Evaluation of Acceptance and Commitment Therapy delivered by Psychologists and Non-

Psychologists in Community Adult Mental Health

Dr. Thomas Richardson Principal Clinical Psychologist

(Research Lead)

Mental Health Recovery Teams, Portsmouth

Acceptance and Commitment Therapy (ACT)

Attempts to avoid emotional distress cause many psychological problems

People become very fused with thoughts

Aims to open up/accept emotionsDefuse from thoughts Live in line with values despite problems

Introduction: What is ACT?

ACT part of depression and transdiagnostic pathway

Training:Psychological therapists Non-psychologist practitioners (nurses, OTs, SWs)

●Training delivered by two experts, fortnightly supervision afterwards

●12-16 sessions of individual ACT

ACT in our service

Aims: Determine if ACT effective and if differences in psychologists versus non-psychologists

Case series: measures given pre and post therapy, 3-month follow up.

Method

CORE: Global mental health (I have felt OK about myself)

PHQ-9: Depression (Little pleasure in doing things)

Valued Living Questionnaire: how important values are, how much currently living in line

Cognitive Fusion Questionnaire: (I struggle with my thoughts)

Method: Measures

Statistical analysis● General Linear Model (Mixed Factorial ANOVA)● Time X Clinician● All subscales analysed

● Intent to Treat Analysis● Follow-Up: Last Observation Carried Forward

Method

23 participants so far17 women, 6 men

Recurrent depression most common primary diagnosis, three bipolar disorder

Most had co-morbidity: Anxiety Disorder, Personality Disorder, Physical Health, Alcohol.

One Anorexia and Two Bulimia cases Majority had previous therapy

Sample Characteristics

Statistically significant improvement for:◦CORE: F=17, p<.001

◦ PHQ (Depression): F=19, p<.001

◦ Valued Living: Action: F=5, p<.05

◦Cognitive fusion: F=19, p<.001

Trend for:◦ Valued Living: Importance: F=4, p<.1

Results: Post-Treatment(n=23)

Statistically significant improvement for:◦CORE Total: F=11, p<.01

◦ PHQ (Depression): F=12, p<.01

◦Cognitive fusion: Valued: F=20, p<.05

No improvement for:◦ Valued Living: Importance: F=1, p<.05

◦ Valued Living: Action: F=1, p<.05

Results: Three-Month(n=21)

No significant difference in outcomes between psychologists and non-psychologists

Drop out higher:◦Non-psychologists: 33% (n=4) dropped out◦ Psychologists: 9% (n=1) dropped out

Psychologists took on the more complex cases

Results: By Clinician

ACT effective intervention in our service

Improvements in global mental health, depression, cognitive fusion

Outcomes maintained at follow- up

Higher drop out for non-psychologist staff, but similar outcomes

Conclusions