An Exploratory Mixed-Methods Evaluation of Acceptance and Commitment Therapy for Outpatient Group Treatment of Adolescents
Year: 2017
Type: dissertation
Study design: Clinical Trial
Abstract: Acceptance and commitment therapy (ACT) is a transdiagnostic therapeutic approach that has proven effective for a wide range of psychiatric disorders with adults. There is some evidence suggesting the effectiveness of group-based ACT with adolescents, but the research is limited. This dissertation aims to expand on previous research of group-based ACT with adolescents experiencing heterogeneous anxiety and/or depressive psychiatric disorders in a community hospital outpatient setting. The research consists of two studies using a mixed-methods approach to examine the utility and participants’ experience of group-based ACT. The first study utilized a quantitative methodology to explore treatment effects on symptom amelioration and the therapeutic processes underlying ACT. Seventy-two adolescents participated in this preliminary investigation, and completed outcome and ACT-related process measures at pre, post and three-month follow-up (3MFU) intervals. Repeated measures ANOVAs and pairwise comparisons revealed significant reductions in anxiety and depression symptoms from pre to post, and further significant reductions in symptoms post to 3MFU. There were significant changes in the therapeutic processes of acceptance/defusion, mindfulness and committed action. An investigation of mechanisms of change revealed that change in particular ACT process measures was related to reductions in anxiety and depression symptoms. The second study utilized a qualitative approach to explore adolescents’ experience and better understand the utility of group-based ACT to corroborate and potentially expand on Study 1 results. A subset of 10 adolescents from Study 1 participated in semi-structured interviews at post and 3MFU. Interpretative phenomenological analysis revealed themes of usefulness of treatment, improvements attributed to ACT, non-ACT factors, barriers to treatment use, and treatment within a group context. All participants reported ACT to be a beneficial treatment for emotional difficulties and behavioural functioning, with a few indicating that other factors, in addition to ACT, contributed to improvements. Overall this mixed-methods evaluation provides support for the utility of group-based ACT as a transdiagnostic treatment approach with adolescents. Firm conclusions could not be drawn, however, due to the exploratory nature of this investigation and lack of control or comparison group. Future research is warranted comparing ACT group treatment to control and existing treatments with a similar population across multiple contexts.
Source: TSpace (University of Toronto)
Author: Tajinder Uppal Dhariwal
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W2952526305