scholarly journals P120 Development and analysis of acceptance and commitment therapy (ACT)-informed group and 1-1 psychological interventions for a rheumatology population

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Lorraine Maher-Edwards ◽  
Alexandra Quigley ◽  
David Gillanders ◽  
Nora Ng
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Acceptance And Commitment Therapy ◽  
Psychological Flexibility ◽  
Evidence Base ◽  
Effect Sizes ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
One To One

Abstract Background Psychiatric comorbidities are common in patients living with rheumatological conditions and are associated with poorer health outcomes and treatment response. The evidence-base for psychological intervention in this population is scarce. Acceptance- and mindfulness-based cognitive therapies are of increasing popularity. Acceptance and Commitment Therapy (ACT) is a psychological therapy with a robust evidence-base for mood disorders and long-term health conditions, in particular in chronic pain populations. ACT aims to help clients to develop skills to identify and let go of unhelpful patterns of symptom control and avoidance so that they can move towards important life areas (values) and goals. Research has consistently shown that higher levels of acceptance (a component of psychological flexibility) in chronic illness is associated with better quality of life and emotional well-being. No studies have looked at the effects of ACT-based interventions in rheumatology. This study aimed to: Develop and pilot I) a 6-week group and II) a brief (up to 6 sessions) one to one intervention based on Acceptance and Commitment Therapy (ACT) in a rheumatology population. Outcomes were evaluated using patient satisfaction data, qualitative feedback and quantitative outcomes using a range of questionnaires measuring mood, quality of life and psychological flexibility. Methods Patients attending a rheumatology psychology service received either group OR brief one to one intervention delivered by a qualified psychologist. Group consisted of 6 sessions; each session was 3 hours (18 hours total). The brief one to one intervention consisted of up to 6 one-hour face to face sessions (max 6 hours total). A range of outcome measures were administered pre- and post-treatment. Paired t-tests were conducted, and the Jacobson and Truax method used to calculate Reliable Change Index and Clinically Significant Change criteria. Effect sizes were calculated using Cohens’ d. For comparison published data in chronic pain populations were used. Results Patients responded well to ACT-based interventions: with improvements in mood, psychological flexibility and quality of life. All effect sizes were large and compared favourably to published trials in chronic pain populations. Group participants showed significant improvements in depression and psychological flexibility pre- to post- treatment. On the other hand, participants who received the brief one to one intervention showed significant improvements on all measures. Overall those who had group therapy showed smaller improvements in outcome measures, rated themselves as less improved and were less satisfied with their therapy than those that received up to 6 sessions of individualised therapy. Conclusion A brief one to one intervention of up to 6 sessions of ACT-based psychological therapy conferred good benefit for a rheumatology population and outperformed group therapy. More studies are needed to understand whether this effect is generalisable and longer-term outcomes. Disclosures L. Maher-Edwards None. A. Quigley None. D. Gillanders None. N. Ng None.

P060 Pilot study showing the efficacy and acceptability of an acceptance and commitment therapy based brief psychological intervention on mood and disability in patients with early inflammatory arthritis

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Lorraine Maher-Edwards ◽  
Nora Ng ◽  
David Gillanders
Keyword(s):  
Quality Of Life ◽  
Correlation Analysis ◽  
Acceptance And Commitment Therapy ◽  
Inflammatory Arthritis ◽  
Psychological Intervention ◽  
Psychological Flexibility ◽  
Evidence Base ◽  
Effect Sizes ◽  
Acceptance And Commitment

