ABSTRACT
The coronavirus (COVID-19) pandemic is currently a global health threat attributed to negatively affecting the mental health and well-being of people globally. The purpose of the present study is to examine the mediating role of optimism-pessimism and psychological inflexibility in the relationship of coronavirus stress with psychological problems among Turkish adults. The sample of the study included 451 adults (55% women). Participants mainly consisted of young adults with a mean age of 23.30 years, ranging from 18 to 65 years (SD = 6.97). A mediation model indicated that coronavirus stress had a significant predictive effect on optimism-pessimism, psychological inflexibility, and psychological problems. Further, optimism-pessimism and psychological inflexibility mediated the effect of coronavirus stress on psychological problems in adults. Lastly, optimism-pessimism predicted the psychological problems of adults through psychological inflexibility. These results elucidate our understanding of the role of mediators in coronavirus stress and psychological health problems. The findings are useful in terms of providing evidence for tailoring interventions and implementing preventative approaches to mitigate the psychopathological consequences of COVID-19. Based on the present findings, the potential utility of acceptance and commitment therapy is discussed within the context of COVID-19.
ABSTRACT
Despite facing various challenges relating to mental health and often dealing with a highly stressful work environment, physicians often feel as though they cannot readily access mental healthcare services. This is due to an array of elements, such as personality factors, systemic barriers, and cultural issues. While the prevalence of mental health difficulties within a physician population is relatively well researched, very little has been done to address the obstacles to treatment. Physicians are regularly exposed to potentially traumatic experiences and often make morally ambiguous decisions. While highly trained and undeniably competent, no physician is perfect, and medical errors with severe consequences do happen. Further, healthcare systems face unprecedented challenges worldwide due to circumstances following the onset of the Covid-19 pandemic. This manuscript discusses the risk of what is known as Moral Injury in a physician population due to everyday difficulties and the extraordinary circumstances resulting from the Covid-19 pandemic. Subsequently, the discussion is then broadened to propose implementing a form of Acceptance and Commitment Therapy (ACT) as a means of treatment for said Moral Injury. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
ABSTRACT
OBJECTIVES: To examine, in depth, the perspectives of facilitators of a videoconference-delivered group Acceptance Commitment Therapy (ACT) intervention for perinatal women with moderate-severe mood and/or anxiety disorders. DESIGN: Qualitative study. METHODS: Thematic analysis was used to analyse semi-structured interviews with seven facilitators and post-session reflections with six facilitators. RESULTS: Four themes were generated. First, there are barriers to accessing psychological therapies during the perinatal period and improvements are required. Second, COVID-19 has accelerated the provision of remote therapies, including videoconference-delivered group therapy, enabling a continuity of service, and facilitating diversification of treatment access and choice. Third, there are benefits of videoconference-delivered group ACT in the perinatal period, with reservations. Attending a group via videoconference is perceived to be less exposing, and offers normalisation, social support, empowerment, and flexibility. Facilitators also shared reservations including whether service users would prioritise videoconference-delivered group therapy, concerns about limited non-verbal cues and the therapeutic alliance, reporting a lack of an evidence base, and technology challenges when working online. Finally, facilitators offered recommendations for videoconference-delivered group therapy best practice in the perinatal period, including the provision of equipment and data, contracts for attendance and suggestions to maximise engagement and group cohesion. CONCLUSIONS: This study raises important considerations regarding the use of videoconference-delivered group ACT in the perinatal context. There are opportunities afforded by videoconference-delivered group therapies, which is important and timely given the increased drive towards improving access to perinatal services and psychological therapies, and the need for 'COVID-proof' therapies. Recommendations for best practice are offered.
ABSTRACT
Background: As a result of the COVID-19 pandemic and its far-reaching impact, the prevalence of posttraumatic stress disorder (PTSD) symptoms is increasing significantly in China. Yet access to reliable and effective psychological treatment is still limited during the pandemic. The widespread adoption of mobile technologies may provide a new way to address this gap. In this research we will develop an Acceptance and Commitment Therapy (ACT) based intervention delivered by mobile application and will test its usability, efficacy, and mechanism of its effects in relieving PTSD symptoms. Methods: A total of 147 Chinese participants with a diagnosis of PTSD according to the Clinician Administered PTSD Scale (CAPS-5) will be randomly assigned to an intervention group (app-delivered ACT), an active comparison group (app-delivered mindfulness), or a waitlist group. Participants in the intervention group or comparison group will use their respective apps for one month. Online self-report questionnaires will be used to assess the primary outcome of PTSD symptoms and the secondary outcomes symptoms of depression, symptoms of anxiety, and posttraumatic growth. The potential mediating variable to be tested is psychological flexibility and its components. These assessments will be conducted at baseline, at five times during treatment, at the end of treatment, and at 1- and 3-month follow-ups. Discussion: As far as we know, this study is the first randomized controlled trial to investigate the usability, efficacy, and mechanism of an app-delivered ACT intervention for PTSD. Furthermore, the research will assess the effect of treatment in reducing dropout rates, explore effective therapeutic components, and investigate mechanisms of symptom change, which will be valuable in improving the efficacy and usability of PTSD interventions.Trial registration: ChiCTR2200058408.
