Efficacy of telehealth acceptance and commitment therapy for weight loss: a pilot randomized clinical trial

2021 ◽  
Author(s):  
Jonathan B Bricker ◽  
Kristin E Mull ◽  
Brianna M Sullivan ◽  
Evan M Forman
Keyword(s):  
Weight Loss ◽  
Acceptance And Commitment Therapy ◽  
Behavioral Therapy ◽  
Pilot Trial ◽  
Population Level ◽  
Baseline Body Mass Index ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Telephone Coaching

Abstract Telehealth coaching for weight loss has high population-level reach but limited efficacy. To potentially improve on this limitation, the purpose of this study was to determine the preliminary efficacy of the first known telephone coaching acceptance and commitment therapy (ACT) intervention for weight loss. A two-arm, stratified, individually randomized pilot trial comparing ACT (n = 53) with standard behavioral therapy (SBT; n = 52) was used for this study. Both interventions were delivered in 25 telephone coaching calls (15–20 min each) over a 12 month period. Weight was measured at baseline and 3, 6, and 12 month postrandomization follow-ups. Recruited from 32 U.S. states, participants were of mean age 40.7, 42% male, 34% racial/ethnic minority, and mean baseline body mass index of 34.3. Fractions of 10% or more scale-reported weight loss: 15% for ACT versus 4% for SBT at 3 month follow-up (N = 86; odds ratio [OR] = 4.61; 95% confidence interval [CI]: 0.79, 26.83), 24% for ACT versus 13% for SBT at 6 month follow-up (N = 72; OR = 2.45; 95% CI: 0.65, 9.23), 30% for ACT versus 30% for SBT at 12 month follow-up (N = 57; OR = 0.93; 95% CI: 0.28, 3.09). Fractions of 10% or more self-reported weight loss at 12 month follow-up: 25% for ACT versus 15% for SBT (N = 75; OR = 2.38; 95% CI: 0.68, 8.34). The conclusion of the study was the preliminary evidence that telephone coaching ACT may be efficacious for weight loss.

scholarly journals MECHANISM OF ACTION: AGE DIFFERENCES IN RESPONSE TO ACCEPTANCE AND COMMITMENT THERAPY FOR CHRONIC PAIN

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S809-S809
Author(s):  
Julie L Wetherell ◽  
Matthew Herbert ◽  
Niloofar Afari
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Acceptance And Commitment Therapy ◽  
Behavioral Therapy ◽  
Pain Interference ◽  
Younger Adults ◽  
Pain Acceptance ◽  
Commitment Therapy ◽  
Acceptance And Commitment

Abstract A recent randomized comparison of Acceptance and Commitment Therapy (ACT) vs. Cognitive-Behavioral Therapy for chronic pain found a clear age interaction effect, such that older adults benefitted more from ACT. In a subsequent study comparing ACT delivered in person to ACT delivered via telehealth to a sample of veterans (N=128, mean age 51.9, SD 13.3, range 25-89), we found no significant age by modality interactions, suggesting that older veterans responded as well as younger people did to telehealth delivery. Consistent with our previous findings, we found a trend for older adults to experience greater reduction in pain interference (p = .051) and significantly greater reduction in pain severity (p = .001) than younger adults following ACT. In younger veterans, change in pain acceptance from baseline to posttreatment was related to change in pain interference from baseline to 6-month follow-up (r = -.38), but change in pain interference from baseline to posttreatment was not related to change in pain acceptance from baseline to follow-up (r = .14), suggesting that, consistent with the ACT model, increased pain acceptance at posttreatment was related to reduced pain interference at follow-up. By contrast, in older veterans, both correlations were significant and of comparable magnitude (rs = -.43 and -.46, respectively), providing no support for the idea that change in pain acceptance drove change in pain interference. Overall, our findings suggest that ACT may work better in older adults with chronic pain than in younger adults, but via a different mechanism.

scholarly journals Short Report: Evaluation of Acceptance and Commitment Therapy Training for Psychologists Working with People with Multiple Sclerosis

2018 ◽  
Vol 20 (1) ◽  
pp. 44-48 ◽  
Author(s):  
Kenneth I. Pakenham ◽  
Theresa Scott ◽  
Michele Messmer Uccelli
Keyword(s):  
Multiple Sclerosis ◽  
Acceptance And Commitment Therapy ◽  
Behavioral Therapy ◽  
Well Being ◽  
Short Report ◽  
Beneficial Effects ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Almost All

