Friday, January 28, 2011

A Novel Application of Acceptance and Commitment Therapy for Psychosocial Problems Associated with Multiple Sclerosis

In a previous post, I wrote about an 8-week mindfulness-based intervention for multiple sclerosis. Here's one that's even shorter: it's a one-shot 5-hour workshop.

This study is from Dr. John Forsyth's lab at the University of Albany - SUNY. His lab is also currently investigating the effectiveness of Dr. Forsyth's self-help book, from which some preliminary data looking at mindfulness and self-compassion was recently published.

Dr. Forsyth and another psychologist led a 5-hour Acceptance and Commitment Therapy (ACT) workshop for people with multiple sclerosis (MS). At the end of the workshop, participants were given a CD of various mindfulness exercises and a bunch of worksheets and exercises from the workshop. They also received daily practice logs to track what they did following the workshop. Fifteen people with MS completed a battery as part of the workshop, and 11 completed the battery again 12 weeks later.

According to the authors, MS is the most common cause of neurologic disability in the US. MS is incurable and associated with pain, fatigue, depression, and anxiety.

For a one-short 5-hour workshop, the results are very promising. Depression decreased over time, showing a large effect. (Depression went from the moderate-severe range down to the mild-moderate range.) Although the effect of pain itself did not change, the impact of pain on behavior and mood decreased at follow-up. Mindfulness did not improve, but people reported a reduced tendency to suppress thoughts, which suggests increased mindful acceptance. Lastly, overall quality of life improved at the follow-up. Participants reported practicing exercises from the workshop or listening to the mindfulness CD nearly 3 hours per week, which is pretty good.

Because of the design of the study, the findings are preliminary. With only 15 people, 4 of whom dropped out, it's difficult to know how representative the sample is; however, with such a small sample size, it's impressive the researchers found significant results at all, as the results had to be very strong to be detected. Also, without a comparison group, it's impossible to know if ACT was the active ingredient. The authors acknowledged these weaknesses and others in the paper.

Limitations aside, the results are extremely promising. If a 5-hour group could lead to some pretty strong improvements for people with a painful, incurable disease, this is well worth exploring further. According to the authors, traditional cognitive behavioral treatments have shown mixed results for people with MS, and even the positive results weren't all that impressive. By contrast, this is a short, inexpensive group intervention that may have made a real different in the lives of people with MS.

To download a pdf of the article, click on the citation below:

Sheppard, S.C., Forsyth, J.P., Hickling, E.J., & Bianchi, J.M. (2010). A Novel Application of Acceptance and Commitment Therapy for Psychosocial Problems Associated with Multiple Sclerosis: Results from a Half-Day Workshop Intervention. International Journal of MS Care, 12, 200-206.

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