ACT

Improve College Student Psychological Well-Being with Mindfulness and Relaxation

psyjdc Leave a comment

Improve College Student Psychological Well-Being with Mindfulness and Relaxation

 

By John M. de Castro, Ph.D.

 

“mindfulness helps focus by tuning out distractions, improving memory, decision-making and attention skills. . . It is not a panacea; it is not for everyone. However, it is very worth trying. It may be the next evolution in health care and well-being.” – Affordable Colleges

 

In the modern world education is a key for success. There is a lot of pressure on college students to excel so that they can get the best jobs after graduation. The pressure can lead to stress, anxiety, and depression which can impede the student’s mental health, well-being, and school performance. So it is important that methods be found to reduce the college students’ responses to stress; to make them more resilient.

 

Contemplative practices including meditation, mindfulness training, exercise, Tai Chi and Qigong, and yoga practice have been shown to reduce the psychological and physiological responses to stress, relieve anxiety, and reduce depression .  A therapeutic technique that contains mindfulness training and Cognitive Behavioral Therapy (CBT) is Acceptance and Commitment Therapy (ACT). It focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. This suggests that ACT may be effective in improving the psychological well-being of college students.

 

In today’s Research News article “Effect of Acceptance and Commitment Therapy Combined with Music Relaxation Therapy on the Self-Identity of College Students.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8853795/ ) Yin recruited college students and assigned them to receive either  a 2-month program of Acceptance and Commitment Therapy (ACT) plus systematic muscle relaxation with music, or conventional self-identity intervention, including health education, regular communication, and regular follow-up. They were measured before and after the treatments for anxiety, depression, resilience, and quality of life.

 

They found that in comparison to baseline and the control condition Acceptance and Commitment Therapy (ACT) plus relaxation produced significant reductions in anxiety and depression and significant increases in resilience and quality of life. It cannot be determined if the combination of ACT and relaxation was necessary for the benefits or is each individually may have been effective.

 

So, improve college student psychological well-being with mindfulness and relaxation.

 

“mindfulness . . . can also be a great tool for students, reducing stress and increasing well-being and productivity.” – Rebecca Enderby

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Yin J. (2022). Effect of Acceptance and Commitment Therapy Combined with Music Relaxation Therapy on the Self-Identity of College Students. Journal of healthcare engineering, 2022, 8422903. https://doi.org/10.1155/2022/8422903

 

Abstract

This paper analyzes various effects of acceptance and commitment therapy combined with music relaxation therapy on the self-identity of the college students. Through open recruitment and following the principle of voluntary and confidential, 80 college students were selected from our school, and then they were divided into two groups: the control group (40 cases) and the observation group (40 cases). The observation group received acceptance and commitment therapy combined with music relaxation therapy. For the control group, conventional mental health interventions were administered. Two months after intervention, psychological status, mental resilience, and quality of life scores were compared between the two groups. Before intervention, there was no significant difference in SAS and SDS scores between the two groups (P > 0.05). After intervention, SAS and SDS scores were significantly higher than those in the control group, and the difference between the two groups was statistically significant (P < 0.05). Before intervention, there was no significant difference in the scores of toughness, strength, and optimism between the two groups (P > 0.05). After intervention, the scores of toughness, strength, and optimism in the two groups were all improved, and the scores of mental resilience in the observation group were higher than those in the control group, with statistical significance (P < 0.05). Before intervention, there was no significant difference in the quality of life scores between the observation group and the control group (P > 0.05). After intervention, the quality of life score of the observation group was higher than that of the control group, and the difference between the two groups was statistically significant (P < 0.05). The combined application of acceptance and commitment therapy and music relaxation therapy can help college students to improve their mental state, improve their mental resilience, enhance their evaluation of life quality, improve their sense of self-identity, and reduce the probability of the occurrence of unhealthy emotions such as depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8853795/

 

Mindfulness Improves Obsessive Compulsive Disorder as well as Drug Treatment

psyjdc Leave a comment

Mindfulness Improves Obsessive Compulsive Disorder as well as Drug Treatment

 

By John M. de Castro, Ph.D.

 

“most OCD sufferers I know who practice mindfulness find it very helpful in fighting their disorder. To be able to focus on what is really happening in any given moment, as opposed to dwelling on the past or anticipating the future, takes away the power of OCD.” – Janet Singer

 

Obsessive-Compulsive Disorder (OCD) sufferers have repetitive anxiety producing intrusive thoughts (obsessions) that result in repetitive behaviors to reduce the anxiety (compulsions). In a typical example of OCD, the individual is concerned about germs and is unable to control the anxiety that these thoughts produce. Their solution is to engage in ritualized behaviors, such as repetitive cleaning or hand washing that for a short time relieves the anxiety. The obsessions and compulsions can become so frequent that they become a dominant theme in their lives. Hence OCD drastically reduces the quality of life and happiness of the sufferer and those around them. About 2% of the population, 3.3 million people in the U.S., are affected at some time in their life.

 

Fortunately, Obsessive-Compulsive Disorder (OCD) can be treated. Mindfulness training including Mindfulness-Based Cognitive Therapy (MBCT) has been shown to be effective in treating OCD.  A therapeutic technique that contains mindfulness training and Cognitive Behavioral Therapy (CBT) is Acceptance and Commitment Therapy (ACT). It focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. This suggests that ACT may be an effective treatment for obsessive-compulsive disorder (OCD),

 

In today’s Research News article “A randomized clinical trial: Comparison of group acceptance and commitment therapy with drug on quality of life and depression in patients with obsessive-compulsive disorder.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8943588/ ) and colleagues recruited patients with Obsessive-Compulsive Disorder (OCD) and either treated them with drugs (SSRIs) or with Acceptance and Commitment Therapy (ACT) twice weekly for 1 hour for 4 weeks. They were measured before and after treatment and 3 months later for depression, anxiety, perceived stress, and quality of life.

