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Acceptance and Commitment Therapy to Promote Value Attainment Among Individuals with Overweight: a Multiple Baseline Evaluation
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden; Stockholm Cty Council, Stockholm Hlth Care Serv, Stockholm, Sweden; Ctr Psychotherapy Educ & Res, Stockholm, Sweden.
Res & Dev Ctr, Primary Hlth Care, Region Vastra Gotaland, Sweden; Univ Gothenburg, Dept Psychol, Gothenburg, Sweden.
Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
2018 (English)In: Journal of Contextual Behavioral Science, ISSN 2212-1447, Vol. 10, p. 41-49Article in journal (Refereed) Published
Abstract [en]

Although overweight is typically associated with lower quality of life, weight loss in itself does not necessarily improve quality of life. Therefore, there is an increase of studies investigating the effect of Acceptance and Commitment Therapy (ACT) to promote values-based behavior among people with overweight. However, few have evaluated the use of brief self-help interventions with minimal therapist support. The aim of the present study was to evaluate the impact with regard to value attainment related to health and weight related experiential avoidance as well as the acceptability of a self-help intervention based on ACT with therapist support via telephone. A single subject multiple baseline design with temporal staggering and randomization of treatment onset was used. Participants with overweight or obesity (n = 13, 100% women) with a mean age of 42 (SD = 13.79) were recruited through social media. The intervention consisted of a workbook and weekly telephone support during a 3-week treatment period. Primary and secondary outcome measures were collected daily and before, after and at 3-months follow up. Results indicate that the intervention improved daily ratings of value attainment related to health among seven participants and reduced experiential avoidance among five of the participants. Effect sizes for those who improved were medium to large. Remaining participants did not improve with regard to the primary outcomes. Moreover, results indicate that the intervention was associated with acceptable adherence and treatment satisfaction. Future studies are needed in order to understand more about for what types of clients a brief self-help ACT intervention may be helpful to improve values based behavior.

Place, publisher, year, edition, pages
2018. Vol. 10, p. 41-49
National Category
Psychology (excluding Applied Psychology)
Research subject
Psychology
Identifiers
URN: urn:nbn:se:uu:diva-354027DOI: 10.1016/j.jcbs.2018.08.007ISI: 000450806800006OAI: oai:DiVA.org:uu-354027DiVA, id: diva2:1220303
Available from: 2018-06-18 Created: 2018-06-18 Last updated: 2018-12-21Bibliographically approved
In thesis
1. Remote delivery of psychological interventions: Impact and acceptability of preventive strategies to improve risk factors associated with coronary heart disease
Open this publication in new window or tab >>Remote delivery of psychological interventions: Impact and acceptability of preventive strategies to improve risk factors associated with coronary heart disease
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Depression, anxiety and excessive weight are public health concerns that have been associated with an increased risk and worse prognosis of coronary heart disease. Remote delivery of psychological interventions may be an effective preventive strategy to improve these lifestyle-related risk factors as treatment may be delivered to many people at a low cost and reduce stigma related to seeking help. The general contribution of this thesis is to investigate the impact and indicators of treatment acceptability in contexts where this type of delivery may improve access to psychological interventions. The aim of Study I was to investigate whether stigma predicts the intention to seek help via the Internet compared to face to face among undergraduate students (N=267) and primary care patients (N=195). The results indicate that Internet-based interventions may improve intentions to seek help among individuals who are reluctant to seek psychological treatment face to face due to stigma. In Study II, the effect of a guided Internet-based Cognitive Behavior Therapy (iCBT) and Treatment-As-Usual (TAU) was compared to TAU only to reduce symptoms of depression and anxiety among patients with a recent myocardial infarction (N=239) in a randomized controlled trial. The results indicate no difference in symptoms of depression and anxiety between the groups. Study III describe treatment activity among participants allocated to the iCBT intervention in Study II (N=117). Furthermore, user experiences were explored using a semi-structured interview with 21 of these participants. The results indicate overall low treatment activity and different preferences regarding the web-based portal, treatment program and therapist communication. The aim of Study IV was to evaluate the impact and investigate indicators of treatment acceptability of a guided Acceptance and Commitment Therapy (ACT) self-help intervention to improve value attainment related to health and reduce experiential avoidance among individuals with overweight or obesity using a multiple baseline design (N=13). The results indicate that theACT intervention may be an acceptable intervention to improve value attainment related to health and decrease experiential avoidance. In conclusion, the studies in this thesis illustrate several challenges related to the willingness to seek and engage in Internet-based interventions. Furthermore, the results indicate varying responses to the remote delivery of ACT. The principal findings are discussed in relation to methodological limitations. Possible strategies to improve the take-up rates, adherence and treatment satisfaction are suggested as well as areas of future research.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2018. p. 75
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Social Sciences, ISSN 1652-9030 ; 156
Keywords
Depression, anxiety, overweight, obesity, technology-assisted interventions, Cognitive Behavioral Therapy, Acceptance and Commitment Therapy
National Category
Social Sciences
Research subject
Psychology
Identifiers
urn:nbn:se:uu:diva-354028 (URN)978-91-513-0373-4 (ISBN)
Public defence
2018-09-14, Blåsenhus, Betty Pettersson-salen (14:031), Campus Blåsenhus, von Kreamers allé 1A och 1C, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2018-08-22 Created: 2018-06-18 Last updated: 2018-08-28

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Wallin, EmmaDahl, JoAnne

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