Developmental trajectories of experiential avoidance and depressive symptoms and association to health behaviors among adolescents during brief guided online acceptance and commitment therapy

Abstract While many children and adolescents experience psychological problems with up to 20 percent estimated to develop a mental health problem, only few receive treatment. Online interventions can help respond to the need of support among young people without requiring considerable resources. However, relatively few studies have examined the efficacy of online interventions for youth and more research is needed to understand individual differences in benefiting from these interventions. The current study sought to examine different developmental trajectories of experiential avoidance and depressive symptoms and their association to health behaviors measured at baseline during a brief gui…

The role of psychological inflexibility in adolescent satisfaction with the educational track and school dropout intentions

This study aimed to obtain novel understanding of the associations between psychological inflexibility and adolescents' engagement with upper secondary studies. The participants were 885 Finnish adolescents (mean age 15.74 at the outset) whose psychological inflexibility was measured with the short form of the Acceptance and Fusion Questionnaire for Youth (AFQ-Y8) in the fall of the final (ninth) grade of basic education. School engagement was measured as satisfaction with the educational track and as school dropout intentions, and they were measured twice in the first study year after the transition to upper secondary education. The results showed that high psychological inflexibility in t…

Predictors of changing patterns of adherence to containment measures during the early stage of COVID-19 pandemic: an international longitudinal study

Abstract Background Identifying common factors that affect public adherence to COVID-19 containment measures can directly inform the development of official public health communication strategies. The present international longitudinal study aimed to examine whether prosociality, together with other theoretically derived motivating factors (self-efficacy, perceived susceptibility and severity of COVID-19, perceived social support) predict the change in adherence to COVID-19 containment strategies. Method In wave 1 of data collection, adults from eight geographical regions completed online surveys beginning in April 2020, and wave 2 began in June and ended in September 2020. Hypothesized pre…

Virtual reality acceptance and commitment therapy intervention for social and public speaking anxiety : A randomized controlled trial

Virtual reality (VR) offers new and flexible ways to provide psychological interventions. The aim of this study was to develop and investigate the effectiveness of a VR intervention based on acceptance and commitment therapy (ACT) for social and public speaking anxiety. ACT is a process-based approach that aims to (a) increase individuals’ abilities to handle difficult emotional and cognitive experiences and (b) develop the motivation required for change to occur. In this study, a sample of university students with social interaction or communication anxiety (N = 76; age M = 24.95, SD = 6.50, 69.7% females) was blindly randomized into a total of 2 h of VR ACT training (VRACT; n = 37) or a w…

Early sudden gains in an acceptance and values-based intervention: Effects on treatment outcome for depression and psychological flexibility

Abstract Objective The aim of this study was to explore early temporal patterns of change in a treatment delivered by novice therapists. We examined if early sudden gains (ESGs) in a six-session acceptance and values-based intervention would produce superior treatment outcomes when compared to slower improvements. Method The temporal patterns of change of 56 clients diagnosed with depression were analyzed. ESGs were defined as reaching the status of recovered or improved in the Reliable Change Index (RCI) (Jacobson & Truax (1991)) classification after two sessions. The group with ESGs was then compared to participants without ESGs for differences in treatment outcome on measures of symptoma…

A dance movement therapy group for depressed adult patients in a psychiatric outpatient clinic: effects of the treatment

We were interested in investigating the effects of dance movement therapy (DMT) in a psychiatric outpatient clinic with patients diagnosed with depression. DMT aims to engage the patients in physical and verbal exploration of their experiences generated in movement based interaction. The assumption was that DMT, which includes both physical engagement as well as emotional and social exploration, would alleviate the mood and psychiatric symptoms. All adult patients (n = 33) included in the study received treatment as usual (TAU). Twenty-one patients participated in a 12-session DMT group intervention, and the remaining 12 patients chose to take TAU only. The majority of the patients suffered…

ACT for sleep - Internet-delivered self-help ACT for sub-clinical and clinical insomnia : A randomized controlled trial

Background: Sleep disturbances are a common health problem. New and more accessible alternatives are needed to improve the availability of psychological treatments for insomnia. - Objective: The aim of the present study was to investigate the effects of a self-help Acceptance and Commitment Therapy-based web-intervention for sleep disturbances. - Method: Participants (N = 86) reporting symptoms of insomnia were randomly assigned to an Internet-delivered ACT (iACT, n = 43) or a control condition (WLC, n = 40) and assessed with standardized self-report measures related to sleep (ISI, BNSQ, ESS, DBAS), psychological symptoms (BDI-II, SCL-90), life satisfaction, and ACT-related processes (AAQ-2…

Does mindfulness-, acceptance-, and value-based intervention alleviate burnout? : A person-centered approach

This study investigated individual differences in changes in burnout symptoms during a brief mindfulness-, acceptance-, and value-based intervention. It also studied whether the changes in burnout were simultaneous with the changes in mindfulness skills. The role of practices and learning experiences in these changes were investigated. The participants were employees of various occupations (n = 105, 80% women, Mage = 48 years). Latent profile analysis was used to investigate the associations between burnout and mindfulness skills during the intervention and a 4-month follow-up period. Six distinct profiles were found that differed in levels and changes of both burnout and mindfulness skills…

Cognitive Insight, Clinical Insight, and Reasoning in Schizophrenia : A Pilot Study in a Forensic Setting

This pilot study of 20 chronically ill male inpatients with schizophrenia and a history of violence investigates the relationships between cognitive insight, clinical insight, reasoning, and symptoms in a forensic setting. The majority (75%) of the patients with schizophrenia made hasty decisions based on a small amount of information (the jumping-to-conclusion bias, JTC). In addition, the data suggested that the more information patients gather, the more clinical insight they have and the less distressed they are by their symptoms. However, neither cognitive nor clinical insight were found to be statistically significantly associated with symptoms. The Beck Cognitive Insight Scale (BCIS) s…

Eating behavior dimensions and 9-year weight loss maintenance : a sub-study of the Finnish Diabetes prevention study

Abstract Background Behavioral processes through which lifestyle interventions influence risk factors for type 2 diabetes (T2DM), e.g., body weight, are not well-understood. We examined whether changes in psychological dimensions of eating behavior during the first year of lifestyle intervention would mediate the effects of intervention on body weight during a 9-year period. Methods Middle-aged participants (38 men, 60 women) with overweight and impaired glucose tolerance (IGT) were randomized to an intensive, individualized lifestyle intervention group (n = 51) or a control group (n = 47). At baseline and annually thereafter until nine years body weight was measured and the Three Factor Ea…

The effectiveness and applicability of different lifestyle interventions for enhancing wellbeing : the study design for a randomized controlled trial for persons with metabolic syndrome risk factors and psychological distress

Background: Obesity and stress are among the most common lifestyle-related health problems. Most of the current disease prevention and management models are not satisfactorily cost-effective and hardly reach those who need them the most. Therefore, novel evidence-based controlled interventions are necessary to evaluate models for prevention and treatment based on self-management. This randomized controlled trial examines the effectiveness, applicability, and acceptability of different lifestyle interventions with individuals having symptoms of metabolic syndrome and psychological distress. The offered interventions are based on cognitive behavioral approaches, and are designed for enhancing…

Physical activity, heart rate variability-based stress and recovery, and subjective stress during a 9-month study period.

The aim of this study was to investigate the association between physical activity (PA) and objective heart rate variability (HRV)-based stress and recovery with subjective stress in a longitudinal setting. Working-age participants (n = 221; 185 women, 36 men) were overweight (body mass index, 25.3–40.1 kg/m2) and psychologically distressed (≥3/12 points on the General Health Questionnaire). Objective stress and recovery were based on HRV recordings over 1–3 work days. Subjective stress was assessed with the Perceived Stress Scale and PA level with a questionnaire. Data were collected at three time points: baseline, 10 weeks post intervention, and at the 36-week follow-up. We adopted a late…

In the shadow of COVID-19: A randomized controlled online ACT trial promoting adolescent psychological flexibility and self-compassion.

