Group-based Acceptance And Commitment Therapy Research Articles

Facilitating adaptive coping with fear of recurrence among breast cancer survivors: Feasibility and acceptability outcomes from a three-arm randomized controlled trial.

1630 Background: Fear of cancer recurrence (FCR) is one of the most prevalent and disruptive problems for breast cancer survivors (BCS). Acceptance and commitment therapy (ACT) and cognitive behavioral therapy (CBT) have shown promising effects for FCR in a recent meta-analysis, yet head-to-head comparisons of these interventions are rare. We present feasibility and acceptability outcomes from a randomized controlled trial comparing ACT to CBT and enhanced usual care (EUC) for BCS with clinically significant FCR. Methods: Eligible women were ≥18 years old, diagnosed with stage I-IIIA breast cancer, within 5 years of completing cancer treatment (ongoing endocrine therapy was allowed), and reported clinical FCR at enrollment. Participants were randomly assigned to group-based ACT, CBT, or EUC, all delivered via videoconference. ACT and CBT consisted of 6 weekly 1.5-hour sessions; EUC was a single 1.5-hour survivorship coaching session. Outcomes included accrual, session attendance and engagement, intervention helpfulness, and retention. Variables were summarized by mean (SD) if numerical or relative frequency if categorical. At significance level α = 0.05, the Kruskal-Wallis test was used to compare overall differences between the three groups, and two-sample T-tests with unequal variances were used for pairwise comparisons between the groups with Bonferroni multiple-comparison adjustment. Results: Of 446 BCS who screened eligible, 390 (87.4%) enrolled. Most participants were white (81.8%), not Hispanic (98.4%), partnered (68.4%), and college-educated (71.3%). Most were within 2 years of completing cancer treatment (55.7%), and mean age was 55.8 (SD = 12.0) years. Among those assigned to a 6-session intervention, participants attended a mean of 5.0 (ACT) and 5.2 (CBT) sessions; 96.1% of EUC participants attended the single session. Mean session engagement (rated per participant per session by interventionists on a 0-10 scale) was significantly different across the three groups (p < .0001), with mean (SD) of 9.3 (0.8) for ACT, 9.5 (1.0) for CBT, and 7.9 (1.3) for EUC. Pairwise comparisons showed higher engagement ratings in ACT (p < .0001) and CBT (p < .0001) over EUC, with no significant difference between ACT and CBT (p = .14). At post-intervention, participants rated mean (SD) helpfulness on a 0-10 scale as 7.2 (2.6) for ACT, 7.9 (2.0) for CBT, and 5.5 (2.7) for EUC. Overall, mean helpfulness was significantly different across the groups (p < .0001) and favored CBT over ACT (p = .0109) and EUC (p < .001) and favored ACT over EUC (p < 0.001). Outcome data retention was 93.8% through the 6-month follow-up. Conclusions: High accrual and attendance rates suggest that BCS are receptive to FCR interventions and may find ACT or CBT more engaging and helpful than a single session of survivorship coaching. Clinical trial information: NCT05364450 .

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.

The effect of online group based acceptance and commitment therapy on psychotic symptoms and functioning levels of individuals with early psychosis

ObjectiveThis study examined the effect of online group-based Acceptance and Commitment Therapy (ACT) applied to individuals with early psychosis on psychotic symptoms and functionality levels. MethodsThis randomized controlled study population consisted of 77 individuals who had been diagnosed with schizophrenia and other psychotic disorders according to DSM-5 diagnostic criteria at most three years ago. The study sample consisted of 53 individuals who met the inclusion criteria and were assigned to the intervention (n = 26) and control (n = 27) groups by simple randomization method. The intervention group received an eight-session ACT program as online group therapy, while the control group received no application made by the researchers. Data were obtained using the “Positive and Negative Syndrome Scale (PANSS)” and the “Social Functioning Assessment Scale (SFAS)” at pre-test, post-test and 3-month follow-up. ResultsWhile it was found that the post-test and 3-month follow-up test PANSS mean scores of the individuals in the intervention group were lower than the mean score of the individuals in the control group; it was determined that the mean score of SFAS was higher than the mean score of the individuals in the control group (p < 0.05). In addition, while no hospitalization was observed in the intervention group during the follow-up period, 14.8 % (n = 4) of the individuals in the control group were hospitalized. DiscussionIt was found that online group-based ACT applied to individuals with early psychosis reduced psychotic symptoms and increased their functionality levels. It was also found that hospitalizations were less in the intervention group.ClinicalTrials.gov ID: NCT05210816.