 

They found that in comparison to baseline both groups had significant decreases in depression and significant increases in quality of life and these improvements were maintained the 3-month follow-up. Hence, Mindfulness training is as effective as drugs in treating Obsessive-Compulsive Disorder (OCD).

 

Since mindfulness training, unlike drugs, doesn’t have significant side effects, it would appear to be the preferred treatment for Obsessive-Compulsive Disorder (OCD),

 

“The struggle of the OCD sufferer is one in which certain internal experiences (thoughts, etc.) are viewed as unacceptable, whereas others are allowed to pass by without critique. Mindfulness suggests a different perspective on the presence of these internal experiences, that they be simply noticed, not judged or pushed away.” – Sheppard Pratt

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Ebrahimi, A., Nasre Esfahan, E., Akuchekian, S., Izadi, R., Shaneh, E., & Mahaki, B. (2022). A randomized clinical trial: Comparison of group acceptance and commitment therapy with drug on quality of life and depression in patients with obsessive-compulsive disorder. Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences, 27, 9. https://doi.org/10.4103/jrms.jrms_449_21

 

Abstract

Background:

Acceptance and commitment therapy (ACT) is one of the newest treatment strategies that has been developed rapidly to improve the treatment of patients with obsessive–compulsive disorder (OCD). The aim of this study was to evaluate and compare the effect of ACT and selective serotonin reuptake inhibitors (SSRIs) drugs on the severity of depression symptoms and quality of life (QOL) in obsessive–compulsive patients.

Materials and Methods:

A randomized clinical trial with a control group was conducted including 27 patients with OCD. Based on the Diagnostic and Statistical Manual of Mental Disorders-5 criteria for OCD diagnosis, participants were recruited from Tamasha Counseling Center and obsessive–compulsive clinic in the Psychosomatic Research Center in Isfahan, Iran. Selected patients were allocated to two groups (14 in ACT the group and 13 in the drug group with SSRI with a simple random sampling method. ACT group was treated by an ACT therapist in eight 1-h sessions. Data were collected by the World Health Organization QOL Questionnaire (WHOQOL-BREF) and Depression subscale of DASS-42 at admission, after the intervention, and 3 months thereafter. Therapists and evaluators were blind to each other’s work. Data were analyzed using analysis of variance with repeated measures method using IBM SPSS Statistics software (V 23, IBM Corporation, Armonk, NY, USA).

Results:

Results revealed that both treatments (ACT and SSRIs drug therapy) had significant impacts on reducing depression subscales scores and increasing WHOQOL-BREF scores at posttreatment (P < 0.05). There were no significant differences in QOL scores between the two groups after the intervention and follow-up (P > 0.05). Nevertheless, drug therapy presented a significantly greater improvement in depression scores of patients than those resulting from ACT (P = 0.005). The persistence of treatment effects continued after 3 months (follow-up) in both groups.

Conclusion:

ACT is equal to SSRIs drug therapy in terms of improving QOL in patients with OCD. However, SSRIs are more effective in treating depression in obsessive–compulsive patients. It may be presumed that ACT without any chemical side effect is equal to drug and is preferred for patients who either cannot use drugs or prefer not to have a drug treatment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8943588/

 

Improve the Psychological Well-Being of Patients with Breast Cancer with Mindfulness

psyjdc Leave a comment

Improve the Psychological Well-Being of Patients with Breast Cancer with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness based interventions hold a great deal of promise for helping people with cancer cope across a broad range of symptoms and issues, both during and after the completion of active treatment.” – Jessica Pieczynski

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. A therapeutic technique that contains mindfulness training and Cognitive Behavioral Therapy (CBT) is Acceptance and Commitment Therapy (ACT). It focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. This suggests that ACT may be an effective treatment for women with breast cancer.

 

In today’s Research News article “Efficacy of acceptance and commitment therapy (ACT) on depression, pain acceptance, and psychological flexibility in married women with breast cancer: a pre- and post-test clinical trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8317551/ ) Ghorbani and colleagues recruited married women with breast cancer who exhibited moderate levels of anxiety and depression and randomly assigned them to receive 8 weekly 90 minute sessions of Acceptance and Commitment Therapy (ACT) or to a wait list control condition. They were measured before and after ACT and 2 months later for perceived stress, anxiety, depression, chronic pain, and acceptance and action.

 

They found that in comparison to baseline and the wait-list control group after Acceptance and Commitment Therapy (ACT) there were significant reductions in depression and significant increases in pain acceptance and flexibility. These improvements were maintained at the 2-month follow-up.

 

The study did not have an active control condition, rather employing a wait-list control. This leaves open the possibility of participant expectancy (placebo) effects or attentional (Hawthorne) effects explaining the results. In addition, Acceptance and Commitment Therapy (ACT) is a complex therapy with several therapeutic components. It is unclear what components or combination of components are critical for the benefits. Nevertheless, the results demonstrate that Acceptance and Commitment Therapy (ACT) is effective in improving the psychological well-being of breast cancer patients. This could well translate into better recovery and health in these women.

 

So, improve the psychological well-being of patients with breast cancer with mindfulness.