Background Although some adolescents managed to cope well with the challenges brought on by the COVID-19 pandemic, the well-being of many was adversely affected due to school closures, distance education, restrictions on gathering with friends, and limited access to mental health services. Many adolescents reported increased anxiety and depression as well as decreased psychological wellbeing due to the pandemic. Consequently, there is a need for psychological support that exceeds the strained resources available to schools to support young people during times of crisis and societal pressure. Objective The present study aimed to explore the effects of an online-delivered ACT intervention to …

Supporting parents of children with chronic conditions: A randomized controlled trial of web-based and self-help ACT interventions

Objective Many parents of children with chronic conditions and developmental disabilities experience high rates of burnout and psychological distress. The aim of the current study was to examine the effects of two differently delivered interventions based on acceptance and commitment therapy (ACT) on symptoms of burnout, depression, quality of life, psychological flexibility, and mindfulness skills. Method A total of 110 parents of children aged 0.8 to 17 years with chronic conditions and developmental disabilities participated in a randomized controlled trial lasting 13 weeks with two intervention groups: (1) an iACT intervention, including three psychologist-led video conferencing session…

Effectiveness of a web-based acceptance and commitment therapy program for adolescent career preparation : A randomized controlled trial

Acceptance and commitment therapy (ACT) programs have rarely been used as tools for promoting adolescents' career preparation. This randomized controlled trial examined the possibility to promote the career preparation of Finnish ninth-grade adolescents (n = 249, 49% females) with a web-based five-week ACT-based online intervention program. Participants were randomly assigned to three conditions, of which two groups received an iACT including support via SMS (iACTface: iACT+two face-to-face sessions; only iACT: iACT with no face-to-face sessions) and the third (control) group received no treatment. The results showed that career-related insecurity decreased as a result of the intervention i…

A Pilot Study of Group Administered Metacognitive Training (MCT) for Schizophrenia Patients in a High-Security Forensic Setting: Subjective Training Success and Health-Related Quality of Life

Metacognitive group training (MCT) for psychosis has showed promising effects on positive symptoms of schizophrenia, even in forensic settings. Its effect on health-related quality of life (HRQOL) or patient perspective of it has not been studied before in violent inpatients. This pilot study investigated the patient perspective of the MCT, assessed the intervention’s effects on HRQOL compared with the control group, and compared the patients’ HRQOL with that of the general population. Twenty male violent inpatients with schizophrenia participated and were randomized to the eight-session MCT or to treatment as usual. The participants’ HRQOL was assessed at baseline, at posttreatment, and 3 …

Mindfulness-, hyväksyntä- ja arvopohjaisen (MIHA) ohjelman vaikuttavuus työuupumusoireiden lievittäjänä : tutkimusyhteenveto Muupu-hankkeesta

Työuupumuksen lievittämiseksi on alettu maailmalla käyttää mindfulness-, hyväksyntä- ja arvopohjaisia (MIHA) -menetelmiä. Muupu-tutkimuksen tarkoituksena oli selvittää, voidaanko uudenlaisella, kahdeksanviikkoisella MIHA- ohjelmalla lievittää työuupumusoireita tehokkaasti. Ohjelma toteutettiin ryhmä- ja verkkointervention yhdistelmänä. Muupu-tutkimuksessa selvitettiin sekä ohjelman vaikuttavuutta että sen vaikutusmekanismeja. 218 tutkittavaa satunnaistettiin kahteen ryhmään: MIHA-interventioryhmään ja tavanomaista tukea (TAV) saavien ryhmään. Tutkimuksessa hyödynnettiin myös pilottiryhmän (n = 24) ja heidän vastinpariensa (n = 24) kyselyvastauksia. Noin 80 % tutkittavista oli naisia, ja yli…

Feasibility of a personal health technology-based psychological intervention for men with stress and mood problems: Randomized controlled pilot trial

BackgroundWork-related stress is a significant problem for both people and organizations. It may lead to mental illnesses such as anxiety and depression, resulting in increased work absences and disabilities. Scalable interventions to prevent and manage harmful stress can be delivered with the help of technology tools to support self-observations and skills training. ObjectiveThe aim of this study was to assess the feasibility of the P4Well intervention in treatment of stress-related psychological problems. P4Well is a novel intervention which combines modern psychotherapy (the cognitive behavioral therapy and the acceptance and commitment therapy) with personal health technologies to deliv…

Does a Mindfulness-, Acceptance-, and Value-Based Intervention for Burnout Have Long-Term Effects on Different Levels of Subjective Well-Being?

This study investigated whether beneficial intervention effects on burnout and mindfulness skills diffuse and facilitate the long-term development of different levels of subjective well-being: experiential (perceived stress), eudaimonic (psychological and social well-being), and evaluative (life satisfaction). Participants were Finnish employees with notable burnout (n = 105, 80% women). The study utilized individual profiles of burnout and mindfulness skills identified in a previous study (Kinnunen, Puolakanaho, Tolvanen, Mäkikangas, & Lappalainen, 2019). The profiles were based on levels and changes in burnout and mindfulness skills during an 8-week intervention and 4-month follow-up. In …

Finnish diabetes‐related quality of life questionnaire for children and adolescents: Reliability and validity

Aim To study the psychometric properties, reliability, and validity of the FinDiab quality of life questionnaire (FDQL), a strength‐oriented quality of life (QOL) questionnaire for children and adolescents with type 1 diabetes (T1D). Methods Participants were 215 youths with T1D (aged 10–17 years). They completed FDQL and comparison questionnaires (KINDL‐R and SDQ). Demographic and disease measures were collected from the participants’ medical records. The questionnaire’s psychometric properties were investigated. Construct validity was studied through principal component analysis using Promax rotation, reliability with alphas, and criterion and convergent validity with correlations between…

Perceptions, motives, and psychological flexibility associated with weight management

Introduction: Overweight people are often able to lose weight with the help of professionals, but majority (about 85 %) of the weight losers fail to maintain behavioral changes that would lead to favorable results in the long term [1‐3]. Studies suggest that obesity treatment failures may reflect motivational and contextual impediments to weight loss, rather than limitations of the behavior change strategies per se [4, 5]. A stronger emphasis on motivational factors within a behavioral weight maintenance program offers promise for improving long-term outcomes. The motivation-focused approach has been shown to be as effective as the successful standard skill-based method in weight maintenanc…

Change in body image among depressed adult outpatients after a dance movement therapy group treatment

Abstract This study reports on the body image of depressed psychiatric outpatients, and the impact thereon of a dance movement therapy (DMT) group. Body image is perceived as a tri-partite construct consisting of image-properties, body-self, and body memory. Depressed patients in an outpatient mental health service participated in a DMT group treatment consisting of twelve 90-min long sessions in groups of 4–7 patients. Patients (N = 18) responded to a structured Body Image Assessment (BIA) before and after the treatment. Initially, the depressed patients’ body image was characterized by fragmentation, distortions, and shallowness of body awareness. The DMT group treatment aimed to offer th…

The Roles of Adherence and Usage Activity in Adolescents' Intervention Gains During Brief Guided Online Acceptance and Commitment Therapy.

OBJECTIVEThis study investigated the roles of adherence and usage activity in adolescents’ (n = 161) gains during a 5-week web intervention program based on acceptance and commitment therapy (ACT).METHODProgram adherence was calculated as adherence percentage in relation to intended usage, whereas completion percentage, usage time, and usage weeks were used as indicators for usage activity. Subjective well-being was measured by self-reported life satisfaction and stress before and after the intervention.RESULTSFirst, regression analysis results showed that higher adherence predicted an increase in life satisfaction during intervention. Second, three subgroups of adolescents were identified …

Temperament and symptoms of stress and depression among adolescents: The mediating role of psychological flexibility

Abstract Background Early appearing temperamental differences and the psychological flexibility skills of individuals are proposed factors influencing stress and depression among adolescents. We test the theoretical assumption that temperament may form a basis for facing the outer world, while the development of psychological flexibility being another such basis and a mediator in well-being outcomes. Methods Using data on 740 adolescents (Mage = 15.7 years, 57% female) assessed at the beginning and end of the final grade of basic education, structural equation modeling (SEM) with mediation analysis was conducted to examine the associations between the key temperament dimensions, changes in …

Managing Depression through a Behavior Change Support System without Face-to-Face Therapy

We present results from a study that examines impact of persuasive reminders and virtual rehearsal on the effectiveness of a Behavior Change Support System. Good Life Compass is a web-based BCSS aimed at supporting people with mild to moderate depression without face-to-face therapy. The content of virtual rehearsal were drawn from Acceptance and Commitment Therapy. Eligible participants were randomized into an intervention study and a control wait-list group. In this paper, both groups shall be reported as intervention group 1 and 2 respectively. For data collection, we employed semi-structured questionnaires and post-study interviews. As a result, participants acknowledged persuasive remi…

High perceived stress is associated with unfavorable eating behavior in overweight and obese Finns of working age

Stress-related eating may be a potential factor in the obesity epidemic. Rather little is known about how stress associates with eating behavior and food intake in overweight individuals in a free-living situation. Thus, the present study aims to investigate this question in psychologically distressed overweight and obese working-aged Finns. The study is a cross-sectional baseline analysis of a randomized controlled trial. Of the 339 study participants, those with all the needed data available (n = 297, 84% females) were included. The mean age was 48.9 y (SD = 7.6) and mean body mass index 31.3 kg/m(2) (SD = 3.0). Perceived stress and eating behavior were assessed by self-reported questionn…

Empowering citizens for well-being and chronic disease management with wellness diary.