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.

Effect of a group-based acceptance and commitment therapy (ACT) intervention on self-esteem and psychological flexibility in patients with schizophrenia in remission.

The present study explored whether acceptance and commitment therapy (ACT), a cognitive behavioral therapy approach, could improve the symptoms of schizophrenia spectrum disorders among patients with schizophrenia in remission. A pre- and post-treatment design with two evaluation time points was employed. Sixty outpatients with schizophrenia in remission were randomly divided into two groups: the ACT plus treatment as usual (ACT+TAU) and treatment as usual (TAU) groups. The ACT+TAU group participated in 10 group-based ACT interventions and TAU in the hospital, and the TAU group only received TAU interventions. General psycho-pathological symptoms, self-esteem, and psychological flexibility were assessed before intervention (baseline; pre-test) and after intervention (five weeks; post-test). Results indicated that, compared to the TAU group, the ACT+TAU group exhibited a more significant improvement in general psychopathological symptoms, self-esteem, cognitive fusion, and acceptance and action at post-test. ACT intervention could effectively decrease the general psycho-pathological symptoms and increase self-esteem level and psychological flexibility in people with schizophrenia in remission.

Virtual Acceptance and Commitment Therapy (vACT) For Youth with Chronic Illnesses: A Case Report

Youth with chronic medical conditions need accessible and effective mental health interventions to address high levels of disruption in their psychological, social, and emotional development. Acceptance and Commitment Therapy (ACT) is an empirically supported psychotherapy based on behavioral interventions that combines the principles of Relational Frame Theory and Mindfulness. ACT has been shown to be effective in populations of youth with various chronic conditions. As telehealth use has increased, ACT has been administered virtually on an individual level to adults and adolescents with chronic conditions, including chronic pain and Type II diabetes. However, few studies have incorporated a group-based element to the virtual delivery of ACT, which may be more accessible, cost-effective and may have additional therapeutic value in the form of peer connection and cohesion. To investigate the potential benefits of a virtual group model, we developed a web-based virtual ACT (vACT) group intervention for youth with chronic illness aged 14-21. The 6-week virtual group consisted of 1.5-hour sessions that each focused on a unique ACT concept: acceptance, values, mindfulness, cognitive defusion, experiential avoidance, and willingness/commitment. Additionally, the sessions included exercises to engage group members and teach skills. Baseline, post-, and follow-up data were collected on stress, mental health, functional outcomes, and satisfaction from one participant, “Kasey”, a 14-year-old Latina adolescent with comorbid Type I diabetes, depression, and anxiety. This case report details the procedures for the vACT group, discusses the barriers, and provides examples and recommendations for future administration of the group model. The report also describes Kasey’s experience during the group and presents quantitative/qualitative data supporting her improvement. Kasey’s perceived stress declined across sessions, while her anxiety sensitivity and depressive symptoms improved from the moderate range to the mild range, with sustained improvements at follow-up. Additionally, Kasey reported improvements in her peer relations with sustained improvements at follow-up, which was initially a significant concern. This case report provides promising preliminary data for the virtual administration of a group-based ACT intervention. We hope that clinicians can use this approach to provide evidence-based services that can reach a wider range of youth with chronic illnesses who may not otherwise have access to care and/or are estranged from their peers.

Cognitive Defusion and Psychological Flexibility Predict Negative Body Image in the Chinese College Students: Evidence from Acceptance and Commitment Therapy.

Body dissatisfaction is a global phenomenon. Despite the significant cultural difference, most research on negative body image was conducted in Western countries. How do cognitive fusion and psychological flexibility relate to negative body image in the Chinese population? In the present study, this question was investigated through the intervention technique, Acceptance and Commitment Therapy (ACT). Here, 86 young Chinese university students with high negative physical self were invited, in which 42 students received 10 sessions of group-based ACT intervention in a clinical setting while the remained acted as the control group with no intervention. Pretests showed no statistical differences in negative body image between these two groups, while both cognitive fusion and psychological flexibility predicted negative body image. Post-pre tests showed no change in the control group, while enhanced cognitive defusion and psychological flexibility in the ACT group. Individual differences in psychological flexibility and cognitive defusion enhancement predicted improved body image. A strong association of implicit body image with Fatness and Shortness changes suggested that although with individual differences, those components could be internalized during the intervention in the College students.

