Comparing of the Effects of Acceptance and Commitment Therapy and Emotion Regulation Training on Diabetes Empowerment

Background: Diabetes mellitus is a widely diffused chronic condition that affects several aspects of patients’ lives. The patient’s life in this condition depends on diabetes management ability. Therefore, this study aimed to compare the effects of Acceptance and Commitment Therapy (ACT) and Emotion Regulation Training (ERT) on the diabetes empowerment of patients with type 2 diabetes. Methods: This was a quasi-experimental study with a pre-test, post-test-follow-up and a control group design. Of the statistical population of patients referring to the Diabetes Prevention and Control Center of Mashhad Province, Iran, 45 subjects were recruited by convenience sampling method; they were randomly assigned into three groups of ACT, ERT, and control (n=15/group). The study subjects were assessed using the Diabetes Empowerment Scale (F-DES-28) in the pre-test stage, after the intervention, and 3 months later. The obtained data were analyzed by repeated-measures Analysis of Variance (ANOVA) in SPSS V. 22. Results: Both provided interventions presented a significant effect on the empowerment of the research subjects, compared to the controls (P<0.001). The effectiveness of ACT on the diabetes empowerment of patients was significantly higher than that of the ERT group (P=0.04). Conclusion: It is recommended to use ACT and ERT to empower patients with type 2 diabetes.

Effectiveness of Acceptance and Commitment Therapy in Depression and Anxiety in People with Substance Use Disorder

Background: The comorbidity of substance use, mood disorders, and anxiety has been proven in various studies, leading to many clinical implications. Objectives: This study aimed to evaluate the effectiveness of acceptance and commitment therapy (ACT) in depression and anxiety in individuals with substance use disorder. Methods: This quasi-experimental study utilized a pretest-posttest design with a control group. The statistical population consisted of all people with substance abuse in Urmia in 2019, including 220 subjects. The sample consisted of 50 individuals with substance use disorders selected by purposive sampling and randomly assigned to experimental and control groups. The experimental group was trained in eight sessions, each lasting 90 min, based on the ACT protocol by Hayes et al. (2004), while the control group did not receive any intervention. The data were obtained using the Beck Depression Inventory and Beck Anxiety Inventory. Pretest and posttest were performed in both groups. The collected data were analyzed by multivariate analysis of covariance (MANCOVA) using SPSS23 software. Results: The results showed that after controlling for the pretest effects, a significant difference was observed between the mean posttest scores of the two groups in both depression and anxiety (P < 0.05). Conclusions: Acceptance and commitment therapy is an appropriate strategy to effectively improve depression and anxiety in people with substance use disorder.

Effects of acceptance and commitment therapy on self-management skills and psychological resilience of young and middle-aged patients underwent percutaneous transluminal coronary intervention for primary myocardial infarction: a pilot study

Background Acceptance and commitment therapy (ACT) is an intervention focusing on altering how patients relate to their thoughts. This study aimed to investigate the effects of ACT on self-management ability and psychological resilience of young and middle-aged patients undergoing percutaneous transluminal coronary intervention (PCI) for primary myocardial infarction (MI). Methods This pilot study included 98 young and middle-aged patients who underwent PCI for primary MI using a convenient sampling method. The patients were divided into a control group and an ACT group using the random number table method. The patients in the control group received routine nursing, while those in the ACT group received routine nursing combined with ACT. Results The psychological resilience and self-management ability scores were significantly higher in the ACT group than in the control group 3 months after the intervention (P < 0.001 and < 0.05, respectively). In addition, compared to the baseline scores of psychological resilience and self-management ability, these scores were significantly higher in the ACT group at 3 months post-intervention (P < 0.001 and < 0.05, respectively). Conclusion ACT could enhance the psychological resilience and self-efficacy and improve the self-management ability of young and middle-aged patients who underwent PCI for primary MI. Trial registration China Clinical Trial Center ChiCTR2000029775. Registered on 13 February 2020. Registration title:Study on the popularization and application of rotational atherectomy for the treatment of severely calcified coronary lesions.