Abstract Background: Acceptance and commitment therapy (ACT) is the most widely used and researched recent variant of cognitive behavioral therapy and has been shown to increase quality of life in people with chronic illnesses, including multiple sclerosis (MS). However, few MS health practitioners are trained in ACT. This study evaluated a 2-day ACT training workshop for Italian psychologists working with people with MS. Methods: Data were collected via online questionnaires from 34 psychologists before the workshop, after the workshop, and at 6-month follow-up. Two sets of variables were measured at each assessment: primary outcomes (well-being, negative affect, positive affect, and job satisfaction) and ACT processes (values, mindfulness, psychological flexibility, and cognitive defusion). A separate online workshop evaluation questionnaire and an ACT knowledge examination were administered after the workshop. Results: Most participants (94%) acknowledged the potential beneficial effects of the workshop on their work. Almost all participants reported their intention to apply ACT clinically. More than 90% of participants indicated that the workshop was efficacious. All participants scored higher than 75% on the examination. Mindfulness increased from after the workshop to follow-up; however, there were no statistically significant changes in other variables. Correlations suggested beneficial associations between the ACT processes and the primary outcomes. Conclusions: Results suggest that ACT training is personally and professionally helpful for psychologists in the MS field.

scholarly journals Comparing the Effects of Cognitive-Behavioral Therapy and Acceptance and Commitment Therapy on the Perfectionism of Patients with Obsessive-Compulsive Disorder

2020 ◽  
Vol 26 (1) ◽  
pp. 24-37
Author(s):  
Mahdi Taghavizade Ardakani ◽  
◽  
Bahman Akbari ◽  
Abbas Ali HosseinKhanzade ◽  
Mohsen Moshkbide Haghighi1 ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Acceptance And Commitment Therapy ◽  
Behavioral Therapy ◽  
Control Group ◽  
Therapeutic Approaches ◽  
Obsessive Compulsive ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Obsessive Compulsive Personality Disorder

Aims: Despite the high prevalence of Obsessive-Compulsive Personality Disorder (OCPD), there are few therapeutic resources in its treatment. The purpose of this study is to compare the effects of two therapeutic approaches of Cognitive-Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) on improving the perfectionism of patients with Obsessive-Compulsive personality disorder. Methods & Materials: This is a quasi-experimental study with pre-test, post-test, and follow-up design using a control group. The study population consisted of 73 patients with OCPD referred to the Ehya counseling center in Rasht, Iran in 2017. Of these, 45 were selected using a purposive sampling method and randomly assigned into two intervention groups and one control group (each with 15 samples). Data were collected using Hill’s perfectionism inventory at three pretest, posttest and follow up phases. Collected data were analyzed using Multivariate Analysis of Covariance (MANCOVA). Findings: The two therapeutic approaches of CBT (P=0.001) and ACT (P=0.000) had a significant effect on the perfectionism of OCPD patients. Pairwise comparison of groups using Bonferroni test indicated that ACT had more significant effect on perfectionism in comparison with CBT (P=0.035). Meanwhile, the one-month follow-up showed the sustainability and improvement of the results. Conclusion: Acceptance and Commitment Therapy (ACT), due to focusing on psychological flexibility, is more effective than CBT in improving the perfectionism of OCPD patients.

scholarly journals Evaluating the Open and Engaged Components of Acceptance and Commitment Therapy in an Online Self-Guided Website: Results from a Pilot Trial

2019 ◽  
pp. 014544551987866 ◽  
Author(s):  
Julie M. Petersen ◽  
Jennifer Krafft ◽  
Michael P. Twohig ◽  
Michael E. Levin
Keyword(s):  
Acceptance And Commitment Therapy ◽  
Psychosocial Functioning ◽  
Pilot Trial ◽  
Post Treatment ◽  
Optimal Outcomes ◽  
Online Platforms ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
High Satisfaction

Online acceptance and commitment therapy (ACT) is promising for treating a range of psychological problems. Component research can further clarify which components are needed for optimal outcomes in what contexts. Online platforms provide a highly controlled format for such research. In this pilot trial, 55 adults were randomized to: ACT-Open (i.e., acceptance, defusion components), ACT-Engaged (i.e., values, committed action), or ACT-Combined (i.e., acceptance, defusion, values, committed action). Each condition was 12 sessions over 6 weeks, with assessments at baseline, post-treatment, and 4-week follow-up. ACT-Open, ACT-Engaged, and ACT-Combined all significantly improved from pre- to post-treatment on mental health, psychosocial functioning, and components of psychological flexibility. Compared to ACT-Combined, ACT-Open improved less on psychosocial functioning at post-treatment, and ACT-Engaged worsened on functioning at follow-up. The platform was acceptable with high satisfaction ratings. Results support the feasibility of conducting online ACT component research, which will be tested in a fully powered non-inferiority trial.

scholarly journals Comparing the effect of cognitive-behavioral therapy and acceptance and commitment therapy on hope, resilience, and happiness of veterans with psychopathy

2021 ◽  
Vol 7 (3A) ◽  
pp. 707-718
Author(s):  
Mohammad Hatami ◽  
Maryam Kalhor Nia Golkar ◽  
Simin Farshadi
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Acceptance And Commitment Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Post Test ◽  
Quasi Experimental ◽  
And Control

