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Despite the high prevalence of yips, a psychoneuromuscular impairment affecting fine motor skills in sports performance, the specific aspects of its causality and treatment have not been identified or verified. This cross-sectional study examined psychosocial factors relating to throwing yips in baseball. Amateur baseball players (N = 292) living in Japan completed a self-report questionnaire on their anxiety/fear about throwing the ball, the Acceptance and Action Questionnaire-II, the Cognitive Fusion Questionnaire, the Short Fear of Negative Evaluation Scale, and self-reports evaluating values and social factors relevant to baseball. A hierarchical multiple regression analysis indicated that a low values-based throwing score, a high Cognitive Fusion Questionnaire score, and overreprimanding others' mistakes were positively associated with baseball players' yips symptoms. These results suggest that changing the context of playing baseball, reducing cognitive fusion, and improving coaching methods could reduce the risk of baseball players' throwing yips. [ABSTRACT FROM AUTHOR]

• ACT RCTs in LMIC journals show the importance of focusing on LMIC research. • Machine learning analysis of abstracts showed diverse topics from different countries. • Research in LMICs is often nonindexed, leading to lower citations. • Ignoring non-indexed LMIC studies distorts evidence-based intervention. • Affirmative action needed from psychology professional associations and journal editors. Despite the global nature of psychological issues, an overwhelming majority of research originates from a small segment of the world's population living in high-income countries (HICs). This disparity risks distorting our understanding of psychological phenomena by underrepresenting the cultural and contextual diversity of human experience. Research from lower- and middle-income countries (LMIC) is also less frequently cited, both because it is seemingly viewed as a "special case" and because it is less well known due to language differences and biases in indexing algorithms. Acknowledging and actively addressing this imbalance is crucial for a more inclusive, diverse, and effective science of evidence-based intervention. In this state-of-the-science review, we used a machine learning method to identify key topics in LMIC research on Acceptance and Commitment Therapy (ACT), choosing ACT due to the significant body of work from LMICs. We also examined one indication of study quality (study size), and overall citations. Research in LMICs was often nonindexed, leading to lower citations, but study size could not explain a lack of indexing. Many objectively identified topics in ACT research became invisible when LMIC research was ignored. Specific countries exhibited potentially important differences in the topics. We conclude that strong and affirmative actions are needed by scientific associations and others to ensure that research from LMICs is conducted, known, indexed, and used by CBT researchers and others interested in evidence-based intervention science. [ABSTRACT FROM AUTHOR]

Background: Integrating the approach based on acceptance and commitment with the approach of schema therapy to be more effective and respond to a wider range of couple problems has attracted the attention of researchers. Aims: This study aimed to determine the effectiveness of the combined approach of couple therapy based on acceptance and commitment with schema formulation (ACT/SF) on psychological flexibility and marital satisfaction. Methods: The research method used was quasi-experimental with a pre-test, post-test design, and a control group. The statistical population consisted of all couples referred to counseling centers in Qom in 2022. From this population, 16 couples (32 people) were selected using available sampling and divided into two groups: control and experimental. Both groups completed the ENRICH Marital Satisfaction Scale and the Acceptance and Action Questionnaire-II (AAQ-II) in the pre-test and posttest. The experimental group received therapeutic intervention for twelve 120-minute sessions. Data analysis was performed using covariance analysis at a significant level (P<0.05). Results: The results indicated that, by controlling the pre-test as a covariate variable, the experimental group experienced a significant increase in marital satisfaction with a strong effect size (η2= 0.62) and in psychological flexibility with a medium effect size (η²= 0.32). Conclusion: The combined approach of couple therapy based on acceptance and commitment with schema formulation significantly improves psychological flexibility and marital satisfaction. This is achieved through formulating problems, recognizing schemas, and becoming aware of cognitive distortions, which helps people understand and be more aware of their own and their spouse's psychological processes. Techniques based on acceptance and commitment are then used to encourage couples to improve their relationships based on their values. [ABSTRACT FROM AUTHOR]

• There is no established treatment for problematic chemsex. • Problematic chemsex can be comorbid with sexual addiction. • Results of this exploratory study using ACT with MSM engaging in chemsex are promising. • Preliminary results suggest the efficacy of ACT towards associated psychological inflexibility, anxiety, depression, and sexual addiction. • Further research on ACT for chemsex in MSM is needed. Chemsex, a phenomenon involving the use of psychoactive substances in sexual contexts to facilitate or enhance sexual experiences, is substantially increasing among men who have sex with men (MSM), and has been described as a significant risk factor for mental and physical illness. However, no specialized treatment approach has yet been established. Acceptance and commitment therapy (ACT) could potentially be an appropriate psychotherapeutic framework, especially considering the MSM and sexual minority unique challenges and the role of psychological flexibility in this context. The present paper describes the assessment and ACT interventions, reports and discusses the results, of 10 adult MSM who self-referred to an outpatient psychiatry and addiction department in France for self-reported problematic chemsex that interfered with their quality of life. They completed symptom- and process-based measures at three different timepoints. Results were quantitatively analyzed, and the clinician's session notes and patients' experiences/accounts, recorded verbatim, served as a support for evaluating the global effects of ACT interventions. Results on outcome measures showed clinically notable and statistically significative improvements in psychological flexibility, anxiety and depression symptoms, as well as sexual addiction intensity between pre- and posttreatment, which were all persistent at 3- to 4-month follow-up. Process measure results indicated a high and consistent therapeutic alliance throughout therapy. This exploratory study, directly derived from clinical practice, suggests promising preliminary results. It can provide clinicians with a useful resource for using ACT as a potentially effective approach for problematic chemsex and comorbidities, and may guide future investigation to inform treatment development efforts, especially for MSM and sexual minority communities. [ABSTRACT FROM AUTHOR]

Objective: Obesity is a complex chronic metabolic disease characterized by excessive body fat accumulation, resulting from an imbalance between energy intake and energy expenditure. The aim of this study was to determine the effectiveness of acceptance and commitment group therapy on cognitive fusion, mindfulness, and body mass index in individuals with obesity. Methods and Materials: This quasi-experimental research was conducted using a pre-test and post-test design with a control group. The statistical population included all women who visited a beauty clinic in West Tehran during the first six months of 2020. Sampling was done through convenience sampling. Out of the women who visited the beauty clinic, 40 were selected. The Cognitive Fusion Questionnaire by Gillanders et al. and the Five Facet Mindfulness Questionnaire were administered to the participants. The subjects were then randomly assigned to an experimental group and a control group. The experimental group received 12 sessions of 120-minute acceptance and commitment therapy. Post-tests were administered to both the experimental and control groups after the intervention. Findings: The results indicated that acceptance and commitment therapy was effective in reducing cognitive fusion and increasing mindfulness in individuals with obesity (P < 0.05). Conclusion: Given the confirmed effectiveness of acceptance and commitment therapy in treating obesity, it is recommended that therapists consider this therapy to improve cognitive fusion and mindfulness in overweight individuals. [ABSTRACT FROM AUTHOR]

Introduction: A growing body of literature supports the use of Acceptance-and commitment therapy (ACT) for a wide range of mental health problems in children and adolescents, but less is known about ACT when given to adolescents in a group format. Consequently, this study aimed to explore the subjective experiences of adolescents who had completed a group-based ACT for symptoms of anxiety and depression. Adolescents’ perceptions of the core therapeutic processes of ACT and the means used to enhance them, as well as the interplay between ACT processes and the group format, were of primary interest. Methods: Semi-structured qualitative interviews were conducted with seven adolescents, of which five were girls and two were boys, between 16 and 19  years old. Transcripts were analyzed using reflexive thematic analysis. Results: The adolescents varied greatly in their experience of ACT’s core processes and the methods used to enhance them. Most found the core processes meaningful and educational, especially appreciating the concept of values and value-based action. However, some perceived the core processes as irrelevant and provocative, particularly interpreting acceptance as “giving up.” The metaphors and practical exercises were experiences as playful and instructive supplements to the more theoretical elements of therapy, but also as childish and embarrassing. The group format facilitated normalization and support and seemed to increase the adolescents’ motivation and adherence to therapeutical work, but it also triggered socially anxious thoughts and self-censoring for some. Conclusion: The results from the current study support previous literature indicating that group-based ACT is an acceptable and feasible treatment format for adolescents. Yet, the varying experiences underscores the need for further studies exploring how to accommodate the group format to the diverse personal and developmental disparities in this age group. Randomized controlled trials are also needed to compare the effectiveness of individual versus group format of ACT for adolescents. [ABSTRACT FROM AUTHOR]

