A mixed methods exploration of self-help acceptance and commitment therapy for individuals diagnosed with fibromyalgia: a multiple single-case experimental design
Year: 2020
Type: dissertation
Abstract: Objective: Individuals diagnosed with fibromyalgia are reported to have reduced levels of physical activity which is a key focus of treatment guidelines. Acceptance and commitment therapy (ACT) has previously been shown to increase value-consistent behaviour and levels of activity in individuals with other chronic health conditions. Research into ACT for fibromyalgia has so far been limited but has reported a range of positive outcomes. A key aim of this study was to examine levels of activity utilising activity trackers, and to investigate possible relationships between levels of activity and psychological flexibility (a key process in ACT). In addition the study set out to investigate relationships between psychological flexibility, its core processes, and levels of psychological health, functional ability, symptom severity and the overall impact of fibromyalgia, to identify any possible mechanisms of change. Methods: This study utilised a non-concurrent mixed-method case-series design (SCED) to explore the effectiveness of an eight-week supported self-help ACT predicated intervention (delivered via bibliotherapy) for six participants diagnosed with fibromyalgia. Multiple levels of analysis focussed on baseline stability, difference between phases, reliable and clinically significant change, individual and overall effect size. Results: Levels of physical activity were not found to be reduced for this population with no measurable change across the intervention. However, participants reported an increase in meaningful activity. Reliable, clinically significant and beneficial change was shown in psychological flexibility for all participants which was maintained at follow up. Beneficial change was also reported for all participants in psychological distress, functional ability and disorder impact. Symptom severity increased for half of the participants. Conclusions: The ACT self-help intervention appeared to benefit all six participants in terms of increasing psychological flexibility and meaningful activity. However, levels of physical activity did not increase, and the results suggest the levels of activity reported for individuals diagnosed with fibromyalgia require further investigation. The intervention also appeared to benefit the psychological and functional wellbeing of individuals with fibromyalgia although no clear pattern to infer a mechanism of change emerged from the results. The findings of this study are coherent with ACT theory but call into question assumptions about low levels of activity within a fibromyalgia population.
Author: Rainbow, Carla
Institution: University of Nottingham
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W7218185813