Chronic conditions closely related to lifestyles are the major cause of disability and death in the developed world. Behavior change is the key to managing well-being and preventing and managing chronic diseases. Wellness diary (WD) is a mobile application designed to support citizens in learning about their behavior, and both making and maintaining behavior changes. WD has been found acceptable, useful, and suitable for long-term use as a part of an intervention. When used independently, however, it does not seem to have enough engaging and motivating features to support adoption and long-term commitment. The main improvement needs identified based on a review of WD-related studies were: p…

A concept to empower self-management of psychophysiological wellbeing: preliminary user study experiences.

In prevention of chronic diseases, health promotion and early interventions based on self-management should be emphasized. Mental health problems and stress cause a significant portion of healthcare costs, and also complicate the management of other chronic conditions. In addition to physical health, psychophysiological and social wellbeing should be equally promoted. Thus, we have previously designed and reported the P4Well or Pervasive Personal and PsychoPhysiological management of WELLness concept for working-age citizens. The concept supports the stress and recovery management on a daily basis through improved health management strategies, and combines psychological methods with persona…

Supported Web-Based Acceptance and Commitment Therapy for Older Family Caregivers (CareACT) Compared to Usual Care

Objectives: The objective of the present study was to investigate whether an acceptance and commitment therapy (ACT)-based web-intervention (Group 1, CareACT), or a standardized rehabilitation in a rehabilitation center (Group 2) was effective in enhancing the psychological well-being of family caregivers aged 60 and over compared to support provided by voluntary caregiver associations (Group 3). Methods: Altogether, 149 family caregivers participated in this quasi-experimental study. Primary outcome measure was depression. Secondary outcomes included anxiety, sense of coherence, quality of life, psychological flexibility, experiential avoidance, and thought suppression. The questionnaires …

Cognitive behavioural therapy and mindfulness for stress and burnout : a waiting list controlled pilot study comparing treatments for parents of children with chronic conditions

Background Parents of children with chronic conditions often experience a crisis with serious mental health problems for themselves as a consequence. The healthcare focus is on the children; however, the parents often worry about their children's health and future but are seldom offered any counselling or guidance. Aim The aim of this study was to investigate the effectiveness of two group-based behavioural interventions on stress and burnout among parents of children with chronic conditions. Design, participants and setting After a waiting list control period (n = 28), parents were offered either a cognitive behavioural (CBT, n = 10) or a mindfulness program (MF, n = 9). Results Both inter…

Personal health promotion through personalized health technologies — Nuadu experience

Poor lifestyles — overweight, unhealthy diet, physical inactivity, sleep deprivation, and stress — are significant risk factors to chronic illnesses, which cause majority of the health care costs. Hence, behavioral change towards healthy lifestyles is one of the keys to health care cost containment. Personal health systems (PHS) offer tools to support behavioral change. As health risks, personal needs and preferences vary from an individual to another, personalization of the PHS is needed. In Nuadu project we have developed a PHS integrating several different personal health technologies. This system was studied in a large (N=354) randomized controlled trial where employees with several hea…

Effects of an Online Acceptance and Commitment Therapy Intervention on Children’s Quality of Life

AbstractThe present study examined if an Acceptance and Commitment Therapy (ACT)–based online intervention for parents had indirect effects on their children’s quality of life mediated by changes in parental well-being, psychological flexibility and mindfulness skills. Participants were 74 adults, who either received an ACT-based guided online intervention or were allocated to the wait list control group, and their children (n = 66) who had type 1 diabetes or functional disabilities. Structural equation modeling (SEM) and a bias-corrected bootstrap approach were applied to examine the indirect effects of the treatment on children’s quality of life through changes in parents’ well-being and …

Reducing Stress and Enhancing Academic Buoyancy among Adolescents Using a Brief Web-based Program Based on Acceptance and Commitment Therapy : A Randomized Controlled Trial

Acceptance and commitment therapy programs have rarely been used as preventive tools for alleviating stress and enhancing coping skills among adolescents. This randomized controlled trial examined the efficacy of a novel Finnish web- and mobile-delivered five-week intervention program called Youth COMPASS among a general sample of ninth-grade adolescents (n= 249, 49% females). The intervention group showed a small but significant decrease in overall stress (between-group Cohen’s d = 0.22) and an increase in academic buoyancy (d= 0.27). Academic skills did not influence the intervention gains, but the intervention gains were largest among high-stressed participants. The results suggest that …

Treating Sleep Disorders with an ACT-Based Behavior Change Support System

Suitable duration and appropriate quality of sleep are essential for mental and cognitive wellbeing. Sleep disorders, whether mild or severe, have proven to have adverse effects on general wellbeing. One's quality of life could be disturbed as a consequence of various mental conditions, sleep disorders being one of them. Researchers have started paying attention to designing, implementing and evaluating eHealth interventions to address sleep disorders. In this chapter, we highlight findings from a field study that was conducted to evaluate effect of software features on a Web-based intervention for sleep disorders. Tyyne is a Web-based eHealth intervention that will be repeatedly mentioned …

What happens after five years?: The long-term effects of a four-session Acceptance and Commitment Therapy delivered by student therapists for depressive symptoms

Brief interventions can be viable treatment options worth consideration in addressing the growing need for treatments of subclinical and clinical depressive symptoms. However, there is uncertainty regarding the long-term benefits of these interventions. The aim was to examine the long-term (5-year) effects of a 4-session Acceptance and Commitment Therapy (ACT) intervention for low mood delivered by novice therapists in order to see whether lasting effects could be achieved cost-effectively with four intervention sessions. Originally, 57 self-referred clients were randomized into two groups: an intervention group and a waiting-list control group which received treatment later. The groups wer…

The co-occurrence of nonsuicidal and suicidal self-injurious acts in adult women: A pilot study of similarities and differences

Nonsuicidal self-injury (NSSI) and suicidal self-injury (SSI) co-occur in adults. The purpose of the current study was to examine differences and similarities in NSSI and SSI in adult women with respect to (1) methods used and lethality of methods, (2) intent and impulsivity of act, (3) precipitating events, and (4) consequences. The data consist of variables pertaining to 46 self-injurious acts committed by 16 Finnish female participants and recorded using Suicide Attempt Self-Injury Interviews (SASII). The data were analyzed using variables weighted by the number of acts. This study found several differences as well as similarities between the acts of SSI and those of NSSI: (a) the respec…

Mindfulness skills, psychological flexibility, and psychological symptoms among physically less active and active adults

Abstract Mindfulness skills, psychological flexibility and psychological symptoms were compared among 58 physically less active and 50 physically active adults who were recruited and classified based on their self-reported physical activity. Additionally, this study evaluated the association of objectively measured physical activity with psychological variables. Methods Participants completed questionnaires evaluating their mindfulness skills and psychological flexibility as well as their psychological and depressive symptoms. Physical activity was assessed objectively using an accelerometer for seven consecutive days. Results Based on the self-reported physical activity levels physically a…

Burnout-related ill-being at work : Associations between mindfulness and acceptance skills, worksite factors, and experienced well-being in life

The aim of this paper was to investigate the associations between mindfulness and acceptance (MAA) skills and burnout-related ill-being at work (ILLB) after eliminating the impact of worksite (WS) and general well-being in life (WELLB) factors. The results were derived from data on employees (n = 168) of varying professional backgrounds, who experienced relatively high levels of burnout. Analyses were conducted using structural equation modelling (SEM) and the Cholesky decomposition method, since these allow for the investigation of multiple measures and multiple factors in relation to one another. In relation to ill-being at work, the analyses revealed a general MAA factor as well as a spe…

Additional file 1: of The effects of acceptance and commitment therapy on eating behavior and diet delivered through face-to-face contact and a mobile app: a randomized controlled trial

Table S1. The effects of ACT-based Face-to-face and Mobile interventions on diet quality. (PDF 26Â kb)

Mediators of change in online acceptance and commitment therapy for psychological symptoms of parents of children with chronic conditions : An investigation of change processes

