness among older adults is addressed.

A Web-Based Intervention Based on Acceptance and Commitment Therapy for Family Caregivers of People With Dementia: Mixed Methods Feasibility Study.

Acceptance and commitment therapy (ACT), as an empirically based third-wave cognitive behavioral therapy, has shown promise in enhancing well-being and functioning across diverse populations. However, in the context of caregiving, the effect size of available ACT interventions remains at best moderate, sometimes accompanied by high dropout rates, highlighting the need for more effective and feasible intervention designs. The objective of our study was to evaluate the feasibility and acceptability of a fully online ACT program designed for family caregivers of people with dementia. This study aimed to boost psychological flexibility and support caregivers, enabling them to realize and prioritize their own life values alongside their caregiving responsibilities. A mixed methods feasibility study using an uncontrolled pretest-posttest design was conducted. This intervention included a 9-week web-based self-help program based on ACT incorporating collaborative goal setting and weekly web-based motivational coaching for family caregivers of people with dementia. This study involved 30 informal caregivers recruited through memory clinics and social media platforms in the Netherlands and received approval from the Medical Ethics Committee of the Maastricht University Medical Center+ (NL77389.068.21/metc21-029). A total of 24 caregivers completed the postintervention assessment, indicating a high adherence rate (24/29, 83%). Caregivers reported positive feedback regarding collaborative goal setting, but some found challenges in implementing new skills due to their own habitual responses or the unpredictable context of dementia caregiving. Personalizing the intervention based on individual value preferences was highlighted as beneficial. Compared to other web-based self-help ACT interventions for family caregivers, this intervention showed a high adherence and sufficient level of feasibility, which underscores the use of personalization in delivering web-based interventions. Moreover, the potential of this ACT-based intervention for family caregivers of people with dementia was demonstrated, suggesting that further research and a larger-scale controlled trial are warranted to validate its effectiveness. RR2-10.1136/bmjopen-2022-070499.

The Effectiveness of ACT and DBT-Based Interventions with and without Exercise on Pain Outcomes and Desire for Treatment in Substance-Dependent Patients with Chronic Pain

Background: Managing chronic pain outcomes and addressing the desire for addiction treatment can be crucial for recovery from substance dependence and chronic pain. Objectives: This study aimed to control pain outcomes and enhance the desire for treatment using interventions based on acceptance and commitment therapy (ACT), Dialectical Behavior Therapy (DBT), and physical exercise. Methods: This quasi-experimental study employed a pre-test-post-test design with a two-month follow-up period and included a control group. Seventy-five voluntary patients undergoing addiction treatment in 2021 at Taban, Hayate Pak, and Omid addiction treatment centers in Zahedan with chronic pain participated. Participants were selected through purposive sampling and randomly assigned to five groups (ACT and DBT groups with and without exercise, and a control group). Data were collected using the Pain Outcomes Questionnaire-VA (POQ-VA) (Clark, Gironda, & Young, 2003) and the Stages of Change Readiness and Treatment Eagerness scale (SOCRATES) (Miller & Tonigan, 1996). Acceptance and Commitment Therapy intervention (eight sessions), DBT intervention (eight sessions), and aerobic exercise (24 sessions) were conducted only for the intervention groups over two months. Data were analyzed using repeated measures analysis of variance (ANOVA) and Bonferroni's post hoc test with SPSS-26 software at a significance level of 0.05 (P < 0.05). Results: Repeated measures ANOVA revealed significant changes for ACT and DBT interventions with and without exercise in the intragroup effect (time) for pain outcomes and the desire for treatment across the pre-intervention, post-intervention, and follow-up stages (P ≤ 0.001), as well as for time-group interaction (P ≤ 0.001). Furthermore, the three groups exhibited significant differences in pain outcomes and the desire for treatment across the three evaluation stages (P ≤ 0.01). Notably, compared to other interventions, ACT intervention with exercise was more effective in managing pain outcomes and enhancing the desire for treatment (P ≤ 0.001). Conclusions: The findings suggest that ACT intervention with exercise, while controlling pain outcomes and increasing the desire for treatment, can contribute to successful addiction cessation and serve as an effective intervention in healthcare settings.