 

“mindfulness-based stress reduction can be effective in alleviating anxiety and depression, decreasing long-term emotional and physical side effects of treatments and improving the quality of sleep in breast cancer patients.” –  BCRF

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are available on Twitter @MindfulResearch

 

Study Summary

 

Ghorbani, V., Zanjani, Z., Omidi, A., & Sarvizadeh, M. (2021). Efficacy of acceptance and commitment therapy (ACT) on depression, pain acceptance, and psychological flexibility in married women with breast cancer: a pre- and post-test clinical trial. Trends in psychiatry and psychotherapy, 43(2), 126–133. https://doi.org/10.47626/2237-6089-2020-0022

 

Abstract

Objective:

Breast cancer is the most common cancer in women worldwide. Many of these patients suffer from multiple psychological symptoms. The present study aimed to investigate the impact of acceptance and commitment therapy (ACT) on depression, pain acceptance, and psychological flexibility in married women with breast cancer.

Methods:

The present study was a pre- and post-test clinical trial with intervention and control groups. The research population consisted of women with breast cancer referred to the Ayatollah Yasrebi and Shahid Beheshti Hospitals in Kashan in 2018. Through a purposive sampling method, 40 women were selected and randomly divided into two groups, namely, intervention (n = 20) and control (n = 20). The applied tools included the Depression, Anxiety and Stress Scale (DASS-21), Chronic Pain Acceptance Questionnaire 8 (CPAQ-8), and Acceptance and Action Questionnaire – II (AAQ-II). Data were analyzed by SPSS 16 using descriptive statistics and analysis of variance (ANOVA).

Results:

The results showed that ACT treatment significantly reduced the mean scores of depression compared to the control group (F = 107.72, p < 0.001). The mean scores of pain acceptance (F = 9.58, p < 0.05) and psychological flexibility (F = 10.61, p < 0 .05) significantly increased in comparison with the control group.

Conclusion:

ACT can be considered as an effective therapeutic approach to reduce depression and increase pain acceptance and psychological flexibility in women with breast cancer. These changes appear to be due to improved acceptance of thoughts and feelings associated with cancer and increased psychological flexibility, which is the primary goal of ACT treatment.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8317551/

 

Improve Anxiety Disorders with Mindfulness

psyjdc Leave a comment

Improve Anxiety Disorders with Mindfulness

 

By John M. de Castro, Ph.D.

 

“[Anxiety Disorders] primarily involves unrelenting worry. With meditation, you can learn to accept those worries without letting them upset you, which is likely to diminish your stress.” – Arlin Cuncic

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. A characterizing feature of anxiety disorders is that the sufferer overly identifies with and personalizes their thoughts. The sufferer has recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Anxiety disorders have generally been treated with drugs. But there are considerable side effects, and these drugs are often abused. There are several psychological therapies for anxiety. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders. There has developed a considerable volume of research on the effectiveness of mindfulness-based therapies for anxiety disorders. So, it is reasonable to summarize what has been learned.

 

In today’s Research News article “A systematic review and meta-analysis of acceptance- and mindfulness-based interventions for DSM-5 anxiety disorders.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8516851/ ) Haller and colleagues review, summarize, and perform a meta-analysis on the published research on the effectiveness of mindfulness-based therapies for anxiety disorders. They identified 23 randomized controlled trials including a total of 1815 patients with anxiety disorders; Generalized Anxiety Disorder, Social Anxiety Disorder, and mixed anxiety diagnoses. Twelve studies employed Acceptance and Commitment Therapy (ACT), 3 ones Mindfulness-Based Cognitive Therapy (MBCT), and 8 ones Mindfulness-Based Stress Reduction (MBSR).

 

They report that the published research studies found that Acceptance and Commitment Therapy (ACT), Mindfulness-Based Cognitive Therapy (MBCT), and Mindfulness-Based Stress Reduction (MBSR) in comparison to treatment as usual produced significant reduction in anxiety either based on clinician or patient reports and also depression in these patients. ACT appeared to have superior effects, followed by MBCT, and lastly MBSR. These effects, however, were no longer significant at follow up 6- and 12-months after the interventions.

 

This analysis of the published research suggests that mindfulness-based therapies are effective in relieving anxiety and depression in patients with anxiety disorders. But they appear to be only effective over the short term. More work needs to be done to optimize the effectiveness of these therapies and to identify how to make the effects longer lasting.

 

So, improve anxiety disorders with mindfulness.

 

“Mindfulness counters the overthinking and hypervigilance of anxiety. When we’re anxious, our minds are full of ruminations about the past and worries about the future, and the more anxiety pulls us away from the present moment, the more stressed and unhappy we are.  . . mindfulness offers a break from the worries and fears of anxiety.” – Tanya Peterson

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are available on Twitter @MindfulResearch

 

Study Summary

 

Haller, H., Breilmann, P., Schröter, M., Dobos, G., & Cramer, H. (2021). A systematic review and meta-analysis of acceptance- and mindfulness-based interventions for DSM-5 anxiety disorders. Scientific reports, 11(1), 20385. https://doi.org/10.1038/s41598-021-99882-w

 

Abstract

This meta-analysis systematically reviewed the evidence on standardized acceptance-/mindfulness-based interventions in DSM-5 anxiety disorders. Randomized controlled trials examining Acceptance and Commitment Therapy (ACT), Mindfulness-Based Cognitive Therapy (MBCT), and Mindfulness-Based Stress Reduction (MBSR) were searched via PubMed, Central, PsycInfo, and Scopus until June 2021. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated for primary outcomes (anxiety) and secondary ones (depression and quality of life). Risk of bias was assessed using the Cochrane tool. We found 23 studies, mostly of unclear risk of bias, including 1815 adults with different DSM-5 anxiety disorders. ACT, MBCT and MBSR led to short-term effects on clinician- and patient-rated anxiety in addition to treatment as usual (TAU) versus TAU alone. In comparison to Cognitive Behavioral Therapy (CBT), ACT and MBCT showed comparable effects on both anxiety outcomes, while MBSR showed significantly lower effects. Analyses up to 6 and 12 months did not reveal significant differences compared to TAU or CBT. Effects on depression and quality of life showed similar trends. Statistical heterogeneity was moderate to considerable. Adverse events were reported insufficiently. The evidence suggests short-term anxiolytic effects of acceptance- and mindfulness-based interventions. Specific treatment effects exceeding those of placebo mechanisms remain unclear.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8516851/