Purpose: To explore the experiences of patients with chronic low back pain (CLBP) plus comorbid depressive symptoms who received a remote synchronous videoconference group form of Acceptance and Commitment Therapy (ACT) or Behavioral Activation Treatment for Depression (BATD). Methods: A qualitative study (IMPACT-Q) was nested within a randomized controlled trial (RCT) designed to assess the efficacy and the cost-utility/cost-effectiveness of two therapies in the management of CLBP and depression. Fifty-five patients with CLBP plus depression were selected from the RCT. Twelve focus group sessions, each approximately 60–90 min long, were audio-recorded, transcribed verbatim, and analyzed by six coders through a thematic analysis (deductive and inductive) based on a descriptive phenomenological approach. Results: Patients perceived behavioral, affective, and cognitive improvements after completing group sessions. Overall, psychotherapy was perceived as a safe and non-judgmental place to express emotions and feel understood. The main barriers reported were lack of human contact and loss of social interaction. In contrast, ease of access, flexibility in the ability to connect from anywhere, avoidance of the need to travel, and savings in time and money were key facilitators to increase attendance and adherence to therapy. Conclusion: This study provided support for the acceptability of videoconference-delivered ACT or BATD in patients with CLBP plus comorbid depressive symptoms. IMPLICATIONS FOR REHABILITATION: Overall, patients reported behavioral, affective, and cognitive improvements after Acceptance and Commitment Therapy and Behavioral Activation Treatment for Depression group sessions. Acceptance and Commitment Therapy and Behavioral Activation Treatment for Depression delivered via videoconference platform were perceived as a facilitator for therapy attendance rather than a barrier. The findings indicate that group therapy on videoconferencing is perceived favorably as an alternative for managing patients with chronic pain and comorbid depression. Technical and social aspects of implementing videoconferencing therapies should be improved, as well as guidelines for adequate support for patients and therapists should also be provided. [ABSTRACT FROM AUTHOR]

Background and aims: Giulia, an 11-year-old girl diagnosed with ligyrophobia, has been experiencing intense anxiety related to loud noises since the age of two. This case report aims to explore the efficacy of Third-Wave Cognitive Behavioral Therapy, specifically Acceptance and Commitment Therapy (ACT), in addressing Giulia's anxiety and avoidance behaviors. The primary goal is to examine the impact of ACT on reducing ligyrophobic symptoms and enhancing psychological flexibility. Methods: The therapeutic intervention spanned 24 sessions and was divided into two phases. The initial phase focused on emotional competence using characters from the movie "Inside Out," aiding Giulia in recognizing and understanding her emotions. The subsequent phase targeted the six processes of psychological inflexibility identified in ACT, fostering increased flexibility. Results: Throughout the intervention, Giulia demonstrated significant improvements in anxiety symptoms, as evidenced by a decrease in Subjective Units of Distress (SUD) scores. Avoidance behaviors also diminished, and Giulia exhibited enhanced mindfulness skills. She became more cognizant of her emotional experiences and more certain of her personal ideals as a result of the therapy. Giulia's active participation and commitment to exposure exercises led to a substantial reduction in ligyrophobic reactions. Discussion: The successful application of ACT in Giulia's case suggests that targeting psychological inflexibility through mindfulness and values clarification can be effective in treating ligyrophobia in children. The integration of metaphors and creative exercises proved valuable in engaging Giulia and fostering therapeutic progress. The findings underscore the importance of a tailored, third-wave therapeutic approach in addressing specific phobias in pediatric populations. [ABSTRACT FROM AUTHOR]

The aim of this clinical article is to propose the relevance of the acceptance and commitment therapy (ACT) model Hayes, S. C., Villatte, M., Levin, M., & Hildebrandt, M. [2011. Open, aware, and active: Contextual approaches as an emerging trend in the behavioral and cognitive therapies. Annual Review of Clinical Psychology, 7(1), 141–168. https://doi.org/10.1146/annurev-clinpsy-032210-104449] to alleviate climate-induced psychological suffering. After a brief introduction establishing the need for climate-informed mental health intervention, the article is divided into three sections. The first section briefly presents ACT, highlighting the six core components of psychological flexibility. The second section provides a discussion to broaden and deepen psychotherapists’ understanding of eco-emotions, particularly eco-anxiety and eco-anger. The third section presents how this framework is relevant to assessing psychological flexibility in the context of climate change, using a hypothetical clinical example partly based on empirical findings. [ABSTRACT FROM AUTHOR]

Background: Myocardial infarction (Ml) is a condition characterized by the death of heart muscle cells due to a lack of oxygen, frequently resulting in death. Disease and health-related beliefs may play a function in the progression of Ml. The current study aimed to examine the effectiveness of acceptance and commitment therapy on psychological flexibility of patients with Ml. Methods: The current research was semi-experimental research with a control group. The statistical population included all patients with Ml referred to Nasiriyah Heart Center, Nasiriyah, Iraq, in 2021 and 2022 (n = 473). In the current study, 90 individuals were selected by simple random sampling and divided evenly between intervention and control groups. The Cognitive Flexibility Inventory (CFI) was utilized for data collecting. Utilizing SPSS software, the analysis of covariance (ANCOVA) method was performed. The statistical significance level was considered to be 0.05. Results: Acceptance and commitment therapy was effective in psychological flexibility (F = 116.17, P < 0.001) in patients with Ml. Besides, the results of a one-way ANCOVA indicated that the subscales, including avoidance (F = 8.27, P < 0.001), acceptance (F = 13.86, P < 0.001), and harnessing (F = 6.14, P < 0.001), improved significantly. Conclusion: Acceptance and commitment therapy has increased the psychological flexibility of patients with Ml and is effective non-pharmaceutical therapy for the psychological management of these patients. [ABSTRACT FROM AUTHOR]

Background: Physical and psychological problems are common among individuals with multiple sclerosis (MS), thus emphasizing the need for the evaluation of the effectiveness of different psychological therapies for these patients. Thus, this study aimed to compare the efficacy of group cognitive behavioral therapy (GCBT) with group acceptance and commitment therapy (GACT) in the treatment of fear beliefs related to panic disorder in MS patients, focusing on the revised sensitivity theory of brainbehavioral systems. Methods: This experimental study was conducted employing a pretest-posttest design with a control group. The statistical population consisted of MS patients with panic disorder who sought treatment at the Khorasan MS Association in Mashhad, Iran. Through the convenience sampling method, 36 women who met the inclusion criteria were selected from among 3200 patients. The participants were randomly divided into 3 groups: GCBT (N = 12), GACT (N = 12), and the control group (N = 12). Pretest and posttest intervention assessments were conducted using Jackson's five-factor questionnaire and the Panic Belief Inventory (PBI). Descriptive methods and repeated measures analysis of variance were utilized for data analysis. Results: The results revealed a significant reduction in fear beliefs among participants in the intervention groups compared to the control group (P < 0.05). Furthermore, significant changes were observed in the behavioral-brain systems of the participants in the intervention group compared to the control group (P < 0.05). Comparing the intervention groups revealed that the impact of GACT is higher than GCBT on the behavioral activation system (BAS) and panic beliefs (P = 0.04). Conclusion: It can be concluded that GCBT and GACT were effective in improving the fear beliefs of patient and changing their brain-behavioral systems. Comparing two interventions showed higher efficacy of GACT. [ABSTRACT FROM AUTHOR]