A digital Acceptance and Commitment Therapy and education intervention targeting stress of parents and caregivers with preterm babies in the neonatal intensive care unit: A randomised controlled cluster trial protocol

BackgroundParents with babies in the neonatal intensive care unit (NICU) experience high levels of stress, anxiety, and depression. The NICU experience may also lead to impaired parenting and early childhood socio-emotional problems.Psychosocial interventions can reduce NICU parent distress. Yet many are time-intensive and costly to deliver. Acceptance and Commitment Therapy (ACT), an evidence-based psychological therapy, may address these needs. ACT has been shown to be effective in reducing distress of parents of children with chronic illnesses, particularly when combined with parent education.Therefore, the primary aim of this study is to determine if a digital intervention that uses a brief form of ACT plus parent education will reduce the stress of primary caregivers with preterm babies in the NICU more than a digital education-only intervention or standard care control group. MethodsIn a randomised controlled cluster trial design, participants will be randomly assigned to one of three groups: ACT plus education; education-only; or standard care control. The primary outcome will be parental/caregiver stress levels, measured on the Parental Stress Scale: Neonatal Intensive Care Unit. Secondary outcomes include overall stress, anxiety, and depression. Outcome measures will be evaluated at baseline, two weeks after enrolment, discharge to home, and 3-months post-discharge. ConclusionThis study will explore the efficacy of a digital ACT plus education intervention on parental stress levels. While position papers have advocated for the use of ACT with NICU parents, this study will be the first to test ACT as a stand-alone intervention with this population. Trial registrationThis trial was prospectively registered with the Australian New Zealand Clinical Trials Registry on 14 June 2023 (ACTRN12623000641695p).

Investigating the acceptability of a culturally adapted acceptance and commitment therapy group for UK Vietnamese communities: A practice-based feasibility study.

Acceptance and Commitment Therapy (ACT) is an empirically supported psychotherapy that offers promise for the mental health of minoritised ethnic populations. Given the diversity of those presenting to inner-city services and barriers to accessing appropriate mental healthcare, we sought to develop a culturally syntonic ACT intervention for UK Vietnamese refugee communities in a practice-based partnership project between a National Health Service and local third-sector service in East London. The aim was to explore the feasibility, acceptability and impact of the adapted intervention to inform culturally inclusive clinical practice and future research. We outline key aspects of Vietnamese belief systems and culture, and consider how these might influence the optimisation of group-based ACT. We then present a mixed-method evaluation of the seven-session adapted ACT group for 11 participants (9 male and 5 female, aged between 44 and 73years). Individual-level change analyses indicated clinically significant improvements in psychological flexibility for the minority of participants and a mixed pattern for impact on well-being. A thematic analysis and descriptive approach examined acceptability, feasibility and narratives of impact. Participants reported positive feedback on group experience, relevance and usefulness, and emergent themes indicate that the group facilitated key acceptance, commitment and behaviour-change processes, promoted social connections and increased engagement in meaningful life activities in relation to new perspectives and values-based action. Limitations are outlined, but overall, findings suggest preliminary support for the potential beneficial effect of the adapted ACT group as a feasible, culturally acceptable therapeutic approach for UK Vietnamese communities that is worthy of further investigation.

Evaluation of an Integrated Fluency and Acceptance and Commitment Therapy Intervention for Adolescents and Adults Who Stutter.