Improve the Psychological Well-Being of Parents of Children with Autism Spectrum Disorder with Mindfulness

psyjdc Leave a comment

Improve the Psychological Well-Being of Parents of Children with Autism Spectrum Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness instruction may help to ease the stress of parenting young children with autism.” – B. Grace Bullock

 

Providing care for children with autism spectrum disorder (ASD) can be particularly challenging. These children’s behavior is characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors. These make it difficult to relate to the child and receive the kind of positive feelings that often help to support caregiving. The challenges of caring for a child with ASD require that the parent be able to deal with stress, to regulate their own emotions, and to be sensitive and attentive to their child. These skills are exactly those that are developed in mindfulness training. It improves the psychological and physiological responses to stress. It improves emotion regulation. And it improves the ability to maintain attention and focus in the face of high levels of distraction.

 

A therapeutic technique that contains mindfulness training and Cognitive Behavioral Therapy (CBT) is Acceptance and Commitment Therapy (ACT). It focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. It is not known whether ACT can improve the psychological well-being of parents of children with autism spectrum disorder. 

 

In today’s Research News article “The Effect of Acceptance and Commitment Therapy for Improving Psychological Well-Being in Parents of Individuals with Autism Spectrum Disorders: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7892587/ ) Marino and colleagues recruited families with children between the ages of 4-10 and diagnosed with autism spectrum disorder and randomly assigned them to receive 24 weekly 90-minute sessions of either Acceptance and Commitment Therapy (ACT) or positive parent training to teach behavioral management skills to the children. The parents were measured before and after training for psychological flexibility, their emotions, the severity of disruptive and non-compliant behaviors in the children, behavior congruent with values, mindfulness, parental distress, parent-child dysfunction, and difficult child measures.

 

They found that in comparison to baseline and the positive parent training group, the group that received either Acceptance and Commitment Therapy (ACT) had significantly greater improvements in psychological flexibility, their emotions, the severity of disruptive and non-compliant behaviors in the children, behavior congruent with values, mindfulness, and parental distress.

 

The results are exciting particularly because of the strength of the research design. The control condition was an alternative therapy that met similarly over a similar period of time. This controls for most sources of research confounding which greatly improves the strength of the conclusions. These results suggest that Acceptance and Commitment Therapy (ACT) is a safe and effective treatment for parents of children with autism spectrum disorder improving the parent’s psychological well-being and also the children’s’ behavior.. One of the key differences between ACT and positive parent training is the training in mindfulness. This suggests that mindfulness may be the key training for the benefits to the parents.

 

So, improve the psychological well-being of parents of children with autism spectrum disorder with mindfulness.

 

“mindfulness means that parents are developing more compassion for themselves instead of feeling like it’s the end of the world when they do yell. Instead, they can mindfully reflect, repair if needed, and try again.” Katy Oberle

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Twitter @MindfulResearch

 

Study Summary

 

Marino, F., Failla, C., Chilà, P., Minutoli, R., Puglisi, A., Arnao, A. A., Pignolo, L., Presti, G., Pergolizzi, F., Moderato, P., Tartarisco, G., Ruta, L., Vagni, D., Cerasa, A., & Pioggia, G. (2021). The Effect of Acceptance and Commitment Therapy for Improving Psychological Well-Being in Parents of Individuals with Autism Spectrum Disorders: A Randomized Controlled Trial. Brain sciences, 11(7), 880. https://doi.org/10.3390/brainsci11070880

 

Abstract

Background: Acceptance and Commitment Therapy (ACT) has been demonstrated as effective in improving psychological well-being in several clinical domains, but there is no evidence regarding the parents of children with Autism Spectrum Disorder (ASD). Methods: In this randomized controlled trial, we evaluated the efficacy of the ACT matrix behavioral protocol in comparison to the Parent Training (PT) program, measuring several primary and secondary outcomes prior to and following treatments. Twelve parents were randomly and equally assigned to two demographically matched groups wherein individuals underwent 24 weekly meetings of ACT protocol (experimental group) or conventional PT (control group). Results: Parents enrolled in the ACT protocol demonstrated significant improvement in psychological flexibility, awareness states, personal values in everyday life, and parental stress, whereas reduced scores were elicited in parents’ perceptions of their child’s disruptive behaviors. Conclusions: The results of this randomized controlled trial, if repeated with a large number of subjects, could open the way to include ACT protocols in daily practice to support the development of new parenting skills.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8301771/

 

Improve the Symptoms of Central Pain Sensitization Syndromes with Mindfulness

psyjdc Leave a comment

Improve the Symptoms of Central Pain Sensitization Syndromes with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Central sensitization, in short, is a hypersensitivity to stimuli from things that are not typically painful. . . Stress can heighten pain even more, so various forms of stress management may be recommended to patients. This may include practices such as yoga, mindfulness, or meditation.” – Southern Pain

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. Central Pain Sensitization Syndromes such as fibromyalgia and Migraine headaches are particularly difficult to deal with as they have triggers that are not normally painful.

 

The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain. There is an accumulating volume of research findings that demonstrate that mindfulness practices, in general, are effective in treating pain.

