scholarly journals Is it time to ACT? A qualitative study of the acceptability and feasibility of Acceptance and Commitment Therapy for adolescents with Chronic Fatigue Syndrome

2021 ◽  
Author(s):  
Philippa Clery ◽  
Jennifer Starbuck ◽  
Amanda Laffan ◽  
Roxanne Parslow ◽  
Catherine Linney ◽  
...  
Keyword(s):  
Acceptance And Commitment Therapy ◽  
Healthcare Professionals ◽  
Controlled Trial ◽  
Alternative Therapy ◽  
Chronic Fatigue ◽  
List Type ◽  
Fatigue Syndrome ◽  
Acceptance And Commitment ◽  
One Year ◽  
Randomised Controlled

Abstract Background Paediatric Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) is disabling and relatively common. Although evidenced based treatments are available, at least 15% of children remain symptomatic after one year of treatment. Acceptance and Commitment Therapy (ACT) is an alternative therapy option; however, little is known about whether it is an acceptable treatment approach. Our aim was to find out if children who are still disabled by CFS/ME after 12 months of treatment would find ACT acceptable, to inform a randomised controlled trial (RCT) of ACT. Methods We recruited children (diagnosed with CFS/ME; not recovered after one year of treatment; aged 11-17 years), their parent/carer, and healthcare professionals (HCPs) from one specialist UK paediatric CFS/ME service. We conducted semi-structured interviews to explore barriers to recovery; views on current treatments; acceptability of ACT; and feasibility of using an RCT to test effectiveness. Thematic analysis was used to identify patterns in data. Results Twelve adolescents, eleven parents, and seven HCPs were interviewed. All participants thought ACT was acceptable. Participants identified reasons why ACT might be efficacious: pragmatism, acceptance and compassion are valued in chronic illness; values-focussed treatment provides motivation and direction; psychological and physical needs are addressed; normalising difficulties is a useful life-skill. Some adolescents preferred ACT to Cognitive Behavioural Therapy as it encouraged accepting (rather than challenging) thoughts. Most adolescents would consent to an RCT of ACT but a barrier to recruitment was reluctance to randomisation. All HCPs deemed ACT feasible to deliver. Some were concerned patients might confuse ‘acceptance’ with ‘giving up’ and called for clear explanations. All participants thought the timing of ACT should be individualised. Conclusions All adolescents with CFS/ME, parents, and HCPs thought ACT was acceptable, and most adolescents were willing to try ACT. An RCT needs to solve issues around randomisation and timing of the intervention. BOX What is known about the subject? Not all young people with CFS/ME recover. ACT is a possible alternative therapy for CFS/ME, which focuses on improving functioning and quality of life rather than symptom reduction. ACT is efficacious in paediatric chronic pain, and preliminary results show promising effects in adults with CFS/ME. What this study adds? ACT is an acceptable therapy for young people with CFS/ME. Participants thought the ‘pragmatic’, ‘compassionate’ and ‘values-based’ focus of ACT would be helpful. Adolescents, parents and healthcare professionals support a randomised controlled trial of ACT.

scholarly journals Qualitative study of the acceptability and feasibility of acceptance and commitment therapy for adolescents with chronic fatigue syndrome

2021 ◽  
Vol 5 (1) ◽  
pp. e001139
Author(s):  
Philippa Clery ◽  
Jennifer Starbuck ◽  
Amanda Laffan ◽  
Roxanne Morin Parslow ◽  
Catherine Linney ◽  
...  
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Acceptance And Commitment Therapy ◽  
Controlled Trial ◽  
Alternative Therapy ◽  
Chronic Fatigue ◽  
Structured Interviews ◽  
Fatigue Syndrome ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
One Year

BackgroundPaediatric chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is disabling and relatively common. Although evidenced-based treatments are available, at least 15% of children remain symptomatic after one year of treatment. Acceptance and commitment therapy (ACT) is an alternative therapy option; however, little is known about whether it is an acceptable treatment approach. Our aim was to find out if adolescents who remain symptomatic with CFS/ME after 12 months of treatment would find ACT acceptable, to inform a randomised controlled trial (RCT) of ACT.MethodsWe recruited adolescents (diagnosed with CFS/ME; not recovered after one year of treatment; aged 11–17 years), their parent/carer and healthcare professionals (HCPs) from one specialist UK paediatric CFS/ME service. We conducted semi-structured interviews to explore barriers to recovery; views on current treatments; acceptability of ACT; and feasibility of an effectiveness RCT. Thematic analysis was used to identify patterns in data.ResultsTwelve adolescents, eleven parents and seven HCPs were interviewed. All participants thought ACT was acceptable. Participants identified reasons why ACT might be efficacious: pragmatism, acceptance and compassion are valued in chronic illness; values-focussed treatment provides motivation and direction; psychological and physical needs are addressed; normalising difficulties is a useful life-skill. Some adolescents preferred ACT to cognitive behavioural therapy as it encouraged accepting (rather than challenging) thoughts. Most adolescents would consent to an RCT of ACT but a barrier to recruitment was reluctance to randomisation. All HCPs deemed ACT feasible to deliver. Some were concerned patients might confuse ‘acceptance’ with ‘giving up’ and called for clear explanations. All participants thought the timing of ACT should be individualised.ConclusionsAll adolescents with CFS/ME, parents and HCPs thought ACT was acceptable, and most adolescents were willing to try ACT. An RCT needs to solve issues around randomisation and timing of the intervention.