This study aimed to compare the effect of cognitive-behavioral therapy (CBT), and acceptance and commitment therapy (AT) on resilience, happiness, and hope of veterans with psychopathy. The present study was applied in terms of purpose, a pre-test, post-test, and follow-up research in terms of method, and a quasi-experimental design in terms of nature.  The results showed a difference between the mean scores of resilience, happiness, and hope in the three acceptance and commitment therapy, cognitive-behavioral therapy, and control groups within pre-test, post-test, and follow-up steps. There was a difference between the effects of ACT and CBT on resilience, happiness, and hope of veterans with psychopathy living in Dezful. Moreover, ACT performed better rather than CBT in terms of resilience, happiness, and hope rate among veterans with psychopathy living in Dezful, Iran.

scholarly journals ACTonFood. Acceptance and Commitment Therapy-Based Group Treatment Compared to Cognitive Behavioral Therapy-Based Group Treatment for Weight Maintenance: An Individually Randomized Group Treatment Trial

2021 ◽  
Author(s):  
Roberto Cattivelli ◽  
Anna Guerrini Usubini ◽  
Gian Mauro Manzoni ◽  
Francesco Vailati Riboni ◽  
Giada Pietrabissa ◽  
...  
Keyword(s):  
Weight Loss ◽  
Acceptance And Commitment Therapy ◽  
Group Treatment ◽  
Group Intervention ◽  
Behavioral Therapy ◽  
Weight Loss Maintenance ◽  
Treatment Trial ◽  
The Core ◽  
Acceptance And Commitment

The purpose of this Individually Randomized Group Treatment Trial was to compare an Acceptance and Commitment Therapy-based (ACT) group intervention and a Cog-nitive Behavioral Therapy-based (CBT) group intervention for weight loss maintenance in a sample of adult patients with obesity seeking treatment for weight loss. 155 over-weight adults (BMI: Kg/m2= 43.8[6.8]) attending a multidisciplinary rehabilitation program for weight loss were randomized into two conditions: ACT and CBT. Demo-graphical, physical, and clinical data were assessed at the beginning of the program (t0), at discharge (t1), and at 6-month follow-up (t2). The following measures were ad-ministered: The Acceptance and Action Questionnaire-II (AAQ-II) and the Clinical Outcome in Routine Evaluation-Outcome Measure (CORE-OM). Generalized linear mixed models were performed to assess differences between groups. Moderation ef-fects for gender and eating disorders (ED) have been considered. From baseline to dis-charge no significant differences between interventions were found, with the only ex-ception of an improvement in the CORE-OM total score and in the CORE-OM subjective well-being subscale for those in the CBT condition. From discharge to follow-up ACT group participants showed significant results in terms of weight loss maintenance, CORE-OM total score, and CORE-OM and AAQ-II’s wellbeing, symptoms, and psy-chological problems subscales. Gender moderated the effects of time and intervention on the CORE-OM’ subscale reporting the risk for self-harm or harm others. The pres-ence of an eating disorder moderated the effect of time and intervention on the CORE-OM total score, on the CORE-Om’ symptoms and psychological problems sub-scales, and on the AAQ-II. Patients who received the ACT intervention were more likely to achieve a ≥5% weight loss from baseline to follow-up and to maintain the weight loss after discharge. The ACT intervention was thus effective in maintaining weight loss over time.

scholarly journals ACTonFood. Acceptance and Commitment Therapy-Based Group Treatment Compared to Cognitive Behavioral Therapy-Based Group Treatment for Weight Loss Maintenance: An Individually Randomized Group Treatment Trial

2021 ◽  
Vol 18 (18) ◽  
pp. 9558
Author(s):  
Roberto Cattivelli ◽  
Anna Guerrini Usubini ◽  
Gian Mauro Manzoni ◽  
Francesco Vailati Riboni ◽  
Giada Pietrabissa ◽  
...  
Keyword(s):  
Weight Loss ◽  
Acceptance And Commitment Therapy ◽  
Group Treatment ◽  
Group Intervention ◽  
Behavioral Therapy ◽  
Weight Loss Maintenance ◽  
Treatment Trial ◽  
The Core ◽  
Acceptance And Commitment