ABSTRACT
Despite facing various challenges relating to mental health and often dealing with a highly stressful work environment, physicians often feel as though they cannot readily access mental healthcare services. This is due to an array of elements, such as personality factors, systemic barriers, and cultural issues. While the prevalence of mental health difficulties within a physician population is relatively well researched, very little has been done to address the obstacles to treatment. Physicians are regularly exposed to potentially traumatic experiences and often make morally ambiguous decisions. While highly trained and undeniably competent, no physician is perfect, and medical errors with severe consequences do happen. Further, healthcare systems face unprecedented challenges worldwide due to circumstances following the onset of the Covid-19 pandemic. This manuscript discusses the risk of what is known as Moral Injury in a physician population due to everyday difficulties and the extraordinary circumstances resulting from the Covid-19 pandemic. Subsequently, the discussion is then broadened to propose implementing a form of Acceptance and Commitment Therapy (ACT) as a means of treatment for said Moral Injury. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
ABSTRACT
The overarching objective of this study was to investigate the impact of individual psychological flexibility (PF) based on three fundamental constructs: secondary trauma, compassion fatigue, and burnout experienced by healthcare workers during the COVID-19pandemic. Data were gathered from healthcare workers in the United States in ambulatory community health centers. Participants were drawn from public databases of demographic information, professional and social platforms such as LinkedIn, licensing and professionallistservs, and healthcare organization associations. Data sources included online self-report questionnaires using the AAQ-II and ProQOL. An analysis was conducted to determine if a relationship exists between PF and compassion fatigue (CF), secondary traumatic stress (STS), and burnout. Furthermore, data were reviewed and compiled for healthcare leaders, consultants, policymakers, and other relevant stakeholders to analyze the benefit of developing psychological flexibility as a tool to promote emotional and psychological wellness and resiliency in their staff and organizations. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
ABSTRACT
BACKGROUND: Research and dissemination of smartphone apps to deliver coaching and psychological driven intervention had seen a great surge in recent years. Notably, Acceptance Commitment Therapy (ACT) protocols were shown to be uniquely effective in treating symptoms for both depression and anxiety when delivered through smartphone apps. The aim of this study is to expand on that work and test the suitability of artificial intelligence-driven interventions delivered directly through popular texting apps. OBJECTIVE: This study evaluated our hypothesis that using Kai.ai will result in improved well-being. METHODS: We performed a pragmatic retrospective analysis of 2909 users who used Kai.ai on one of the top messaging apps (iMessage, WhatsApp, Discord, Telegram, etc). Users' well-being levels were tracked using the World Health Organization-Five Well-Being Index throughout the engagement with service. A 1-tailed paired samples t test was used to assess well-being levels before and after usage, and hierarchical linear modeling was used to examine the change in symptoms over time. RESULTS: The median well-being score at the last measurement was higher (median 52) than that at the start of the intervention (median 40), indicating a significant improvement (W=2682927; P<.001). Furthermore, HLM results showed that the improvement in well-being was linearly related to the number of daily messages a user sent (ß=.029; t81.36=4; P<.001), as well as the interaction between the number of messages and unique number of days (ß=-.0003; t81.36=-2.2; P=.03). CONCLUSIONS: Mobile-based ACT interventions are effective means to improve individuals' well-being. Our findings further demonstrate Kai.ai's great promise in helping individuals improve and maintain high levels of well-being and thus improve their daily lives.
ABSTRACT
BACKGROUND: During a global pandemic, it is critical to rapidly deploy a psychological intervention to support the mental health and resilience of highly affected individuals and communities. OBJECTIVE: This is the rationale behind the development and implementation of the Pandemic Acceptance and Commitment to Empowerment Response (PACER) Training, an online, blended, skills building intervention to increase the resilience and well-being of participants while promoting their individual and collective empowerment and capacity building. METHODS: Based on acceptance and commitment therapy (ACT) and social justice-based group empowerment psychoeducation (GEP), we developed the Acceptance and Commitment to Empowerment (ACE) model to enhance psychological resilience and collective empowerment. The PACER program consists of 6 online, interactive, self-guided modules complemented by 6 weekly, 90-minute, videoconference, facilitator-led, group sessions. RESULTS: As of August 2021, a total of 325 participants had enrolled in the PACER program. Participants include frontline health care providers and Chinese-Canadian community members. CONCLUSIONS: The PACER program is an innovative intervention program with the potential for increasing resilience and empowerment while reducing mental distress during the pandemic. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/33495.
ABSTRACT
BACKGROUND: Mild traumatic brain injury (mTBI) is a signature wound of Veterans of operations in Iraq and Afghanistan (i.e., OIF/OEF/OND). Most Veterans with mTBI also experience stress-based psychopathology (e.g., depression, posttraumatic stress disorder) and chronic pain. This combination - referred to as polytrauma - results in detrimental long-term effects on social, occupational, and community reintegration. This study will compare the efficacy of a one-day Acceptance and Commitment Training plus Education, Resources, and Support (ACT+ERS) workshop to a one-day active control group (ERS) on symptoms of distress and social, occupational, and community reintegration. We will also examine mediators and moderators of treatment response. METHODS: This is an ongoing randomized clinical trial. 212 OIF/OEF/OND Veterans with polytrauma are being recruited. Veterans are randomly assigned to a one-day ACT+ERS or a one-day ERS workshop with two individualized booster sessions approximately two- and four-weeks post-workshop. Veterans complete assessments prior to the workshop and again at six weeks, three months, and six months post-workshop. Of note, workshops were converted to a virtual format due to the COVID-19 pandemic. RESULTS: The primary outcomes are symptoms of distress and reintegration; secondary outcomes are post-traumatic stress disorder symptoms and pain interference. Secondary analyses will assess whether changes in avoidance at three months mediate changes in distress and reintegration at six months. CONCLUSION: Facilitating the psychological adjustment and reintegration of Veterans with polytrauma is critical. The results of this study will provide important information about the impact of a brief intervention for Veterans with these concerns.