Despite recent calls for more peer support initiatives aimed at promoting mental health in postsecondary institutions, those initiatives remain scarce. In this study, a multisite randomized controlled trial was designed to assess the effect of an online peer support intervention based on acceptance and commitment therapy using mental health and school indicators. Undergraduate students were recruited in three Canadian universities and randomly assigned to an intervention (n = 54) or a wait-list control group (n = 53). Compared to control participants, those who took part in the program self-reported reduced psychological inflexibility, stress, anxiety and depression, and increased psychological flexibility and well-being. The intervention had no effect on academic satisfaction and engagement. These results were found both in completer and intent-to-treat samples. The findings provide evidence that peer support may be a beneficial adjunct to mental health interventions offered to college and university students. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to determine the effectiveness of Acceptance and Commitment Therapy (ACT) on pregnancy concerns, stress coping schemas, and interpersonal sensitivity in pregnant women with pregnancy anxiety. Methods: The research method was quasi-experimental, utilizing a pre-test, post-test design with a control group and a two-month follow-up phase. The statistical population consisted of all pregnant women with pregnancy anxiety at Shaheed Beheshti Women's Hospital in the city of Nowshahr, who scored one standard deviation above the mean and were willing to participate in the therapy sessions. A purposive sampling method was used to calculate a sample size of 75 participants (at least 25 per group). These 75 participants were then randomly assigned to two groups of 25 each (25 in the ACT experimental group and 25 in the control group). The Parker Interpersonal Sensitivity Questionnaire (1989), Wong and colleagues' Stress Coping Schemas (2006), and Alderdice and Lynn's Pregnancy Concerns Questionnaire (2011) were distributed among them. As mentioned, after collecting the data from the initial sample, the data were entered into SPSS software version 26. Findings: The results showed that Acceptance and Commitment Therapy significantly reduced pregnancy concerns (F=68.93, P<0.001), interpersonal sensitivity (F=39.73, P<0.001), and increased stress coping schemas (F=265.90, P<0.001) in pregnant women with pregnancy anxiety. Conclusion: It can be concluded that Acceptance and Commitment Therapy is effective on the dimensions of stress coping schemas in the subjects. [ABSTRACT FROM AUTHOR]

Objective: The present study aimed to compare the effectiveness of Acceptance and Commitment Therapy (ACT) and Emotion-Focused Therapy (EFT) on the burden of caregivers of individuals with dementia. Methods and Materials: This research employed a quasi-experimental method with a pretest-posttest-follow-up design and a control group. The statistical population of this study was selected from the primary caregivers (wives and daughters) of individuals with dementia who visited the Iranian Dementia Association (located in Tehran) in 2023. From this population, 45 subjects were purposefully selected and randomly assigned to three equal groups of 15 (two experimental groups and one control group). To collect data, the Caregiver Burden Scale by Novak and Guest (1989) was utilized. Data were analyzed using SPSS software and multivariate analysis of covariance (MANCOVA) tests. Findings: The results indicated that both ACT and EFT interventions had a significant effect on reducing the burden of caregivers of individuals with dementia in the post-test and follow-up phases compared to the control group. Conclusion: The findings suggest that ACT had a greater impact on reducing the burden of caregivers of individuals with dementia compared to EFT. [ABSTRACT FROM AUTHOR]

Sensory impairment is common in older age and is associated with intra- and interpersonal struggles, however, treatment efforts may be hampered by functional difficulties or unwillingness to seek face-to-face mental health services. The current study examined the efficacy of an online psychological intervention for older adults with sensory loss and their spouses in Denmark, using a two-arm, parallel-group, randomized controlled trial study design with a wait-list control group. The intervention consisted of four digital, sequential modules that contained psychoeducation and Acceptance and Commitment Therapy inspired therapeutic activities. Individuals (N = 662) completed online surveys (using the SurveyXact platform) at baseline, 6 weeks, and 10 weeks post-baseline, in terms of well-being, relationship satisfaction, and depressive symptoms. The data were analyzed in SAS, version 9.4, using multilevel modeling to account for non-independence of data (nesting within participant and within couple), specifying an alpha level of 0.05. Inconsistent with the hypotheses, we found that the intervention group reported poorer well-being at 6 weeks, compared to the control group, and we found no effect in terms of relationship satisfaction or depressive symptoms. As the first study of an online intervention for older adults with sensory loss and their spouses, the study highlights the need for simple login procedures, and we speculate whether a user customizable format may be better, features that might be useful for any digital intervention aimed at elderly populations. These features may be of particular importance in implementing digital interventions into standard healthcare practices. [ABSTRACT FROM AUTHOR]

Background: Personal recovery is a persisting concern for people with psychotic disorders. Accordingly, mental health services have adopted frameworks of personal recovery, prioritizing adaptation to psychosis alongside symptom remission. Group acceptance and commitment therapy (ACT) for psychosis aims to promote personal recovery alongside improved mood and quality of life. Aims: The objectives of this uncontrolled, prospective pilot study were to determine whether 'Recovery ACT' groups for adults are a feasible, acceptable and safe program within public mental health services, and assess effectiveness through measuring changes in personal recovery, wellbeing, and psychological flexibility. Method: Program feasibility, acceptability and safety indicators were collected from referred consumers (n =105). Adults (n =80) diagnosed with psychotic disorders participated in an evaluation of 'Recovery ACT' groups in Australian community public mental health services. Participants completed pre- and post-group measures assessing personal recovery, wellbeing, and psychological flexibility. Results: Of 101 group enrollees, 78.2% attended at least one group session (n =79); 73.8% attended three or more, suggesting feasibility. Eighty of 91 first-time attendees participated in the evaluation. Based on completer analyses (n =39), participants' personal recovery and wellbeing increased post-group. Outcome changes correlated with the linear combination of psychological flexibility measures. Conclusions: 'Recovery ACT' groups are feasible, acceptable and safe in Australian public mental health services. 'Recovery ACT' may improve personal recovery, wellbeing, and psychological flexibility. Uncontrolled study design, completer analyses, and program discontinuation rates limit conclusions. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To develop and determine the acceptability of a group-based digital health psychoeducational intervention aimed at reducing cancer worry based on acceptance and commitment therapy for individuals at high risk for pancreatic cancer. SAMPLE & SETTING: 13 individuals at high risk for pancreatic cancer with a genetic variant or family history. METHODS & VARIABLES: Three groups met virtually for one hour each week for four weeks. These sessions provided psychoeducational materials. Digital resources provided mindfulness and educational content. Reported measurements included qualitative responses and participant-reported acceptability. RESULTS: All participants found the sessions to be useful and would recommend them to others. Recommendations from the first two groups included requests to access the content provided during the remote sessions, contributing to the creation of digital content for the third group. IMPLICATIONS FOR NURSING: Individuals at high risk for pancreatic cancer can benefit from psychoeducation to reduce cancer worry, which can be accomplished through digital psychoeducational interventions. [ABSTRACT FROM AUTHOR]

Around 42% of individuals with cancer experience distress. Acceptance and commitment therapy (ACT) can reduce distress, but effects are small, and mechanisms unclear. This review aimed to identify associations between ACT processes and distress in cancer. Search terms included cancer, ACT processes, self-compassion, and distress. Six online databases and grey literature were searched until March 2022. Of 6555 papers screened, 108 studies were included with 17,195 participants. Five meta-analyses of 77 studies were conducted. Random effects meta-analyses of correlations revealed higher scores on flexible processes (acceptance, present moment awareness, self-compassion) were associated with lower distress (rpooled = -0.24, -0.39, -0.48, respectively); whilst higher scores on inflexible processes (experiential avoidance, cognitive fusion) were associated with higher distress (rpooled = 0.58, 0.57, respectively). Meta-analyses displayed moderate-to-high heterogeneity with most studies assessed as low risk of bias. Meta-regressions revealed no significant moderators (stage, time since diagnosis, gender and age). This review provides a theoretically aligned evidence base for associations between ACT processes and distress in cancer, supporting elements of ACT theory and providing targeted directions for intervention development. Due to limited evidence, future research should focus on self-as-context, values and committed action and conduct mediation analysis in controlled trials of ACT processes on distress in cancer. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the intervention effectiveness of acceptance and commitment therapy (ACT) for patients with depressive disorders. Methods: A computer search of the Web of Science Core Collection, Pubmed, EMBASE, Cochrane Library, PsycINFO, CNKI, WanFang and WeiPu full-text databases (until October 23, 2023) was used to collect randomized controlled studies that used acceptance and commitment therapy for treating patients with depressive disorders. Using Stata 17 software, meta-analysis was performed on the literature data that met the inclusion criteria. Results: After screening, 11 studies remained for data extraction. The results of a random effects model indicated that ACT could significantly reduce depression levels in patients with depressive disorders (SMD 1.22, 95% CI: 2.050.40, P <0.01), and had a certain maintenance effect (SMD = 3. 59, 95% CI: 1.57-5.62, P<0.01). Conclusion: Acceptance and commitment therapymay could improve the level of depression in patients. [ABSTRACT FROM AUTHOR]