A Brief Acceptance and Commitment Therapy Group Intervention on Systemic Lupus Erythematosus

Systemic lupus erythematosus (SLE) is a systemic autoimmune rheumatic disease of unknown etiology that mainly affects women of reproductive age. SLE causes a series of physical and psychological symptoms that, due to its chronic course, lead to a diminished quality of life. Acceptance and Commitment Therapy (ACT) is accumulating evidence supporting its usefulness in improving the psychological problems associated with SLE although research remains scarce. The aim of this study was to study the efficacy of a 10-hour brief ACT intervention protocol in group format in 15 patients with SLE from Navarra. Nine belonged to the experimental group (n1 = 9) and six to the control group (n2 = 6). Measures related to psychological flexibility processes and quality of life were taken before the intervention (pre), at the end (post), at one month and after three months (follow-up). The participants in the experimental group showed a substantial improvement in the degree of acceptance of pain and in variables focused on quality of life with respect to the control group. The improvements tended to be sustained over time. These results suggest that brief, group-based ACT interventions show promise for intervention in patients with SLE.

Benchmarks for Group Acceptance and Commitment Therapy: Tools for Social Work Professionals

Purpose This article provides within-group effect size benchmarks for RCTs of group-based Acceptance and Commitment Therapy (ACT) for adults with anxiety and/or depression. Methods A systematic literature search of RCTs of the group-based ACT intervention was conducted following PRISMA guidelines. Articles were selected based on predetermined eligibility criteria. Pre/post within-group effect sizes were calculated using the Glass approach, adjusted using Hedges g, and aggregated to produce separate benchmarks for symptoms of depression and anxiety for ACT and the comparison/control group(s). Results Results indicate that the average within-group pre/post effect sizes for the group-based ACT intervention is .59 (95% CI 0.37–0.81) for anxiety and .73 (95% CI 0.56–0.89) for depression. Discussion These benchmarks may be used by social workers to evaluate the effectiveness of their group-based ACT intervention and to guide clinical decision making.

Comparing the Effects of Acceptance and Commitment Group Therapy and Cognitive-Behavioral Group Therapy on Life Habits, Disordered Eating Behavior, and Health-Promoting Lifestyle in Obese Women

Background and Aim: Despite numerous advances in treating various diseases and increased life expectancy, obesity will be the leading cause of hopelessness in the next 100 years. The present study aimed to compare the effects of Acceptance and Commitment Therapy (ACT) and Cognitive-Behavioral Therapy (CBT) on lifestyle habits, disordered eating behavior, and health-promoting lifestyle in obese women. Methods &amp; Materials: The statistical population consisted of all women referring to obesity clinics in district 2 of Tehran City, Iran, in 2019. Forty-Five patients were selected by convenience sampling method and replaced in 3 groups of 15 (two experimental &amp; one control groups). The study participants were assessed using the Assessment of Life Habits Scale (LIFE-H)), the Eating Attitudes Test (EAT), and the Health Promoting Lifestyle Profile-II (HPLP-II). The ACT group underwent nine 90-minute sessions and the CBT group received eight 90-minute sessions. The control group received no training. The collected data were analyzed using Mixed Design and repeated-measures Analysis of Variance (ANOVA) in SPSS. Ethical Considerations This study was approved by the Research Ethics Committee of Islamic Azad University, Karaj Branch (Code: IR.IAU.K.REC.1398.039). Results: The present research results signified that ACT and CBT were effective on the habits of eating disorders and health-promoting lifestyles in the explored obese women. The achieved changes remained stable until the follow-up phase (P&lt;0.001). Moreover, ACT was more successful than CBT in improving the components of life habits and health responsibilities in the study subjects (P&lt;0.001). Conclusion: Considering the significant effect of group-based ACT and CBT, it is recommended to use these methods to increase the mental health of obese individuals.

