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| Int'l Symposium - Acceptance and Commitment therapy in Behavior Medicine - A New Approach to Treatment |
| Sunday, May 30, 2004 |
| 10:30 AM–11:50 AM |
| Conference Room 2 |
| Area: CBM/CSE; Domain: Applied Research |
| Chair: Rikard K. Wicksell (Karolinska Hospital, Sweden) |
| Abstract: . |
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| Evaluation of a Brief ACT Model Intervention for the Treatment of Refractory Epilepsy |
| JOANNE DAHL (University of Gavle, Sweden), Tobias Lundgren (University of Uppsala, Sweden) |
| Abstract: Epileptic seizures can be traumatic, stigmatizing and disabling for the persons who have a tendency to seize. In the western countries, most persons with epilepsy will be given an anticonvulsant drug therapy, which appears to reduce seizure frequency for a number of these persons but also leaves a number of undesirable side effects. In many non-western countries these drugs are far too expensive and inaccessible to many. The aim of this study was to develop and evaluate a brief treatment model based on acceptance and commitment therapy (ACT) applied on a group of people with refractory seizures in Belgrade. The design of the study was a RCT, ABC group design (n=24) with two conditions; ACT and a control group. The inclusion criteria for participation was: at least 2 seizures a week, age 14 or older, no progressive disease and willing and able to participate in the study. Each condition consisted of one individual session, one group session followed by one more individual session. The ACT condition consisted of the treatment principles: Values identification, cognitive diffusion, exposure, and commitment. In the control group, an supportive therapy was provided (Borcovec). Treatment effects were measured by means of looking at life quality, experiential avoidance, mental health well being, seizure frequency, EEG and blood serum levels. The results of this ongoing study will be presented at the conference. |
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| Improving Psychological Adjustment among Cancer Patients: Treatment Development and Comparison |
| ANN BRANSTETTER-ROST (Washington University Medical School), Mikaela J. Hildebrandt (Southwest Missouri State University) |
| Abstract: Each year over 77,000 women are diagnosed with gynecological cancers, and 26,000 die with the disease (ACS, 2001). Research suggests that at least 30% of these women experience significant psychological distress (Zabora, Brintzenhofeszoc, Curbow, Hooker, & Piantadosi, 2001). Clearly, coping with cancer presents unique challenges to patients, and as such requires unique and specialized psychological interventions. However, little empirical evidence exists to suggest how to best meet the emotional needs of patients with cancer. It is believed that Acceptance and Commitment Therapy (ACT) offers a strong possibility of an empirically supported treatment approach for the distress of this unique population. In the current study, ACT was compared to a Cognitive Behavioral intervention. The ACT protocol focused on supporting emotional experience and expression. The CBT intervention focused on cognitive restructuring and distraction techniques. Data concerning mood, coping, quality of life, and overall psychological distress were collected across four time points. Results indicate that although both groups reported improvements, reaction to therapy varied by pre-intervention coping style. Outcomes were further mediated by emotional avoidance. Future work will include further developments and improvements in the protocol, and attempts to shorten the length of the intervention to improve portability. |
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| Effectiveness of an Acceptance and Commitment Therapy Intervention for Type 2 Diabetes: Implementation Issues in a Low-income Medical Clinic |
| JENNIFER A. GREGG (University of Nevada, Reno) |
| Abstract: Multiple modalities (e.g., weekly groups, workshops, individual sessions) have been used and examined for effectiveness for diabetes education interventions in a medical setting. We will present data from a randomized controlled trial examining process and outcome differences between individuals with type 2 diabetes who received either basic education treatment or Acceptance and Commitment Therapy (ACT) in either weekly group sessions or an all day workshop format. Outcomes of interest in this study were self-reported engagement in self-care behaviors, physiological measures of diabetes self-management such as Hemoglobin A1c, and psychological functioning and use of acceptance coping methods. We will discuss the impact of this treatment modality in ACT compared to the control condition on these outcomes. The reasons for the relative success of the group workshop will be discussed with respect to both theoretical mechanisms of change in ACT interventions and the pragmatic issues of treatment with this population. |
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| Acceptance and Commitment Therapy (ACT) within a Behavior Medicine Approach –Effective in Rehabilitation for Patients with Chronic Debilitating Pain? |
| RIKARD K. WICKSELL (Karolinska Hospital, Sweden), Gunnar Olsson (Karolinska Hospital, Sweden) |
| Abstract: Chronic pain with an unclear origin (idiopathic) is common, in adults as well as in children and adolescents. Pharmacological therapies are many times ineffective and for some patients´ pain becomes debilitating, resulting in marked levels of functional impairment across important life domains. Cognitive behavior therapy (e.g relaxation and stress management) have traditionally focused on reducing pain and related distress.
Acceptance and Commitment Therapy (ACT) emphasizes values-based exposure and acceptance strategies to increase patient willingness to experience negative private events in the service of acting in alignment with their chosen values. This represents a shift in perspective from symptom alleviation to valued life, and recent findings indicate that such interventions have beneficial effects for adults with chronic pain.
ACT is used in the development of a rehabilitation program for young people with chronic pain. 15 adolescents with chronic disabling pain participated in a pilot study. A randomized controlled trial, (ACT vs. standard pharmacological treatment) is currently being performed. Treatment and outcome measures focused on functional ability and individual values-based goal setting, and results from the pilot study indicate a substantial improvement at post-treatment and follow-up. Changes in pain intensity ratings varied across patients.
Results including follow-up data from the pilot study as well as preliminary results from the RCT will be presented. |
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