Objective: To explore the effect of online acceptance and commitment therapy (ACT) on the psychological flexibility in patients with depression during recovery. Methods: A total of 58 patients with depression during the recovery period were randomly divided into the online ACT intervention group (n=27) and the waiting control group (n=31). The intervention group received 20-day online ACT intervention, while the control group remained waiting. The Comprehensive Assessment of Acceptance and Commitment Therapy (CompACT), Patient Health Questionnaire-9 (PHQ-9), Five-Factor Mindfulness Questionnaire (FFMQ) and Mental Health Continuum Short Form (MHC-SF) were used to evaluate the two groups at the baseline, at the end of the 20-day intervention and 1 month after the intervention. Results: The scores of CompACT and MHC-SF were lower in the intervention group than in the control group at the end of the 20-day intervention and 1 month after the intervention (Ps <0.05). The scores of CompACT, PHQ-9, FFMQ and MHC-SF in the intervention group were lower at the end of the 20-day intervention and 1 month after the intervention than at the baseline (Ps <0.01). Conclusion: Online acceptance and commitment therapy could improve the level of psychological flexibility, mindfulness and mental health of patients with depression during recovery period, and reduce their depression level. [ABSTRACT FROM AUTHOR]

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Aims/Background Gastric cancer is a common and life-threatening cancer, which predisposes patients to certain psychological problems. Implementation of both personalized nutrition and acceptance and commitment therapy (ACT) have shown unique advantages in the treatment of cancer patients. This study aims to evaluate the effects of this comprehensive therapy on psychological resilience, quality of life and side effects of chemotherapy in patients with advanced gastric cancer (AGC), yielding findings that can inform the development of holistic and effective treatment methods. Methods The clinical data of 240 AGC patients who underwent chemotherapy in the Fourth Hospital of Hebei Medical University from February 2021 to February 2023 were retrospectively analyzed. After excluding 15 patients who did not meet the inclusion criteria, 225 patients were included in the study. According to the management methods, the patients were divided into three groups: group A receiving routine management (n = 76), group B receiving routine management plus personalized nutrition (n = 75), and group C receiving routine management, personalized nutrition and ACT (n = 74). The psychological resilience, quality of life and side effects of chemotherapy were evaluated in the three groups. Results There was no difference in the Connor-Davidson resilience scale (CD-RISC) scores and quality of life questionnaire-core 30 (QLQ-C30) scores among the three groups at admission (p > 0.05). After chemotherapy, compared with the group C, the CD-RISC scores of group A and group B were significantly lower (p < 0.001), and the scores of physical function, cancer-related symptoms and overall health in group A and group B were significantly lower (p < 0.001). The incidence of side effects of chemotherapy in group C was 25.68%, which was significantly lower than that in group A and group B (p < 0.05); there was no statistical difference in this regard between group A and group B (p > 0.05), and the same parameter was significantly different between group A and group C (p < 0.05). Conclusion Personalized nutrition management plus ACT has a significant favorable effect on improving psychological resilience, alleviating the side effects of chemotherapy, and enhancing the quality of life in patients with AGC undergoing chemotherapy. [ABSTRACT FROM AUTHOR]

Objective: Ego strength indicates an individual's capacity to endure stress without experiencing crippling anxiety and is related to a sense of competence and self-sufficiency in personal and social domains. Therefore, the aim of the present study was to investigate the effectiveness of therapy based on the integrated self-analytic approach on psychological capital, psychological well-being, ego strength, and emotion regulation difficulties in individuals suffering from COVID-19 grief syndrome. Methods and Materials: The present research method was quasi-experimental, employing a pretest-posttest control group design with a two-month follow-up. The statistical population consisted of individuals with COVID-19 grief syndrome in Isfahan during the second half of 2022. Using a purposive sampling method, 30 eligible individuals were selected and randomly assigned equally to experimental and control groups. The experimental group received the integrated self-analytic approach therapy (Atashpour et al., 2021) and the acceptance and commitment therapy (Hayes, 2004), while the control group did not receive any intervention. Data collection tools included the Bart and Scott Grief Experience Questionnaire (1989), the Garnefski and Kraaij Emotion Regulation Scale (2006), and the Ego Strength Scale (PIES). Descriptive statistics (mean and standard deviation) and inferential statistics (mixed ANOVA with repeated measures) were used for data analysis. SPSS-26 software was used for conducting the statistical tests. Findings: The calculated F-value for the between-group factor was significant at the 0.05 level (P<0.05). Consequently, there was a significant difference between the mean pretest, posttest, and follow-up scores of psychological capital in the experimental and control groups. Bonferroni post-hoc test results also indicated a significant difference between pretest and posttest, and pretest and follow-up scores of ego strength and emotion regulation difficulties in both experimental groups (P<0.05). However, the post-hoc test results showed no significant difference between posttest and follow-up scores of the study variables (P>0.05). The Tukey post-hoc test also indicated no significant difference in the effectiveness of these two approaches (P>0.05). Conclusion: The results demonstrated that both integrated self-analytic approach therapy and acceptance and commitment therapy were significantly effective in improving ego strength and reducing emotion regulation difficulties. These effects were sustained at the follow-up stage, and the effectiveness of the two approaches was identical. [ABSTRACT FROM AUTHOR]

Abstract Background Regarding the prevalence and pervasiveness of psychiatric disorders, which significantly affect not only the patients themselves, but also their families, family therapy has emerged as a promising intervention. This research examined the effects of Acceptance and Commitment Therapy (ACT) on stigma and family functioning in family members of patients with psychiatric illnesses, demonstrating effectiveness in improving family functioning and coping strategies in the face of mental illness. Methods This randomized controlled clinical trial without blinding. Forty family members of patients with psychiatric disorders were randomly assigned to an intervention group (N = 20) or a control group (N = 20). The intervention group received ACT in eight weekly sessions, each lasting 90 min, while control group remained on a waiting list. Both groups were assessed at three time points: pre-intervention, post-intervention, and at a one-month follow-up. Data collection instruments included a demographic information questionnaire, a stigma assessment, and a family functioning measure. Data were analyzed using SPSS software version 23. Results A statistically significant difference was observed between the mean post-test and follow-up stigma scores of the intervention and control groups (P

Background and Objective: Vitiligo is a chronic skin disease. Considering that this disease affects a person's appearance, psychological symptoms, such as depression, isolation, and low self-confidence, are very common in these patients. The present study aimed to determine the effectiveness of Acceptance and Commitment Therapy (ACT) on psychological symptoms of patients with vitiligo disease. Materials and Methods: The present study employed a quasi-experimental design featuring a pre-test, post-test, and unequal control group. The statistical population of the research comprised soldiers and other military personnel with vitiligo who were serving in military centers of the armed forces in Tehran in 2020. The experimental group (n=11) received ACT, and the control group (n=13) did not receive any intervention. The subjects completed the questionnaires before and after the intervention. The analysis of covariance was used to analyze the data. Results: The results indicated that ACT improved depression, quality of life, and acceptance, and reduced experiential avoidance in vitiligo patients. No significant difference was observed in anxiety or mindfulness between the two groups. The effect size indicated that the differences between the groups were moderate. Conclusion: ACT is an evidence-based treatment for vitiligo patients, and psychologists can use this treatment to improve the quality of life and reduce the psychological symptoms of these patients.