Developmental stuttering is a complex and multifaceted neurodevelopmental disorder that may cause pervasive negative consequences for adults who stutter (AWS). Historically, intervention for AWS has primarily addressed speech fluency, with less focus on the covert psychosocial aspects of the disorder. The purpose of this article is to report on a feasibility trial evaluating a novel integrated intervention that combines traditional stuttering management techniques with Acceptance and Commitment Therapy (ACT) for AWS. Twenty-nine AWS participated in the feasibility trial. All participants successfully completed a combined fluency and ACT intervention, titled the fluency and Acceptance and Commitment Therapy for Stuttering (fACTS) Program. As this was a feasibility study, no control group was included. Intervention was administered by two certified practicing speech-language pathologists, over eight 60- to 90-min sessions. Generalized linear mixed modeling was used to determine change from pre- to post-intervention and follow-up. Significant pre- and post-intervention improvements in self-efficacy, psychosocial functioning, and psychological flexibility were observed, along with significant reductions in observable stuttering behaviors (i.e., stuttered speech frequency). Intervention gains for all variables of interest were maintained 3 and 6 months post-intervention. The fACTS Program was created to be a holistic and flexible intervention to promote self-efficacy beliefs and address stuttering-related psychosocial impacts and speech fluency goals of AWS. Preliminary results indicated positive improvement in all psychosocial outcomes (i.e., self-efficacy, psychosocial impact, and psychological flexibility) and observable speech fluency following completion of the program. Future clinical trials of the fACTS Program with an included control group will further investigate the mechanisms of change for the positive effects observed.

The Impact of Acceptance and Commitment Therapy on Trauma and Psychological Flexibility among University Students Affected by the Earthquake

This study aims to examine the impact of Acceptance and Commitment Therapy (ACT) on the trauma levels and psychological flexibility of university students affected by the earthquake. The study included a total of 15 participants in the research. Participants in the research were divided into two groups, an experimental group and a control group, using the stratified random sampling method. In the experimental group, there were 8 males (53.3%) and 7 females (46.7%) aged between 18-30 (M = 23.26; SD = 3.19). Similarly, in the control group, there were 8 males (53.3%) and 7 females (46.7%) aged between 18-30 (M = 23.33; SD = 3.47). The study employed a true experimental design and a 2x2 split-plot the randomized pre-test post-test control group design. The instruments used for data collection were the Post-Earthquake Trauma Level Determination Scale and the Multidimensional Psychological Flexibility Inventory. The experimental group received a 6-week ACT intervention, while no intervention was applied to the control group. In data analysis, paired-sample t-tests, independent samples t-tests, and Pearson correlation analysis were conducted using IBM SPSS 26.0 software. The research found that ACT intervention reduces the impact of earthquake related trauma and enhances psychological flexibility. Additionally, a negative correlation has been observed between earthquake induced trauma and psychological flexibility.

Exploring Relationships Between Fear of Cancer Recurrence, Psychological Distress, and Mental Health Service Use in Breast Cancer Survivors

Background: Breast cancer survivors (BCS) have an increased risk of psychological distress compared with healthy controls. Fear of cancer recurrence (FCR) is one of the most reported forms of distress, with approximately 50% of BCS reporting clinically significant FCR. Designed to give alternatives to avoidant coping, acceptance and commitment therapy (ACT) has shown promise in reducing distress and FCR in BCS. The primary objective of this study was to explore relationships between psychological distress and mental health service use in BCS with FCR.
 Methods: Baseline data from 384 early-stage, post-treatment BCS with clinically significant FCR at screening enrolled in an RCT comparing 3 FCR interventions were analyzed. Prevalence of clinically significant FCR and symptoms of anxiety, depression, and posttraumatic stress was measured. Associations between each distress measure and mental health service use were assessed, in addition to the association between FCR and avoidant coping.
 Results: Clinically significant levels of at least one form of psychological distress besides FCR were reported in 226 (58.85%) BCS. Of 298 (77.60%) BCS with at least one significant distress score including FCR at baseline, only 61 (20.47%) reported using any mental health service within the 3 months before baseline. Clinically significant anxiety (p = 0.0027), depression (p = 0.0015), and post-traumatic stress symptoms (p = 0.0227) were significantly associated with mental health service use. FCR was significantly associated with fewer visits to certain mental health services. FCR was strongly correlated with increased avoidant coping (ρ = .6313, p < .0001).
 Conclusion: Anxiety, depression, and post-traumatic stress symptoms may be better predictors of mental health service use than FCR given the tendency for patients with fear to cope with avoidance. ACT interventions emphasizing alternatives to avoidant coping may benefit BCS with FCR. Further research is needed to identify barriers to mental health service use in BCS.

