Acceptance And Commitment Therapy Intervention Research Articles

A pilot trial of acceptance and commitment therapy for symptoms of depression and anxiety in older adults residing in long-term care facilities

ABSTRACTObjectives: The aim of this study was to evaluate the efficacy and acceptability of a psychological intervention based on acceptance and commitment therapy (ACT) to improve symptoms of depression and anxiety among older adults living in long-term care.Method: Forty one residents aged between 63 and 97 years (M = 85.3 years) participated in this study. Residents were allocated to receive either a 12 session ACT intervention implemented by trainee psychology therapists or a wait-list control group. Measures of depression and anxiety were collected at baseline and 8 week post-intervention, and residents who received the intervention were tracked for three months. A treatment satisfaction questionnaire was administered to residents who received the intervention and a sample of 10 facility staff members.Results: Using an intention to treat approach and controlling for baseline scores, scores on depression measures were significantly lower after the ACT intervention than after the wait-list control. These outcomes were maintained at three-month follow-up. Treatment satisfaction was rated highly by both residents and their care staff.Conclusion: This preliminary trial suggests that ACT shows promise as a therapeutic approach to address symptoms of depression in long-term care.

Comparing the effectiveness of an internet-delivered Acceptance and Commitment Therapy (ACT) intervention with a wait list control on health related quality of life among adults with multimorbidity: Study protocol for a randomised controlled trial

Event Abstract Back to Event Comparing the effectiveness of an internet-delivered Acceptance and Commitment Therapy (ACT) intervention with a wait list control on health related quality of life among adults with multimorbidity: Study protocol for a randomised controlled trial Brian Slattery1*, Laura O'Connor1, Christopher Dwyer1, Siobhan O'Higgins1 and Brian McGuire1 1 NUI Galway, School of Psychology, Ireland Multimorbidity is defined as the coexistence of two or more conditions within one person, where no one condition is primary. Chronic Pain (CP) is found to be one of the most frequent conditions represented amongst multimorbidities. CP and in particular MM, can have significant debilitating effects on a persons’ Health Related Quality of Life (HRQoL). There is a dearth of research however, targeting and improving HRQoL for people living with MM, were CP is a feature. Aim of Investigation: This study will compare the clinical- effectiveness of an online ACT intervention with a waitlist control condition in terms of increasing health related quality of life among people with multimorbidities, were chronic pain is a feature. Methods: Adult participants with non-malignant pain that persists for at least three months and at least one other condition as diagnosed by a doctor will be randomised to one of two study conditions. The experimental group will undergo an 8-session internet-delivered ACT-programme over an 8-week period. A wait-list group will be offered the ACT intervention after the 3-month follow-up period. Results: Participants will be assessed pre-intervention, post-intervention and at a 3-month follow-up. HRQoL will be the primary outcome. Secondary outcomes will include: pain intensity; depression; acceptance of chronic pain and symptoms of other morbidities. Conclusions: At present, we are in the early stages of participant recruitment. As a result, the focus of this poster will be on describing the methodological and recruitment processes for the current study. Acknowledgements Acknowledgements: This study is part of a larger project funded by the HRB – reference number RLA/ 2013/ Brian McGuire. Keywords: multimorbidity, Chronic Pain, ACT, online-Intervention, randomised controlled trials Conference: 2nd Behaviour Change Conference: Digital Health and Wellbeing, London, United Kingdom, 24 Feb - 25 Feb, 2016. Presentation Type: Poster presentation Topic: Academic Citation: Slattery B, O'Connor L, Dwyer C, O'Higgins S and McGuire B (2016). Comparing the effectiveness of an internet-delivered Acceptance and Commitment Therapy (ACT) intervention with a wait list control on health related quality of life among adults with multimorbidity: Study protocol for a randomised controlled trial. Front. Public Health. Conference Abstract: 2nd Behaviour Change Conference: Digital Health and Wellbeing. doi: 10.3389/conf.FPUBH.2016.01.00095 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 27 Nov 2015; Published Online: 09 Jan 2016. * Correspondence: Dr. Brian Slattery, NUI Galway, School of Psychology, Galway, Ireland, brian.slattery@nuigalway.ie Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Brian Slattery Laura O'Connor Christopher Dwyer Siobhan O'Higgins Brian McGuire Google Brian Slattery Laura O'Connor Christopher Dwyer Siobhan O'Higgins Brian McGuire Google Scholar Brian Slattery Laura O'Connor Christopher Dwyer Siobhan O'Higgins Brian McGuire PubMed Brian Slattery Laura O'Connor Christopher Dwyer Siobhan O'Higgins Brian McGuire Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