Background and Objective: Renal failure is associated with significant mood and emotional problems in patients, which necessitates effective psychological interventions. This study aimed to evaluate the effectiveness of Acceptance and Commitment Therapy (ACT) on difficulties in emotion regulation in depressed dialysis patients. Materials and Methods: This semi-experimental study employed a pretest-posttest design with an unequal control group. The statistical population comprised dialysis patients undergoing treatment at Shahid Hashminejad Hospital (Tehran) during 2020-2021. A total of 42 depressed dialysis patients, each scoring above 29 on the Beck Depression Inventory (BDI), were selected through purposive sampling (homogeneous type) and randomly assigned to an experimental group or a control group. First, both groups completed the Difficulties in Emotion Regulation Scale (DERS) as a pretest. The experimental group then participated in ACT sessions, while the control group remained on the waiting list. Finally, the groups completed the posttest, and the data were collected. Results: The results of the MANCOVA test revealed a significant difference in the linear combination of the components of difficulties in emotion regulation between the two groups (Pillai's T= 0.904, F6,25= 39.070, P=0.001). The ANCOVA test results also showed a significant decrease (P

BACKGROUND: Improving access to evidence-based psychotherapies (EBPs) is a Veterans Health Administration (VHA) priority. Cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and mindfulness-based stress reduction (MBSR) are effective for chronic pain and several mental health conditions. We synthesized evidence on implementation strategies to increase EBP access and use. METHODS: We searched MEDLINE, Embase, PsycINFO, and CINAHL from inception until March 2021 for articles on EBP implementation within integrated health systems to treat chronic pain or chronic mental health conditions. Reviewers independently screened articles, extracted results, coded qualitative findings, and rated quality using modified criteria from Newcastle-Ottawa (quantitative results) or Critical Appraisal Skills Programme (qualitative results). We categorized implementation strategies using the Expert Recommendations for Implementing Change (ERIC) framework and classified outcomes using RE-AIM domains (Reach, Effectiveness, Adoption, Implementation, Maintenance). RESULTS: Twelve articles (reporting results from 10 studies) evaluated CBT (k = 11) and ACT (k = 1) implementation strategies in large integrated healthcare systems. No studies evaluated MBSR implementation. Eight articles evaluated strategies within VHA. Six articles reported on national VHA EBP implementation programs; all involved training/education, facilitation, and audit/feedback. CBT and ACT implementation demonstrated moderate to large improvements in patient symptoms and quality of life. Trainings increased mental health provider self-efficacy in delivering EBPs, improved provider EBP perceptions, and increased provider EBP use during programs, but had unclear impacts on Reach. It was unclear whether external facilitation added benefit. Provider EBP maintenance was modest; barriers included competing professional time demands and patient barriers. DISCUSSION: Multi-faceted CBT and ACT implementation programs increased provider EBP Adoption but had unclear impacts on Reach. Future implementation efforts should further evaluate Reach, Adoption, and Maintenance; assess the added value of external facilitation; and consider strategies targeting patient barriers. Future work should use implementation frameworks to guide evaluations of barriers and facilitators, processes of change, and outcomes. REGISTRATION: PROSPERO registration number CRD42021252038.

Background: The elderly population is widely acknowledged as a valuable asset to any society. Given the potential psychological and physical challenges associated with death obsession and self-care ability among the elderly, this research aims to address these issues. Notably, there is a dearth of investigation into the comparison of two interventions targeting death obsession and self-care in the Iranian elderly. Consequently, this study is designed to contribute to the enhancement of both variables in this specific demographic. Aims: The purpose of this study was to compare the effectiveness of acceptance and commitment therapy and compassion therapy on death obsession and self-care ability in the elderly. Methods: The research employed a semi-experimental design with a pre-test-post-test structure, incorporating two experimental groups and a control group. The study focused on the welfare elderly population in Behshahr City, selected through purposeful sampling and subsequently randomly assigned to the experimental and control groups. The first experimental group underwent eight 90- minute sessions of compassion therapy (Gilbert, 2009), while the second experimental group participated in nine 120-minute sessions of acceptance and commitment therapy (Hayes et al., 2013). In contrast, the control group did not receive any treatment. Data collection involved the use of the self-care ability scale for the elderly developed by Yonsi et al. (2019) and the death obsession scale by Abdul Khaliq (1998). Statistical analysis utilized descriptive and inferential statistics, multivariate covariance analysis, and the SPSS 23 statistical software. Results: The results revealed that both acceptance and commitment therapy and compassion therapy led to a reduction in death obsession and an enhancement in self-care ability among the elderly. Additionally, no significant difference was observed in the effectiveness of acceptance and commitment therapy compared to compassion therapy concerning death obsession (p>0.05). However, it was noted that compassion therapy exhibited a higher effectiveness in improving self-care ability in the elderly (p< 0.05). Conclusion: In light of the findings, it can be inferred that both acceptance and commitment therapy and compassion therapy were effective in addressing death obsession and enhancing self-care ability in the elderly. Consequently, psychotherapy centers and elderly care facilities can consider employing acceptance and commitment therapy as well as compassion therapy as effective treatment approaches to enhance the well-being of the elderly, specifically targeting the improvement of death obsession and self-care ability. [ABSTRACT FROM AUTHOR]

Background: Adolescents are in special and critical situations and sometimes they may distance themselves from society due to hormonal and appearance changes. This avoidance can create feelings of loneliness and isolation. Research on teenagers is one of the urgent needs of any society, because teenagers are the active human resources of any society. Aims: The present study was conducted with the aim of determining and comparing the effectiveness of reality therapy and therapy based on acceptance and commitment on feelings of loneliness among male high school students. Methods: The research method was semi-experimental (pre-test design, post-test with control group). The statistical population of the current research is all the male students of the second year of secondary school in Sari city and the sample group was conducted with a multi-stage cluster sampling method. Forty-five students were replaced in three groups (15 people in experiment 1), (15 people in experiment 2) and (15 people in control). Then, 15 students of the first experimental group received reality therapy, 15 students of the second experimental group received acceptance and commitment therapy sessions. The control group were on the waiting list. The UCLA Lonliness Scale (Russel, 1996) was used to collect the data. Results: The survey results showed; Reality therapy on feeling loneliness and acceptance and commitment therapy were effective significantly (p< 0.001). However, there was a significant difference between the two treatment methods of interventions on feelings of loneliness. That is, reality therapy has more effective on feelings of loneliness in adolescents. The results of the follow-up test showed that the effect of reality therapy and acceptance and commitment therapy on feelings of loneliness of adolescents is lasting after two months. Conclusion: As a result, both treatment methods, reality therapy and acceptance and commitment therapy, were effective feelings of loneliness, reality therapy was better than acceptance and commitment therapy [ABSTRACT FROM AUTHOR]

Objective: Previous qualitative studies have investigated the experiences of undergoing an evidence‐based psychotherapy for psychosis among individuals affected by such condition. However, the literature investigating the perspectives, experiences and needs of psychological practitioners providing the treatment remains considerably underrepresented. In the context of Asian cultures, where pervasive stigma towards psychosis and mental health services exists and interferes with proactive help‐seeking, such research appears even more pertinent. To address the gap in the existing literature, this study utilised qualitative methodology to investigate the experiences of practitioner psychologists working with clients with psychosis in a South‐East Asian city‐state. Method: Six fully qualified participants were recruited from the local mental health services via convenience sampling. Semi‐structured qualitative interviews were conducted. Transcribed verbatim data were then subjected to inductive thematic analysis. Results: Four superordinate themes emerged, as follows: therapeutic alliance, cognitive behavioural therapy for psychosis (CBTp) as primary approach, cultural influences and needs of practitioners. Conclusions: Results indicated that both practitioner psychologists and their clients contributed collaboratively to the establishment of therapeutic alliance. Although CBTp was utilised as a principal psychotherapeutic approach, acceptance and commitment therapy (ACT) was also valued. Necessary adaptations in the treatment were reflected on to address the specificity of local cultures, including the use of language and addressing pervasive public stigma. The necessity of multidisciplinary collaboration, localised training and supervision was also expressed. [ABSTRACT FROM AUTHOR]

Mindfulness and acceptance-based approaches have shown promise as alternative interventions to trauma-focused therapies for PTSD. This open trial examined the potential effectiveness of an 8-session Acceptance and Commitment Therapy (ACT) group in reducing psychiatric symptoms and improving quality of life in outpatient adults (N = 86, 79% female) receiving treatment for PTSD in a health maintenance organization (HMO) psychiatry clinic. The group therapy was an adjunct to usual care and utilized the six core processes of ACT: acceptance, cognitive defusion, mindfulness, self-as-context, values, and committed action. Participants completed self-report measures of PTSD symptoms, depression, anxiety and quality of life; and self-report ACT-specific process measures of acceptance, cognitive defusion and mindfulness at pretreatment, posttreatment and 3-month follow-up. Repeated measures analyses of variance conducted with a completer sample (n = 55) demonstrated significant improvements on all variables with medium to large effect sizes at posttreatment and follow-up. The study findings support further investigation in a randomized controlled trial. [ABSTRACT FROM AUTHOR]