scholarly journals Feasibility of acceptance and commitment therapy for post-bariatric surgery patients: the FAB study protocol

2019 ◽  
Vol 6 (4) ◽  
pp. 198
Author(s):  
Lisa Cotter ◽  
Samantha Scholtz ◽  
Shikta Das ◽  
John Tayu Lee ◽  
Dayna Lee-Baggley ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Acceptance And Commitment Therapy ◽  
Controlled Trial ◽  
Operative Outcomes ◽  
Post Surgery ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Increased Sensitivity ◽  
One Year ◽  
Randomised Controlled

<p class="abstract"><strong>Background:</strong> Bariatric surgery is an effective treatment for obesity. However, around one in five people experience significant weight regain. In the months following surgery, loss of food as a hedonic reward, increased sensitivity to food-related cues, alcohol use and depression may translate into new obesogenic behaviours which can be targeted in therapy. Acceptance and Commitment Therapy (ACT) teaches acceptance of and defusion from thoughts and feelings which influence behaviour, and commitment to act in line with personal values. We will test whether people who have had bariatric surgery over one year ago find 10 weeks of ACT group therapy an acceptable treatment and whether a larger trial to test whether ACT can improve long-term post-operative outcomes would be feasible.</p><p class="abstract"><strong>Methods:</strong> This will be a feasibility randomised controlled trial (RCT) with participants randomised to either ACT or a Usual Care Support Group control. Participants will be recruited at 15-18 months post-surgery and compared at baseline, 3, 6 and 12 months. The trial will provide information about recruitment and characteristics of the proposed outcome measures to inform a definitive RCT.</p><p class="abstract"><strong>Conclusions: </strong>Trials big enough to determine whether a treatment approach works are costly, so this small study will help determine whether the methods used, such as how people are recruited, allocated to groups, and how data are collected, are likely to work on a bigger scale. This project is the first step in testing whether ACT can help people who have had bariatric surgery.</p><p><strong>Trial Registration: </strong>Researchregistry.com, UIN: 3959 (date registered: 10 April 2018); ISRCTN registry ID: ISRCTN52074801.</p>

Commentary on: Randomised, double-blind, placebo-controlled trial of fluoxetine and graded exercise for chronic fatigue syndrome†

1998 ◽  
Vol 172 (6) ◽  
pp. 491-492 ◽  
Author(s):  
Alicia Deale ◽  
Trudie Chalder ◽  
Simon Wessely
Keyword(s):  
Randomised Controlled Trial ◽  
Chronic Fatigue Syndrome ◽  
Controlled Trial ◽  
Chronic Fatigue ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Fatigue Syndrome ◽  
Graded Exercise ◽  
Randomised Controlled

A variety of treatments for chronic fatigue syndrome (CFS) have been proposed but few have been systematically evaluated. The publication of this well-designed, double-blind, randomised controlled trial is therefore a welcome contribution to the literature.

scholarly journals Efficacy of Acceptance and Commitment Therapy in Daily Life (ACT-DL) in early psychosis: study protocol for a multi-centre randomized controlled trial

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Ulrich Reininghaus ◽  
Annelie Klippel ◽  
Henrietta Steinhart ◽  
Thomas Vaessen ◽  
Martine van Nierop ◽  
...  
Keyword(s):  
Mental Health ◽  
Randomised Controlled Trial ◽  
Acceptance And Commitment Therapy ◽  
Daily Life ◽  
Controlled Trial ◽  
Psychotic Experiences ◽  
Intervention Period ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Randomised Controlled

Abstract Background Psychotic experiences, social functioning and general psychopathology are important targets for early intervention in individuals with Ultra-High-Risk state (UHR) and a first-episode psychosis (FEP). Acceptance and Commitment Therapy (ACT) is a promising, next-generation Cognitive Behavioural Therapy (CBT) that aims to modify these targets, but evidence on sustainable change and its underlying mechanisms in individuals’ daily lives remains limited. The aim of the INTERACT study is to investigate the efficacy of a novel ecological momentary intervention, Acceptance and Commitment Therapy in Daily Life (ACT-DL) in a multi-centre randomised controlled trial of individuals with UHR or FEP. Methods/design In a multi-centre randomised controlled trial, individuals aged 16–65 years with UHR or FEP will be randomly allocated to ACT-DL in addition to treatment as usual (TAU) as the experimental condition or a control condition of TAU only, which will include – for the entire study period – access to routine mental health care and, where applicable, CBT for psychosis (CBTp). Outcomes will be assessed at baseline (i.e. before randomisation), post-intervention (i.e. after the 8-week intervention period), and 6-month and 12-month follow-ups (i.e. 6 and 12 months after completing the intervention period) by blinded assessors. The primary outcome will be distress associated with psychotic experiences, while secondary outcomes will include (momentary) psychotic experiences, social functioning and psychopathology. Process measures to assess putative mechanisms of change will include psychological flexibility, stress sensitivity and reward experiences. In addition, acceptability, treatment adherence and treatment fidelity of ACT-DL will be assessed. Discussion The current study is the first to test the efficacy of ACT-DL in individuals with UHR and FEP. If this trial demonstrates the efficacy of ACT-DL, it has the potential to significantly advance the treatment of people with UHR and FEP and, more generally, provides initial support for implementing mHealth interventions in mental health services. Trial registration Netherlands Trial Register, ID: NTR4252. Registered on 26 September 2013.

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