Abstract Background/Aims  Psychiatric comorbidities are common in patients living with rheumatological conditions and are associated with poorer health outcomes and treatment response. The evidence base for psychological intervention is scarce and of poor quality. One trial has found CBT intervention early post-diagnosis of rheumatoid arthritis has small to medium effect sizes for depression and anxiety and no effect on disability. Acceptance and Commitment Therapy (ACT) is a psychological therapy with a good evidence base for a number of long term health conditions. The target process in ACT is psychological flexibility, which relates closely to a number of positive life outcomes including adaptive response to illness and trauma. Psychological inflexibility has been shown to be associated with poorer function and psychological wellbeing in chronic pain populations and more recently juvenile idiopathic arthritis specifically. We aimed to evaluate outcomes for a sample (n = 12) of newly diagnosed (within 3 years of diagnosis) patients with inflammatory arthritis who underwent an individualised ACT intervention using patient satisfaction data, qualitative feedback and measures of mood, quality of life and psychological flexibility. Methods  Patients received up to 7 sessions of one to one therapy. Outcome measures included PHQ-9, GAD-7, compACT, and Brief Pain Inventory (BPI) and a satisfaction questionnaire with open questions inviting qualitative responses. Paired t-tests were conducted, and the Jacobson and Truax method used to calculate Reliable Change Index and Clinically Significant Change criteria. Effect sizes were calculated using Cohens’ d. Correlation analysis was conducted using Pearsons correlation coefficients. Results  Patients who took part in the brief intervention showed significant improvement in depression, anxiety, quality of life and psychological flexibility. Effect sizes were large. Correlation analysis showed strong correlations between PF and both depression and quality of life. Changes in PF from baseline to end of therapy strongly correlated with changes in depression and disability, and moderately correlated with anxiety. Subanalyses will be presented to understand which particular components of PF most closely relate to improvements in outcomes on disability and mood. Conclusion  A brief one to one ACT-based psychological intervention conferred good benefit for a rheumatology population. Results suggest PF is a key therapeutic target in psychological interventions for people with arthritis and that ACT is a viable, highly acceptable and promising alternative to CBT in this population. More studies are needed to understand whether this effect is generalisable and longer-term outcomes. Disclosure  L. Maher-Edwards: None. N. Ng: None. D. Gillanders: None.

scholarly journals Investigating the effectiveness of an online acceptance and commitment therapy (ACT) intervention versus a waiting list control condition on pain interference and quality of life in adults with chronic pain and multimorbidity: protocol for a randomised controlled trial

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e012671
Author(s):  
Brian W Slattery ◽  
Laura L O’Connor ◽  
Stephanie Haugh ◽  
Katie Barrett ◽  
Kady Francis ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Acceptance And Commitment Therapy ◽  
Linear Mixed Model ◽  
Well Being ◽  
Waiting List ◽  
Pain Interference ◽  
Commitment Therapy ◽  
Acceptance And Commitment

IntroductionMultimorbidity refers to the presence of two or more chronic health conditions within one person, where no one condition is primary. Research suggests that multimorbidity is highly correlated with chronic pain, which is pain lasting longer than 3 months. Psychotherapeutic interventions for people living with chronic illness have resulted in reduced symptom reporting and improved psychological well-being. There is a dearth of research, however, using online psychotherapy for people living with multimorbidity where chronic pain is a central condition. This study will compare the effectiveness of an online acceptance and commitment therapy (ACT) intervention with a waiting list control condition in terms of improving health-related quality of life (HRQoL) and reducing levels of pain interference in people with chronic pain and at least one other condition.Methods and analysis192 adult participants with non-malignant pain that persists for at least 3 months and at least one other medically diagnosed condition will be randomised to one of two study conditions. The experimental group will undergo an eight-session internet-delivered ACT programme over an 8-week period. A waiting list group will be offered the ACT intervention after the 3-month follow-up period. HRQoL and pain interference will act as the primary outcomes. Data will be analysed using a linear mixed model and adjusted to account for demographic and clinical variables as necessary. A Study Within a Trial will be incorporated to examine the effect on recruitment and retention of showing participants an animated educational video.Ethics and disseminationEthical approval has been granted by the Research Ethics Committee of the National University of Ireland, Galway. Dissemination of results will be via peer reviewed journal articles and conference presentations.Trial registration numberISRCTN22343024.

scholarly journals A pilot case series of a brief acceptance and commitment therapy (ACT)-based guided self-help intervention for improving quality of life and mood in muscle disorders