Highlights: Parents of children with chronic conditions can benefit from an ACT web intervention. Cognitive defusion and acting with awareness mediated effects on psychological symptoms. General psychological flexibility did not mediate effects on outcomes. Improving mindfulness skills aid in optimizing treatment effects in online interventions. peerReviewed

Illness perceptions of COVID-19 in Europe: Predictors, impacts and temporal evolution

Objective: Illness perceptions (IP) are important predictors of emotional and behavioral responses in many diseases. The current study aims to investigate the COVID-19-related IP throughout Europe. The specific goals are to understand the temporal development, identify predictors (within demographics and contact with COVID-19) and examine the impacts of IP on perceived stress and preventive behaviors. Methods: This was a time-series-cross-section study of 7, 032 participants from 16 European countries using multilevel modeling from April to June 2020. IP were measured with the Brief Illness Perception Questionnaire. Temporal patterns were observed considering the date of participation and t…

A psychological flexibility -based intervention for burnout : A randomized controlled trial

A novel eight-week program based on Acceptance and Commitment Therapy (ACT) principles was created to alleviate burnout-related ill-being and to enhance well-being. This randomized controlled trial investigated the effectiveness of the program and explored whether changes in psychological flexibility mediated the results of the intervention. The program consisted of structured weekly face-to-face group meetings and daily practices provided via a website. Employees from varying professional backgrounds with burnout (mean age = 47 years, 79% female), who all received usual treatment, 1 were randomized into control (TAU, n = 80, receiving no other support) and ACT + TAU intervention (n = 88, r…

Sleep-time physiological recovery is associated with eating habits in distressed working-age Finns with overweight: secondary analysis of a randomised controlled trial

Background Association of physiological recovery with nutrition has scarcely been studied. We investigated whether physiological recovery during sleep relates to eating habits, i.e., eating behaviour and diet quality. Methods Cross-sectional baseline analysis of psychologically distressed adults with overweight (N = 252) participating in a lifestyle intervention study in three Finnish cities. Recovery measures were based on sleep-time heart rate variability (HRV) measured for 3 consecutive nights. Measures derived from HRV were 1) RMSSD (Root Mean Square of the Successive Differences) indicating the parasympathetic activation of the autonomic nervous system and 2) Stress Balance (SB) indica…

User experiences of a mobile mental well-being intervention among pregnant women

Postnatal depression affects 10 to 15 percent of women after childbirth. Acceptance and commitment therapy (ACT) is associated with better mental well-being and lower levels of depression. Digital ACT solutions enable providing potentially cost-effective access to interventions. This paper reports the user experiences of an ACT-based mobile mental well-being intervention among pregnant women. Twenty-nine mothers were recruited to a 6-month study. Usage rates were collected via usage logs and user experiences via questionnaires and interviews. The total usage time of the application was about 53 min per user. The application was perceived easy to use. The most common barriers of use were: co…

Effects of training on attitudes of psychiatric personnel towards patients who self-injure

Background Improving attitudes of personnel towards self-injurious patients leads to better working alliance and contributes to better patient outcomes. Previous research into the improvement of these attitudes has recorded the need for specific training in evidence-based assessment and treatment of self-injurious patients. Aim The current study describes the attitudes towards self-injurious patients among psychiatric personnel. The study also evaluates the effect of a structured clinical training program on psychiatric personnel's attitudes towards patients who self-injure. It further examines whether age, education, frequency of self-injurious patients contact, and work experience of the …

Flexibility in weight management.

The purpose of the study was to investigate the relationships between changes in flexible vs. rigid restraints of eating during weight management, as well as how changes in the cognitive restraint of eating were related to psychological well-being and flexibility. The data includes information on 49 overweight persons who participated in a weight loss and maintenance (WLM) intervention and a follow-up assessment after 8-9 months. An increase in flexible cognitive restraint during the weight loss intervention was related to better weight loss maintenance and well-being. The more flexible restraint increased during the WLM intervention, the more psychological distress decreased. Moreover, lar…

Challenges in the evolution toward process‐based interventions

The effects of acceptance and commitment therapy on eating behavior and diet delivered through face-to-face contact and a mobile app: a randomized controlled trial

Background Internal motivation and good psychological capabilities are important factors in successful eating-related behavior change. Thus, we investigated whether general acceptance and commitment therapy (ACT) affects reported eating behavior and diet quality and whether baseline perceived stress moderates the intervention effects. Methods Secondary analysis of unblinded randomized controlled trial in three Finnish cities. Working-aged adults with psychological distress and overweight or obesity in three parallel groups: (1) ACT-based Face-to-face (n = 70; six group sessions led by a psychologist), (2) ACT-based Mobile (n = 78; one group session and mobile app), and (3) Control (n = 71; …

Acceptance and Commitment Therapy Using Finnish Sign Language : Training Counselors in Signed ACT for the Deaf. A Pilot Study

This study evaluated the implementation of Acceptance and Commitment Therapy in Finnish Sign Language in a rehabilitation center for deaf people. Sixteen (16) clients and nine (9) staff members participated in this pilot study. Staff members received a brief training in Acceptance and Commitment Therapy (ACT) including 16 h lectures, 15 h supervision, and studying material. Each staff member treated 1–2 clients during 8–10 sessions. As part of the study, several ACT metaphors and exercises were translated into Finnish Sign Language. The study indicated that counselors with limited knowledge of psychological interventions were able to deliver an ACT intervention using Finnish Sign Language a…

Motivators, barriers and strategies of weight management: A cross-sectional study among Finnish adults.

Abstract Background Weight management (WM) is an ongoing global challenge. The purpose of this study was to analyze motivators, barriers, and strategies of WM among Finnish adults. Methods Data were collected in the ‘KULUMA’ (Consumers at the Weight Management Market) project among 667 community-dwelling adults in Eastern and Central Finland (Kuopio and Jyvaskyla). The self-reported questionnaire collected background information and responses to motivators, barriers, and strategy items. Principal component analysis (PCA) was used to extract components of motivators, barriers, and strategies of WM, along with K-means clustering to categorize the participants. Results About 55% of the respond…

Examining the relationship between public speaking anxiety, distress tolerance and psychological flexibility

Public speaking is an important skill for university students to learn and practice as they progress through education and into their careers. However, individuals often avoid facing public speaking, as they lack the skills to cope with the anxiety that arises when speaking in front of others. The current study aimed to investigate the relationship between public speaking anxiety, distress tolerance, and psychological flexibility. A sample of 95 college students completed psychological flexibility measures and self-ratings of public speaking anxiety before and after a public speaking challenge. A behavioral index of public speaking distress tolerance (i.e., speech duration) was also recorde…

Competence and adherence in an acceptance and values-based intervention: Effects on treatment outcome and early changes in depression

Abstract Background The present study investigated competence and adherence in an acceptance- and values-based intervention and their impact on the outcomes of treatment and early changes in depression. Method A total of 74 sessions delivered by novice therapists (n = 37) were rated for overall competence and adherence to treatment manual, as well as for process-specific components of acceptance and commitment therapy (ACT) using the ACT Adherence Scale (Plumb & Vilardaga, 2010). The relationships between (a) competence and adherence, (b) treatment outcome, and (c) early therapeutic changes among patients diagnosed with major depressive disorder (n = 37) were explored. Results Higher compet…

Change in body image among depressed adult outpatients after a dance movement therapy group treatment

This study reports on the body image of depressed psychiatric outpatients, and the impact thereon of a dance movement therapy (DMT) group. Body image is perceived as a tri-partite construct consisting of image-properties, body-self, and body memory. Depressed patients in an outpatient mental health service participated in a DMT group treatment consisting of twelve 90-min long sessions in groups of 4–7 patients. Patients (N = 18) responded to a structured Body Image Assessment (BIA) before and after the treatment. Initially, the depressed patients’ body image was characterized by fragmentation, distortions, and shallowness of body awareness. The DMT group treatment aimed to offer the patient…

Additional file 1 of Predictors of changing patterns of adherence to containment measures during the early stage of COVID-19 pandemic: an international longitudinal study

Additional file 1: Supplementary Table 1. Measures used in the COVID-IMPACT study.

Rehearsing to control depressive symptoms through a behavior change support system

Depressive symptoms are generally coupled with distress and high treatment costs. We present our on-going research on a Web-based behavior change support system, which utilizes Acceptance and Commitment Therapy as a rehearsal tool. We present a summarized account of the research setting, studied persuasive software features, and a brief account of initial data analysis. Our work presents implications on design interventions for mental well-being and human-computer interaction.