 

A therapeutic technique that contains mindfulness training and Cognitive Behavioral Therapy (CBT) is Acceptance and Commitment Therapy (ACT). It focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

The research on the effectiveness of Acceptance and Commitment Therapy (ACT) for  Central Pain Sensitization Syndromes has been accumulating. So, it makes sense to pause and review what has been learned. In today’s Research News article “Effectiveness of Acceptance and Commitment Therapy in Central Pain Sensitization Syndromes: A Systematic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8235706/ ) Galvez-Sánchez and colleagues review and summarize the published research evidence on the effectiveness of Acceptance and Commitment Therapy (ACT) for  Central Pain Sensitization Syndromes. They identified 21 published studies that included a total of 1090 adult participants.

 

They report that 8 studies found that Acceptance and Commitment Therapy (ACT) significantly improved the symptoms of fibromyalgia especially anxiety and depression and improved pain acceptance, self-efficacy, and psychological flexibility. Six studies found that ACT improved the patient’s acceptance of irritable bowel syndrome and the psychological distress produced by IBS. In 7 studies ACT was shown to significantly improve migraine pain and the affective distress resulting from the disease including anxiety and depression. These improvements were greater than those seen with pharmacological and psychoeducational interventions.

 

Mindfulness training has been shown to improve the symptoms of fibromyalgia, irritable bower syndrome, and migraine headache. The finding from the currently published research studies of the effectiveness of the mindfulness training of Acceptance and Commitment Therapy (ACT) suggests that it is similarly effective in treating the symptoms from Central Pain Sensitization Syndromes particularly the psychological distress produced by them and improve the patients’ health related quality of life.

 

So, improve the symptoms of Central Pain Sensitization Syndromes with mindfulness.

 

“The goal of meditation is not to eliminate pain or anxiety, but rather to get patients to focus on breathing and relaxation techniques. . . to reverse some of the negative central sensitization that can occur with chronic pain.” – Mel Pohl

 

MCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Galvez-Sánchez, C. M., Montoro, C. I., Moreno-Padilla, M., Reyes Del Paso, G. A., & de la Coba, P. (2021). Effectiveness of Acceptance and Commitment Therapy in Central Pain Sensitization Syndromes: A Systematic Review. Journal of clinical medicine, 10(12), 2706. https://doi.org/10.3390/jcm10122706

 

Abstract

Objectives: Acceptance and commitment therapy (ACT) is considered by the American Psychological Association as an evidence-based treatment for a variety of disorders, including chronic pain. The main objective of the present systematic review was to determine the effectiveness of ACT in patients with central pain sensitization syndromes (CPSS). Methods: This systematic review was conducted according to the guidelines of the Cochrane Collaboration and PRISMA statements. The protocol was registered in advance in the Prospective Register of Systematic Reviews (PROSPERO) international database. The selected articles were evaluated using the Cochrane risk of bias (ROB) assessment tool. The PubMed, Scopus, and Web of Science databases were searched. Results: The literature search identified 21 studies (including investigations of fibromyalgia syndrome, irritable bowel syndrome, and migraine) eligible for the systematic review. There were no studies regarding the effectiveness of ACT for chronic tension-type headache (CTTH), interstitial cystitis (IC), or temporomandibular disorder (TMD). The evaluation of ROB showed that 12 of the selected studies were of low quality, 5 were of moderate quality, and 4 were high quality. ACT reduces some clinical symptoms, such as anxiety, depression, and pain. This positive effect of ACT might be mediated by pain acceptance, psychological flexibility, optimism, self-efficacy, or adherence to values. ACT showed better results in comparison to non-intervention (e.g., “waiting list”) conditions, as well as pharmacological and psychoeducational interventions. It is not entirely clear whether extended ACT treatments are more advantageous than briefer interventions. Conclusions: There are few studies about the effectiveness of ACT on CPSS. However, ACT seems to reduce subjective CPSS symptoms and improve the health-related quality of life of these patients. The absence of studies on the effectiveness of ACT in CTTH, IC, and TMD, indicate the pressing need for further ACT studies in these CPSS.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8235706/

Improve the Well-Being of Children with Special Health Care Needs and Their Parents with Mindfulness

psyjdc Leave a comment

Improve the Well-Being of Children with Special Health Care Needs and Their Parents with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness-based parenting program can be an effective intervention for reducing the stress experienced by parents of children with special needs.” – Elizabeth J. Shaffer

 

There is a tremendous demand for caregiving in the US. It is estimated that over 65 million (29% of the adult population) provides care to someone who is ill, disabled, or aged, averaging 20 hours per week spent caring for their loved ones. Children with special health care needs include a variety of conditions from psychological such as anxiety disorders or depression to chronic conditions such as asthma or diabetes or chronic pain, to developmental issues such as autism. They place considerable burdens on their caregivers.  Mindfulness practice for caregivers has been shown to help them cope with the physical and psychological demands of caregiving.

 

A therapeutic technique that contains mindfulness training and Cognitive Behavioral Therapy (CBT) is Acceptance and Commitment Therapy (ACT). It focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

There has been accumulating research on the application of Acceptance and Commitment Therapy (ACT) for the treatment of children with special health care needs and their caregivers and there is a need to review and summarize the findings. In today’s Research News article “Acceptance and Commitment Therapy for Children with Special Health Care Needs and Their Parents: A Systematic Review and Meta-Analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8345967/ ) Parmar and colleagues review, summarize, and perform a meta-analysis of the published research studies on the effectiveness of Acceptance and Commitment Therapy (ACT) for the treatment of children with special health care needs and their caregivers.

 

They identified 10 published research studies. They report that the published research finds that Acceptance and Commitment Therapy (ACT) produces significant reductions in depression and perceived stress, and increases in psychological flexibility in the children. On the other hand, the parents did not show similar improvements except for a small improvement in psychological flexibility.