2017 ◽  
Vol 10 ◽  
Author(s):  
Christopher D. Graham ◽  
Trudie Chalder ◽  
Michael R. Rose ◽  
Dimitri Gavriloff ◽  
Lance M. McCracken ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Acceptance And Commitment Therapy ◽  
Case Series ◽  
Psychological Flexibility ◽  
Secondary Outcome ◽  
Muscle Disorders ◽  
Self Help ◽  
Commitment Therapy ◽  
Acceptance And Commitment

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.

scholarly journals The Improvement of Elderly Acceptance in Cronic Pain, Comfort, and Quality of Life through Acceptance and Commitment Therapy (ACT)

Jurnal NERS ◽  
2016 ◽  
Vol 9 (2) ◽  
pp. 252
Author(s):  
Dhina Widayati ◽  
Ahmad Yusuf ◽  
Rizki Fitryasari P.K.
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Acceptance And Commitment Therapy ◽  
Joint Pain ◽  
T Test ◽  
Control Group ◽  
Pain Acceptance ◽  
Commitment Therapy ◽  
Acceptance And Commitment

Introduction: Chronic joint pain is a problem for the majority of elderly. Psychosocial factors have a great impact on people with chronic pain. The acceptance of pain in people with chronic pain can increase their activity daily living, comfort, and quality of life. Acceptance And Commitment Therapy (ACT) is a form of psychotherapy which effective in the management of chronic pain. The objective of this study was to analyze the effect of ACT on improvement acceptance of chronic pain, comfort, and quality of life elderly with chronic joint pain. Method: This study was used a quasy experiment pre-post test control group design. Population were elderly who lived at UPT PSLU Jombang di Pare-Kediri. Sample were 32 respondents gotten by purposive sampling, divided into experiment and control group. Independent variable was ACT, and dependent variables were pain acceptance, comfort, and quality of life elderly with chronic joint pain. Data were collected by using questionnaire with CPAQ (pain acceptance), GCQ (comfort) and WHO-QOLBREF (Quality of Life). Data then analyzed by using Wilcoxon Signed Ranks Test, Mann Whitney U Test, Paired t test and Independent Samples t test with significance value of 0.05. Result: The results had showed that there was an influence ACT to improvement acceptance of chronic pain (p=0,003), comfort (p=0,008), and quality of life elderly with chronic joint pain (p=0,002). Discussion: ACT improved pain acceptance, comfort, and quality of life of elderly with joint chronic pain. Geriatric nurses should include psychosocial activities as a routine activities, as an effort to improve the quality of life. Beside that, the quality of nursing care for elderly can be improved.Keywords: ACT, pain acceptance, comfort, quality of life, elderly, chronic joint pain

scholarly journals Do quality of life, anxiety, depression and acceptance improve after interdisciplinary pain rehabilitation? A multicentre matched control study of acceptance and commitment therapy-based versus cognitive–behavioural therapy-based programmes

2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110274
Author(s):  
Marcelo Rivano Fischer ◽  
Marie-Louise Schult ◽  
Monika Löfgren ◽  
Britt-Marie Stålnacke
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Acceptance And Commitment Therapy ◽  
Depression Scale ◽  
Life Questionnaire ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Cognitive Behavioural ◽  
Health Related

Objective Interdisciplinary pain rehabilitation (IPR) usually employs a cognitive–behavioural therapeutic (CBT) approach. However, there is growing support for chronic pain treatments based on acceptance and commitment therapy (ACT). Most studies of ACT and CBT for chronic pain have evaluated their effects after psychological interventions, not after IPR. We compared the results of an ACT-based IPR programme with two CBT-based IPR programmes. Methods We used a retrospective multicentre pretest–posttest design with matched patient groups at three centres. Data were collected from the Swedish Quality Registry for Pain Rehabilitation before and after IPR participation. Participants completed the EQ-5D health-related quality of life questionnaire, the Chronic Pain Acceptance Questionnaire, (CPAQ) and the Hospital Anxiety and Depression Scale (HADS). Analyses were performed to compare the effects of the different interventions. Results Neither EQ-5D nor HADS depression scores were affected by the psychological approach used. The score changes on both CPAQ subscales (activity engagement and pain willingness) indicated significant improvements between admission and discharge at all centres. Conclusions These findings indicate the effectiveness of using psychological approaches to manage chronic pain. Both CBT and ACT had a beneficial effect on most of the assessed health-related parameters.

