The link between stress, well-being, and psychological flexibility during an Acceptance and Commitment Therapy self-help intervention

AbstractThis study aimed to demonstrate proof of concept and acceptability of a brief acceptance and commitment therapy (ACT)-based guided self-help intervention for improving quality of life (QoL) and mood for people with muscle disorders (MD). A case-series with an AB design was used to assess changes in primary (QoL) and secondary (depression and anxiety) outcome variables across the period of study. Change in the psychological process targeted by ACT – psychological flexibility – was also investigated, to allow insight into possible treatment mechanisms. Post-intervention, participants also completed a brief free-text evaluation. Relative to pre-intervention scores, four (of seven) participants showed varying degrees of improvement in all primary and secondary outcome variables and were thus considered responders. However, consistent concomitant improvements in psychological flexibility were not apparent. Participants reported a mostly positive experience of the intervention; all appeared to complete the intervention, and no adverse events were reported. Nonetheless, there was evidence that those with compromised concentration or who report good initial QoL and low levels of distress may derive less benefit. Although several methodological weaknesses limit the strength of our conclusions, this ACT-based guided self-help intervention shows encouraging utility for improving QoL and mood in MD.

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An acceptance and commitment therapy self-help intervention for carers of patients in palliative care: Protocol of a feasibility randomised controlled trial

Journal of Health Psychology ◽

10.1177/1359105316679724 ◽

2016 ◽

Vol 24 (5) ◽

pp. 685-704 ◽

Cited By ~ 2

Author(s):

Esther L Davis ◽

Frank P Deane ◽

Geoffrey CB Lyons

Keyword(s):

Palliative Care ◽

Randomised Controlled Trial ◽

Acceptance And Commitment Therapy ◽

Controlled Trial ◽

Well Being ◽

Self Help ◽

Feasibility Randomised Controlled Trial ◽

Commitment Therapy ◽

Acceptance And Commitment ◽

Randomised Controlled

Undertaking a caregiving role at end of life can have enduring psychological consequences for carers, including poor adjustment in bereavement. Acceptance and commitment therapy–based interventions have demonstrated effectiveness in helping people cope with a range of life challenges. This article presents the protocol of a feasibility randomised controlled trial of an acceptance and commitment therapy self-help intervention for psychological distress and grief in carers of patients in palliative care. We will assess feasibility and acceptability of the trial procedures and intervention as well as preliminary effectiveness of the intervention on carer well-being outcomes.

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ACTyourCHANGE Study Protocol. The Promotion of Healthy Lifestyle for Obese Patients with Acceptance and Commitment Therapy provided with A Modular Approach.

10.21203/rs.3.rs-47403/v1 ◽

2021 ◽

Author(s):

Anna Guerrini Usubini ◽

Roberto Cattivelli ◽

Emanuele Giusti ◽

Francesco Vailati Riboni ◽

Giorgia Varallo ◽

...

Keyword(s):

Acceptance And Commitment Therapy ◽

Psychological Health ◽

Behavioral Change ◽

Healthy Lifestyle ◽

Psychological Flexibility ◽

Well Being ◽

Obese Patients ◽

Commitment Therapy ◽

Acceptance And Commitment ◽

The Impact

Abstract Background: Acceptance and Commitment Therapy (ACT) resulted to be efficacious in promoting the core process of Psychological Flexibility, a key ability related to physical and psychological health outcomes. Despite evidence-based ACT protocols were applied successfully in different contexts, including the promotion of long-standing behavioral change, the impact of the single processes in the psychological flexibility model remains unclear. The aim of the present study is to evaluate the efficacy of a Focused-ACT intervention for the maintenance of a healthy lifestyle, by separating and evaluating the impact of single core processes targeted into a modular intervention on the maintenance of healthy lifestyle. Methods: An individually randomized group treatment trial will be conducted. 150 adult obese patients who are attending a four-week medically-based multidisciplinary rehabilitation of weight loss will be randomly allocated into three groups: Module Engage, Module Openness, and Module Awareness. At the beginning (Time 0) and at the end of the intervention (Time 1), at six months (Time2) and one year (Time 3) follow-up weight and height will be recorder and participants will complete the Psychological General Well Being Inventory(PGWBI), the Outcome Questionnaire-45.2 (OQ-45.2), the Brief Values Inventory (BVI), the Committed Action Questionnaire (CAQ), the Italian-Cognitive Fusion Questionnaire (I-CFQ), the Acceptance and Action Questionnaire (AAQ II) and the Five Facet Mindfulness Questionnaire (FFMQ). Repeated measures 3 (conditions) x 4 (times) will be assessed to examine differences between three groups within four times on both general outcomes measure of weight, BMI, PGWBI and OQ-45.2, and FACT processes targeted during the interventions.Discussion: By providing additional evidence supporting the relevance of modular transdiagnostic interventions in clinical practice and the use of Process-Based Therapy, this study will contribute toclarify which mechanisms are involved in a generalizable lifestyle behavioral change intervention. Trial registrationClinicalTrials.gov Registration number: NCT04474509 Date: July, 4 2020 https://clinicaltrials.gov/ct2/show/NCT04474509