 

The published research, then, suggests that Acceptance and Commitment Therapy (ACT) is effective for children with special health care needs in reducing mental distress and increasing their flexibility in dealing with it.  ACT also produce small improvements in their caregivers. This suggests that ACT should be recommended to increase mindfulness in children with special health care needs to improve their psychological well-being.

 

CMCS – Center for Mindfulness and Contemplative Studies

 

“cultivating a more mindful way of parenting is associated with reduced stress, anxiety, and depression. Parents experienced increased mindful awareness and improved psychological well-being, and they were more accepting of their children. Their children also had fewer behavior problems and enhanced positive interaction with their parents.” – Manika Petcharat

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Parmar, A., Esser, K., Barreira, L., Miller, D., Morinis, L., Chong, Y. Y., Smith, W., Major, N., Church, P., Cohen, E., & Orkin, J. (2021). Acceptance and Commitment Therapy for Children with Special Health Care Needs and Their Parents: A Systematic Review and Meta-Analysis. International journal of environmental research and public health, 18(15), 8205. https://doi.org/10.3390/ijerph18158205

 

Abstract

Context: Acceptance and Commitment Therapy (ACT) is an emerging treatment for improving psychological well-being. Objective: To summarize research evaluating the effects of ACT on psychological well-being in children with special health care needs (SHCN) and their parents. Data Sources: An electronic literature search was conducted in PubMed, Web of Science, Ovid/EMBASE and PsycINFO (January 2000–April 2021). Study Selection: Included were studies that assessed ACT in children with SHCN (ages 0–17y) and/or parents of children with SHCN and had a comparator group. Data Extraction: Descriptive data were synthesized and presented in a tabular format, and data on relevant outcomes (e.g., depressive symptoms, stress, avoidance and fusion) were used in the meta-analyses to explore the effectiveness of ACT (administered independently with no other psychological therapy) compared to no treatment. Results: Ten studies were identified (child (7) and parent (3)). In children with SHCN, ACT was more effective than no treatment at helping depressive symptoms (standardized mean difference [SMD] = −4.27, 95% CI: −5.20, −3.34; p < 0.001) and avoidance and fusion (SMD = −1.64, 95% CI: −3.24, −0.03; p = 0.05), but not stress. In parents of children with SHCN, ACT may help psychological inflexibility (SMD = −0.77, 95% CI: −1.07, −0.47; p < 0.01). Limitations: There was considerable statistical heterogeneity in three of the six meta-analyses. Conclusions: There is some evidence that ACT may help with depressive symptoms in children with SHCN and psychological inflexibility in their parents. Research on the efficacy of ACT for a variety of children with SHCN and their parents is especially limited, and future research is needed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8345967/

 

Improve Health Outcomes in Women on Long-Term Sick Leave with Mindfulness

psyjdc Leave a comment

Improve Health Outcomes in Women on Long-Term Sick Leave with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Since stress compromises our immune system, becoming caught up in this way can slow down our recovery. Instead, aim to approach your illness with care, seeing things as they are, with acceptance and compassion.” — Mark Bertin

 

Chronic Pain and mental health issues are the most common causes of long-term sick leave. At least 100 million adult Americans have chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain. There is an accumulating volume of research findings that demonstrate that mindfulness practices, in general, are effective in treating pain.

 

Depression affects over 6% of the population. Depression can be difficult to treat. It is usually treated with antidepressant medication. But, of patients treated initially with drugs only about a third attained remission of the depression. Even after remission there are a number of symptoms that remain. These include lingering dysphoria, impaired psychosocial functioning, fatigue, and decreased ability to work. These residual symptoms can lead to relapse. Mindfulness training is also an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail.

 

Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. A characterizing feature of anxiety disorders is that the suffer overly identifies with and personalizes their thoughts. The sufferer has recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Anxiety disorders have generally been treated with drugs. But there are considerable side effects, and these drugs are often abused. Recently, it has been found that mindfulness training can be effective for anxiety disorders.

 

A therapeutic technique that contains mindfulness training and Cognitive Behavioral Therapy (CBT) is Acceptance and Commitment Therapy (ACT). It focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. This suggests that ACT may be an effective treatment for women who are on long-term sick leave.

 

In today’s Research News article “Comparing the Efficacy of Multidisciplinary Assessment and Treatment, or Acceptance and Commitment Therapy, with Treatment as Usual on Health Outcomes in Women on Long-Term Sick Leave-A Randomised Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7916944/ ) Finnes and colleagues recruited working age women who were on long-term sick leave and randomly assigned them to receive either treatment as usual, Acceptance and Commitment Therapy (ACT), or ACT in combination with a multidisciplinary team consisting of a physician, a psychologist, an occupational therapist and a social worker. They were measured before and after treatment and at 6 and 12 months after treatment for sick leave, satisfaction with treatment, pain, anxiety, depression, satisfaction with life, and general health well-being.

 

They found that there were no significant differences between Acceptance and Commitment Therapy (ACT), or ACT plus team with the women’s satisfaction with treatment. But in comparison to baseline and the treatment as usual group, both treatments produced significant reductions in anxiety, depression, pain intensity and significant increases in satisfaction with life, and general health well-being. At one year after treatment the ACT plus team group had significantly more patients classified as recovered than the ACT alone group.

 

These results demonstrate that Acceptance and Commitment Therapy (ACT) is effective in treating the physical and psychological symptoms of women who were on long-term sick leave. Women on long-term sick leave are very difficult to treat as their issues have resisted improvement for a substantial period of time. So, the ability of ACT to improve these symptoms is impressive. Adding the team produced slightly better outcomes at 12 months but the additional cost of the team is quite significant. So, from a cost effectiveness standpoint, ACT alone is superior.