The purpose of this Individually Randomized Group Treatment Trial was to compare an Acceptance and Commitment Therapy-based (ACT) group intervention and a Cognitive Behavioral Therapy-based (CBT) group intervention for weight loss maintenance in a sample of adult patients with obesity seeking treatment for weight loss. One hundred and fifty-five adults (BMI: Kg/m2 = 43.8 [6.8]) attending a multidisciplinary rehabilitation program for weight loss were randomized into two conditions: ACT and CBT. Demographical, physical, and clinical data were assessed at the beginning of the program (t0), at discharge (t1), and at 6-month follow-up (t2). The following measures were administered: The Acceptance and Action Questionnaire-II (AAQ-II) and the Clinical Outcome in Routine Evaluation-Outcome Measure (CORE-OM). Generalized linear mixed models were performed to assess differences between groups. Moderation effects for gender and Eating Disorders (ED) have been considered. From baseline to discharge, no significant differences between interventions were found, with the only exception of an improvement in the CORE-OM total score and in the CORE-OM subjective wellbeing subscale for those in the CBT condition. From discharge to follow-up, ACT group participants showed significant results in terms of weight loss maintenance, CORE-OM total score, and CORE-OM and AAQ-II wellbeing, symptoms, and psychological problems subscales. Gender moderated the effects of time and intervention on the CORE-OM subscale reporting the risk for self-harm or harm of others. The presence of an eating disorder moderated the effect of time and intervention on the CORE-OM total score, on the CORE-OM symptoms and psychological problems subscales, and on the AAQ-II. Patients who received the ACT intervention were more likely to achieve a ≥5% weight loss from baseline to follow-up and to maintain the weight loss after discharge. The ACT intervention was thus effective in maintaining weight loss over time.

Internet-Delivered Acceptance and Commitment Therapy for Adolescents with Chronic Pain and Their Parents: A Nonrandomized Pilot Trial

2020 ◽  
Vol 45 (9) ◽  
pp. 990-1004
Author(s):  
Vendela Zetterqvist ◽  
Charlotte Gentili ◽  
Jenny Rickardsson ◽  
Isabel Sörensen ◽  
Rikard K Wicksell
Keyword(s):  
Chronic Pain ◽  
Acceptance And Commitment Therapy ◽  
Psychological Treatment ◽  
Pilot Trial ◽  
Evidence Base ◽  
Recruitment Rate ◽  
Outcome Evaluation ◽  
Commitment Therapy ◽  
Acceptance And Commitment

Abstract Background Acceptance and Commitment Therapy (ACT) is an empirically supported treatment for chronic pain in adults. There is also a small but growing evidence base of ACT for pediatric chronic pain. However, because of limited access to psychological treatment for pain, and geographical distances from pain facilities, many patients will not receive such treatment. Objective The aim of the study was to evaluate the feasibility and preliminary effects of an internet-delivered ACT for adolescents with chronic pain, and their parents. Methods In this nonrandomized pilot study 28 self-recruited adolescents, aged 13–17 years, received 8 weeks of internet-delivered ACT, while outcomes were assessed at pre-, posttreatment, and at follow-up (17–25 weeks). Parents of the adolescents received an 8-week internet-delivered parental program, and their outcomes were assessed at the same timepoints. Both treatments were guided by a therapist experienced in ACT and chronic pain. Results Some threats to feasibility were identified such as slow recruitment rate, low compliance and a delay in completion of follow-up assessments. Preliminary outcome evaluation showed that adolescents showed a large significant improvement on their main outcome (pain interference, d = 1.09), and parents a medium improvement on their main outcome, pain reactivity (d = 0.70). Improvements were also seen in adolescents’ depressive symptoms and insomnia severity. Conclusion The preliminary results of internet-delivered ACT are promising with regards to improvements in adolescent and parent outcome. Measures to improve feasibility are needed prior to conducting a larger randomized trial.

Case Study of Acceptance and Commitment Therapy and Functional Analysis for Emetophobia

2018 ◽  
Vol 17 (2) ◽  
pp. 77-90 ◽  
Author(s):  
Leah M. Bogusch ◽  
Mary T. Moeller ◽  
William H. O’Brien
Keyword(s):  
Functional Analysis ◽  
Acceptance And Commitment Therapy ◽  
Behavioral Therapy ◽  
Reliable Change Index ◽  
Cognitive Fusion ◽  
Thought Control ◽  
Commitment Therapy ◽  
Acceptance And Commitment

Acceptance and Commitment Therapy (ACT) is a third-wave behavioral therapy that is an empirically supported treatment for various mental health concerns. ACT has been found to be efficacious for treating different types of anxiety disorders. This case study presents the conceptualization (functional analysis), treatment (ACT), and treatment outcomes of a client who presented with emetophobia, a phobia of vomiting, complicated by a metabolic disorder. Measures of emetophobia symptoms, mindfulness, cognitive fusion, thought control strategies, and believability of anxious thoughts and feelings, were collected at pretreatment, posttreatment, 6-month follow-up, and 12-month follow-up. The Reliable Change Index was used to evaluate changes across time. Large and clinically significant decreases on all measures were observed at posttreatment. At 12-month follow-up, improvements were maintained on all measures except the Reappraisal subscale of the Thought Control scale. The implications of this study are discussed, and recommendations are made for clinicians using ACT for the treatment of emetophobia.

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