The Effectiveness of Acceptance and Commitment Therapy on Psychological Well-being, Resilience, and Hope for Life in Coronary Heart Disease Patients with High Blood Pressure Visiting Shahid Rajaei Hospital

The purpose of this study was to examine the effectiveness of Acceptance and Commitment Therapy (ACT) on psychological well-being, resilience, and hope for life among patients with coronary heart disease and high blood pressure who attended Shahid Rajaei Hospital. This was a quasi-experimental study with a pre-test, post-test, and a 3-month follow-up, including a control group. The study population included all individuals with a diagnosis of coronary heart disease and high blood pressure. The sample consisted of 30 patients selected through purposive sampling and randomly assigned to either the experimental or the control group. Data were collected using Ryff's Psychological Well-being Scale (1989), Bond et al.'s Resilience Scale (2011), and Snyder et al.'s Life Hope Scale (1991). The ACT intervention was conducted over eight 90-minute sessions held weekly; however, the control group received no intervention. Data analysis was performed using a repeated measures analysis of variance (ANOVA) with SPSS-26. Findings indicated that Acceptance and Commitment Therapy significantly enhances psychological well-being, resilience, and hope for life in patients with coronary heart disease and high blood pressure (p < 0.05). In conclusion, ACT can improve psychological well-being, resilience, and life expectancy in patients with coronary heart disease and high blood pressure. Therefore, this approach can be used alongside medical interventions in healthcare centers.

Aksept og verdibasert atferdsterapi (ACT)

Acceptance and commitment therapy (ACT) is a form of contextual cognitive behavioural therapy. The present article briefly presents the philosophical foundation of ACT and a core understanding of precipitating and perpetuating factors in both physical and mental health. ACT aims to increase psychological flexibility and improve quality of life. ACT is transdiagnostic and is considered an evidence-based treatment for a wide range of psychological disorders. Using a case formulation of ‘Nadine’, we illustrate examples of ACT techniques and interventions that may facilitate meaningful change. Keywords: psychological flexibility, transdiagnostic, case formulation, evidence-based

Participant experiences of guided self-help Acceptance and Commitment Therapy for improving quality of life in muscle disease: a nested qualitative study within the ACTMus randomized controlled trial.

In adults, muscle disease (MD) is typically a chronic long-term condition that can lead to a reduced quality of life (QoL). Previous research suggests that a psychological intervention, in particular Acceptance and Commitment Therapy (ACT), may help improve QoL for individuals living with chronic conditions such as MD. This nested qualitative study was incorporated within a randomized controlled trial which evaluated a guided self-help ACT intervention for people living with MD to explore their experiences of the intervention. Semi-structured interviews (n = 20) were conducted with those who had received ACT. Data were analyzed via thematic analysis. There were four overarching themes. (1) Views on whether therapy sessions would help with a medical condition: participants' expectations regarding ACT varied. Some participants were skeptical about mindfulness. (2) I was able to look at things in a different way: participants described increased meaningful activity, greater awareness of thoughts and emotions and acceptance or adaptation to mobility problems. Some described improvement in the quality of relationships and a sense of feeling free. (3) Treating the body and the mind together: following the intervention participants noted that a holistic approach to healthcare is beneficial. (4) Intervention delivery: The remote delivery was generally seen as helpful for practical reasons and allowed participants to speak openly. Participants voiced a need for follow-up sessions. Overall, the intervention was experienced as acceptable. Suggested improvements included de-emphasizing the role of mindfulness and adding follow-up sessions.