Purpose: This paper advocates for the inclusion of patient perspectives in the diagnosis and treatment of eating disorders (EDs) for ethical, epistemological, and pragmatic reasons. We build upon the ideas of a recent editorial published in this journal. Using EDs as their example, the authors argue against dominant DSM-oriented approaches in favor of an increased focus on understanding patients’ subjective experiences. We argue that their analysis stops too soon for the development of practical—and actionable—insights into how to effect the integration of first-person and third-person accounts of EDs. Methods: Contextual analysis was used to make the case for patient perspectives. Results: We use anorexia nervosa (AN) as an example to demonstrate how the integration of patient manifestations and voices offers a promising methodology to improve patient diagnosis and treatment. We suggest that Acceptance and Commitment Therapy (ACT) can support patients with AN by reconciling their values with the values that arise from a clinician’s duty of care. Conclusions: We conclude that there are no good scientific reasons to exclude first-person perspectives of EDs in psychiatry. Level of evidence: Level V: Opinions based on clinical experience. [ABSTRACT FROM AUTHOR]

Abstract Background Vaccination uptake is a complex behavior, influenced by numerous factors. Behavioral science theories are commonly used to explain the psychosocial determinants of an individual’s health behavior. This study examined the behavioural, cognitive, and emotional determinants of COVID-19 vaccination intention based on well-established theoretical models: Acceptance and Commitment Therapy (ACT), Capability, Opportunity, Motivation, and Behaviour (COM-B) and the Health Belief Model (HBM). Additionally, it examined the mediating role of institutional trust in the relationship between determinants of these models and vaccination intentions. Methods A cross-sectional study was conducted from January to May 2022, where university students in Cyprus completed an online survey. Results A total of 484 university students completed the online survey, with 23.8% reporting being vaccinated with fewer than three vaccination doses and/or no intention to vaccinate further. Hierarchical logistic regression analysis showed that higher scores in institutional trust, perceived severity, motivation, physical and psychological capability were significantly associated with higher odds of intending to vaccinate. Higher psychological flexibility and not being infected with COVID-19 were also associated with higher odds of vaccination intention, but not in the final model when all determinants were included. Additionally, significant indirect effects of psychological and physical capability, motivation and perceived severity on vaccination intention were found to be mediated by institutional trust. Conclusions When tackling COVID-19 vaccination hesitancy, behavioural, cognitive, and emotional aspects should be considered. Stakeholders and policymakers are advised to implement targeted vaccination programs in young people while at the same time building trust and improving their capabilities and motivation towards getting vaccinated.

The present study was to investigate the efficacy of acceptance and commitment therapy in the context of infertile women’s emotional expression and sexual function. The study was a quasi-experimental design with pretest-posttest and control group design, with a two-month follow-up period. The statistical population included infertile women who submitted referrals to the infertility clinics at Mother and Child Hospital and Samar infertility clinic in Shiraz during the winter of 2021. The experimental and control groups were randomly assigned to 36 infertile women who were selected through the voluntary sampling procedure. Over the course of two and a half months, the experimental group was subjected to ten sessions of acceptance and commitment therapy. In this study, the Emotional Expression Questionnaire (EEQ) (King, Emmons, 1990) and the Sexual Function Questionnaire (Keraskian, Mojembari, and Kaiballah, 2014) were implemented. The SPSS23 software was used to analyze the collected data using mixed ANOVA. The findings indicated that acceptance and commitment therapy has a substantial impact on the emotional expression and sexual function of infertile women (p

Background: Many single-parent or parentless individuals tend to engage in social misconduct due to family and community incompetence and lack of support. The present study investigated the effectiveness of acceptance and commitment therapy on the self-control of single-parent high school students in Kerman, Iran.Methods: This was a quasi-experimental study with a pretest-posttest design and a control group. The study population were single-parent high school students in Kerman, Iran in the academic year 2023-2024. A total number of 30 participants were selected through convenience sampling and randomly divided into two groups of 15. First, all participants completed the Tangney Self-Control Scale (SCS) as a pre-test measure. The experimental group underwent eight sessions of acceptance and commitment therapy, while the control group did not receive any intervention. Then, the research instruments were applied as a post-test measure. Data analysis was conducted using SPSS version 25, particularly for univariate analysis of covariance.Results: There was a significant difference in self-control at the post-test stage between the two groups of Acceptance and commitment therapy and the control group, even after accounting for the pre-test scores (P=0.003). Additionally, the data revealed a significant contrast in self-control improvement from the pre-test to the post-test stage within the acceptance and commitment therapy group (P=0.002). However, no notable change was observed in self-control in the control group throughout the study (P=0.484). Furthermore, no significant difference was found between the pre-test and post-test stages in the control group (P=0.233).Conclusions: According to our results, Acceptance and Commitment Therapy (ACT) is effective in improving self-control among single-parent high school students in Kerman, Iran. Thus, ACT is recommended in counseling and psychotherapy centers, especially for students who lack proper supervision and have only one guardian.

Background: Previous studies have shown that catastrophizing and avoiding pain increase suffering and disability of patients with fibromyalgia (FM). Acceptance and Commitment Therapy (ACT) has demonstrated good results in the treatment of chronic pain. Method: This study applies a group ACT therapy for women with fibromyalgia, focusing on therapeutic components, such as acceptance, defusion, and personal values. An experimental design with control group was used; 57 women diagnosed with FM participated in this study (25 in the ACT group and 32 in the control group). The ACT group received five intervention sessions. Psychological symptoms, perceived health, mindfulness, catastrophic thinking, and cognitive fusion were evaluated at pre- and post-treatment and at six-month follow-up. Results: The results showed that the ACT group had significantly better results in mental health, social role and functioning, anxiety, depression, somatization, and obsession-compulsion, less catastrophic thinking, and improved capacity for mindfulness at six-month follow-up. Conclusions: The results are discussed in the light of previous interventions.

A better understanding of modifiable psychological processes that could reduce pathways to violent radicalization (VR) would greatly aid researchers, providers, policy makers, and individuals at risk for VR. Cognitive fusion, the tendency for behavior to be overly regulated and influenced by one’s thoughts and feelings, and a common intervention target within Acceptance and Commitment Therapy (ACT), may be one such fulcrum. Participants, recruited via gateway snowball sampling, were 233 young adults drawn from five communities in North America as part of Wave 4 of the Somali Youth Longitudinal Study. Utilizing moderation and mediation path analysis in MPlus, the study examined the relations between cognitive fusion, VR, and three important variables associated with VR risk: post traumatic stress symptoms, experiences of daily discrimination, and perceptions of a just government. Findings supported that higher levels of cognitive fusion were directly related to greater openness to VR. Additionally, higher levels of cognitive fusion statistically mediated the link between both daily discrimination and openness to VR as well as between post traumatic stress symptoms and openness to VR. Findings also highlighted that cognitive fusion and perceptions of a just government interacted such that openness to VR was highest in individuals who had low perceptions of a just government and had high levels of cognitive fusion. Results of this study provide preliminary evidence of the potential role of high cognitive fusion in the pathways to VR and further evidence for its potential integration as a target domain within deradicalization efforts.