 

So, improve health outcomes in women on long-term sick leave with mindfulness.

 

“Musculoskeletal pain, depression, and anxiety cause the majority of all sick leave. . . Interestingly enough, mindfulness has become an important construct in return-to-work rehabilitation.” – Emily Lipinski

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Finnes, A., Anderzén, I., Pingel, R., Dahl, J., Molin, L., & Lytsy, P. (2021). Comparing the Efficacy of Multidisciplinary Assessment and Treatment, or Acceptance and Commitment Therapy, with Treatment as Usual on Health Outcomes in Women on Long-Term Sick Leave-A Randomised Controlled Trial. International journal of environmental research and public health, 18(4), 1754. https://doi.org/10.3390/ijerph18041754

 

Abstract

Background: Chronic pain and mental disorders are common reasons for long term sick leave. The study objective was to evaluate the efficacy of a multidisciplinary assessment and treatment program including acceptance and commitment therapy (TEAM) and stand-alone acceptance and commitment therapy (ACT), compared with treatment as usual (Control) on health outcomes in women on long-term sick leave. Method: Participants (n = 308), women of working age on long term sick leave due to musculoskeletal pain and/or common mental disorders, were randomized to TEAM (n = 102), ACT (n = 102) or Control (n = 104). Participants in the multidisciplinary assessment treatment program received ACT, but also medical assessment, occupational therapy and social counselling. The second intervention included ACT only. Health outcomes were assessed over 12 months using adjusted linear mixed models. The results showed significant interaction effects for both ACT and TEAM compared with Control in anxiety (ACT [p < 0.05]; TEAM [p < 0.001]), depression (ACT [p < 0.001]; TEAM [p < 0.001]) and general well-being (ACT [p < 0.05]; TEAM [p < 0.001]). For self-rated pain, there was a significant interaction effect in favour of ACT (p < 0.05), and for satisfaction with life in favour of TEAM (p < 0.001). Conclusion: Both ACT alone and multidisciplinary assessment and treatment including ACT were superior to treatment as usual in clinical outcomes.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7916944/

 

Effectively Treat Substance Use Disorder with Mindfulness

psyjdc Leave a comment

Effectively Treat Substance Use Disorder with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness is likely an effective tool in helping people with addiction because it’s a single, simple skill that a person can practice multiple times throughout their day, every day, regardless of the life challenges that arise.” – James Davis

 

Substance abuse is a major health and social problem. There are estimated 22.2 million people in the U.S. with substance dependence. It is estimated that worldwide there are nearly ¼ million deaths yearly as a result of illicit drug use which includes unintentional overdoses, suicides, HIV and AIDS, and trauma. Obviously, there is a need to find effective methods to prevent and treat substance abuse. There are a number of programs that are successful at stopping the drug abuse, including the classic 12-step program emblematic of Alcoholics Anonymous. Unfortunately, the majority of drug and/or alcohol abusers relapse and return to substance abuse.

 

Hence, it is important to find an effective method to treat substance abuse and prevent relapse but an effective treatment has been elusive. Most programs and therapies to treat addictions have poor success rates. Recently, mindfulness training has been found to be effective in treating addictions. The research has been accumulating. So, it makes sense to pause and take a look at what has been learned.

 

In today’s Research News article “A Narrative Review of Third-Wave Cognitive-Behavioral Therapies in Addiction.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8080172/ ) Balandeh and colleagues review and summarize the published research studies of the effectiveness of mindfulness-based therapies for the treatment of addictions.

 

They report that the published research demonstrates that the mindfulness-based therapies of Mindfulness-Based Relapse Prevention (MBRP), Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), Mindfulness-Based Stress Reduction (MBSR), and Mindfulness-Based Cognitive Therapy (MBCT) are all effective for the treatment of addictions. These therapies vary greatly in emphasis and techniques. The major common thread is mindfulness training. This would suggest that it’s developing mindfulness per se that is effective in treating addictions.

 

They report that on a number of explanations for the effectiveness of mindfulness-based therapies for the treatment of addictions. These include the ability of mindfulness training to change the individual’s responses to the usual triggers for drug use, changing the brain’s response to cravings, and sensing cravings as just another physical sensation. Regardless of the mechanism or mechanisms, it is clear that mindfulness training is effective for the treatment of substance use disorder.

 

So, effectively treat substance use disorder with mindfulness.

 

“One reason addiction is so hard to beat is that it’s a pattern of conditioned responses. The part of your brain responsible for higher reasoning essentially gets cut out of the decision-making process and you react reflexively to stimuli associated with drugs and alcohol. Practicing mindfulness gradually undoes this conditioning.” – Renewal Lodge

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Balandeh, E., Omidi, A., & Ghaderi, A. (2021). A Narrative Review of Third-Wave Cognitive-Behavioral Therapies in Addiction. Addiction & health, 13(1), 52–65. https://doi.org/10.22122/ahj.v13i1.298

 

Abstract

Substance use disorder (SUD) is a prevalent health issue with serious social and personal consequences. SUDs are linked to numerous physical health problems. In the Diagnostic and Statistical Manual of Mental Disorders-5th Edition (DSM-V), the essential characteristic of a SUD is a collection of cognitive, behavioral, and psychological manifestations indicative of the subject’s unbaiting substance use despite experiencing significant problems due to continued use. Several alternative interventions have been indicated. Among them, mindfulness-based therapies are receiving growing attention. This article reviews evidence for the use of third-wave cognitive-behavioral therapies (CBTs) in addiction treatment. We have reviewed the literature published from 1990 to 2019. Further research is required to better understand the types of mindfulness-based interventions that work best for specific types of addiction, patients, and situations. Current findings increasingly support third-wave CBTs as a promising complementary therapy for the treatment and prevention of addiction.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8080172/