Mental Health and Adherence to COVID-19 Protective Behaviors among Cancer Patients during the COVID-19 Pandemic: An International, Multinational Cross-Sectional Study

Simple Summary Whilst information on the impact of COVID-19 on cancer care continues to increase exponentially, little is known about the impact of COVID-19 on the mental health and coping behaviors of cancer patients. This study constitutes a sub-study of a large international survey conducted during the first wave of the pandemic, looking specifically at the impact of COVID-19 on the mental health and protective behaviors of cancer participants, compared to non-cancer participants. It also explored whether cancer participants perceived COVID-19 as a bigger threat compared to their cancer and whether this perception affected their psychological outcomes, such as their perceived level of st…

A brief Acceptance and Commitment Therapy intervention for depression : A randomized controlled trial with 3-year follow-up for the intervention group

Abstract Objective This study examined the outcomes of a brief Acceptance and Commitment Therapy (ACT) intervention for depression delivered by novice therapists. Method Participants (N = 115) were randomized either to the brief (six sessions) ACT or to a waitlist control condition (WLC). Outcomes were assessed with diagnoses of depressive episodes (ICD-10) and questionnaires. Results After the 6-week intervention, diagnostic remission rates were 60% in the ACT and 22% in the control group. Further, 70% of the ACT participants were classified as either recovered or improved. The post-measurement between-group effect size for depression symptoms was large and favored the ACT group (BDI-II, d…

Additional file 2 of Predictors of changing patterns of adherence to containment measures during the early stage of COVID-19 pandemic: an international longitudinal study

Additional file 2: Supplementary Table 2. Number of the participants involved in the study from each country and geographical region.

Psychological flexibility mediates change in intuitive eating regulation in acceptance and commitment therapy interventions

AbstractObjectiveDespite the promising results related to intuitive eating, few studies have attempted to explain the processes encouraging this adaptive eating behaviour. The focus of the present study was on exploring mechanisms of change in intuitive eating and weight in acceptance and commitment therapy (ACT) interventions. Mediation provides important information regarding the treatment processes and theoretical models related to specific treatment approaches. The study investigates whether psychological flexibility, mindfulness skills and sense of coherence mediated the interventions’ effect on intuitive eating and weight.DesignSecondary analysis of a randomized control trial. Mediati…

Mobile diary for wellness management--results on usage and usability in two user studies.

The prevalence of lifestyle-related health problems is increasing rapidly. Many of the diseases and health risks could be prevented or alleviated by making changes toward healthier lifestyles. We have developed the Wellness Diary (WD), a concept for personal and mobile wellness management based on Cognitive-Behavioral Therapy (CBT). Two implementations of the concept were made for the Symbian Series 60 (S60) mobile phone platform, and their usability, usage, and acceptance were studied in two 3-month user studies. Study I was related to weight management and study II to general wellness management. In both the studies, the concept and its implementations were well accepted and considered as…

Added Value of Intangibles for Organizational Innovation

The purpose of this paper is to present the theoretical basis for a measurement and improvement system that will help organizations create a more innovative climate. The role of intangible assets in contributing to organizational innovativeness is clarified within six hypotheses on the basis of a cross-disciplinary literature review combining studies from psychology, human resources management, communication, information technology, and marketing. These factors range from the individual level to interaction with the environment surrounding the organization, and involve (a) individual psychological flexibility, (b) institutional and interpersonal trust, (c) diverse human resources, (d) strat…

A randomized controlled trial protocol for persistent physical symptoms associated with indoor environment or chronic fatigue : Effectiveness of video-based functional case conceptualization and web-program for improving quality of life

IntroductionPersistent physical symptoms (PPS) refer to symptoms that cannot be fully explained by structural bodily pathology or by environmental factors. Their impact on daily functioning varies from mild to severe disability. So far, evidence-based treatments for PPS have resulted in only small to moderate effects. Treatment protocols with a stronger orientation toward personalized approaches are needed to improve the efficacy and applicability of treatment. In this study, we aim to assess the effect of an online individual case conceptualization with web-based program for PPS. This study is conducted among two focus groups: patients with indoor air-related symptoms and patients with chr…

Metacognitive group training for forensic and dangerous non-forensic patients with schizophrenia: A randomised controlled feasibility trial

BACKGROUND: In schizophrenia, the presence of certain cognitive biases has been established. Informed by this, metacognitive training (MCT) has been developed for schizophrenia. There is increasing evidence of its effectiveness with some patients, but its applicability to dangerous patients has not yet been demonstrated. AIMS: Our aim was to test the feasibility of a randomised controlled trial (RCT) of MCT for patients in a high-security hospital setting. METHODS: Twenty of 33 eligible and selected male in-patients with schizophrenia and a history of violence were randomised pairwise to eight sessions of MCT or treatment as usual. Symptom severity and reasoning, according to the jumping to…

Effectiveness of a web-based Acceptance and Commitment Therapy intervention for wellbeing of parents whose children have chronic conditions: A randomized controlled trial

Effectiveness of a web-based acceptance and commitment therapy intervention for wellbeing of parents whose children have chronic conditions : A randomized controlled trial

Nuorten KOMPASSI näyttää tietä, kun stressi käy liian kovaksi

Examining mediators of change in wellbeing, stress, and depression in a blended, Internet-based, ACT intervention for university students

A coach-guided Acceptance and Commitment Therapy (ACT) intervention that uses a blended approach of two face-to-face and five online sessions (iACT; N = 33) has been found to be more effective than a waiting-list control condition (WLC; N = 35) at enhancing the wellbeing of university students while also reducing stress and depression. The present study explored possible mediators of change that may account for the outcomes of the study. Mediation analyses revealed that changes in the non-reactivity subscale of mindfulness mediated changes in wellbeing, depression, and stress in the iACT group. In addition, changes in the sense of coherence subscale of meaningfulness mediated changes in all…

Towards a physically more active lifestyle based on one's own values: study design of a randomized controlled trial for physically inactive adults

Background This randomised controlled trial demonstrates the effectiveness of a value-based intervention program to encourage a physically more active lifestyle among physically inactive adults aged 30 to 50 years. The conceptual framework of the program is based on an innovative behavioural therapy called Acceptance and Commitment Therapy (ACT) that aims to increase an individual’s psychological flexibility and support behaviour change towards a higher quality and more meaningful life. Methods Participants will be randomly allocated to a feedback group (FB) or an Acceptance and Commitment based (ACT + FB) group. Both the groups will receive written feedback about their objectively measured…

A Concept for ICT Assisted Health Promotion in the Occupational Healthcare

Lifestyle related health risks, such as overweight, work stress, and physical inactivity, have become pervasive in most modern societies. These risk factors have a debilitating impact on the well being of citizens and play a major role in the onset of many chronic diseases. As a result, working life is affected due to impaired work ability, decreased productivity, absenteeism, and disability pensions. Lifestyle changes are the key to managing these problems, but they are often difficult to accomplish and maintain. We present a concept for ICT (Information and Communication Technology) assisted health promotion in the occupational healthcare. ICT tools are provided for employees participatin…

Psychological flexibility, occupational burnout and eating behavior among working women

Background: Occupational burnout is associated with diminished psychological flexibility and higher emotional (EE) and uncontrolled eating (UE). Psychological flexibility could be a mediating factor between burnout and eating behaviour. Objectives: To investigate differences in eating behaviour between those with different levels of psychological flexibility, and the association of the interaction between psychological flexibility and occupational burnout with eating behaviour. Design: The participants were working women (n = 263), who took part in the randomized controlled health intervention trial. Analyses were performed in a cross-sectional setting at baseline. Methods: Eating behaviour…

Web-Based Acceptance and Commitment Therapy for Depressive Symptoms With Minimal Support : A Randomized Controlled Trial

Low-intensity interventions for people suffering from depressive symptoms are highly desirable. The aim of the present study was to investigate the outcomes of a web-based acceptance and commitment therapy (ACT)–based intervention without face-to-face contact for people suffering from depressive symptoms. Participants ( N = 39) with depressive symptoms were randomly assigned to an Internet-delivered acceptance and commitment therapy (iACT) intervention or a waiting list control condition (WLC). Participants were evaluated with standardized self-reporting measures (Beck Depression Inventory [BDI-II], Symptom Checklist–90 [SCL-90], Acceptance and Action Questionnaire [AAQ-2], Five Facet Mind…

Nuadu Concept for personal management of lifestyle related health risks

Majority of the health risks and diseases in the modern world are related to lifestyles, e.g., overweight, unhealthy diet, physical inactivity, sleep deprivation, and stress. Behavioral change towards healthy lifestyles is the key to the prevention and management of these risks, but early and efficient interventions are scarcely available. We present the Nuadu Concept, an ICT (Information and Communication Technologies) assisted wellness toolbox for the management of multiple, behavior-originated health risks. The concept is based on psychological models, which provide methods and motivation for behavior change. The individual is considered as the best expert of his/her own wellness. Thus, …

Plasma lipid profile associates with the improvement of psychological well-being in individuals with perceived stress symptoms

Psychological stress is a suggested risk factor of metabolic disorders, but molecular mediators are not well understood. We investigated the association between the metabolic profiles of fasting plasma and the improvement of psychological well-being using non-targeted liquid chromatography-mass spectrometry (LC-MS) platform. The metabolic profiles of volunteers participating in the face-to-face intervention group (n = 60) in a randomised lifestyle intervention were compared to ones of controls (n = 64) between baseline and 36-week follow-up. Despite modest differences in metabolic profile between groups, we found associations between phosphatidylcholines (PCs) and several parameters indicat…

An online guided ACT intervention for enhancing the psychological wellbeing of university students: A randomized controlled clinical trial.