The Use of Mind-body Medicine in Chronic Pain Management: Differential Trends and Session-by-Session Changes in Anxiety

The evidence to date suggests that the use of mind-body medicine in chronic pain management can improve physical and psychological symptoms. However, past research evidence has largely relied on global measures of distress at pre- and post-intervention. Even though it is plausible that reported anxiety occurs in the context of pain, there is also evidence to suggest a reciprocal relationship. Thus, the purpose of the current study was to determine the differential impact that mind-body medical interventions have on anxiety among Veterans with chronic, non-cancer pain. The current study utilized multiple, repeated assessments of anxiety to better understand changes made over time between two mind-body interventions (Acceptance and Commitment Therapy (ACT) and Cognitive Behavioral Therapy (CBT)) used for chronic pain management. Ninety-six Veterans elected to participate in either intervention following the completion of a pain health education program at a Midwestern VA Medical Center between November 3, 2009-November 4, 2010. A 2 × 7 repeated measures multivariate analyses of variance indicated significantly lower levels of global distress by the end of both the ACT and CBT interventions. Trend analysis revealed differential patterns of change in levels of anxiety over time. Helmert contrast analyses found several modules of ACT were statistically different than the overall mean of previous sessions. Implications related to timing and patterns of change for the interventions are discussed.

Preliminary results of an Acceptance and Commitment Therapy (ACT) brief group intervention for psychosis

Acceptance and Commitment Therapy (ACT) is a contextual-behavioral therapy with promising results in various psychological disorders, including psychosis. This study aims to compare the potential benefits of a 4-session ACT group intervention with the interventions commonly offered in Portugal. ACT participants improved in a wider range of measures and 2 of the 3 patients improved significantly in both symptoms, cognitive processes and positive indicators of adjustment (without any deterioration). Future studies should explore the relationship between participants’ clinical profile and benefits from ACT interventions.

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

Background and objectivesAcceptance and Commitment Therapy (ACT) is a contextual cognitive-behavioural approach with a developing evidence base for clinical and cost-effectiveness as an individually-delivered intervention to promote recovery from psychosis. ACT also lends itself to brief group delivery, potentially increasing access to therapy without inflating costs. This study examined, for the first time, the feasibility and acceptability of ACT groups for people with psychosis (G-ACTp). MethodsParticipants were recruited from community psychosis teams. Ratings of user satisfaction, and pre-post change in self-rated functioning (primary outcome), mood (secondary outcome) and ACT processes were all completed with an independent assessor. Of 89 people recruited, 83 completed pre measures, 69 started the four-week G-ACTp intervention, and 65 completed post measures. ResultsIndependently assessed acceptability and satisfaction were high. Functioning (Coeff. = -2.4, z = −2.9, p = 0.004; 95% CI: -4.0 to −0.8; within subject effect size (ES) d = 0.4) and mood (Coeff. = -2.3, z = −3.5, p = 0.001; 95% CI: -3.5 to −1.0; d = 0.4) improved from baseline to follow-up. Commensurate changes in targeted ACT processes were consistent with the underlying model. LimitationsThe uncontrolled, pre-post design precluded blinded assessments, and may have inflated effect sizes. Participants may have improved as a result of other factors, and findings require replication in a randomized controlled trial (RCT). ConclusionsThis preliminary study showed that brief group ACT interventions for people with psychosis are feasible and acceptable. Uncontrolled, pre-post assessments suggest small clinical improvements, and changes in psychological processes consistent with an ACT model. Replication in an RCT is required, before implementation can be recommended.