Factors Anticipating Adolescents’ Adherence and Dropout in an Online ACT Intervention During the COVID-19 Pandemic

This study examined factors anticipating adolescents’ (N = 232) adherence and dropout in an online acceptance and commitment therapy (ACT) intervention targeted at promoting well-being during the COVID-19 pandemic. First, results showed that adolescents with high academic achievement and educational expectations were more likely to participate in the induction meeting and start the program. Second, adolescents in the human-supported model fulfilled the adherence criteria more often than adolescents supported by virtual coach only. Finally, though male participants were less likely to participate in the study, participants who started the online program were likely to adhere to it regardless of gender.

Adding online storytelling-based acceptance and commitment therapy to antidepressant treatment for primary care patients: a randomized clinical trial

ABSTRACT Depression is most often treated in primary care, where the prevailing treatment is antidepressant medication. Primary care patients with depression are less likely to be exposed to psychosocial interventions, despite evidence suggesting many of these treatments are effective. An example is acceptance and commitment therapy (ACT), a behavioral treatment for depression with a growing evidence base. A self-guided ACT intervention with a peer narrative (i.e. storytelling) format was developed with the intention of creating a treatment option for primary care patients that was more accessible than traditional psychotherapy. Titled LifeStories, the online program features videos of real individuals sharing coping skills for depression based on lived experiences and key ACT principles. A total of 93 primary care patients taking antidepressants were randomized to either continued antidepressant treatment alone or antidepressant treatment plus LifeStories for 4 weeks. There were no differences over time on depression severity and psychological inflexibility. However, LifeStories led to greater improvements in quality of life and increased patients’ interest in additional treatment compared to antidepressant medication alone.Clinical trial pre-registration: ClinicalTrials.gov (NCT04757961)

Effect of group-based acceptance and commitment therapy on older stroke survivors: study protocol for a randomized controlled trial

IntroductionOlder stroke survivors usually experience various psychology disorders, such as post-stroke depression (PSD), which may be associated with high experiential avoidance (EA) and can seriously affect their quality of life. To date, the efficacy of group-based acceptance and commitment therapy (ACT) for older stroke survivors has not been established. The aim of this study is to investigate the effectiveness of group-based ACT on EA, PSD, psychological distress, and quality of life in older stroke survivors after group-based ACT.Methods and analysisThis study is a randomized, single-blind, wait-list controlled, parallel-arm trial. A total of 66 stroke survivors will be randomly assigned to wait-list control group or intervention group. Participants in wait-list control group will receive treatment as usual (TAU), while the intervention group will receive group-based ACT once a week for eight weeks. The primary outcome measure being EA, and the secondary outcome measures being PSD, psychological distress, and quality of life. Results of the two groups will be blindly assessed by professional evaluators at baseline (T0), post-treatment (T1), and one-month follow up (T2).DiscussionThe results of this study will provide the first evidence for the effectiveness of a group-based ACT intervention in reducing EA, PSD, psychological stress, and improving quality of life for post-stroke survivors.Trial RegistrationChiCTR2200066361.

Examining the effectiveness and acceptability of a group-based ACT intervention delivered by videoconference to international university students during the COVID-19 pandemic

