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

Author(s):  
Roberto Cattivelli ◽  
Anna Guerrini Usubini ◽  
Gian Mauro Manzoni ◽  
Francesco Vailati Riboni ◽  
Giada Pietrabissa ◽  
...  

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.

Author(s):  
Roberto Cattivelli ◽  
Anna Guerrini Usubini ◽  
Gian Mauro Manzoni ◽  
Francesco Vailati Riboni ◽  
Giada Pietrabissa ◽  
...  

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.


Author(s):  
Jonathan B Bricker ◽  
Kristin E Mull ◽  
Brianna M Sullivan ◽  
Evan M Forman

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.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S809-S809
Author(s):  
Julie L Wetherell ◽  
Matthew Herbert ◽  
Niloofar Afari

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.


2018 ◽  
Vol 22 (3) ◽  
pp. 354-362 ◽  
Author(s):  
Jennifer B McClure ◽  
Jonathan Bricker ◽  
Kristin Mull ◽  
Jaimee L Heffner

Abstract Introduction Preliminary trial data suggest group-delivered acceptance and commitment therapy (ACT) might be effective for smoking cessation. If so, this could offer a viable alternative to mainstream behavioral therapies, such as those grounded in cognitive behavioral therapy (CBT). The goal of the current study was to compare the effectiveness of group-delivered ACT versus group-delivered CBT in a rigorous randomized trial design with long-term follow-up. Methods Participants (n = 450) were recruited from the Kaiser Permanente Washington health care system and randomized to either ACT-based group counseling or an attention-matched CBT-based group program. All were prescribed an 8-week course of nicotine patches. The primary outcome was self-reported 30-day point prevalence abstinence at 12 months post-randomization assessed with missing values imputed as smoking. Sensitivity analyses using multiple imputation and complete cases were examined, as were biochemically confirmed and 6-month outcomes. Results Thirty-day point prevalence abstinence rates at the 12-month follow-up did not differ between study arms in the primary analysis (13.8% ACT vs. 18.1% CBT, adjusted odds ratio = 0.68 [95% CI = 0.35 to 1.27], p = .23) or the sensitivity analyses. Conclusions Group-based ACT and CBT had similar long-term quit rates in this methodologically rigorous randomized trial. Group-based ACT is a reasonable alternative to group-based CBT for smoking cessation. Implications This study compared the effectiveness of group-based ACT with group-based CBT for smoking cessation using a rigorous, large-scale, attention-matched, randomized trial with 1-year follow-up. One-year cessation rates did not differ between group-based ACT and CBT, suggesting ACT-based intervention is a reasonable alternative to CBT-based counseling for smoking cessation. The results add to the nascent but growing literature assessing ACT and other mindfulness-based treatments for smoking cessation.


2018 ◽  
Vol 20 (1) ◽  
pp. 44-48 ◽  
Author(s):  
Kenneth I. Pakenham ◽  
Theresa Scott ◽  
Michele Messmer Uccelli

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.


2013 ◽  
Vol 23 (2) ◽  
pp. 54-69 ◽  
Author(s):  
Palasik Scott ◽  
Hannan Jaime

The field of fluency disorders has used Cognitive Behavioral Therapy (CBT) techniques to help clients who stutter manage their thoughts about stuttering by engaging in cognitive restructuring activities. In the late ‘90s, a new form of cognitive therapy called Acceptance and Commitment Therapy (ACT) emerged, stemming from classic CBT and Relational Frame Theory (RFT). Though there is only one documented study in which ACT is used with clients who stutter, there is tremendous clinical potential to assist clients who stutter of all ages using the six core principles of ACT (contact with the present moment, acceptance, thought defusion, self as a context, defining values, and committed actions). The core principles encourage clients who stutter to live a values‐based life by assisting them in defusing adverse thoughts related to stuttering and choosing committed action behaviors and goals in accordance with their individual values through mindfulness practices. Participating in activities related to the core principles of ACT can help clients who stutter to become more psychologically flexible when managing their perceptions related to stuttering. Using ACT can further lead clients toward acceptance of all thoughts while learning to observe themselves in the present moment and make values‐based choices for future behaviors.


2020 ◽  
Vol 26 (1) ◽  
pp. 24-37
Author(s):  
Mahdi Taghavizade Ardakani ◽  
◽  
Bahman Akbari ◽  
Abbas Ali HosseinKhanzade ◽  
Mohsen Moshkbide Haghighi1 ◽  
...  

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.


Author(s):  
Idoia Iturbe ◽  
Eva Pereda-Pereda ◽  
Enrique Echeburúa ◽  
Edurne Maiz

Although several interventions that target obesity have been examined, the success of these interventions in generating and maintaining positive results has yet to be confirmed. This study protocol therefore presents a trial aimed at analyzing the effectiveness of a well-being-centered acceptance and commitment therapy (ACT)- and mindfulness-based group intervention following the valued-based healthy living (VHL) approach (Mind&Life intervention) for individuals experiencing overweight-related distress. A randomized controlled trial with two parallel groups will be conducted in 110 adults attending primary care units with overweight or obesity. Participants will be randomly allocated to one of the two study conditions. Interventions will either be the treatment as usual (TAU) or the Mind&Life intervention—an ACT- and mindfulness-based intervention—plus the TAU intervention. Quality of life, weight self-stigma, general health status, eating habits, physical activity, eating behavior, anthropometric, body composition, cardiovascular, and physiological variables, as well as process variables, will be examined at baseline, posttreatment, 6-month follow-up, and 1-year follow-up. This trial aims to offer a novel psychological approach for addressing the psychological and physical impairments suffered by people with overweight or obesity in the current environment. ClinicalTrials.gov identifier: NCT03718728.


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