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A self-help based Acceptance and Commitment Therapy programme using Internet delivery: effect on adults intending to work who have utilized their sick leave due to depressive symptoms

European Journal for Person Centered Healthcare ◽

10.5750/ejpch.v5i4.1358 ◽

2017 ◽

Vol 5 (4) ◽

pp. 462

Author(s):

Maki Tei-Tominaga

Keyword(s):

Depressive Symptoms ◽

Sick Leave ◽

Acceptance And Commitment Therapy ◽

Psychological Flexibility ◽

The Self ◽

Secondary Outcome ◽

Self Help ◽

Commitment Therapy ◽

Acceptance And Commitment ◽

Internet Delivery

Rationale: The aim of this study was to develop a self-help based Acceptance and Commitment Therapy (ACT) programme using Internet delivery, which can be practised at the workplace or at home and to examine its effect on adults intending to work who have utilized their sick leave due to depressive symptoms. Method: A one-group, baseline-to-post-intervention design was utilized with participants in Japan. Among the participants (N = 35), 26 completed the self-help based programme and answered all questionnaire surveys on 3 occasions: baseline (T1), after 3 weeks (T2) and after 6 weeks when the programme ended (T3). As the primary outcome, depressive symptoms were assessed using the Zung Self-Rating Depression Scale. As the secondary outcome, psychological flexibility was assessed using the Japanese version of the revised Acceptance and Action Questionnaire. Additionally, 3 items to assess process were administered and participants’ written comments were organized by content.Results: Although the number of participants who showed mild and moderate depressed states decreased, depressive symptom scores did not significantly change over time. Psychological flexibility at T3 significantly improved compared to baseline, while the effect size was relatively low (Cohen’s d = 0.35). One of the scores from the process measures showed a significant difference between T2 and T3. There were 5 positive and 5 negative comments. Conclusions: Along with participants’ comments, the findings suggested the effectiveness of the self-help based ACT programme using Internet delivery. This has the potential to help develop mindfulness and acceptance skills in adults who are intending to return to work after taking sick leave for depressive symptoms.

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Exploring Acceptance and Commitment Therapy for parents of preterm infants

Paediatrics & Child Health ◽

10.1093/pch/pxaa003 ◽

2020 ◽

Author(s):

Kayla Esser ◽

Lesley Barreira ◽

Doug Miller ◽

Paige Church ◽

Nathalie Major ◽

...

Keyword(s):

Mental Health ◽

Preterm Infants ◽

Acceptance And Commitment Therapy ◽

Neonatal Intensive Care ◽

Psychological Flexibility ◽

Well Being ◽

Behavioural Therapy ◽

Anxiety And Depression ◽

Commitment Therapy ◽

Acceptance And Commitment

Abstract The start of a parenting journey in the neonatal intensive care unit (NICU) presents many stressors to parents. Previous research has shown parents of infants admitted to the NICU experience heightened stress, anxiety, and depression. Mental health support varies across Canadian NICUs with mixed results. One promising intervention that has not been explored in the NICU is Acceptance and Commitment Therapy (ACT), a behavioural therapy that has had positive mental health-related outcomes in similar parental populations. ACT differs from previous mental health interventions such as traditional Cognitive Behavioural Therapy (CBT) as it involves mindfulness and acceptance to increase psychological flexibility. Increased psychological flexibility is linked to greater emotional well-being, a higher quality of life, and decreased stress, anxiety, and depression. There is a need for research investigating the utility of ACT in improving mental health outcomes for parents of preterm infants.

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Faculty Opinions recommendation of Internet-based guided self-help intervention for chronic pain based on Acceptance and Commitment Therapy: a randomized controlled trial.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726343262.793518093 ◽

2016 ◽

Author(s):

Joel Katz ◽

Vered Latman ◽

Muhammad Abid Azam

Keyword(s):

Chronic Pain ◽

Randomized Controlled Trial ◽

Acceptance And Commitment Therapy ◽

Controlled Trial ◽

Randomized Controlled ◽

Self Help ◽

Commitment Therapy ◽

Acceptance And Commitment

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Understanding and promoting students’ well-being and performance in university studies – effects of a 7-week Acceptance and Commitment Therapy based course (Preprint)

10.2196/preprints.13405 ◽

2019 ◽

Author(s):

Henna Asikainen ◽

Nina Katajavuori ◽

Kirsikka Kaipainen

Keyword(s):

