Is it time to act? The potential of acceptance and commitment therapy for psychological problems following acquired brain injury

Abstract Background Following an acquired brain injury, individuals frequently experience anxiety and/or depressive symptoms. However, current treatments for these symptoms are not very effective. A promising treatment is acceptance and commitment therapy (ACT), which is a third-wave behavioural therapy. The primary goal of this therapy is not to reduce symptoms, but to improve psychological flexibility and general well-being, which may be accompanied by a reduction in symptom severity. The aim of this study is to investigate the effectiveness of an adapted ACT intervention (BrainACT) in people with acquired brain injury who experience anxiety and/or depressive symptoms. Methods The study is a multicenter, randomized, controlled, two-arm parallel trial. In total, 94 patients who survive a stroke or traumatic brain injury will be randomized into an ACT or control (i.e. psycho-education and relaxation) intervention. The primary outcome measures are the Hospital Anxiety and Depression Scale and the Depression Anxiety Stress Scale. Outcomes will be assessed by trained assessors, blinded to treatment condition, pre-treatment, during treatment, post-treatment, and at 7 and 12 months. Discussion This study will contribute to the existing knowledge on how to treat psychological distress following acquired brain injury. If effective, BrainACT could be implemented in clinical practice and potentially help a large number of patients with acquired brain injury. Trial registration Dutch Trial Register, NL691, NTR 7111. Registered on 26 March 2018. https://www.trialregister.nl/trial/6916.

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A Systematic Review of Acceptance and Commitment Therapy (ACT) for Managing Anxiety: Applicability for People With Acquired Brain Injury?

Brain Impairment ◽

10.1375/brim.12.1.54 ◽

2011 ◽

Vol 12 (1) ◽

pp. 54-70 ◽

Cited By ~ 16

Author(s):

Cheryl Soo ◽

Robyn L. Tate ◽

Amanda Lane-Brown

Keyword(s):

Brain Injury ◽

Acceptance And Commitment Therapy ◽

Methodological Quality ◽

Single Case ◽

Controlled Trial ◽

Acquired Brain Injury ◽

Emotional States ◽

Compulsive Disorder ◽

Commitment Therapy ◽

Acceptance And Commitment

AbstractAcceptance and commitment therapy (ACT) is increasingly used in clinical practice to manage anxiety conditions. This psychotherapeutic approach focuses on the following: (1) acceptance of an individual's experience of the spectrum of psychological and emotional states, (2) choosing valued direction for the individual's life, and (3) commitment to action that leads the individual in the direction of those values. This article presents an empirical review of ACT for treatment of anxiety in two parts. In the first part we systematically review the literature for studies examining ACT for anxiety management in the general population with anxiety problems. In the second part, we discuss applicability of acceptance-based approaches for a health population in which these techniques may have applicability, that is, for people with acquired brain injury (ABI). Electronic searches for the review were conducted on PsycINFO and Medline. Inclusion criteria were as follows: (1) used an ACT intervention study, (2) the target of the intervention was an anxiety disorder or anxiety symptomatology, (3) the intervention used a randomised controlled trial (RCT) or single case experimental design (SCED) methodology, and (4) the paper was available in English. Studies were rated for methodological quality using standardised assessment procedures. Four RCTs provided support for ACT for obsessive compulsive disorder (OCD), maths anxiety, trichotillomania (TTM), and mixed anxiety and depression. Three SCED trials scoring in the high range on the scale of methodological quality revealed some support for ACT for managing TTM, skin picking, and OCD. Although no studies were identified that investigated ACT for managing anxiety in people with ABI, the review highlights issues for consideration when applying ACT in this population.