Acceptance and Commitment Therapy and Implementation Intentions Increase Exercise Enjoyment and Long-Term Exercise Behavior Among Low-Active Women

The current study evaluated the long-term effectiveness of acceptance and commitment therapy (ACT) for promoting exercise behavior in comparison with planning in the form of implementation intentions (forming situational cues and action plans as to when, where, and how to incorporate exercise). We expected both interventions to increase exercise behavior (assessed using the Godin Leisure-Time Exercise Questionnaire; Godin and Shephard 1985) from baseline to 6-months post-intervention, but expected only ACT to also increase exercise enjoyment (assessed using the Physical Activity Enjoyment Scale; Kendzierski and DeCarlo 1991). A total of 32 women, randomized to receive a single session of either ACT training or instructions to form implementation intentions for exercise activities, took part in this study. The participants were contacted by email 6-months following the intervention to determine the amount of self-reported exercise. As expected, exercise amount increased in both groups. Contrary to our expectations, both groups also increased in exercise enjoyment. This study provides initial evidence that exercising can be increased through an ACT intervention. ACT and implementation intentions may both be effective and brief interventions for promoting exercise behavior and exercise-related enjoyment in low-active women. Future research needs to establish the psychosocial and personality factors that lead to the effectiveness of ACT and implementation intentions.

Acceptance and Commitment Therapy and Selective Optimization with Compensation for Institutionalized Older People with Chronic Pain.

Recent studies support the efficacy of Acceptance and Commitment Therapy (ACT) with people with chronic pain. In addition, Selective Optimization with Compensation strategies (SOC) can help the elderly with chronic pain to accept their chronic condition and increase functional autonomy. Our aim was to analyze the efficacy of an ACT treatment program combined with training in SOC strategies for elderly people with chronic pain living in nursing homes. 101 participants (mean age = 82.26; SD = 10.00; 78.6% female) were randomized to the intervention condition (ACT-SOC) or to a minimal support group (MS). Complete data are available for 53 participants (ACT-SOC: n = 27; MS: n = 26). Assessments of functional performance, pain intensity, pain acceptance, SOC strategies, emotional well being and catastrophizing beliefs were done preintervention and postintervention. Significant time by intervention changes (P = 0.05) were found in acceptance, pain related anxiety, compensation strategies, and pain interference in walking ability. Simple effects changes were found in acceptance (P = 0.01), selection strategies (P = 0.05), catastrophizing beliefs (P = 0.03), depressive symptoms (P = 0.05), pain anxiety (P = 0.01) and pain interference in mood and walking ability (P = 0.03) in the ACT-SOC group. No significant changes were found in the MS group. These results suggest that an ACT intervention combined with training in SOC strategies could help older people with pain to improve their emotional well being and their functional capability.

A Case Study of Overselling Psychotherapy: An ACT Intervention for Diabetes Management

There have been numerous indications that the scientific literature regarding treatment safety and effectiveness can be biased. In this case study, we examine several reports relevant to an acceptance and commitment therapy (ACT) intervention attempting to improve diabetes self-management. The analysis indicated that several key negative results found in the original research—a dissertation—were not reported in the subsequent journal publication. Further, descriptions by some of the original authors in other peer-reviewed publications did not accurately portray the actual results reported in the dissertation. Also, subsequently a diabetes management self-help book was published by the same authors, that contained claims that this intervention is supported by the dissertation results although the dissertation only studied group face-to-face contact. Questions are raised regarding whether professionals and consumers are being misled about data that allegedly support claims about the efficacy of this intervention and serious methodological shortcomings of the original dissertation, that were not reported in the subsequent journal publication, are noted that add to the concern that the ACT intervention is being oversold.