ABSTRACT Studies have shown that international students are at increased risk of experiencing poor mental health. The COVID-19 pandemic has had further negative impacts on the psychological well-being of students. In this quasi-experimental study, we examined the impact of a brief acceptance and commitment therapy (ACT) -based group intervention delivered by videoconference (ACT videoconference; n = 48). We used an equivalent in-person group intervention administrated prior to the pandemic as a reference group (ACT face-to-face; n = 53). In addition, we investigated the exposure – response relationship, dropout attrition, acceptability, and user experiences. International university students participated in five online group meetings using a videoconferencing app during the COVID-19 pandemic and were compared with students participating in five face-to-face group meetings prior to the pandemic. Symptoms (stress, anxiety, depression) and process measures (psychological inflexibility, mindfulness, engaged living) indicated similar positive changes in both groups (e.g. PSS-10, ACT videoconference dw = 0.54; ACT face-to face dw = 0.94; AFQ-Y, ACT videoconference dw = 0.55; ACT face-to-face, dw = 0.84), with a slightly larger effect in the ACT face-to-face group. This study suggests that brief ACT-based group workshops can be effective in enhancing the psychological flexibility of international university students, and decreasing symptoms of stress, depression and anxiety whether delivered by videoconference or face-to-face format.

The Effect of Acceptance and Commitment Therapy on High-risk Behaviors of Delinquent Adolescents in a Juvenile Detention Center

Introduction: A juvenile detention center is a place where teenagers with risky behaviors, such as competitiveness, separation from family, impatience, aggression, physical abuse, suicide, addiction, and theft, are kept to be corrected and trained. Acceptance and commitment therapy (ACT) can greatly reduce high-risk behaviors in these individuals. Objective: This study aimed to investigate the effect of ACT on the risk-taking behaviors of delinquents in a juvenile detention center. Materials and Methods: This quasi-experimental study was performed on 60 male juvenile delinquents aged 12-18 years in a juvenile detention center in Southeast Iran. The participants were recruited by the census method and assigned to the intervention and control groups (30 in each group) using simple random sampling. The participants in the intervention group attended eight 90-min sessions of ACT, and the participants in the control group received routine training in the center. Iranian adolescents’ risk-taking scale was used to assess the risk-taking of samples before and one month after the ACT intervention. The study data were analyzed using descriptive (frequency, percentage, mean, and standard deviation) and inferential statistics (independent samples t-test, paired-samples t-test, chi-square test, and the analysis of covariance). Results: Most adolescents in the intervention and control groups were in the age group of 16-20 years (96.7%, and 93.3%, respectively) and had a middle school degree (56.7%, and 40%, respectively). A comparison of the mean risk-taking behaviors scores in the intervention (56.53±11.4) and the control groups (57.28±11.18) showed that the participants in both groups were engaged in high-risk behaviors and were similar. However, in the post-test stage, the mean risk-taking behaviors score in the intervention group decreased (39.64±10.26) compared with the control group (56.31±11.5) with a significant intergroup difference (P<0.05). Also, the Mean±SD risk-taking scores after the intervention were higher than the control group calculated by the covariance analysis for the intervention group participants. These differences were statistically significant (Cohen’s d=15.24, 95% CI, 10.91%-19.56%). Conclusion: According to the results, ACT reduced high-risk behaviors in juvenile delinquents. Thus, such psychological interventions can be performed to reduce high-risk behaviors in vulnerable groups such as adolescents in juvenile detention centers. Also, the effectiveness of these interventions can be evaluated in longitudinal studies.

Application of Acceptance and Commitment Therapy (ACT) in Hospice and Palliative Care Settings.

Many terminally ill cancer patients grapple with a range of physical, psychological, and social challenges. Therefore, it is critical to offer effective psychological interventions to assist them in managing these issues and enhancing their quality of life. This brief communication provides a concise overview of acceptance and commitment therapy (ACT), along with empirical evidence of its application for patients, caregivers, and healthcare professionals in hospice and palliative care settings and an overview of future directions of ACT interventions in South Korea. ACT, a third-wave type of cognitive behavioral therapy, is a model of psychological flexibility that promotes personal growth and empowerment across all life areas. Currently, there is substantial evidence from overseas supporting the effectiveness of ACT on health-related outcomes among patients with various diseases, caregivers, and healthcare professionals. The necessity and significance of conducting ACT-based empirical research in hospice and palliative care settings in South Korea are discussed.