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A Four-Session Acceptance and Commitment Therapy Based Intervention for Depressive Symptoms Delivered by Masters Degree Level Psychology Students: A Preliminary Study

Published online by Cambridge University Press:  11 November 2013

Aino Kohtala*
Affiliation:
University of Jyväskylä, Finland
Raimo Lappalainen
Affiliation:
University of Jyväskylä, Finland
Laura Savonen
Affiliation:
University of Jyväskylä, Finland
Elina Timo
Affiliation:
University of Jyväskylä, Finland
Asko Tolvanen
Affiliation:
University of Jyväskylä, Finland
*
Reprint requests to Aino Kohtala, Department of Psychology, PO Box 35, 40014 University of Jyväskylä, Finland. E-mail: aino.kohtala@gmail.com

Abstract

Background: Depressive symptoms are one of the main reasons for seeking psychological help. Shorter interventions using briefly trained therapists could offer a solution to the ever-rising need for early and easily applicable psychological treatments. Aims: The current study examines the effectiveness of a four-session Acceptance and Commitment Therapy (ACT) based treatment for self-reported depressive symptoms administered by Masters level psychology students. Method: This paper reports the effectiveness of a brief intervention compared to a waiting list control (WLC) group. Participants were randomized into two groups: ACT (n = 28) and waiting list (n = 29). Long-term effects were examined using a 6-month follow-up. Results: The treatment group's level of depressive symptoms (Beck Depression Inventory) decreased by an average of 47%, compared to an average decrease of 4% in the WLC group. Changes in psychological well-being in the ACT group were better throughout, and treatment outcomes were maintained after 6 months. The posttreatment “between-group” and follow-up “with-in group” effect sizes (Cohen's d) were large to medium for depressive symptoms and psychological flexibility. Conclusions: The results support the brief ACT-based intervention for sub-clinical depressive symptoms when treatment was conducted by briefly trained psychology students. It also contributes to the growing body of evidence on brief ACT-based treatments and inexperienced therapists.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2013 