 

Improve Pain, Sleep, and the Mental Health of Chronic Pain Patients with Internet Mindfulness Training

psyjdc Leave a comment

Improve Pain, Sleep, and the Mental Health of Chronic Pain Patients with Internet Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“In the context of chronic pain . . . meditation can help you to stop your mind wandering back to your pain when you are trying to focus on something else, therefore improving your ability to give your entire attention to the task at hand and in turn, improve your level of functioning. It gives you the power to take your mind off your pain and refocus it, therefore aiding you in replacing unhelpful, behaviours with healthy ones which can reduce your pain and allow you to take better care of your health.” – Ann-Marie D’arcy-Sharpe

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain.

 

There is an accumulating volume of research findings that demonstrate that mindfulness practices, in general, are effective in treating pain. A therapeutic technique that contains mindfulness training and Cognitive Behavioral Therapy (CBT) is Acceptance and Commitment Therapy (ACT). It focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

Acceptance and Commitment Therapy (ACT) requires a scheduled program of sessions with a trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient. As an alternative, mindfulness training over the internet have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. In addition, research has indicated that mindfulness training online can be effective for improving the health and well-being of the participants.

 

In today’s Research News article “Internet‐delivered acceptance and commitment therapy as microlearning for chronic pain: A randomized controlled trial with 1‐year follow‐up.” (See summary below or view the full text of the study at: https://onlinelibrary.wiley.com/doi/10.1002/ejp.1723 ) Rickardsson and colleagues recruited adult chronic pain patients and randomly assigned them to either a wait-list control condition or to receive an 8-week program of Acceptance and Commitment Therapy (ACT) delivered over the internet. ACT was delivered in daily microlearning short learning interactions. There was a 74% completion rate of the modules. The participants were measured before and after training and at 3-, 6-, and 12-month follow-ups for psychiatric problems, pain interference, pain intensity, anxiety, depression, psychological inflexibility, values, and health-related quality of life.

 

They found that compared to baseline and the wait-list control group, the group that received internet-delivered Acceptance and Commitment Therapy (ACT) had significant decreases in pain interference, pain intensity, anxiety, depression, psychological inflexibility, value obstruction, and insomnia. These improvements were long-lasting as they were maintained at the 12-month follow-up.

 

These are impressive improvements in the pain and psychological health of these diverse chronic pain patients. These results correspond with the frequent prior observations that mindfulness training produces reductions in pain, anxiety, depression, psychological inflexibility, and insomnia in a wide range of patient types and normal individuals. These results are particularly impressive as Acceptance and Commitment Therapy (ACT) was delivered over the internet. in daily microlearning short learning interactions. This was very convenient for the patients and required only 12.4 minutes per week of therapist time per week and was thus very inexpensive to deliver. Yet ACT was highly effective and lasting in relieving the suffering of these chronic pain patients.

 

So, improve pain, sleep, and the mental health of chronic pain patients with internet mindfulness training.

 

“What we want to do as best as we can is to engage with the pain just as it is. It’s not about achieving a certain goal – like minimizing pain – but learning to relate to your pain differently.” – Elisha Goldstein

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Jenny Rickardsson, Charlotte Gentili, Linda Holmström, Vendela Zetterqvist, Erik Andersson, Jan Persson, Mats Lekander, Brjánn Ljótsson, Rikard K. Wicksell. Internet‐delivered acceptance and commitment therapy as microlearning for chronic pain: A randomized controlled trial with 1‐year follow‐up, European Journal of Pain, 2021;00:1–19, https://doi.org/10.1002/ejp.1723

 

Abstract

Background

Studies of Internet‐delivered acceptance and commitment therapy (ACT) for chronic pain have shown small to moderate positive effects for pain interference and pain acceptance. Effects on pain intensity, depression, anxiety and quality of life (QoL) have been less favourable, and improvements for values and sleep are lacking. In this randomized controlled trial iACT – a novel format of Internet‐ACT using daily microlearning exercises – was examined for efficacy compared to a waitlist condition.

Methods

Adult participants (mean age 49.5 years, pain duration 18.1 years) with diverse chronic pain conditions were recruited via self‐referral, and randomized to iACT (n = 57) or waitlist (n = 56). The primary outcome was pain interference. The secondary outcomes were QoL, depression, anxiety, insomnia and pain intensity. The process variables included psychological inflexibility and values. Post‐assessments were completed by 88% (n = 100) of participants. Twelve‐month follow‐up assessments were completed by 65% (iACT only, n = 37). Treatment efficacy was analysed using linear mixed models and an intention‐to‐treat‐approach.

Results

Significant improvements in favour of iACT were seen for pain interference, depression, anxiety, pain intensity and insomnia, as well as process variables psychological inflexibility and values. Between‐group effect sizes were large for pain interference (d = 0.99) and pain intensity (d = 1.2), moderate for anxiety and depressive symptoms and small for QoL and insomnia. For the process variables, the between‐group effect size was large for psychological inflexibility (d = 1.0) and moderate for values. All improvements were maintained at 1‐year follow‐up.

Conclusions

Internet‐ACT as microlearning may improve a broad range of outcomes in chronic pain.

Significance

The study evaluates a novel behavioral treatment with positive results on pain interference, mood as well as pain intensity for longtime chronic pain sufferers. The innovative format of a digital ACT intervention delivered in short and experiential daily learnings may be a promising way forward.

https://onlinelibrary.wiley.com/doi/10.1002/ejp.1723

 

jenny.rickardsson@ki.se