Acceptance & commitment therapy for school leaders’ well-being: an initial feasibility study

ABSTRACT Acceptance and Commitment Therapy (ACT) has evolved a considerable evidence-base in recent years. One area wherein the model has demonstrated strong empirical support is through its application within the workplace. However, little empirical work has been carried out within the educational workforce and even less has been done with school leaders specifically. This paper reports on an initial feasibility study, using a group-based ACT programme to promote the well-being of school leaders. Seven leaders attended the programme, and completed established measures of well-being, burnout and valued living before and after the programme. The patterns of change indicated improvements on all three measures from pre- to post-intervention. Transcripts from semi-structured interviews were thematically analysed, revealing three themes: Increasing Awareness; Building Resilience; and a Safe and Supportive Group. Results and analyses are discussed in terms of future directions for the field and in terms of potential implications for the current COVID-19 pandemic.

The role of parental psychological flexibility in childhood asthma management: An analysis of cross-lagged panel models

ObjectiveThis is a secondary analysis of a previously reported randomized controlled trial, aimed at examining the mediating role of parental psychological flexibility (PF) in an Acceptance and Commitment Therapy (ACT)-based childhood asthma management program for parents. MethodsThe participants were 168 parents (mean age (SD) = 38.40 (5.90) years; 88.1% mothers) and their children who had been diagnosed with asthma (mean age (SD) = 6.81 (2.50) years; 62% boys). They were randomly allocated to either the program composed of a four-session, group-based ACT plus asthma education (ACT Group) or to a group-based asthma education talk plus three telephone follow-ups (Control Group). The parents underwent assessments at baseline, and immediately, 3-months, and 6-months after the intervention for the following outcomes: PF (Acceptance and Action Questionnaire-II), psychological distress of the parents (Depression Anxiety Stress Scale-21); and the asthma symptoms and use of inhaled bronchodilators of their children. ResultsCross-lagged panel models showed that the improvement in parental PF at post-intervention mediated the effect of ACT on reducing parental psychological distress (all beta coefficients (βs) ranged from −2.20 to - 2.30, all Ps < 0.01) and childhood asthma symptoms in terms of daytime symptoms (β = −0.22, 95% CI [−0.52, −0.02], P = 0.04), nighttime symptoms (β = −0.17, 95% CI [−0.33, −0.02], P = 0.04), and the use of bronchodilators (β = −0.22, 95% CI [−0.48, −0.02], P = 0.03) at 6-months post-intervention. ConclusionACT makes a unique contribution to improving the health outcomes of parents and their children diagnosed with asthma through fostering parental PF.

Examining a Group Acceptance and Commitment Therapy Intervention for Music Performance Anxiety in Student Vocalists.

Music performance anxiety (MPA) is a distressing and persistent anxious apprehension related to musical performance. The experience of MPA forces many musicians to give up performing or develop maladaptive coping mechanisms (e.g., avoidance or substance use), which can impact their career and wellbeing. High levels of MPA in students and vocalists are reported in the literature. Vocalists present a unique challenge for clinicians in that vocal and breathing mechanisms, required for performance, are negatively impacted when anxious. Acceptance and commitment therapy (ACT) has demonstrated efficacy for the treatment of a range of psychological problems including social anxiety disorder (of which MPA may be indicated as a subtype). This study sought to investigate whether group-based ACT may be a feasible and effective intervention for MPA in Australian student vocalists and aimed to design an intervention that could be adopted by music education providers. Potential participants (N = 31) completed an online survey including demographic questions and outcome measures. Six vocal students (four females; two males; aged M = 20.33 years) with elevated MPA scores participated in the ACT for MPA group program and 3-month follow-up. Group sessions were 2 h each week for six consecutive weeks. Participants were followed up 3 months post-intervention via online survey. There was a significant increase in psychological flexibility and significant decreases in MPA and psychological inflexibility. Gains were maintained at 3-month follow-up. The current study offers preliminary evidence for the feasibility and effectiveness of a group-based ACT protocol for musicians with performance anxiety which may be incorporated into tertiary performance training curricula.

Psychological Flexibility in Depression Relapse Prevention: Processes of Change and Positive Mental Health in Group-Based ACT for Residual Symptoms.