The Effectiveness of Acceptance and Commitment Therapy and Cognitive-Behavioral ‎Therapy in Enhancing Resiliency and Quality of Life Among Multiple Sclerosis Patients: A Randomized Clinical Trial Study

Background: Multiple sclerosis (MS) is a chronic, common, and progressive disease of the nervous system, and the affected individuals suffer from its complications throughout their lives and experience different physical and emotional disorders. Objectives: The present study aimed to compare the effectiveness of acceptance and commitment therapy (ACT) and cognitive-behavioral ‎therapy (CBT) in enhancing resiliency and quality of life among MS patients. Methods: This randomized clinical trial was carried out on 30 MS patients referred to the Department of Neurology in Baqiyatallah Hospital (Tehran, Iran) during February 19 to September 1, 2017. The patients were randomly assigned to three groups: (1) ACT (n = 10, 8 sessions, 90-minute weekly‎ sessions), (2) CBT (n = 10, 10 sessions, 90-minute weekly‎ sessions), and (3) control group (n = 10, no sessions). The resilience and quality of life were measured in pre-test and post-test phases and 1.5 months after treatment using the Connor-Davidson Resilience and Multiple Sclerosis Impact Scales, respectively. Repeated measurement ANOVA and SPSS Software (version 24) were used in this study to analyze the collected data. Results: The study sample consisted of 30 MS patients (mean age = 31.7 ± 5.7, 60% female and 57% married). The three groups were homogeneous in terms of demographic and baseline variables. The results demonstrated that both ACT and CBT had the same effectiveness in increasing resiliency (mean difference in CBT = 0.9 vs ACT = 0.8 (P = 0.882); CBT = 0.9 vs. Control = -1.4 (P = 0.004); ACT = 0.8 vs. Control = -1.4 (P = 0.0041)) and quality of life (mean difference in CBT = 2.9 vs ACT = 3.1 (P = 0.051); CBT = 2.9 vs. Control = 0.6 (P = 0.002); ACT = 3.1 vs. Control = 0.6 (P = 0.014)) among the MS patients so that the participants’ post-test and follow-up scores increased significantly compared to the pretest scores. Conclusions: The present study results indicate that ACT and CBT can equally enhance resiliency and quality of life among MS patients.

The Effect of Group Acceptance and Commitment Therapy on the Management of Asthma: A Randomized Clinical Trial

Background: Asthma is a common respiratory disorder that negatively affects quality of life (QOL) and mood status. Objectives: The purpose of this study was to investigate the efficacy of group acceptance and commitment therapy (ACT) on the symptom control, QOL, and mood status of asthmatic patients. Methods: This randomized clinical trial study was conducted on 32 asthmatic patients randomly allocated to the case group (underwent group ACT plus medical therapy; n = 15) and the control group (who were medically treated only in 2019; n = 17). The case group participated in 8 sessions of 90-minute group ACT. Spirometry was performed for both groups at baseline and at the end of the intervention. The Asthma Control Questionnaire (ACQ) to assess symptom control status, Hospital Anxiety and Depression Scale (HADS) to assess mood status, and Asthma Quality of Life Questionnaire (AQLQ) to assess QOL were filled out by the patients at baseline and at the end of the intervention. Results: The measurements regarding the trend of changes in the case group over the time were significant in all of the evaluated entities, including ACQ, depression and anxiety subscales of HADS, and AQLQ scores (P < 0.05), while nonsignificant alterations were observed in the controls (P > 0.05). The comparison of the 2 groups revealed significant differences in all the assessed entities (P > 0.05). The spirometry variables were statistically significant in the control group at baseline (P < 0.05), while the post-intervention assessments revealed a nonsignificant difference (P > 0.05). Conclusions: Group ACT can efficiently reduce the asthma symptoms in asthmatic patients, along with the remarkable improvement in mood and QOL. Further evaluations with a longer period of intervention are strongly recommended.

Mindfulness-Based Acceptance and Commitment Therapy

Acceptance and Commitment Therapy (ACT) is one of the latest mindfulness-based behavior therapies shown to have compelling evidence and efficacy with a wide range of clinical conditions. ACT is so hard to categorize that it is often described as an amalgamation of existential, humanistic, cognitive-behavioural therapy. ACT is often referred as process-based CBT and is one of the ‘third-wave' of behavioural therapies. It is currently the fastest growing evidence-based therapy in the world, with currently at least 304 Randomized Control Trials (RCTs) being recorded all over the world. It has proven effective in different cultural contexts with a diverse set of clinical conditions, from depression, Obsessive-compulsive disorder, chronic pain, grief, loss and terminal illness, anxiety, and workplace stress.