Mental Illness ◽

University Students ◽

Acceptance And Commitment Therapy ◽

Well Being ◽

Pharmacy Students ◽

Reflective Journal ◽

Reflective Journals ◽

Commitment Therapy ◽

Acceptance And Commitment ◽

And Performance

BACKGROUND Internationally there have been many studies showing that the number of university students suffering from mental illness is growing and this problem should be addressed OBJECTIVE The aim of this study was to examine 41 pharmacy students’ experiences of a small Acceptance and Commitment Therapy (ACT) -based intervention that was implemented as a 7-week course with weekly online modules. METHODS Students’ well-being, experiences of stress, organised studying and psychological flexibility were measured with questionnaires at the beginning and end of the course. Students’ experiences of the effectiveness of the course and were analysed from open-ended responses and a reflective journal. RESULTS The results show that students’ well-being and ability to manage time and effort increased during the course(p≤0.003). In their reflective journals, students described how their ability to manage stress in their studies, cope with their thoughts and feelings, focus on the things that are more important to them, and manage their time in studying and their well-being had improved. CONCLUSIONS This study showed that it is possible to foster students’ well-being in their studies. More research is needed to identify the long-lasting effects of these kind of interventions.

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The ACTyourCHANGE study protocol: promoting a healthy lifestyle in patients with obesity with Acceptance and Commitment Therapy—a randomized controlled trial

Trials ◽

10.1186/s13063-021-05191-y ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Anna Guerrini Usubini ◽

Roberto Cattivelli ◽

Emanuele Maria Giusti ◽

Francesco Vailati Riboni ◽

Giorgia Varallo ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Acceptance And Commitment Therapy ◽

Mechanism Of Action ◽

Healthy Lifestyle ◽

Controlled Trial ◽

Psychological Flexibility ◽

Randomized Controlled ◽

Link Type ◽

Commitment Therapy ◽

Acceptance And Commitment

Abstract Background As treatment of choice in promoting psychological flexibility, Acceptance and Commitment Therapy (ACT) was found to be effective in several conditions, and among different populations, including weight management in individuals with obesity. However, the mechanism of action of psychological flexibility is less known. The aim of the present study is, within the context of a brief ACT intervention for behavioral change and behavioral maintenance of a healthy lifestyle in a sample of inpatients with obesity, to explore the effect of each subcomponent of the psychological flexibility model on treatment processes and outcomes. Methods A randomized controlled trial will be conducted. Ninety Italian adult inpatients with obesity attending a rehabilitation program for weight loss will be randomly allocated into three experimental conditions targeting respectively each subcomponent of the psychological flexibility model: group Engage focused on values-oriented behaviors, group Openness focused on acceptance and cognitive defusion, and group Awareness focused on being present and aware of thoughts, feelings, and behaviors at every moment. Weight, BMI (kg/m2), the Psychological General Well-Being Inventory (PGWBI), the Outcome Questionnaire-45.2 (OQ-45.2), the Depression Anxiety and Stress Scale (DASS-21), the Difficulties in Emotion Regulation Scale (DERS), the Dutch Eating Behaviors Questionnaire (DEBQ), the Brief Values Inventory (BVI), the Committed Action Questionnaire (CAQ), the Italian-Cognitive Fusion Questionnaire (I-CFQ), the Five Facet Mindfulness Questionnaire (FFMQ), and the Acceptance and Action Questionnaire (AAQ-II) will be assessed at the beginning (time 0), at the end of psychological intervention (time 1), and after 3 (time 2) and 6 months (time 3) and 9 months (time 4) from discharge. During the following month after discharge, outpatients will be monitored in their adherence to a healthy lifestyle, using a wearable device. To assess the effectiveness of the intervention, mixed between-within 3 (conditions) × 4 (times) repeated measure ANOVAs will be conducted to examine changes from time 0 to time 1, 2, 3, and 4 in means of weight, BMI, and means of scores PGWBI, OQ-45.2, DASS, DERS, DEBQ, AAQ-II, BVI, CAQ, I-CFQ, and FFMQ, between three groups. Discussion This study will contribute to clarify the mechanism of action of each subcomponent of the psychological flexibility model and understand its impact on the promotion of a healthy lifestyle. Trial registration ClinicalTrials.govNCT04474509. Registered on July 4, 2020

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Study Protocol for Implementation of An Internet-based Acceptance and Commitment Therapy for Promoting Mental Health Among Migrant Live-in Caregivers in Canada (Preprint)

10.2196/preprints.31211 ◽

2021 ◽

Author(s):

Kenneth Po-Lun Fung ◽

Mandana Vahabi ◽

Masoomeh Moosapoor ◽

Abdolreza Akbarian ◽

Josephine Pui-Hing Wong

Keyword(s):