Relapse rates following a depressive episode are high, with limited treatments available aimed at reducing such risk. Acceptance and commitment therapy (ACT) is a cognitive-behavioral approach that has gained increased empirical support in treatment of depression, and thus represents an alternative in relapse prevention. Psychological flexibility (PF) plays an important role in mental health according to the model on which ACT is based. This study aimed to investigate the role of PF and its subprocesses in reducing residual symptoms of depression and in improving positive mental health following an 8-week group-based ACT treatment. Adult participants (75.7% female) with a history of depression, but currently exhibiting residual symptoms (N = 106) completed measures before and after intervention, and at 6 and 12-month follow-up. A growth curve model showed that positive mental health increased over 12-months. Multilevel mediation modeling revealed that PF significantly mediated these changes as well as the reduction of depressive symptoms, and that processes of acceptance, cognitive defusion, values and committed action, in turn, mediated increased PF.

Effect of a group-based acceptance and commitment therapy (ACT) intervention on illness cognition in breast cancer patients

ObjectiveIllness cognition is an important predictor of psychological adjustment among breast cancer patients; however, interventions related to illness cognition remain limited. This study aimed to determine the feasibility and effectiveness of a group-based acceptance and commitment therapy (ACT) intervention in improving illness cognition among breast cancer patients undergoing chemotherapy. MethodsA quasi-experimental “time-block” design, with two arms and four assessment time points, was used. Eighty-four patients were recruited from a breast cancer center; 42 patients were assigned to the ACT group and 42 to the health education (HE) group. The ACT group participated in four sessions of group-based ACT intervention in a clinical setting, and the HE group underwent one session of group-based HE. Psychological flexibility, illness cognition, and quality of life were assessed at a pre-intervention time point (T1, baseline), a post-intervention time point (T2, 4 weeks), and two follow-up time points (T3, 8 weeks; T4, 16 weeks). ResultsThe effects of time (p < 0.001) and the interaction of time with group (p < 0.001) on psychological flexibility, illness cognition, and quality of life were significant. The rate of improvement in the ACT group was greater than in the HE group. Significant intervention effects were observed for psychological flexibility, illness cognition, and quality of life at T2, T3, and T4. ConclusionsThe intervention was effective in improving psychological flexibility, illness cognition, and quality of life. However, a randomized controlled trial is needed to confirm the findings of this pilot study.

Acceptance and commitment therapy for breast cancer survivors with fear of cancer recurrence: A 3-arm pilot randomized controlled trial.

Fear of cancer recurrence (FCR) has a profound negative impact on quality of life (QOL) for many cancer survivors. Breast cancersurvivors (BCS) are particularly vulnerable, with up to 70% reporting clinically significant FCR. To the authors' knowledge, evidence-based interventions for managing FCR are limited. Acceptance and commitment therapy (ACT) promotes psychological flexibility in managing life's stressors. The current study examined the feasibility and preliminary efficacy of group-based ACT for FCR in BCS. Post-treatment BCS (91 patients with stage I-III disease) with clinical FCR randomly were assigned to ACT (6weekly 2-hour group sessions), survivorship education (SE; 6weekly 2-hour group sessions), or enhanced usual care (EUC; one30-minute group coaching session with survivorship readings). FCR severity (primary outcome) and avoidant coping, anxiety, post-traumatic stress, depression, QOL, and other FCR-related variables (secondary outcomes) were assessed at baseline (T1), after the intervention (T2), 1month after the intervention (T3), and 6months after the intervention (T4) using intent-to-treat analysis. Satisfactory recruitment (43.8%) and retention (94.5%) rates demonstrated feasibility. Although each arm demonstrated within-group reductions in FCR severity over time, only ACT produced significant reductions at each time point compared with baseline, with between-group differences at T4 substantially favoring ACT over SE (Cohen d for effect sizes, 0.80; P<.001) and EUC (Cohen d, 0.61; P<.01). For 10 of 12 secondary outcomes, only ACT produced significant within-group reductions across all time points. By T4, significant moderate to large between-group comparisons favored ACT over SE and EUC with regard to avoidant coping, anxiety, depression, QOL, and FCR-related psychological distress. Group-based ACT is a feasible and promising treatment for FCR and associated outcomes in BCS that warrants testing in larger, fully powered trials.