Acceptance and Commitment Therapy for "Taro," a Japanese Client with Chronic Depression: A Replicated Treatment-Evaluation

This single case study examined the effectiveness of Acceptance and Commitment Therapy (ACT) for "Taro," a chronically depressed Japanese man in his thirties. After his baseline functioning was recorded, 9 one-hour weekly sessions, 3 biweekly one-hour booster sessions (bibliotherapy using ACT self-help reading materials), and then 4 monthly follow-up sessions, were conducted. The study examines the outcome of each of the treatment components, which were introduced in a step-by-step manner. In addition, the effects of interventions directed at each core process were also tested. As a result, the effectiveness of ACT was demonstrated with a chronically depressed Japanese client. The effectiveness of interventions was remarkably high during weekly therapy until the booster sessions; in the follow-up stage previous gains were first maintained, but then showed some regression as the client's job situation deteriorated. Future directions include the identification of factors that maintain an increase in the effectiveness of ACT interventions.

Acceptance and commitment therapy improves exercise tolerance in sedentary women.

To test the efficacy of an acute intervention derived from acceptance and commitment therapy (ACT) for increasing high-intensity constant work rate (CWR) cycle exercise tolerance in a group of low-active women age 18-45 yr. The secondary goals were to examine whether ACT would reduce perceived effort and improve in-task affect during exercise and increase postexercise enjoyment. In a randomized controlled trial, 39 women were randomized to either the experimental (using ACT-based cognitive techniques and listening to music during the CWR exercise tests) or a control group (listening to music during the CWR exercise tests). Before (CWR-1) and after the intervention (CWR-2), participants completed a CWR cycle exercise test at 80% of maximal incremental work rate (Wmax) until volitional exhaustion. On average, ACT (n = 18) and control (n = 21) groups were matched for age, body mass index, weekly leisure activity scores, and Wmax (all P > 0.05). Exercise tolerance time (ETT) increased by 15% from CWR-1 to CWR-2 for the ACT group (392.05 ± 146.4 vs 459.39 ± 209.3 s; mean ± SD) and decreased by 8% (384.71 ± 120.1 vs 353.86 ± 127.9 s) for the control group (P = 0.008). RPE were lower (e.g., by 1.5 Borg 6-20 scale units at 55% of ETT, P ≤ 0.01) during CWR-2 in the ACT versus that in the control group. By contrast, ACT had no effect on in-task affect. Exercise enjoyment was higher after CWR-2 in the ACT group versus that in the control group (P < 0.001). An acute ACT intervention increased high-intensity ETT and postexercise enjoyment and reduced perceived effort in low-active women. Further investigations of ACT as an effective intervention for enhancing the established health benefits of high-intensity exercise need to be provided.

Emerging behavioral treatments for migraine.

Although the efficacy of behavioral interventions for migraine (e.g., relaxation training, stress management, cognitive-behavioral therapy, biofeedback) is well established, other behavioral interventions that have shown efficacy for other conditions are being adapted to treat migraine. This paper reviews the literature to date on acceptance and commitment therapy (ACT), mindfulness-based interventions, and behavioral interventions for common migraine comorbidities. ACT and mindfulness interventions prioritize the outcome of improved functioning above headache reduction and have demonstrated efficacy for chronic pain broadly. These emerging behavioral therapies show considerable promise for improving outcomes of migraine patients, particularly in reducing headache-related disability and affective distress, but efficacy to date is limited by small trials, short follow-up periods, and a need for comparison or integration with established pharmacologic and behavioral migraine treatments.

Flourishing in people with depressive symptomatology increases with Acceptance and Commitment Therapy. Post-hoc analyses of a randomized controlled trial

Mental health is more than the absence of mental illness. Rather, both well-being (positive mental health) and mental illness are actually two related continua, with higher levels of well-being defined as “flourishing.” This two-continua model and existing studies about the impact of flourishing on psychopathology underscore the need for interventions that enhance flourishing and well-being. Acceptance and Commitment Therapy (ACT) is a model of cognitive behavioral therapy that aims not only to reduce psychopathology but also to promote flourishing as well. This is the first study to evaluate the impact of ACT on flourishing. A post-analysis was conducted on an earlier randomized controlled trial of a sample of adults with depressive symptomatology who participated in a guided self-help ACT intervention. This post-analysis showed a 5%–28% increase of flourishing by the participants. In addition, the effects on flourishing were maintained at the three-month follow-up. When compared to participants in a control group, the flourishing of the ACT-trained participants increased from 5% to about 14% after nine weeks. In addition to levels of positive mental health at baseline, an increase of psychological flexibility during the intervention was a significant predictor of flourishing at the three-month follow-up.