Stress, anxiety and depression are relatively common problems among university students. This study examined whether an online psychological intervention aiming at enhancing the wellbeing of university students could be an effective and practical alternative for meeting the needs of a university population. University students (N = 68; 85% female; 19-32 years old) were randomly assigned to either a guided seven-week online Acceptance and Commitment Therapy (iACT) intervention or a waiting list control condition (WLC). A between-groups pre-post (iACT vs WLC) design with 12-month follow-up for the iACT participants was conducted. The intervention participants were offered two face-to-face mee…

The effectiveness of a five-session workshop on the distress of international students in Finland – a pilot study

The mental health of international students has become a concern, as they face high levels of psychological distress. We designed a five-week acceptance and commitment therapy (ACT) workshop with two additional individual assessment meetings. The intervention aimed at helping international students attending a Finnish university to reduce their symptoms of stress, depression, and anxiety, and enhance skills of psychological flexibility. The post-assessment was conducted seven weeks after the pre-measurement. Using data from 53 participants, an evaluation indicated that statistically and clinically significant reductions in symptoms were observed, and the workshop was well received. Regressi…

A case formulation model for the assessment of psychological problems among deafblind persons

In order to describe and understand possible problems associated with deafblindness we applied a functional analysis case formulation strategy and Functional Analytic Clinical Case Diagrams (FACCD). We collected clinical assessment data from deafblind persons who were experiencing multiple psychological problems as reported by their healthcare professionals. The data were collected after the healthcare professionals were trained in functional analyses and in applying FACCD. The 21 deafblind persons assessed by healthcare professionals were reported to have 3–11 psychological problems. Two case examples are given to illustrate the complexity of a deafblind person's life situation and the fun…

Mental Health Status of Healthcare Workers During the COVID-19 Outbreak

Background: The COVID-19 pandemic is a massive health crisis that has exerted enormous physical and psychological pressure. Mental healthcare for healthcare workers (HCWs) should receive serious consideration. This study served to determine the mental-health outcomes of 1,556 HCWs from 45 countries who participated in the COVID-19 IMPACT project, and to examine the predictors of the outcomes during the first pandemic wave. Methods: Outcomes assessed were self-reported perceived stress, depression symptom, and sleep changes. The predictors examined included sociodemographic factors and perceived social support. Results: The results demonstrated that half of the HCWs had moderate levels of pe…

Measuring Public Speaking Anxiety: Self-report, behavioral, and physiological

Self-reports are typically used to assess public speaking anxiety. In this study, we examined whether self-report, observer report, and behavioral and physiological reactivity were associated with each other during a speech challenge task. A total of 95 university students completed a self-report measure of public speaking anxiety before and after the speech challenge. Speech duration (i.e., behavioral measure), physiological reactivity, as well as speech performance evaluated by the participants and observers were also recorded. The results suggest that self-reported public speaking anxiety predicts speech duration, as well as speech quality, as rated by the participants themselves and ob…

Kokemustieto yhteiskehittämisessä : hyppy asiakaslähtöisyyteen terveyspalveluissa

The Effects of Acceptance and Commitment Therapy (ACT) Intervention on Inflammation and Stress Biomarkers : a Randomized Controlled Trial

Abstract Background Psychological processes can be manifested in physiological health. We investigated whether acceptance and commitment therapy (ACT), targeted on psychological flexibility (PF), influences inflammation and stress biomarkers among working-age adults with psychological distress and overweight/obesity. Method Participants were randomized into three parallel groups: (1) ACT-based face-to-face (n = 65; six group sessions led by a psychologist), (2) ACT-based mobile (n = 73; one group session and mobile app), and (3) control (n = 66; only the measurements). Systemic inflammation and stress markers were analyzed at baseline, at 10 weeks after the baseline (post-intervention), and…

Adolescents’ Stress and Depressive symptoms and Their Associations with Psychological Flexibility before Educational Transition

Introduction: Relatively little is known about individual differences in adolescent psychological flexibility and its associations with symptoms of stress and depression. This study examined different profiles of adolescent stress and depressive symptoms and their associations with developing psychological flexibility before the critical educational transition. Methods: The data were derived from a general sample of 740 Finnish ninth-grade adolescents (Mage = 15.7 years, 57% female) who were assessed twice during the final grade of their basic education. The data were analyzed using growth mixture modeling. Results: Four profiles of stress and depressive symptoms were identified during a sc…

Mechanisms of Smartphone Apps for Cigarette Smoking Cessation: Results of a Serial Mediation Model From the iCanQuit Randomized Trial

Background Engagement with digital interventions is a well-known predictor of treatment outcomes, but this knowledge has had limited actionable value. Instead, learning why engagement with digital interventions impact treatment outcomes can lead to targeted improvements in their efficacy. Objective This study aimed to test a serial mediation model of an Acceptance and Commitment Therapy (ACT) smartphone intervention for smoking cessation. Methods In this randomized controlled trial, participants (N=2415) from 50 US states were assigned to the ACT-based smartphone intervention (iCanQuit) or comparison smartphone intervention (QuitGuide). Their engagement with the apps (primary measure: numb…

Long-term stability of early sudden gains in an acceptance and values-based intervention

Though previous research has extensively reported that sudden gains are associated with superior treatment results, research on the long-term effects and stability of sudden gains is not as consistent. The current study explored the long-term stability of early sudden gains (ESGs) observed in a brief acceptance and values-based intervention for depression provided by novice therapists. The participants were 56 volunteers diagnosed with major depressive disorder. Among the participants, 23% experienced ESGs, i.e. they reached the status of improved or recovered in the Reliable Change Index (RCI; Jacobson & Truax, 1991) classification after only two sessions. The current study examined the le…

Use of a mobile phone diary for observing weight management and related behaviours

We studied self-observations related to weight management recorded with a Wellness Diary application on a mobile phone. The data were recorded by 27 participants in a 12-week study, which included a short weight management lecture followed by independent usage of the Wellness Diary. We studied the validity of self-observed weight, and behavioural changes and weight patterns related to weight management success. Self-observed weight data tended to underestimate pre- and poststudy measurements, but there were high correlations between the measures (r ≥ 0.80). The amount of physical activity correlated significantly with weight loss (r = 0.44) as did different measures representing healthy ch…

Improvements in Mindfulness Facets Mediate the Alleviation of Burnout Dimensions

Abstract Objectives While interventions using mindfulness have been effective in treating burnout, the mechanisms of change need more research. This study investigated which of five mindfulness facets (observing, describing, acting with awareness, non-judging, and non-reacting) mediated the intervention effects on three burnout dimensions (exhaustion, cynicism, and reduced professional efficacy) during an 8-week mindfulness-, acceptance-, and value-based (MAV) intervention and a 10-month follow-up. Methods The participants were a heterogeneous sample of employees suffering from burnout (n = 202, 80% women, mean age = 47.5 years). Latent change score modeling was conducted for each combinati…

Additional file 2: of The effects of acceptance and commitment therapy on eating behavior and diet delivered through face-to-face contact and a mobile app: a randomized controlled trial

Table S2. Standardized estimates (standard error) and p-values for moderated intervention effects. (PDF 27Â kb)

Usage activity, perceived usefulness, and satisfaction in a web-based acceptance and commitment therapy program among Finnish ninth-grade adolescents.

