Acceptance and Commitment Therapy in Daily Life Training: A Feasibility Study of an mHealth Intervention

BackgroundWith the development of mHealth, it is possible to treat patients in their natural environment. Mobile technology helps to bridge the gap between the therapist’s office and the “real world.” The ACT in Daily Life training (ACT-DL) was designed as an add-on intervention to help patients pra...

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Main Authors: Batink, Tim, Bakker, Jindra, Vaessen, Thomas, Kasanova, Zuzana, Collip, Dina, van Os, Jim, Wichers, Marieke, Germeys, Inez, Peeters, Frenk
Format: Article
Language:English
Published: JMIR Publications 2016-09-01
Series:JMIR mHealth and uHealth
Online Access:http://mhealth.jmir.org/2016/3/e103/
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author Batink, Tim
Bakker, Jindra
Vaessen, Thomas
Kasanova, Zuzana
Collip, Dina
van Os, Jim
Wichers, Marieke
Germeys, Inez
Peeters, Frenk
author_facet Batink, Tim
Bakker, Jindra
Vaessen, Thomas
Kasanova, Zuzana
Collip, Dina
van Os, Jim
Wichers, Marieke
Germeys, Inez
Peeters, Frenk
author_sort Batink, Tim
collection DOAJ
description BackgroundWith the development of mHealth, it is possible to treat patients in their natural environment. Mobile technology helps to bridge the gap between the therapist’s office and the “real world.” The ACT in Daily Life training (ACT-DL) was designed as an add-on intervention to help patients practice with acceptance and commitment therapy in their daily lives. The ACT-DL consists of two main components: daily monitoring using experience sampling and ACT training in daily life. ObjectivesTo assess the acceptability and feasibility of the ACT-DL in a general outpatient population. A secondary objective was to conduct a preliminary examination of the effectiveness of the ACT-DL. MethodsAn observational comparative study was conducted. The experimental group consisted of 49 patients who volunteered for ACT-DL, and the control group consisted of 112 patients who did not volunteer. As part of an inpatient treatment program, both groups received a 6-week ACT training. Participants went home to continue their treatment on an outpatient basis, during which time the experimental group received the 4-week add-on ACT-DL. Acceptability and feasibility of the ACT-DL was assessed weekly by telephone survey. Effectiveness of the ACT-DL was evaluated with several self-report questionnaires ( Flexibility Index Test (FIT-60): psychological flexibility, Brief Symptom Inventory: symptoms, Utrechtse Coping List: coping, and Quality of life visual analog scale (QoL-VAS): quality of life). ResultsMore than three-quarters of the participants (76%) completed the full 4-week training. User evaluations showed that ACT-DL stimulated the use of ACT in daily life: participants practiced over an hour a week (mean 78.8 minutes, standard deviation 54.4), doing 10.4 exercises (standard deviation 6.0) on average. Both ACT exercises and metaphors were experienced as useful components of the training (rated 5 out of 7). Repeated measures ANCOVA did not show significant effects of the ACT-DL on psychological flexibility (P=.88), symptoms (P=.39), avoidant coping (P=.28), or quality of life (P=.15). ConclusionsThis is the first study that uses experience sampling to foster awareness in daily life in combination with acceptance and commitment therapy to foster skill building. Adherence to the ACT-DL was high for an intensive mHealth intervention. ACT-DL appears to be an acceptable and feasible mHealth intervention, suitable for a broad range of mental health problems. However, short-term effectiveness could not be demonstrated. Additional clinical trials are needed to examine both short-term and long-term effects.
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spelling doaj.art-af36955bd36a4d80bd538d92bcdaabbb2022-12-21T23:19:48ZengJMIR PublicationsJMIR mHealth and uHealth2291-52222016-09-0143e10310.2196/mhealth.5437Acceptance and Commitment Therapy in Daily Life Training: A Feasibility Study of an mHealth InterventionBatink, TimBakker, JindraVaessen, ThomasKasanova, ZuzanaCollip, Dinavan Os, JimWichers, MariekeGermeys, InezPeeters, FrenkBackgroundWith the development of mHealth, it is possible to treat patients in their natural environment. Mobile technology helps to bridge the gap between the therapist’s office and the “real world.” The ACT in Daily Life training (ACT-DL) was designed as an add-on intervention to help patients practice with acceptance and commitment therapy in their daily lives. The ACT-DL consists of two main components: daily monitoring using experience sampling and ACT training in daily life. ObjectivesTo assess the acceptability and feasibility of the ACT-DL in a general outpatient population. A secondary objective was to conduct a preliminary examination of the effectiveness of the ACT-DL. MethodsAn observational comparative study was conducted. The experimental group consisted of 49 patients who volunteered for ACT-DL, and the control group consisted of 112 patients who did not volunteer. As part of an inpatient treatment program, both groups received a 6-week ACT training. Participants went home to continue their treatment on an outpatient basis, during which time the experimental group received the 4-week add-on ACT-DL. Acceptability and feasibility of the ACT-DL was assessed weekly by telephone survey. Effectiveness of the ACT-DL was evaluated with several self-report questionnaires ( Flexibility Index Test (FIT-60): psychological flexibility, Brief Symptom Inventory: symptoms, Utrechtse Coping List: coping, and Quality of life visual analog scale (QoL-VAS): quality of life). ResultsMore than three-quarters of the participants (76%) completed the full 4-week training. User evaluations showed that ACT-DL stimulated the use of ACT in daily life: participants practiced over an hour a week (mean 78.8 minutes, standard deviation 54.4), doing 10.4 exercises (standard deviation 6.0) on average. Both ACT exercises and metaphors were experienced as useful components of the training (rated 5 out of 7). Repeated measures ANCOVA did not show significant effects of the ACT-DL on psychological flexibility (P=.88), symptoms (P=.39), avoidant coping (P=.28), or quality of life (P=.15). ConclusionsThis is the first study that uses experience sampling to foster awareness in daily life in combination with acceptance and commitment therapy to foster skill building. Adherence to the ACT-DL was high for an intensive mHealth intervention. ACT-DL appears to be an acceptable and feasible mHealth intervention, suitable for a broad range of mental health problems. However, short-term effectiveness could not be demonstrated. Additional clinical trials are needed to examine both short-term and long-term effects.http://mhealth.jmir.org/2016/3/e103/
spellingShingle Batink, Tim
Bakker, Jindra
Vaessen, Thomas
Kasanova, Zuzana
Collip, Dina
van Os, Jim
Wichers, Marieke
Germeys, Inez
Peeters, Frenk
Acceptance and Commitment Therapy in Daily Life Training: A Feasibility Study of an mHealth Intervention
JMIR mHealth and uHealth
title Acceptance and Commitment Therapy in Daily Life Training: A Feasibility Study of an mHealth Intervention
title_full Acceptance and Commitment Therapy in Daily Life Training: A Feasibility Study of an mHealth Intervention
title_fullStr Acceptance and Commitment Therapy in Daily Life Training: A Feasibility Study of an mHealth Intervention
title_full_unstemmed Acceptance and Commitment Therapy in Daily Life Training: A Feasibility Study of an mHealth Intervention
title_short Acceptance and Commitment Therapy in Daily Life Training: A Feasibility Study of an mHealth Intervention
title_sort acceptance and commitment therapy in daily life training a feasibility study of an mhealth intervention
url http://mhealth.jmir.org/2016/3/e103/
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