Acceptance and commitment therapy universal prevention program for adolescents: a feasibility study

BACKGROUND Generalised anxiety disorder (GAD) is characterised by excessive worry that is difficult to control and has high comorbidity with mood disorders including depression. Individuals experience long wait times for diagnosis and often face accessibility barriers to treatment. There is a need for a digital solution that is accessible and acceptable to those with GAD. OBJECTIVE This paper aims to describe the development of a digital intervention prototype of acceptance and commitment therapy (ACT) for GAD that sits within an existing wellbeing app platform, BioBase. A pilot feasibility study evaluating acceptability, usability and efficacy study is conducted in a sample of adults with a diagnosis of GAD, self-referred to the study. METHODS Phase 1 applied the person-based approach (creation of guiding principles, intervention design objectives and the key intervention features). In Phase 2 participants received the app-based therapeutic and paired wearable for two weeks. Self-report questionnaires were obtained at baseline and post-treatment. The primary outcome was psychological flexibility (AAQ-II) as this is the aim of ACT. Mental wellbeing (WEMWBS) and symptoms of anxiety (GAD-7) and depression (PHQ-9) were also assessed. Post-treatment usability was assessed via self-report measures (SUS) in addition to interviews that further explored feasibility of the digital intervention in this sample. RESULTS The app-based therapeutic was well received. Of 13 participants, 10 (77%) completed the treatment. Results show a high usability rating (83.5). Participants found the digital intervention to be relevant, useful and helpful in managing their anxiety. Participants had lower anxiety (d=0.69) and depression (d=0.84) scores at exit, and these differences were significantly different from baseline. Participants had higher psychological flexibility and wellbeing scores at exit, although these were not significantly different from baseline. CONCLUSIONS This ACT prototype within BioBase is an acceptable and feasible digital intervention, with evidence of preliminary efficacy in reducing symptoms of anxiety and depression. This study suggests this intervention warrants a larger feasibility study in adults with GAD.

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Acceptability And Feasibility of a Gamified Digital Eating Disorder Selective Prevention Program (AcceptME) Based On Acceptance And Commitment Therapy (ACT)

10.21203/rs.3.rs-871736/v1 ◽

2021 ◽

Author(s):

Patrisia Nikolaou ◽

Rhonda M. Merwin ◽

Maria Karekla

Keyword(s):

At Risk ◽

Acceptance And Commitment Therapy ◽

Prevention Program ◽

Undue Influence ◽

Empirically Supported ◽

Commitment Therapy ◽

Acceptance And Commitment ◽

Women And Girls ◽

Republic Of Cyprus ◽

Selective Prevention

Abstract Background: Digital prevention programs for a variety of psychological conditions, including eating disorders (EDs) are increasing. Yet, none to date have leveraged gamification and vicarious learning components grounded in empirically-supported therapeutic approaches to engage young people at risk for developing EDs in behavior change. The current paper describes the development and preliminary acceptability and feasibility testing of AcceptME, a novel self-directed, gamified digital ED selective prevention program based on Acceptance and Commitment Therapy (ACT). AcceptME helps women and girls identified at risk for an ED relate differently to their thoughts and feelings, such that these experiences do not have undue influence over their behavior and actions can instead be guided by personal values. Methods: Users learned skills of psychological flexibility by helping a third-person avatar (a main character in a storyline) navigate situations that elicit distressing thoughts/feelings, and via interactive exercises, practiced applying these skills to their own experiences. Young women and girls in the Republic of Cyprus with high weight concern scores (N=58, Mage=15.27, SD=2.25) completed six 30-minute digital sessions and reported on session and intervention acceptability.Results: Attrition was 35.42%. The majority of participants were either “Very” (40%) or “Mostly” (57%) Satisfied with the program. Fifty-two percent reported that the program “Helped a lot,” and 48% said it “Helped a bit.” Conclusion: Digital technology and gamification have advantages for engagement and delivery. The current study suggests a promising direction for early ED interventions to reach at risk youth and preliminary data to guide development.

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