Using acceptance and commitment therapy to increase self-compassion: A randomized controlled trial

Self-compassion has been shown to be related to several types of psychopathology, including traumatic stress, and has been shown to improve in response to various kinds of interventions. Current conceptualizations of self-compassion fit well with the psychological flexibility model, which underlies acceptance and commitment therapy (ACT). However, there has been no research on ACT interventions specifically aimed at self-compassion. This randomized trial therefore compared a 6-hour ACT-based workshop targeting self-compassion to a wait-list control. From pretreatment to 2-month follow-up, ACT was significantly superior to the control condition in self-compassion, general psychological distress, and anxiety. Process analyses revealed psychological flexibility to be a significant mediator of changes in self-compassion, general psychological distress, depression, anxiety, and stress. Exploratory moderation analyses revealed the intervention to be of more benefit in terms of depression, anxiety, and stress to those with greater trauma history.

ACT Internet-based vs face-to-face? A randomized controlled trial of two ways to deliver Acceptance and Commitment Therapy for depressive symptoms: An 18-month follow-up

The aim of the present study was to investigate two interventions based on Acceptance and Commitment Therapy (ACT) for depressive symptoms: A face-to-face treatment (ACT group) was compared to a guided self-help treatment delivered via the Internet consisting of two assessment sessions (pre and post) and an ACT-based Internet program (iACT). Outpatients experiencing at least mild depressive symptoms were randomized to either approach. The iACT treatment group received access to an ACT-based Internet program and supportive web-based contact over a period of 6 weeks. The face-to-face group received ACT-based treatment once a week over the same period of time. In both groups, the results showed a significant effect on depression symptomatology, and general wellbeing after treatment and at the 18-month follow-up. However, the data indicated that the iACT group changed differently regarding depressive symptoms and wellbeing as compared to the face-to face ACT group. Results showed large pre-treatment to 18-month follow-up within-group effect sizes for all symptom measures in the iACT treatment group (1.59–2.08), and for most outcome measures in the face-to-face ACT group (1.12–1.37). This non-inferiority study provides evidence that guided Internet-delivered ACT intervention can be as effective as ACT-based face-to-face treatment for outpatients reporting depressive symptoms, and it may offer some advantages over a face-to-face intervention.

Comparing the clinical-effectiveness and cost-effectiveness of an internet-delivered Acceptance and Commitment Therapy (ACT) intervention with a waiting list control among adults with chronic pain: study protocol for a randomised controlled trial

IntroductionInternet-delivered psychological interventions among people with chronic pain have the potential to overcome environmental and economic barriers to the provision of evidence-based psychological treatment in the Irish health service context....

Development of the Valuing Questionnaire (VQ)

Acceptance and Commitment Therapy (ACT) aims to facilitate valued living; however, there are few well-validated questionnaires to assess this. Valuing Questionnaire (VQ) items were generated from ACT texts and rated as representative and face-valid by ACT authors. Exploratory and confirmatory factor analyses supported a 2-factor solution (Factor 1=Progress (in valued living); Factor 2=Obstruction (to valued living)) in undergraduate university (N=630) and clinical adult (N=285) samples. Concurrent validity was measured with the Satisfaction With Life Scale (SWLS), Ryff׳s Psychological Scales of Wellbeing (PSWB), the Valued Living Questionnaire (VLQ), the Acceptance and Action Questionnaire (AAQ-II), the Mindfulness Attention Awareness Scale (MAAS), the Positive and Negative Affect Scales (PANAS) and the Depression Anxiety Stress Scales (DASS). The pattern of relationships with validation measures was predominantly as expected. The VQ should provide ACT researchers and clinicians a convenient, reliable, and valid alternative to symptom measures consistent with ACT theory and useful for evaluating ACT interventions.