Abstract Background Hematopoietic cell transplantation (HCT) is a highly invasive and life-threatening treatment for hematological neoplasms and some types of cancer that can challenge the patient’s meaning structures. Restoring meaning (i.e., building more flexible and significant explanations of the disease and treatment burden) can be aided by strengthening psychological flexibility by means of an Acceptance and Commitment Therapy (ACT) intervention. Thus, this trial aims to examine the effect of the ACT intervention on the meaning-making process and the underlying mechanisms of change in patients following HCT compared to a minimally enhanced usual care (mEUC) control group. The trial will be enhanced with a single-case experimental design (SCED), where ACT interventions will be compared between individuals with various pre-intervention intervals. Methods In total, 192 patients who qualify for the first autologous or allogeneic HCT will be recruited for a two-armed parallel randomized controlled trial comparing an online self-help 14-day ACT training to education sessions (recommendations following HCT). In both conditions, participants will receive once a day a short survey and intervention proposal (about 5–10 min a day) in the outpatient period. Double-blinded assessment will be conducted at baseline, during the intervention, immediately, 1 month, and 3 months after the intervention. In addition, 6–9 participants will be invited to SCED and randomly assigned to pre-intervention measurement length (1–3 weeks) before completing ACT intervention, followed by 7-day observations at the 2nd and 3rd post-intervention measure. The primary outcome is meaning-related distress. Secondary outcomes include psychological flexibility, meaning-making coping, meanings made, and well-being as well as global and situational meaning. Discussion This trial represents the first study that integrates the ACT and meaning-making frameworks to reduce meaning-related distress, stimulate the meaning-making process, and enhance the well-being of HCT recipients. Testing of an intervention to address existential concerns unique to patients undergoing HCT will be reinforced by a statistically rigorous idiographic approach to see what works for whom and when. Since access to interventions in the HCT population is limited, the web-based ACT self-help program could potentially fill this gap. Trial registration ClinicalTrials.gov ID: NCT06266182. Registered on February 20, 2024.

Background: Body dysmorphic disorder is the most common disorder among women with breast cancer. In addition to causing problems for these patients, it has created challenges for their families and those around them. Research has shown that treatment based on acceptance and commitment therapy (ACT) can be effective in the field of this disorder. Therefore, research targeting this topic has received less attention. Aims: The present research aimed to assess the effectiveness of Acceptance and Commitment Therapy (ACT) on body image distortion in women with breast cancer. Methods: The present study is a quasi-experimental research with a pre & post -post-test-followup design with the control group. The statistical population of the research was women aged 30 to 50 years old with breast cancer, who had been referred to breast cancer clinics in Shiraz during the first four months of 2022. Among them, 50 people were assigned with available sampling methods in two groups, the experimental and control group (25 patients in each group). ACT treatment interventions according to the training package of Hayes and Strossahl (2010) were performed on the experimental group during 8 weekly 90-minute group sessions, but no intervention was received by the control group. data were collected using the standard questionnaire for metacognition assessment of body deformity (Rabiei, Salahian, Bahrami, and Palahang, 2011). The data of this research were analyzed by the statistical method of analysis of variance with repeated measurement in SPSS software V24. Results: The findings showed that the treatment based on acceptance and commitment therapy significantly affected breast cancer women with body dysmorphic disorder in the experimental group (P< 0.05). Conclusion: According to the findings of this research, it can be concluded that acceptance and commitment therapy (ACT) interventions have been effective in improving the quality of life of women with breast cancer.

Background: Inflammatory bowel disease (IBD) entails physical, psychological, and social burden and holds a significant impact on quality of life. Experiential avoidance, cognitive fusion, shame, and self-criticism have been identified as possible therapeutic targets for improving mental health in people with IBD. Traditional face-to-face psychological therapy continues to provide obstacles for patients seeking assistance. Online psychological therapies centered on acceptance, mindfulness, and compassion have been shown to improve psychological distress in other populations. Objective: This paper presents the study protocol of a two-arm Randomized Controlled Trial (RCT) of an ACT and compassion-based, online intervention -- eLIFEwithIBD - on the improvement of psychological distress, quality of life, work and social functioning, IBD symptom perception, illness-related shame, psychological flexibility, and self-compassion. Methods: The eLIFEwithIBD intervention is an adaptation of the LIFEwithIBD programme (delivered through an in-person group format) and entails an ACT, mindfulness, and compassion-based intervention designed to be delivered as an e-health tool for people with IBD. This protocol outlines the structure and contents of the eLIFEwithIBD intervention. Participants were recruited by an advertisement on the social media platforms of Portuguese Associations for IBD in January 2022. A psychologist conducted a brief interview with 80 patients who were interested in participating. Fifty-five participants were selected and randomly assigned to one of two conditions [experimental group (eLIFEwithIBD + medical TAU; n = 37) or control group (medical TAU; n = 18)]. Outcome measurement took place at baseline, post-intervention, and 4-month followup. All analyses are planned as intent-to-treat (ITT). Results: The eLIFEwithIBD intervention is expected to empower people with IBD by fostering psychological strategies that promote illness adjustment and well-being and prevent subsequent distress. The eLIFEwithIBD aims to gain a novel and better understanding of the role of online contextual behavioral interventions on improving the quality of life and mental health of people with IBD. Clinical Trial Registration: https://classic.clinicaltrials.gov/ct2/show/NCT05405855, NCT05405855. [ABSTRACT FROM AUTHOR]

Background: Given the degenerative nature of the condition, people living with motor neuron disease (MND) experience high levels of psychological distress. The purpose of this research was to investigate the cost‐effectiveness of acceptance and commitment therapy (ACT), adapted for the specific needs of this population, for improving quality of life. Methods: A trial‐based cost–utility analysis over a 9‐month period was conducted comparing ACT plus usual care (n = 97) versus usual care alone (n = 94) from the perspective of the National Health Service. In the primary analysis, quality‐adjusted life years (QALYs) were computed using health utilities generated from the EQ‐5D‐5L questionnaire. Sensitivity analyses and subgroup analyses were also carried out. Results: Difference in costs was statistically significant between the two arms, driven mainly by the intervention costs. Effects measured by EQ‐5D‐5L were not statistically significantly different between the two arms. The incremental cost‐effectiveness was above the £20,000 to £30,000 per QALY gained threshold used in the UK. However, the difference in effects was statistically significant when measured by the McGill Quality of Life‐Revised (MQOL‐R) questionnaire. The intervention was cost‐effective in a subgroup experiencing medium deterioration in motor neuron symptoms. Conclusions: Despite the intervention being cost‐ineffective in the primary analysis, the significant difference in the effects measured by MQOL‐R, the low costs of the intervention, the results in the subgroup analysis, and the fact that ACT was shown to improve the quality of life for people living with MND, suggest that ACT could be incorporated into MND clinical services. [ABSTRACT FROM AUTHOR]

This article explores the influence of Electronic Word of Mouth (e-WoM) and hospital image on hospital patient loyalty, emphasizing the mediating role of patient commitment. Amidst the development of the healthcare industry sector in Indonesia, this study highlighted that e-WoM and hospital image significantly enhanced patient loyalty, with patient commitment playing an important mediating role. This article suggested practical strategies for hospitals, such as improving the quality of healthcare services, leveraging positive e-WoM, and implementing loyalty programs to elevate patient commitment and loyalty. These findings underscore the importance of hospital image and e-WoM in patient retention, providing valuable insights for strategic planning in the context of the healthcare industry. [ABSTRACT FROM AUTHOR]

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The sudden onset of the coronavirus disease led to a rapid expansion of video telehealth to deliver mental healthcare. Although video telehealth was not a new clinical practice, there was limited guidance on how best to modify evidence-based psychotherapies (EBPs) for virtual delivery (a process also referred to as virtualization). The virtualization process for EBPs remains unclear as newly emerging reports on this topic do not consistently report modification decisions. This commentary calls attention to the need to improve documentation practices to allow a greater understanding of modifications needed to maximize the positive effects of EBPs transported to a virtual format. We used the Framework for Reporting Adaptations and Modifications-Expanded (FRAME) to capture details about the nature, process, and outcomes of intervention modifications across a given clinical setting or population. To illustrate the use of the FRAME, we present a case example describing our experiences with transporting a 1-day in-person Acceptance and Commitment Therapy group workshop to a virtual format. Workshop modifications primarily involved changes to the delivery format, administration procedures, and content. The case example walks through how, why, and by whom specific modifications were made as well as the degree to which fidelity was maintained. In the wake of the telemedicine revolution, further investigation into the virtualization process for EBPs is warranted. Improving reporting practices by using the FRAME or a similar adaptation framework will promote a more rigorous study of virtual modifications to EBPs that inform future guidelines and best practices. [ABSTRACT FROM AUTHOR]