Acceptance and Commitment Therapy Preceded by Attention Bias Modification on Residual Symptoms in Depression: A 12-Month Follow-Up.

Depression is a highly recurrent disorder with limited treatment alternatives for reducing risk of subsequent episodes. Acceptance and commitment therapy (ACT) and attention bias modification (ABM) separately have shown some promise in reducing depressive symptoms. This study investigates (a) if group-based ACT had a greater impact in reducing residual symptoms of depression over a 12-month follow-up than a control condition, and (b) if preceding ACT with ABM produced added benefits. This multisite study consisted of two phases. In phase 1, participants with a history of depression, currently in remission (N = 244), were randomized to either receive 14 days of ABM or a control condition. In phase 2, a quasi- experimental design was adopted, and only phase-1 participants from the Sørlandet site (N = 124) next received an 8-week group-based ACT intervention. Self-reported and clinician-rated depression symptoms were assessed at baseline, immediately after phase 1 and at 1, 2, 6, and 12 months after the conclusion of phase 1. At 12-month follow-up, participants who received ACT exhibited fewer self-reported and clinician-rated depressive symptoms. There were no significant differences between ACT groups preceded by ABM or a control condition. There were no significant differences between ACT groups preceded by ABM or a control condition. Group-based ACT successfully decreased residual symptoms in depression over 12 months, suggesting some promise in preventing relapse.

Acceptance and Commitment Therapy for Parental Management of Childhood Asthma: An RCT.

Few trials have been conducted to address the psychological difficulties of parents in managing their child's asthma. Fostering parental psychological flexibility through Acceptance and Commitment Therapy (ACT) may help parents to accept these psychological difficulties and improve their management of childhood asthma. In this randomized controlled trial, a 4-session, group-based ACT plus asthma education (ACT group) was compared with an asthma education talk plus 3 telephone follow-ups (control group) to train parents of children diagnosed with asthma. The use of health care services due to asthma exacerbations in children and the psychological well-being of their parents were assessed before, immediately after, and at 6 months after the intervention. A total of 168 parents and their children aged 3 to 12 years with asthma were consecutively recruited in a public hospital in Hong Kong. When compared with the control group, children whose parents were in the ACT group made significantly fewer emergency department visits (adjusted 6-month incidence rate ratio = 0.20; confidence interval [CI] 0.08 to 0.53; P = .001) due to asthma exacerbations at 6 months postintervention. These parents also reported a decrease in psychological inflexibility (mean difference = -5.45; CI -7.71 to -3.30; P = .014), less anxiety (mean difference = -2.20; CI -3.66 to -0.73; P = .003), and stress (mean difference = -2.50; CI -4.54 to -0.47; P = .016). Integrating ACT into parental asthma education was effective at decreasing parental anxiety and stress and reducing the asthma-related emergency department visits of children at 6 months postintervention.

Acceptance and Commitment Therapy for Psychosis and Trauma: Investigating Links between Trauma Severity, Attachment and Outcome.

Although Acceptance and Commitment Therapy (ACT) may be effective for individuals with psychosis and a history of childhood trauma, little is known about predictors of treatment response among such patients. The current study examined: (1) whether severity of trauma predicted treatment response, and (2) profiles of patients with regard to their responses to treatment. Fifty participants with psychosis and childhood trauma history were recruited and randomized to take part in either eight sessions of group-based ACT, or to be on a waiting list for the ACT group (i.e. treatment as usual group). The entire sample was used for the first part of the analyses (aim 1), whereas subsequent subsample analyses used only the treatment group (n = 30 for aim 2). It was found that trauma severity did not moderate the effectiveness of ACT on symptom severity, participants' ability to regulate their emotional reactions, or treatment compliance with regard to help-seeking. In addition, among those receiving ACT, the results revealed three distinct and clinically relevant change profiles. Avoidant attachment style and number of sessions attended were predictive of belonging to the different clusters or profiles. Patients in the profile representing the least amount of clinical change attended an average of two sessions less than those in the other change profiles. ACT offered in a group format appears to be a promising treatment for those with psychosis and history of trauma regardless of trauma severity. Given the brevity of the intervention, patients should be encouraged to attend each session to obtain maximum benefit.