Acceptance and Commitment Therapy group for treatment-resistant participants: A randomized controlled trial

Acceptance and Commitment Therapy (ACT) is a theoretically coherent approach addressing common processes across a range of disorders. The aim of this study was to investigate the effectiveness of a group-based ACT intervention for “treatment-resistant” participants with various diagnoses, who had already completed at least one psychosocial intervention. Of 61 individuals randomized into a service-based trial comparing ACT and Treatment as Usual based on Cognitive Behavior Therapy (TAU-CBT), 45 provided data (ACT n=26; TAU-CBT n=19). Primary outcomes were measures of psychological symptoms. All participants showed reduced symptoms immediately after intervention but improvements were more completely sustained in the ACT group at 6-month follow-up. More elaborate and more fully controlled evaluations are required to confirm the findings, improve understanding of ACT processes and assess health economic benefits.

The efficacy of a self‐managed Acceptance and Commitment Therapy intervention DVD for physical activity initiation

Initiating and maintaining physical activity presents the individual with challenges of inconvenience, discomfort, and counteractive energy. Addressing these challenges requires an intervention that elicits motivation to engage in this activity, minimizes the direct relationship between unwanted internal experiences and inaction, and is also in itself accessible and convenient. Accordingly, this study investigated the efficacy of a self-managed Acceptance and Commitment Therapy (ACT) intervention delivered via DVD and tailored for physical activity initiation. Fifty-nine minimally active community participants were randomly allocated to receive a 12-week pedometer-based walking programme, or the same walking programme with the additional provision of the ACT DVD. The primary outcome was overall physical activity level (assessed at baseline and post-intervention), and the secondary outcome was pedometer-assessed step count (measured at 4-weekly intervals throughout the intervention period). Participants who received the ACT DVD achieved a significantly greater increase in physical activity levels post-intervention, were more likely to achieve the goals specified in the programme, and reported a higher average step count than participants who received the walking programme in isolation. The ACT intervention, delivered via DVD for the promotion of physical activity, proved a simple, efficient, and accessible method to encourage positive short-term increases in an important health-promoting behaviour. Statement of contribution What is already known? ACT interventions can increase physical activity levels through augmenting initiatory self-regulatory control. Face-to-face delivery presents challenges of accessibility and feasibility for community implementation. There is a need for effective interventions that maximize impact while minimizing inconvenience. What does this study add? Supplementing a walking programme with a self-managed ACT DVD produced significant increases in physical activity. The ACT DVD is a convenient, accessible, and potentially cost-effective approach to physical activity initiation. ACT lends itself to implementation as a self-managed electronically delivered intervention.

Acceptance and Commitment Training: A Brief Intervention to Reduce Procrastination Among College Students

Academic procrastination is a multifaceted problem with cognitive, behavioral, and motivational correlates. Considered from an acceptance and commitment therapy (ACT) point of view, these correlates relate to experiential avoidance and cognitive fusion. This article describes a brief ACT intervention for reducing procrastination.

Poster #M3 PREDICTION OF SUICIDAL BEHAVIOURS IN YOUNG PEOPLE PRESENTING WITH FIRST-EPISODE PSYCHOSIS IN HONG KONG: A 3-YEAR FOLLOW-UP STUDY

Acceptance and Commitment Therapy (ACT) is a principle-based behavioral intervention that addresses human suffering using mindfulness and acceptance techniques along with behavioral commitments linked to personal values. While ACT has been applied to a wide variety of problems, it is well suited to the treatment of trauma based on its processes specifically designed to reduce experiential avoidance, and it has only just begun to be investigated for its effectiveness with this population. Furthermore, current drop-out and refusal rates for exposure-based therapies, the main empirically supported intervention for the treatment of posttraumatic stress disorder (PTSD), necessitate the development of alternatives. The current pilot studies evaluated a 12-session group ACT intervention with 10 veterans diagnosed with PTSD, and a 12-session individual ACT intervention with 9 veterans diagnosed with PTSD. Significant reductions in PTSD symptoms from pre to post or follow-up were found for both the group intervention (n = 10, g = 0.69) and the individual intervention (n = 9; g = 1.24). Decreases in thought suppression as well as increases in aspects of mindfulness and psychological flexibility were also found, but results were mixed and differed by the individual versus group intervention.