Understanding adolescent usage activity and experiences in web-based psychological intervention programs helps in developing universal programs that can be adopted for promotion of adolescent well-being and prevention of mental health problems. This study examined the usage activity, perceived usefulness (i.e., learning of mindfulness, acceptance and value-related skills), and program satisfaction of 157 Finnish ninth-grade adolescents, who participated in a school-based five-week universal acceptance and commitment therapy web intervention called Youth Compass. Individual and growth environment-related antecedents were measured before the five-week intervention, adolescents' usage activity…

Mobile Mental Wellness Training for Stress Management: Feasibility and Design Implications Based on a One-Month Field Study

Background: Prevention and management of work-related stress and related mental problems is a great challenge. Mobile applications are a promising way to integrate prevention strategies into the everyday lives of citizens. Objective: The objectives of this study was to study the usage, acceptance, and usefulness of a mobile mental wellness training application among working-age individuals, and to derive preliminary design implications for mobile apps for stress management. Methods: Oiva, a mobile app based on acceptance and commitment therapy (ACT), was designed to support active learning of skills related to mental wellness through brief ACT-based exercises in the daily life. A one-month …

Psychological Processes in the Social Interaction and Communication Anxiety of University Students : The Role of Self-Compassion and Psychological Flexibility

University students often experience difficulties in social interactions. The current study examined the role of self-compassion and psychological flexibility among university students (N= 76) reporting high levels of social interaction and communication anxiety. We observed that high social interaction (SIAS) and communication anxiety (PRCA-24) were associated with low levels of self-compassion and psychological flexibility. Upon further investigating the specific predictors for social interaction and communication anxiety, we found that self-judgment, over-identification and openness to experiences were the key components in self-compassion and psychological flexibility, respectively. How…

Additional file 1: of The effects of acceptance and commitment therapy on eating behavior and diet delivered through face-to-face contact and a mobile app: a randomized controlled trial

Table S1. The effects of ACT-based Face-to-face and Mobile interventions on diet quality. (PDF 26Â kb)

Patterns of Psychological Responses among the Public during the Early Phase of COVID-19: A Cross-Regional Analysis

This study aimed to compare the mediation of psychological flexibility, prosociality and coping in the impacts of illness perceptions toward COVID-19 on mental health among seven regions. Convenience sampled online survey was conducted between April and June 2020 from 9130 citizens in 21 countries. Illness perceptions toward COVID-19, psychological flexibility, prosociality, coping and mental health, socio-demographics, lockdown-related variables and COVID-19 status were assessed. Results showed that psychological flexibility was the only significant mediator in the relationship between illness perceptions toward COVID-19 and mental health across all regions (all ps = 0.001–0.021). Seeking …

The Functional Analysis and Functional Analytic Clinical Case Formulation: A Case of Anorexia Nervosa

Predictors of increase in physical activity during a 6-month follow-up period among overweight and physically inactive healthy young adults

Abstract Background/Objective The beneficial effects of physical activity (PA) are well known, but it remains challenging to increase PA among physically inactive and overweight young individuals. The present study aimed to examine how selected psychological and physical characteristics assessed at baseline predict the increase in total PA over a 6-month follow-up among 51 physically inactive and overweight adults (20 women, 31 men; age 26–40 years) who participated in a lifestyle counselling study without supervised PA sessions. Methods Baseline measurements included a questionnaire assessment of sense of coherence and psychological flexibility, heart rate monitoring-based stress/recovery …

Individual differences in processes of lifestyle changes among people with obesity: an acceptance and commitment therapy (ACT) intervention in a primary health care setting

Abstract Aim: To explore what thoughts, feelings, and learning processes were involved in obese participants’ lifestyle change during an acceptance and commitment therapy (ACT) lifestyle intervention delivered in primary health care. Background: Previous studies have revealed that lifestyle interventions are effective at promoting initial weight loss, but reduced weight is often difficult to sustain because of the failure to maintain healthy lifestyle changes. Achieving and maintaining lifestyle changes requires to learn self-regulation skills. ACT-based lifestyle interventions combine many self-regulatory skill factors, and the results from previous studies are promising. Research on the i…

Additional file 2: of The effects of acceptance and commitment therapy on eating behavior and diet delivered through face-to-face contact and a mobile app: a randomized controlled trial

Table S2. Standardized estimates (standard error) and p-values for moderated intervention effects. (PDF 27Â kb)

The Impact of CBT and ACT Models Using Psychology Trainee Therapists

The present study compares the impact of individualized treatment provided by trainee therapists based on a traditional cognitive behavior therapy (CBT) and acceptance and commitment therapy (ACT) model. Fourteen therapists were given initial training in CBT and ACT. Outpatients ( N = 28) were randomized to either approach, with each therapist treating one client within each model, linked to a functional analysis. Clients treated within an ACT model showed better symptom improvement than the CBT clients, despite the fact that students felt initially less knowledgeable about ACT and were more fearful throughout when it was used. CBT improved client self-confidence more rapidly than ACT, and…

Digitaalisen Nuorten Kompassi plus -hyvinvointiohjelman soveltuvuus lukiolaisille

Psyykkinen hyvinvointi on kulmakivi, johon nuoren oppiminen nojaa; hyvinvointi vaikuttaa merkittävättä tavalla nuoren opintosuoriutumiseen ja työelämävalmiuksien omaksumiseen. Tämä on tiedostettu nykyisessä lainsäädännössä, joka velvoittaa oppilaitoksia vahvistamaan opiskelijoiden hyvinvointia. Tarvitaan tutkittuja, vaikuttavia, helposti saatavilla olevia menetelmiä, jotta voidaan laaja-alaisesti tukea nuorten hyvinvointia erilaisista ammatillisista viitekehyksistä käsin. Jyväskylän yliopiston psykologian laitoksella on kehitetty tähän haasteeseen vastaava Nuorten Kompassi plus -hyvinvointiohjelma, joka perustuu hyväksyntä- ja tietoisuustaitojen harjoitteluun sekä arvotyöskentelyyn. Se toim…

Usage and Dose Response of a Mobile Acceptance and Commitment Therapy App: Secondary Analysis of the Intervention Arm of a Randomized Controlled Trial

Background: Mobile phone apps offer a promising medium to deliver psychological interventions. A mobile app based on Acceptance and Commitment Therapy (ACT) was developed and studied in a randomized controlled trial (RCT). Objective: To study usage metrics of a mobile ACT intervention and dose-response relationship between usage and improvement in psychological flexibility. Methods: An RCT was conducted to investigate the effectiveness of different lifestyle interventions for overweight people with psychological stress. This paper presents a secondary analysis of the group that received an 8-week mobile ACT intervention. Most of the analyzed 74 participants were female (n=64, 86%). Their me…

A guided online ACT intervention may increase psychological well-being and support school engagement in adolescents

Objective The aim of the present study was to investigate the extent to which initial levels and changes in ninth-grade adolescents' (n = 243) psychological well-being were associated with their school engagement after the transition to upper secondary education. In addition, we investigated whether a brief guided online acceptance and commitment therapy (ACT) intervention program delivered during ninth grade was associated with adolescents’ subsequent school engagement through changes in their psychological well-being. Method Latent growth modeling (LGM) was used to examine the levels of and changes in well-being during ninth grade. Next, school engagement (measured by school satisfaction …

Impact of COVID-19 pandemic on mental health : An international study

Background The COVID-19 pandemic triggered vast governmental lockdowns. The impact of these lockdowns on mental health is inadequately understood. On the one hand such drastic changes in daily routines could be detrimental to mental health. On the other hand, it might not be experienced negatively, especially because the entire population was affected. Methods The aim of this study was to determine mental health outcomes during pandemic induced lockdowns and to examine known predictors of mental health outcomes. We therefore surveyed n = 9,565 people from 78 countries and 18 languages. Outcomes assessed were stress, depression, affect, and wellbeing. Predictors included country, sociodemogr…

"Mielimatka on ollut mieluisa matka": Yhdistelmäkuntoutus vs. perinteinen Silmu-kuntoutus mielenterveysongelmiin ja asiakkaiden kokemukset yhdistelmäkuntoutuksesta