Objectives: Increasing psychological flexibility is considered an important mechanism of change in psychotherapy across diagnoses. In particular, Acceptance and Commitment Therapy (ACT) primarily aims at increasing psychological flexibility in order to live a more fulfilling and meaningful life. The purpose of this study is to examine 1) how psychological flexibility changes during an ACT-based treatment in a transdiagnostic day hospital and 2) how this change is related to changes in symptomatology, quality of life, and general level of functioning. Methods: 90 patients of a psychiatric day hospital participated in the study. Psychological flexibility, symptomatology, and quality of life were assessed at three measurement time points (admission, discharge, and 3-month follow-up). The level of functioning was assessed at admission and discharge. Differences in psychological flexibility were tested via two-sided paired samples t-tests. Correlations of residualized change scores were calculated to detect associations between changes in psychological flexibility and other outcomes. Results: Psychological flexibility increased significantly from pre-treatment to posttreatment (d = .43, p <.001) and from pre-treatment to follow-up (d = .54, p <.001). This change was significantly correlated to a decrease in symptomatology (r = .60 --.83, p <.001) and an increase in most dimensions of quality of life (r = -.43 -- -.75, p <.001) and general level of functioning (r =-.34, p = .003). Discussion: This study adds further evidence for psychological flexibility as a transdiagnostic process variable of successful psychotherapy. Limitations are discussed. [ABSTRACT FROM AUTHOR]

ObjectiveMethodsResultsConclusionsThis study explored the extent to which within-patient changes in processes targeted in Acceptance and Commitment Therapy (ACT) and Behavioral Activation Therapy for Depression (BATD) are associated with changes within-patient in pain intensity and depressed mood and evaluated the extent that process-outcome relationships differed between patients.An idiographic analysis embedded within a randomized controlled trial comparing ACT, BATD, and treatment-as-usual (TAU) was conducted to examine the strength of the relationship between outcomes and process variables in patients with chronic low back pain (CLBP) plus depressive symptoms. Based on data from ecological momentary assessment in patients (n = 82), the level of heterogeneity and the pooled effects of these relationships during the intervention period (70 days) were explored.Overall, a high level of heterogeneity was identified in the relationship between pain intensity or depressed mood and psychological inflexibility or behavioral activation. Individual differences in the relationships between outcomes and process variables were identified in individual people during the intervention period. These individual differences appear independent of the group (ACT, BATD, and TAU) and other definable differences (responders/non-responders, completers/non-completers, and clinical depression/non-clinical depression).These findings suggest the potential utility of personalizing psychological interventions according to the therapeutic needs of these patients. [ABSTRACT FROM AUTHOR]

ABSTRACT This study investigated the effectiveness of acceptance and commitment therapy (ACT) compared to treatment as usual in managing psychotic symptoms, emotional dysregulation, recovery and psychological flexibility in inpatients with primary psychoses. The Primary outcome assessed the positive and negative syndrome scale, while the secondary outcomes were to assess difficulties in the emotion regulation scale, recovery assessment scale and acceptance and action questionnaire. An open‐label, two‐arm parallel randomized controlled trial was conducted. Participants diagnosed with primary psychoses were randomly assigned to either the ACT (n = 33) or treatment‐as‐usual (n = 32) group. The intervention included six structured sessions of ACT. ACT significantly reduced psychotic symptoms from 128 to 104 (Z = 5.01) compared to treatment as usual from 130 to 117 (Z = 4.88). Emotional regulation improved significantly in the ACT group from 73 to 55 (Z = 4.835) compared to treatment as usual from 73 to 70 (Z = 2.406). Recovery increased in the ACT group from 50 to 88 (Z = 5.01) compared to treatment as usual from 51 to 61 (Z = 4.93). Psychological flexibility improved in the ACT group from 33 to 25 (Z = 4.98) compared to treatment as usual from 33 to 31 (Z = 4.75). Between‐group differences after intervention were significant for psychotic symptoms, emotional regulation, recovery and psychological flexibility (Z = 2.356, 4.652, 3.881 and 4.453, respectively). Accordingly, the current study demonstrates the effectiveness of ACT in reducing psychotic symptoms and improving emotional regulation, recovery and psychological flexibility in patients with primary psychoses. Integrating ACT into standard care protocols can enhance treatment outcomes, offering a comprehensive approach to managing complex mental health conditions.Trial Registration: ClinicalTrials.gov identifier: NCT06160869 [ABSTRACT FROM AUTHOR]

The challenges of parental cancer while caring for young offspring are often neglected by researchers and healthcare providers. Focusing on parents with cancer, this cross-sectional study examines the mediating and moderating roles of a malleable risk factor, psychological inflexibility, in the relationships between perceived illness severity and parental quality of life (QoL) and family outcomes. Psychological inflexibility was conceptualized using the acceptance and commitment therapy (ACT) framework. A total of 86 parents with cancer caring for young offspring (aged 11–24 years; M = 17.94, SD = 3.68) completed a survey that assessed psychological inflexibility, parental mental and physical health QoL, family outcomes (family functioning, parenting concerns, and openness to discuss cancer), socio-demographics, and illness variables. Mediation analyses indicated that higher perceived illness severity was associated with higher levels of psychological inflexibility, which in turn were related to higher detrimental impacts on parental QoL and family outcomes. Results of moderation analyses were non-significant. Findings highlight the detrimental impacts of illness severity on psychological inflexibility, suggesting that it is a psychosocial risk factor in parents dealing with cancer. ACT-based interventions which foster psychological flexibility are likely to enhance parental QoL and family outcomes. [ABSTRACT FROM AUTHOR]

Propose: This study aimed to propose an innovative, open, and circular program that combines acceptance and commitment therapy (ACT) and mindfulness practices. We assessed its feasibility, acceptability, and first signs of its effect on psychological wellbeing in cancer support treatment. Methods: A single-center, single-arm, uncontrolled study was performed. Forty adult patients with non-metastatic prostate or breast cancer, newly diagnosed or undergoing treatment (chemotherapy, radiotherapy, hormone therapy), were recruited. Three cycles of three MAEva program sessions (MAEva: Mindfulness meditation, Acceptance, and Commitment to values program) over nine consecutive weeks were proposed. During the total of 12 weeks of follow-up, after attending the first session, patients were free to attend subsequent sessions. Results: Adherence to the study was high, with participation in an average of 6.8 out of nine sessions. A total of eight patients attended all sessions over the three cycles, and 90% participated in at least one cycle. Furthermore, attendance was associated with a statistically significant improvement in Quality of Life (QoL). Each additional session was associated with a mean increase in overall QoL score of more than one point (β = 1.09 [0.13; 2.04], p = 0.02). The fatigue dimensions decreased with session attendance: physical (β = -2.24 [-3.63; -0.85]), emotional (β =-2.60 [-4.11;-1.09]), and interference with daily life (β = -2.33 [-3.95;-0.72]). The qualitative section demonstrated that patients learned skills and shared their ability to "let go". Patients rated the degree of importance of the program at 8.36/10 (SD ± 1.64). Conclusion: This study highlights the feasibility and acceptability of an original program that combines ACT and mindfulness practices in cancer patients. Future studies are required to demonstrate the efficacy of the MAEVA program. TheMAEva pilot study is registered with ClinicalTrials.gov under the identifier NCT04751201. [ABSTRACT FROM AUTHOR]

Introduction: Children and adolescents with diabetes face challenges that can significantly impact their quality of life. Investigating psychological interventions for stress management can equip them with the skills needed to cope with type 1 diabetes. This study investigated the impact of a brief Acceptance and Commitment Therapy (ACT) intervention on stress management, diabetes acceptance, psychological flexibility, and patient-doctor relationships among this population. Methods: A total of 55 children, and adolescents from Romania participated in a four-session ACT intervention for type 1 diabetes. The evaluation instruments used were the Perceived Stress Scale for Children (PSS-C), Acceptance and Action Diabetes Questionnaire (AADQ), Children's Psychological Flexibility Questionnaire (CPFQ), and Patient-Doctor Relationship Questionnaire (PDRQ-9). Results: The participants (mean age = 14.14, SD = 2.26; 67% girls) reported lower stress levels, increased acceptance of diabetes, and greater psychological flexibility after the intervention. Additionally, the patient-doctor relationship was enhanced, potentially improving patient adherence to treatment. Positive qualitative feedback mirrored previous ACT research in the paediatric population, highlighting the beneficial role of experiential activities and metaphors when working with this target group. Discussion: This study adds to the growing body of evidence supporting the effectiveness of ACT in enhancing healthy coping strategies among children and adolescents with chronic illnesses. [ABSTRACT FROM AUTHOR]