Friday, January 21, 2011

Mental Health Promotion as a New Goal in Public Mental Health Care: A Randomized Controlled Trial of an Intervention Enhancing Psychological Flexibility

Within the past few years, I've been coming across more and more studies of time-limited, group interventions of mindfulness and acceptance-based treatments. Recently, a group of Dutch researchers designed and implemented a brief Acceptance and Commitment Therapy (ACT) intervention for people with mild to moderate distress.

From an initial pool of 140, 93 people were randomly assigned to either an ACT and mindfulness intervention (n = 49) or a wait list (n = 44). They completed measures before the intervention, immediately after the intervention, and 3 months after the intervention.

The ACT and mindfulness intervention consisted of eight 2-hour groups with about 7 people each. Facilitators taught each of the 6 core ACT processes, and mindfulness exercises were woven in each session. After the study ended, the wait list participants were allowed to take part in the intervention.

The researchers found that emotional and psychological well-being improved following the intervention. There was no change in social well-being. Psychological flexibility--defined as the ability to move towards meaningful change in the present moment--did not increase immediately after the intervention but showed improvement at the 3-month follow-up. I always find these sort of delayed effects interesting, as it suggests an active intervention beyond the basic group effects. Moreover, improvements in psychological flexibility appeared to impact improvements in mental health.

As the authors acknowledge, a wait list control group is not ideal, as it doesn't eliminate the possibility that improvements were related to the fact that people received eight session of something; that is, it's hard to tell if improvements are unique to the particular intervention. This caveat aside, the study joins a growing body of literature suggesting that comparatively brief, mindfulness-based intervention can have a significant impact on people.

Member of the Association for Contextual Behavioral Science can download the article here.

See below for the full citation:

Fledderus, M., Bohlmeijer, E.T., Smit, F., & Westerhof, G.J. (2010). Mental Health Promotion as a New Goal in Public Mental Health Care: A Randomized Controlled Trial of an Intervention Enhancing Psychological Flexibility. American Journal of Public Health, 100(12), 2372-2378.

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