scholarly journals Using Acceptance and Commitment Therapy to Improve Outcomes in Functional Movement Disorders: A Case Study

2017 ◽  
Vol 16 (5) ◽  
pp. 401-416 ◽  
Author(s):  
Christopher D. Graham ◽  
Simon R. Stuart ◽  
Daniel J. O’Hara ◽  
Steven Kemp
Keyword(s):  
Acceptance And Commitment Therapy ◽  
Social Adjustment ◽  
Movement Disorders ◽  
Psychological Flexibility ◽  
Secondary Outcome ◽  
Functional Movement ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Functional Movement Disorders

Although there are many theories of functional movement disorders (FMD), the causes and prognosis remain unclear, and there are no treatments with high-quality empirical support. Acceptance and commitment therapy (ACT) is an acceptance-based behavior therapy which, via altering a process called psychological flexibility, aims to support behaviors that are consistent with a person’s overarching values—even in difficult, uncertain, or immutable contexts. It may, therefore, have pragmatic benefits in the context of FMD. We outline the theoretical basis for ACT and detail a case study of a brief (six session) intervention for increasing personally meaningful activity with FMD. The participant was in her early 20s and had been diagnosed with functional propriospinal myoclonus. ACT techniques including relational framing, defusion, and mindfulness exercises were used to increase psychological flexibility, with the goal of enabling effective functioning within the difficult context created by FMD. Following treatment, the participant showed a reliable change/clinical recovery in psychological flexibility (Acceptance and Action Questionnaire II [AAQ-II]), FMD symptom interference (Work and Social Adjustment Scale [WSAS]; primary outcome), and mood (Clinical Outcomes in Routine Evaluation 10-item scale [CORE-10]; secondary outcome). This case study demonstrates an approach that focuses first on improving functioning with FMD, as opposed to eliminating or controlling symptoms.

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.

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

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.

Acceptance and Commitment Therapy for the Treatment of Chronic Pain and Coexisting Depression: A Single-Case Study

2019 ◽  
Vol 18 (4) ◽  
pp. 254-269 ◽  
Author(s):  
Charlie N. Knowlton ◽  
Alena Kryvanos ◽  
Megan Poole ◽  
Michael Christopher ◽  
Theresa Lafavor
Keyword(s):  
Chronic Pain ◽  
Acceptance And Commitment Therapy ◽  
Single Case ◽  
Psychological Flexibility ◽  
Single Case Study ◽  
Reliable Change ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Patient Reported

Pain resulting from chronic medical conditions (CMCs) can create debilitating effects globally across domains of functioning in the lives of those it impacts. There currently remain no treatment options to eliminate associated pain entirely, leaving care efforts often to manage the disabling effects and consequential depression. Acceptance and commitment therapy (ACT) has recently been introduced as an alternative treatment approach, emphasizing the commitment to engage in actions that contribute to a fulfilling life even in the face of disability through the fostering of psychological flexibility. For patients who do not respond to traditional psychological approaches, ACT may offer a sensible substitute. This single-case study delineates ACT for chronic pain and comorbid depression using standardized and patient-centered outcome measures across areas of general symptom functioning, therapeutic processes, and flexibility surrounding pain associated with CMCs. Clinical significance and reliable change were calculated using the reliable change index, in conjunction with patient-reported behavioral engagement and subjective assessment. Results indicate significant improvement across areas of depression, psychological flexibility, and flexibility in relating to pain endured from CMCs. The patient reported perceived improvement in quality of life and no longer viewed herself as a “professional patient.” This case study illustrates the potential of shifting from restraining and extinguishing symptoms to fostering a stance of willingness to reengage in a valued life while continuing to live with CMCs.

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

Trials ◽  
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

scholarly journals Acceptance and Commitment Therapy in Obsessive–Compulsive Disorder: A Case Study

2021 ◽  
pp. 025371762199673
Author(s):  
Joel Philip ◽  
Vinu Cherian
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Acceptance And Commitment Therapy ◽  
Behavioral Therapy ◽  
Third Wave ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Change Acceptance ◽  
Commitment Therapy ◽  
Acceptance And Commitment

Recent years have witnessed an increased interest in the use of “third-wave” psychotherapies in treating psychiatric disorders. These newer therapies are fundamentally different from the existing techniques such as cognitive behavioral therapy in terms of their guiding principles and processes of change. Acceptance and commitment therapy (ACT) is the most prominent among these “third wave” psychotherapies. However, there have not been any reports from India, thus far, that have studied the use of ACT in treating obsessive–compulsive disorder (OCD). We describe a case of OCD that was successfully treated with eight sessions of ACT, with the results being maintained over a one-month follow-up period. Postintervention tests revealed a significant decrease in obsessive–compulsive symptoms and an associated increase in psychological flexibility. This case study highlights the possible utility of ACT as a therapeutic intervention in OCD, especially when combined with pharmacotherapy.

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

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.

scholarly journals Acceptance and Commitment Therapy: A Systematic Literature Review of Prevention and Intervention Programs for Mental Health Difficulties in Children and Young People

2020 ◽  
Vol 34 (4) ◽  
pp. 280-305
Author(s):  
Emma Harris ◽  
Victoria Samuel
Keyword(s):  
Mental Health ◽  
Acceptance And Commitment Therapy ◽  
Psychological Flexibility ◽  
Mental Health Symptoms ◽  
Prevention And Intervention ◽  
Health Symptoms ◽  
Compulsive Disorder ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Mental Health Difficulties

BackgroundAcceptance and commitment therapy (ACT) is increasingly being used to treat mental health difficulties, however there is a paucity of reviews concerning ACT with children.AimTo examine the literature about ACT interventions for child and adolescent mental well-being.MethodsSearches for articles reporting on ACT interventions to prevent/reduce child mental health difficulties were undertaken. Methodological quality was assessed and a narrative synthesis was used to summarize findings about mental health symptoms and psychological flexibility.ResultsTen articles were identified focusing on prevention and intervention for anxiety, depression, obsessive compulsive disorder, anorexia nervosa, and trichotillomania. Most studies found that mental health symptoms reduced following an ACT intervention and psychological flexibility increased. However, findings indicate that other active interventions also led to the same changes.ConclusionsACT is a promising intervention for adolescent mental health, although further research is needed to establish whether reductions in mental health symptoms are due to an increase in psychological flexibility.

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

2012 ◽  
Vol 13 (3) ◽  
pp. 360-376 ◽  
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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