1.
Acceptance-based therapy: the potential to augment behavioral interventions in the treatment of type 2 diabetes.
Cardel, MI, Ross, KM, Butryn, M, Donahoo, WT, Eastman, A, Dillard, JR, Grummon, A, Hopkins, P, Whigham, LD, Janicke, D
Nutrition & diabetes. 2020;(1):3
Abstract
Diabetes is a complex and multifactorial disease affecting more than 415 million people worldwide. Excess adiposity and modifiable lifestyle factors, such as unhealthy dietary patterns and physical inactivity, can play a significant role in the development of type 2 diabetes. Interventions that implement changes to lifestyle behaviors, in addition to pharmacological treatment, may attenuate the development and worsening of diabetes. This narrative review delineates how standard behavioral interventions (SBTs), based in "first wave" behavioral therapies and "second wave" cognitive behavioral therapies, serve as the foundation of diabetes treatment by supporting effective lifestyle changes, including improving adherence to healthful behaviors, medication, and self-monitoring regimens. Moreover, "third wave" "acceptance-based therapies" (ABTs), which integrate techniques from acceptance and commitment therapy, are proposed as a potential novel treatment option for diabetes management. Further research and long-term, randomized controlled trials will clarify the feasibility, acceptability, and effectiveness of ABT for improving glucose control via enhancing medication adherence and promoting effective lifestyle changes in people with diabetes.
2.
New psychological therapies for irritable bowel syndrome: mindfulness, acceptance and commitment therapy (ACT).
Sebastián Sánchez, B, Gil Roales-Nieto, J, Ferreira, NB, Gil Luciano, B, Sebastián Domingo, JJ
Revista espanola de enfermedades digestivas. 2017;(9):648-657
Abstract
The current goal of treatment in irritable bowel syndrome (IBS) focuses primarily on symptom management and attempts to improve quality of life. Several treatments are at the disposal of physicians; lifestyle and dietary management, pharmacological treatments and psychological interventions are the most used and recommended. Psychological treatments have been proposed as viable alternatives or compliments to existing care models. Most forms of psychological therapies studied have been shown to be helpful in reducing symptoms and in improving the psychological component of anxiety/depression and health-related quality of life. According to current NICE/NHS guidelines, physicians should consider referral for psychological treatment in patients who do not respond to pharmacotherapy for a period of 12 months and develop a continuing symptom profile (described as refractory irritable bowel syndrome). Cognitive behavioral therapy (CBT) is the best studied treatment and seems to be the most promising therapeutic approach. However, some studies have challenged the effectiveness of this therapy for irritable bowel syndrome. One study concluded that cognitive behavioral therapy is no more effective than placebo attention control condition and another study showed that the beneficial effects wane after six months of follow-up. A review of mind/body approaches to irritable bowel syndrome has therefore suggested that alternate strategies targeting mechanisms other than thought content change might be helpful, specifically mindfulness and acceptance-based approaches. In this article we review these new psychological treatment approaches in an attempt to raise awareness of alternative treatments to gastroenterologists that treat this clinical syndrome.
3.
[Acceptance and commitment therapy].
Ducasse, D, Fond, G
L'Encephale. 2015;(1):1-9
Abstract
INTRODUCTION Acceptance and commitment therapy (ACT) is a third generation of cognitive-behavioral therapies. The point is to help patients to improve their psychological flexibility in order to accept unavoidable private events. Thus, they have the opportunity to invest energy in committed actions rather than struggle against their psychological events. OBJECTIVES OF THE STUDY (i) To present the ACT basic concepts and (ii) to propose a systematic review of the literature about effectiveness of this kind of psychotherapy. METHOD (i) The core concepts of ACT come from Monestès (2011), Schoendorff (2011), and Harris (2012); (ii) we conducted a systematic review of the literature using the PRISMA's criteria. The research paradigm was « acceptance and commitment therapy AND randomized controlled trial ». The bases of the MEDLINE, Cochrane and Web of science have been checked. RESULTS Overall, 61 articles have been found, of which, after reading the abstracts, 40 corresponded to the subject of our study. (I) Psychological flexibility is established through six core ACT processes (cognitive defusion, acceptance, being present, values, committed action, self as context), while the therapist emphasizes on experiential approach. (II) Emerging research shows that ACT is efficacious in the psychological treatment of a wide range of psychiatric problems, including psychosis, depression, obsessive-compulsive disorder, trichotillomania, generalized anxiety disorder, post-traumatic stress disorder, borderline personality disorder, eating disorders. ACT has also shown a utility in other areas of medicine: the management chronic pain, drug-dependence, smoking cessation, the management of epilepsy, diabetic self-management, the management of work stress, the management of tinnitus, and the management of multiple sclerosis. Meta-analysis of controlled outcome studies reported an average effect size (Cohen's d) of 0.66 at post-treatment (n=704) and 0.65 (n=580) at follow-up (on average 19.2 weeks later). In studies involving comparison between ACT and active well-specified treatments, the effect size was 0.48 at post (n=456) and 0.62 at follow-up (n=404). In comparisons with waist list, treatment as usual, or placebo treatment, the effect sizes were 0.99 at post (n=248) and 0.71 at follow-up (n=176). Furthermore, ACT studies pointed out learning specific skills, such as decreasing experiential avoidance, increasing cognitive defusion, acceptance and contact with the present moment. Finally, all ACT studies showed an improved quality of life. DISCUSSION The loss of psychological flexibility is the origin of the pain caused by psychiatric disorders and chronic diseases. This is why other studies are needed to investigate ACT's full potential.