scholarly journals Research Evaluating Staff Training Online for Resilience (RESTORE):  Protocol for a single-arm feasibility study of an online Acceptance and Commitment Therapy intervention to improve staff wellbeing in palliative care settings

2021 ◽  
Vol 3 ◽  
pp. 26
Author(s):  
Anne Finucane ◽  
Nicholas J Hulbert-Williams ◽  
Brooke Swash ◽  
Juliet A Spiller ◽  
Brigid Lydon ◽  
...  

Background Palliative care workers commonly experience workplace stress and distress. General stressors include unmanageable workloads and staff shortages.  Stressors specific to palliative care include regular exposure to death, loss and grief.  The COVID pandemic exacerbated exhaustion and burnout across the healthcare system, including for those providing palliative care.  Evidence based psychological support interventions, tailored to the needs and context of palliative care workers, are needed.  Acceptance and Commitment Therapy (ACT) is an established form of cognitive behavioural therapy which uses behavioural psychology, values, acceptance, and mindfulness techniques to improve mental health and wellbeing. ACT is effective in improving workplace wellbeing in many occupational settings.  Our study examines the acceptability and feasibility of an online ACT-based intervention to improve mental health and wellbeing in staff caring for people with an advanced progressive illness. Methods A single-arm feasibility trial.  We will seek to recruit 30 participants to take part in an 8- week online ACT-based intervention, consisting of three synchronous facilitated group sessions and five asynchronous self-directed learning modules.  We will use convergent mixed methods to evaluate the feasibility of the intervention. Quantitative feasibility outcomes will include participant recruitment and retention rates, alongside completion rates of measures assessing stress, quality of life, wellbeing, and psychological flexibility.  Focus groups and interviews will explore participant perspectives on the intervention. We will run a stakeholder workshop to further refine the intervention and identify outcomes for use in a future evaluation. Results We will describe participant perspectives on intervention acceptability, format, content, and perceived impact alongside rates of intervention recruitment, retention, and outcome measure completion. Conclusion We will show whether a brief, online ACT intervention is acceptable to, and feasible for palliative care workers.  Findings will be used to further refine the intervention and provide essential information on outcome assessment prior to a full-scale evaluation.

2021 ◽  
Author(s):  
Kenneth Po-Lun Fung ◽  
Mandana Vahabi ◽  
Masoomeh Moosapoor ◽  
Abdolreza Akbarian ◽  
Josephine Pui-Hing Wong

BACKGROUND Psychological distress, isolation, feeling of powerlessness, and limited social support are realities faced by temporary migrant live–in caregivers in Canada. Furthermore, they experience multiple barriers in accessing mental health services due to their long work hours, limited knowledge about health resources, precarious employment, and immigration status. OBJECTIVE Women Empowerment - Caregiver Acceptance & Resilience E-Learning (WE2CARE) project is a pilot intervention research project that aims to promote mental well being and resiliency of migrant live-in caregivers. The objectives include exploring the effectiveness of this program in: (1) reducing psychological distress (depression, anxiety, and stress); (2) promoting committed actions of self-care; and (3) building mutual support social networks. Further, participants’ satisfaction with the intervention and their perceived barriers and facilitators to practicing the self-care strategies embedded in WE2CARE will be examined. METHODS Thirty-six live- in caregivers residing in Great Toronto Area (GTA) will be recruited and randomly assigned to intervention and waitlist control groups. The intervention group will receive a 6-week web-based psychosocial intervention that will be based on Acceptance and Commitment Therapy (ACT). Standardized self-reported surveys will be administered online pre-, post-, and 6-week post-intervention to assess mental distress (DASS 21), psychological flexibility (AAQ-2), mindfulness (CAMS-R) and Multi-System Model of Resilience (MSMR-I). Two focus groups will be held with a subset of participants to explore their feedback on the utility of the WE2CARE program. RESULTS WE2CARE was funded in January 2019 for a year. The protocol was approved by the research ethics boards of Ryerson University (REB 2019-036) in February 2019, and University of Toronto (RIS37623) in May 2019. Data collection started upon ethics approval and was completed by May 2020. A total of 29 caregivers completed the study and 20 participated in the focus groups. Data analyses are in progress and results will be published in 2021. CONCLUSIONS WE2CARE can be a promising approach in reducing stress, promoting resilience, and providing a virtual space for peer emotional support and collaborative learning among socially isolated and marginalized women. The results of this pilot study will inform the adaptation and utility of online delivery of ACT based psychological intervention in promoting mental health among disadvantaged and vulnerable populations. CLINICALTRIAL None


2020 ◽  
Vol 34 (4) ◽  
pp. 280-305
Author(s):  
Emma Harris ◽  
Victoria Samuel

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.


Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Ulrich Reininghaus ◽  
Annelie Klippel ◽  
Henrietta Steinhart ◽  
Thomas Vaessen ◽  
Martine van Nierop ◽  
...  

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.


2021 ◽  
Vol 9 ◽  
Author(s):  
Yonas E. Geda ◽  
Janina Krell-Roesch ◽  
Yaphet Fisseha ◽  
Aida Tefera ◽  
Teferra Beyero ◽  
...  

A worsening trend of critical shortages in senior health care workers across low- and middle-income countries (LMICs) in sub-Saharan Africa has been documented for decades. This is especially the case in Ethiopia that has severe shortage of mental health professionals. Consistent with the WHO recommended approach of task sharing for mental health care in LMICs, Acceptance and Commitment Therapy (ACT), which is an empirically validated psychological intervention aimed at increasing psychological flexibility, may be delivered by trained laypersons who have a grassroots presence. In this paper, we discuss the need for and potential role of ACT to be delivered by health extension workers (HEWs) to address mental health care needs across Ethiopia. To this end, we also reviewed previous studies that have examined the effectiveness of ACT-based interventions in African countries including in Nigeria, Sierra Leone, Uganda, and South Africa. All studies revealed significant improvements of various mental health-related outcome measures such as decreased psychological distress and depressive symptoms, or increased subjective wellbeing and life satisfaction in the groups that received an ACT-based intervention. However, to date, there is no study that applied ACT in Ethiopia. Thus, more research is warranted to examine the effectiveness and, if proven successful, to scale up a task sharing approach of an ACT-based intervention being delivered by trained HEWs at a grassroots level, possibly paving the way for an innovative, sustainable mental health service in Ethiopia as well as other African LMICs.


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