Hankkeen tavoitteena oli tutkia verkkopohjaisen, hyväksymis- ja omistautumisterapiamenetelmiin perustuvan yhdistelmämallin eli verkko-ohjelmasta ja kolmesta ryhmämuotoisesta kuntoutusjaksosta koostuvan kuntoutuksen vaikuttavuutta asiakkaiden mielenterveysoireiluun verrattuna Kelan Silmu-mielenterveyskuntoutukseen. Asiakkaat rekrytoitiin lehti-ilmoituksilla kesällä 2017. Tutkimus toteutettiin vuosien 2017–2019 aikana satunnaistetussa kontrolloidussa asetelmassa vertaamalla yhdistelmäkuntoutusryhmää (n = 32) ja perinteistä Silmu-kuntoutusryhmää (n = 27). Yhdistelmäkuntoutusryhmä sai 12 kuukauden kuntoutuksen, johon sisältyi 3 x 2 päivän lähijaksot Peurunka oy:n kuntoutuspalveluissa sekä verkk…

Effectiveness of a web-based acceptance and commitment therapy program for adolescent career preparation: A randomized controlled trial

Abstract Acceptance and commitment therapy (ACT) programs have rarely been used as tools for promoting adolescents' career preparation. This randomized controlled trial examined the possibility to promote the career preparation of Finnish ninth-grade adolescents (n = 249, 49% females) with a web-based five-week ACT-based online intervention program. Participants were randomly assigned to three conditions, of which two groups received an iACT including support via SMS (iACTface: iACT+two face-to-face sessions; only iACT: iACT with no face-to-face sessions) and the third (control) group received no treatment. The results showed that career-related insecurity decreased as a result of the inter…

A four-session acceptance and commitment therapy based intervention for depressive symptoms delivered by masters degree level psychology students: a preliminary study.

Background:Depressive symptoms are one of the main reasons for seeking psychological help. Shorter interventions using briefly trained therapists could offer a solution to the ever-rising need for early and easily applicable psychological treatments.Aims:The current study examines the effectiveness of a four-session Acceptance and Commitment Therapy (ACT) based treatment for self-reported depressive symptoms administered by Masters level psychology students.Method:This paper reports the effectiveness of a brief intervention compared to a waiting list control (WLC) group. Participants were randomized into two groups: ACT (n= 28) and waiting list (n= 29). Long-term effects were examined using…

Subjective stress, objective heart rate variability-based stress, and recovery on workdays among overweight and psychologically distressed individuals: a cross-sectional study

Background: The present study aimed to investigate how subjective self-reported stress is associated with objective heart rate variability (HRV)-based stress and recovery on workdays. Another aim was to investigate how physical activity (PA), body composition, and age are associated with subjective stress, objective stress, and recovery. Methods: Working-age participants (n = 221; 185 women, 36 men) in this cross-sectional study were overweight (body mass index, 25.3-40.1 kg/m(2)) and psychologically distressed (>= 3/12 points on the General Health Questionnaire). Objective stress and recovery were based on HRV recordings over 1-3 workdays. Subjective stress was assessed by the Perceived St…

The role of thought suppression and psychological inflexibility in older family caregivers’ psychological symptoms and quality of life

Abstract Background Family caregivers often report high levels of distress, including depressive symptoms, anxiety, and reduced quality of life. There is a need for a greater understanding of the factors influencing, explaining, and maintaining psychological distress in family caregivers. Aim The aim of this study was to examine whether avoidance strategies such as thought suppression (WBSI), psychological inflexibility (AAQ-II), and, and caregiver experiential avoidance (EACQ) predict psychological distress (BDI-II, GAD-7) and quality of life (WHOQOL) in family caregivers aged 60 and over. We hypothesized that these avoidance strategies would explain elevated levels of psychological sympto…

The Effects of Dance Movement Therapy in the Treatment of Depression: A Multicenter, Randomized Controlled Trial in Finland

This multicenter research investigates the effects of dance movement therapy (DMT) on participants diagnosed with depression. In total, 109 persons participated in the study in various locations in Finland. The participants were 39 years old, on average (range = 18–64 years), and most were female (96%). All participants received treatment as usual (TAU). They were randomized into DMT + TAU (n = 52) or TAU only (n = 57). The participants in the DMT + TAU group were offered 20 DMT sessions twice a week for 10 weeks in addition to standard care. The measurement points included pretreatment measurement at the baseline, posttreatment measurement at the end of the intervention, and a follow-up me…

Can peer-tutored psychological flexibility training facilitate physical activity among adults with overweight?

Objective An increase in psychological flexibility has been found to be associated with health behavior changes. Peer-led interventions have been advantageous in improving physical activity among individuals at health risk. This study aimed to discover whether an ACT-based peer-tutored online intervention can increase self-reported physical activity participation and psychological flexibility among adults with overweight. Design The study was a non-randomized longitudinal intervention study. The intervention participants (N = 177) were primary health care clients with overweight. They participated in a 24-month program provided by health services, including three online modules of ACT of si…

Psychological flexibility and mindfulness explain intuitive eating in overweight adults.

The current study investigated whether mindfulness and psychological flexibility, independently and together, explain intuitive eating. The participants were overweight or obese persons ( N = 306) reporting symptoms of perceived stress and enrolled in a psychological lifestyle intervention study. Participants completed self-report measures of psychological flexibility; mindfulness including the subscales observe, describe, act with awareness, non-react, and non-judgment; and intuitive eating including the subscales unconditional permission to eat, eating for physical reasons, and reliance on hunger/satiety cues. Psychological flexibility and mindfulness were positively associated with intu…

Towards a physically more active lifestyle based on one’s own values: the results of a randomized controlled trial among physically inactive adults

Background The high prevalence of physical inactivity has led to a search for novel and feasible interventions that will enhance physical activity, especially among the least physically active individuals. This randomized controlled trial aimed to determine the effectiveness of a value-based intervention to promote a physically more active lifestyle among physically inactive adults. The framework of the study was based on Acceptance and Commitment Therapy (ACT). Methods Physically inactive participants aged 30 to 50 years (n = 138) were randomly allocated to a feedback (FB, n = 69) or an acceptance- and commitment-based group (ACT + FB, n = 69). Both groups received written feedback about t…

To Help or Not to Help? Prosocial Behavior, Its Association With Well-Being, and Predictors of Prosocial Behavior During the Coronavirus Disease Pandemic

The coronavirus disease (COVID-19) pandemic fundamentally disrupted humans’ social life and behavior. Public health measures may have inadvertently impacted how people care for each other. This study investigated prosocial behavior, its association well-being, and predictors of prosocial behavior during the first COVID-19 pandemic lockdown and sought to understand whether region-specific differences exist. Participants (N = 9,496) from eight regions clustering multiple countries around the world responded to a cross-sectional online-survey investigating the psychological consequences of the first upsurge of lockdowns in spring 2020. Prosocial behavior was reported to occur frequently. Multi…

The Youth Compass -the effectiveness of an online acceptance and commitment therapy program to promote adolescent mental health: A randomized controlled trial

Abstract Purpose Mental health problems affect 10-20% of adolescents worldwide. Prevention and early interventions for promoting adolescent mental health are therefore warranted. The aim of this randomized controlled trial was to examine the effects of a 5-week web-intervention (Youth COMPASS) based on the principles of Acceptance and Commitment Therapy on adolescents’ depressive symptoms, life satisfaction and psychological flexibility. Methods The sample comprised 243 adolescents at the age of 15-16 years (51%females) from 15 lower secondary schools. Participants were randomly assigned to three groups of which two groups received an ACT-based online-intervention including support via What…

ACT Internet-based vs face-to-face? A randomized controlled trial of two ways to deliver Acceptance and Commitment Therapy for depressive symptoms: An 18-month follow-up

The aim of the present study was to investigate two interventions based on Acceptance and Commitment Therapy (ACT) for depressive symptoms: A face-to-face treatment (ACT group) was compared to a guided self-help treatment delivered via the Internet consisting of two assessment sessions (pre and post) and an ACT-based Internet program (iACT). Outpatients experiencing at least mild depressive symptoms were randomized to either approach. The iACT treatment group received access to an ACT-based Internet program and supportive web-based contact over a period of 6 weeks. The face-to-face group received ACT-based treatment once a week over the same period of time. In both groups, the results showe…

P4Well Concept to Empower Self-Management of Psychophysiological Wellbeing and Load Recovery

Chronic health problems related to mental wellbeing are rapidly growing, calling for novel solutions focusing on individual as a psychophysiological being. We describe a novel technology-based concept for empowering citizen towards holistic self-management of her wellbeing: “P4Well” (Pervasive Personal and PsychoPhysiological management of WELLness). The primary focus of the concept is on management of stress and recovery from stress caused by daily life through improved health management strategies. The P4Well concept combines modern psychological methods with personal health technologies. The technologies include a web-portal and web-based tools, mobile phone with mobile client applicatio…