Mental Health ◽

Psychological Distress ◽

Focus Groups ◽

Acceptance And Commitment Therapy ◽

Psychological Intervention ◽

Self Care ◽

Well Being ◽

Virtual Space ◽

Commitment Therapy ◽

Acceptance And Commitment

BACKGROUND Psychological distress, isolation, feeling of powerlessness, and limited social support are realities faced by temporary migrant live–in caregivers in Canada. Furthermore, they experience multiple barriers in accessing mental health services due to their long work hours, limited knowledge about health resources, precarious employment, and immigration status. OBJECTIVE Women Empowerment - Caregiver Acceptance & Resilience E-Learning (WE2CARE) project is a pilot intervention research project that aims to promote mental well being and resiliency of migrant live-in caregivers. The objectives include exploring the effectiveness of this program in: (1) reducing psychological distress (depression, anxiety, and stress); (2) promoting committed actions of self-care; and (3) building mutual support social networks. Further, participants’ satisfaction with the intervention and their perceived barriers and facilitators to practicing the self-care strategies embedded in WE2CARE will be examined. METHODS Thirty-six live- in caregivers residing in Great Toronto Area (GTA) will be recruited and randomly assigned to intervention and waitlist control groups. The intervention group will receive a 6-week web-based psychosocial intervention that will be based on Acceptance and Commitment Therapy (ACT). Standardized self-reported surveys will be administered online pre-, post-, and 6-week post-intervention to assess mental distress (DASS 21), psychological flexibility (AAQ-2), mindfulness (CAMS-R) and Multi-System Model of Resilience (MSMR-I). Two focus groups will be held with a subset of participants to explore their feedback on the utility of the WE2CARE program. RESULTS WE2CARE was funded in January 2019 for a year. The protocol was approved by the research ethics boards of Ryerson University (REB 2019-036) in February 2019, and University of Toronto (RIS37623) in May 2019. Data collection started upon ethics approval and was completed by May 2020. A total of 29 caregivers completed the study and 20 participated in the focus groups. Data analyses are in progress and results will be published in 2021. CONCLUSIONS WE2CARE can be a promising approach in reducing stress, promoting resilience, and providing a virtual space for peer emotional support and collaborative learning among socially isolated and marginalized women. The results of this pilot study will inform the adaptation and utility of online delivery of ACT based psychological intervention in promoting mental health among disadvantaged and vulnerable populations. CLINICALTRIAL None

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Acceptance and commitment therapy (ACT)-enhanced communication skills: development and evaluation of a novel training programme

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2020-002786 ◽

2021 ◽

pp. bmjspcare-2020-002786

Author(s):

Nicholas J Hulbert-Williams ◽

Lee Hulbert-Williams ◽

Pandora Patterson ◽

Sahil Suleman ◽

Lesley Howells

Keyword(s):

Clinical Practice ◽

Acceptance And Commitment Therapy ◽

Cancer Care ◽

Psychological Flexibility ◽

Training Programme ◽

Free Text ◽

Evaluation Data ◽

Commitment Therapy ◽

Acceptance And Commitment

BackgroundPsychological suffering is ubiquitous with cancer and frequently presents as an unmet supportive care need. In clinical practice, distress-related needs are often addressed by nurses and non-psychologist allied healthcare professionals who may have limited training in psychological therapeutic frameworks, particularly more recently developed interventions such as Acceptance and Commitment Therapy (ACT).AimsWe developed a single-day training programme for professionals working in supportive and palliative cancer care settings to change the nature of clinical communication about psychological distress and suffering towards an ACT-consistent approach.MethodWe report on experiences of training delivery, and evaluation data about training satisfaction and intention to apply the training to clinical practice, from three training iterations in British and Australian, government-funded and charitable sectors. One hundred and sixteen cancer care professionals participated in the training. Evaluation data were collected from 53 participants (at either 2-week or 3-month follow-ups, or both) using self-report survey, including both quantitative and free-text questions.ResultsAt 2 week follow-up, 73% of trainees rating our course as having relevance to their work, and at 3 month follow-up, 46% agreed that they were better placed to provide improved clinical services. Qualitative feedback supported the inclusion of experiential learning and theoretical explanations underpinning ACT techniques. Undertaking this training did not significantly increase trainees’ stress levels, nor did implementation of this new way of working negatively affect staff well-being. Positive, ACT-consistent, changes in communication behaviours and attitudes were reported, however there was a lack of significant change in psychological flexibility.DiscussionAcceptability and applicability of this training to supportive and palliative healthcare is positive. The lack of change in psychological flexibility suggests a potential need for more experiential content in the training programme. Logistical challenges in one training group suggests the need for more robust train-the-trainer models moving forward.

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