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References

Beck, A. T., Ward, C. H., Mendelson, M., Mock, J. and Erbaugh, J. (1961). An inventory of measuring depression. Archives of General Psychiatry, 4, 561571.CrossRefGoogle ScholarPubMed
Bohlmeijer, E. T., Fledderus, M., Rokx, T. A. and Pieterse, M. E. (2011). Efficacy of an early intervention based on acceptance and commitment therapy for adults with depressive symptomatology: evaluation in a randomized controlled trial. Behaviour Research and Therapy, 49, 6267.CrossRefGoogle ScholarPubMed
Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., et al. (2011). Preliminary psychometric properties of the Acceptance and Action Questionniare–II: a revised measure of psychological flexibility and experiential avoidance. Behavior Therapy, 42, 676688.Google Scholar
Bosc, M., Dubini, A. and Polin, V. (1997). Development and validation of a social functioning scale, the Social Adaptation Self-Evaluation Scale. European Neuropsychopharmacology, 7 (Suppl. 1), 5770.CrossRefGoogle ScholarPubMed
Elovainio, M., Aalto, A., Kivimäki, M., Pirkola, S., Sundvall, J., Lönnqvist, J., et al. (2009). Depression and c-reactive protein: population-based health 2000 study. Psychosomatic Medicine, 71, 423430.Google Scholar
Feske, U. and Chambless, D. L. (1995). Cognitive behavioral versus exposure only treatment for social phobia: a meta-analysis. Behavior Therapy, 26, 695720.Google Scholar
Forand, N. R., Evans, S., Haglin, D. and Fishman, B. (2011). Cognitive behavioral therapy in practice: treatment delivered by trainees at an outpatient clinic is clinically effective. Behavior Therapy, 42, 612623.Google Scholar
Forman, E. M., Herbert, J. D., Moitra, E., Yeomans, P. D. and Geller, P. A. (2007). A randomized controlled effectiveness trial of acceptance and commitment therapy and cognitive therapy for anxiety and depression. Behavior Modification, 31, 772799.CrossRefGoogle ScholarPubMed
Haapala, A-M. (2008). Psykologisen joustavuuden yhteys hoitotulokseen hoidettaessa masennusta kognitiivisella käyttäytymisterapialla ja hyväksymis- ja omistautumisterapialla (Masters Thesis). Retrieved 16 February 2012 from http://tutkielmat.uta.fi/pdf/gradu02384.pdf Google Scholar
Hayes, L., Boyd, C. P. and Sewell, J. (2011). Acceptance and Commitment Therapy for the treatment of adolescent depression: a pilot study in a psychiatric outpatient setting. Mindfulness, 2, 8694.Google Scholar
Hayes, S. C., Barnes-Holmes, D. and Roche, B. (Eds.) (2001). Relational Frame Theory: a post-Skinnerian account of human language and cognition. New York: Kluwer Academic/Plenum Publishers.Google Scholar
Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A. and Lillis, J. (2006). Acceptance and Commitment Therapy: model, processes and outcomes. Behaviour Research and Therapy, 44, 125.CrossRefGoogle ScholarPubMed
Hayes, S. C., Masuda, A., Bissett, R., Luoma, J. and Guerrero, F. L. (2004). DBT, FAP, and ACT: how empirically oriented are the new behavior therapy technologies? Behavior Therapy, 35, 3554.Google Scholar
Hayes, S. C., Strosahl, K. and Wilson, K. G. (2011). Acceptance and Commitment Therapy: an experiential approach to behavior change. New York: Guilford.Google Scholar
Haynes, S. N. and O'Brien, W. H. (2000). Principles and Practice of Behavioral Assessment. New York: Kluwer Academic/Plenum Publishers.CrossRefGoogle Scholar
Holi, M. M., Sammallahti, P. R. and Aalberg, V. A. (1998). A Finnish validation study of SCL-90. Acta Psychiatrica Scandinavica, 97, 4246.Google Scholar
Hollon, S. D. and Ponniah, K. (2010). A review of empirically supported psychological therapies for mood disorders in adults. Depression and Anxiety, 27, 891932.CrossRefGoogle ScholarPubMed
Jacobson, N. S. and Truax, P. (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 1219.Google Scholar
Kessler, R. C., Chiu, W. T., Demler, O., Merikangas, K. R. and Walters, E. E. (2005). Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry, 62, 617627.CrossRefGoogle Scholar
Kessler, R. C., Olfson, M. and Berglund, P. A. (1998). Patterns and predictors of treatment contact after first onset of psychiatric disorders. American Journal of Psychiatry, 155, 6269.CrossRefGoogle ScholarPubMed
Lappalainen, R., Lehtonen, T., Hayes, S., Batten, S., Gifford, E., Wilson, K., et al. (2004). Hyväksymis– ja omistautumisterapia käytännön terapiatyössä. Applying Acceptance and Commitment Therapy (ACT): a clinical manual. Tampere: Suomen Käyttäytymistieteellinen Tutkimuslaitos.Google Scholar
Lappalainen, R., Lehtonen, T., Skarp, E., Taubert, E., Ojanen, M. and Hayes, S. C. (2007). The impact of CBT and ACT models using psychology trainee therapists: a preliminary controlled effectiveness trial. Behavior Modification, 31, 488511.Google Scholar
Morris, S. B. and DeShon, R. P. (2002). Combining effect size estimates in meta-analysis with repeated measures and independent-groups designs. Psychological Methods, 7, 105125.Google Scholar
Ojanen, M. (2000). Effects of illness and adversity on quality of life. In Jobin, J., Maltais, F., LeBlanc, P. and Simard, C. (Eds.), Advances in Cardiopulmonary Rehabilitation (pp. 198210). Champaign, IL: Human Kinetics Press.Google Scholar
Ojanen, M. (2001). Graafiset analogia-asteikot elämänlaadun ja hyvinvoinnin mittauksessa. In Talo, S. (Ed.), Toimintakyky – viitekehyksestä arviointiin ja mittaamiseen (pp. 207225). Turku: KELAn Sosiaali– ja terveysturvan katsauksia, 49.Google Scholar
Ojanen, M. and Seppälä, H. (1997). Assessment of Psychosocial Capabilities of Persons with Developmental Disabilities. Helsinki: Finnish Association on Mental Retardation.Google Scholar
Öst, L. G. (2006). Det empiriska stödet för KBT vid psykiska störningar. In Öst, L. G. (Ed.), Kognitiv beteendeterapi inom psykiatrin. Stockholm: Natur och Kultur.Google Scholar
Öst, L.G., Karlstedt, A. and Widén, S. (2012). The effects of cognitive behavior therapy delivered by students in a psychologist training program: an effectiveness study. Behavior Therapy, 43, 160173.Google Scholar
Roth, A. and Fonagy, P. (1996). What Works for Whom? A critical review of psychotherapy research. London: Guilford Press.Google Scholar
Ruiz, F. J. (2010). A review of Acceptance and Commitment Therapy (ACT) empirical evidence: correlational, experimental psychopathology, component and outcome studies. International Journal of Psychology and Psychological Therapy, 10, 125162.Google Scholar
Westen, D. and Morrison, K. (2001). A multidimensional meta-analysis of treatments for depression, panic, and generalized anxiety disorder: an empirical examination of the status of empirically supported therapies. Journal of Consulting and Clinical Psychology, 69, 875899.Google Scholar
Zettle, R. D. and Hayes, S. C. (1986). Dysfunctional control by client verbal behavior: the context of reason giving. Analysis of Verbal Behavior, 4, 3038.Google Scholar
Zettle, R. D. and Rains, J. C. (1989). Group cognitive and contextual therapies in treatment of depression. Journal of Clinical Psychology, 45, 436445.Google Scholar
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