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Acceptance and Commitment Therapy (ACT) for Psychological Adjustment after Traumatic Brain Injury: Reporting the Protocol for a Randomised Controlled Trial

Brain Impairment ◽

10.1017/brimp.2012.28 ◽

2012 ◽

Vol 13 (3) ◽

pp. 360-376 ◽

Cited By ~ 8

Author(s):

Diane L. Whiting ◽

Grahame K. Simpson ◽

Hamish J. McLeod ◽

Frank P. Deane ◽

Joseph Ciarrochi

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Acceptance And Commitment Therapy ◽

Controlled Trial ◽

Consort Statement ◽

Randomised Control Trial ◽

Secondary Outcome ◽

Adjustment Process ◽

Commitment Therapy ◽

Acceptance And Commitment

Following a severe traumatic brain injury (TBI) there is a complex presentation of psychological symptoms which may impact on recovery. Validated treatments addressing these symptoms for this group of people are limited. This article reports on the protocol for a single-centre, two-armed, Phase II Randomised Control Trial (RCT) to address the adjustment process following a severe TBI. Participants will be recruited from Liverpool Brain Injury Rehabilitation Unit and randomly allocated to one of two groups, Acceptance and Commitment Therapy (ACT) or an active control (Befriending). The active treatment group utilises the six core processes of ACT with the intention of increasing participation and psychological flexibility and reducing psychological distress. A number of primary and secondary outcome measures, administered at assessment, post-treatment and 1-month follow-up, will be used to assess clinical outcomes. The publication of the protocol before the trial results are available addresses fidelity criterion (intervention design) for RCTs. This ensures transparency in the RCT and that it meets the guidelines according to the CONSORT statement. The protocol has also been registered on the Australian New Zealand Clinical Trials Registry ACTRN12610000851066.

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Acceptance and Commitment Therapy and Brain Injury

10.4324/9781003024408 ◽

2021 ◽

Author(s):

Will Curvis ◽

Abigail Methley

Keyword(s):

Brain Injury ◽

Acceptance And Commitment Therapy ◽

Commitment Therapy ◽

Acceptance And Commitment

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Acceptance and commitment therapy with children who have experienced brain injury

10.4324/9781003024408-6 ◽

2021 ◽

pp. 29-39

Author(s):

Victoria Gray ◽

Ingram Wright

Keyword(s):

Brain Injury ◽

Acceptance And Commitment Therapy ◽

Commitment Therapy ◽

Acceptance And Commitment

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Running acceptance and commitment therapy-based groups in brain injury settings

10.4324/9781003024408-15 ◽

2021 ◽

pp. 132-140

Author(s):

Reg Morris ◽

Rebecca Large

Keyword(s):

Brain Injury ◽

Acceptance And Commitment Therapy ◽

Commitment Therapy ◽

Acceptance And Commitment

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Brain injury spousal caregivers’ experiences of an acceptance and commitment therapy (ACT) group

Social Care and Neurodisability ◽

10.1108/scn-02-2013-0005 ◽

2014 ◽

Vol 5 (1) ◽

pp. 29-40 ◽

Cited By ~ 10

Author(s):

Jonathan Williams ◽

Frances Vaughan ◽

Jaci Huws ◽

Richard Hastings

Keyword(s):

Brain Injury ◽

Acceptance And Commitment Therapy ◽

Group Intervention ◽

Interpretative Phenomenological Analysis ◽

Belief Systems ◽

Spousal Caregivers ◽

Content Type ◽

Personal Awareness ◽

Commitment Therapy ◽

Acceptance And Commitment

Purpose – The purpose of this paper is to understand the experiences of acquired brain injury (ABI) family caregivers who attended an acceptance based group intervention. Design/methodology/approach – A qualitative design and interpretative phenomenological analysis methodology were used. Findings – Five key themes were identified: increasing personal awareness; the dialectic of emotional acceptance vs emotional avoidance; integration of acceptance and commitment therapy (ACT) principles; peer support; and moving forward after the group. It seemed that some individuals found the ACT exercises distressing, whereas others reported benefits. All participants described experiences of acceptance vs avoidant means of coping, and attempts to integrate new approaches into existing belief systems. Originality/value – This study is the first to explore the experiences of ABI caregivers undertaking an ACT group intervention.

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