scholarly journals Comparing the effectiveness of acceptance and commitment therapy and physiotherapy on quality of life and pain catastrophizing in patients with chronic pain

2019 ◽  
Vol 21 (6) ◽  
pp. 271-275
Author(s):  
Mahnaz Ghatreh Samani ◽  
Mahmoud Najafi ◽  
Issac Rahimian Bouger
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Acceptance And Commitment Therapy ◽  
Pain Catastrophizing ◽  
Control Group ◽  
Control Groups ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
And Control

Background and aims: Chronic pain is a common health problem that affects various aspects of life. Acceptance and commitment therapy (ACT) seems to be helpful in improving the quality of life and pain catastrophizing in patients with chronic pain. The purpose of this study was to compare the efficacy of ACT and physiotherapy on quality of life and pain catastrophizing in patients with chronic pain. Methods: The subjects were 75 women suffering from chronic pain who were considered for physiotherapy. They were randomly divided into 3 groups including ACT, physiotherapy, and control groups. The control group consisted of 25 patients who were on the waiting list for physiotherapy. The first group participated in 8 sessions of ACT, the second group attended 10 sessions of physiotherapy, and the control group received no treatment. The Pain Catastrophizing Scale (PCS) developed by Sullivan et al and the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire were used in this study. Results: The results showed that the quality of life in the ACT group was significantly higher than that in the physiotherapy group and control group (P<0.001). Moreover, there was no significant difference between the ACT and physiotherapy groups in reducing pain catastrophizing (P>0.05), while this difference was significant between the ACT and control groups (P<0.001). Conclusion: In general, ACT leads to a reduction in pain catastrophizing and an increase in the quality of life of patients with chronic pain. Therefore, beside the current therapy like physiotherapy, ACT can be used as another therapeutic choice for patients with chronic pain.

scholarly journals Effectiveness of acceptance and commitment therapy on psychological well-being, quality of life and depression in patients with epilepsy

2019 ◽  
Author(s):  
Ghodsieh Ebrahimpour ◽  
Bahram Mirzaeian ◽  
Ramazan Hasanzade
Keyword(s):  
Quality Of Life ◽  
Acceptance And Commitment Therapy ◽  
Well Being ◽  
Life Questionnaire ◽  
Psychological Well Being ◽  
Statistical Population ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Patients With Epilepsy

Introdution: Epilepsy is known as a cerebrovascular disorder with a continuing readiness for epileptic seizures and psychological neuropsychological outcomes. The purpose of this study was to investigate the effectiveness of acceptance and commitment therapy on psychological well-being, quality of life and depression in patients with epilepsy. Methods: The study was a quasi- experimental with a pre-test, post-test design with a control group. The statistical population of the study consisted of 76 patients, of whom 20 were selected by available sampling method and they were randomly divided into two experimental and control groups. The experimental group received the acceptance and commitment group therapy in eight sessions each of which in two hours. Before and after the intervention, the Multidimensional Reef psychological well-being questionnaire, Quality of life questionnaire, Beck Depression Inventory was administrated in both groups.  Data were analyzed using covariance test and SPSS20 software. Results: The findings of this study showed that acceptance and commitment based treatment had a significant effect on psychological well-being, quality of life and depression in the level of error less than p <0.0001. And the result of P-value was reported as 42.602, 17. 927, 53.528, respectively. Conclusion: The results of this study show that acceptance and commitment therapy is significantly effective in the patients with epilepsy using techniques such as attention to the present time, acceptance and cognitive impairment in increasing psychological well-being and quality of life and reducing depression. Considering the effect of admission therapy and commitment in using this method at all levels of prevention and treatment of the patients with physical and mental illness seems necessary.

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