Acceptance and commitment therapy group intervention for adolescents with type 1 diabetes: A randomized controlled trial

Alho, Iina; Lappalainen, Päivi; Muotka, Joona; Lappalainen, Raimo

doi:10.1016/j.jcbs.2022.08.002

Cited by 7 publications

(6 citation statements)

References 34 publications

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“…ACT interventions in type 2 diabetes have shown promising results 33. A recent study of an ACT intervention for adolescents with type 1 diabetes showed a significant beneficial effect on HbA1c 62. To our knowledge, this is one of the first RCTs to evaluate the effect of a group-based face-to-face ACT intervention on HbA1c in an adult population.…”

Section: Discussionmentioning

confidence: 90%

“… 33 A recent study of an ACT intervention for adolescents with type 1 diabetes showed a significant beneficial effect on HbA1c. 62 To our knowledge, this is one of the first RCTs to evaluate the effect of a group-based face-to-face ACT intervention on HbA1c in an adult population. We used a longitudinal design with a long-term follow-up period of 2 years, which can enlighten the mechanism of change over time.…”

Section: Discussionmentioning

confidence: 97%

“…Another observed aspect that differentiates the current study from other group-based studies showing HbA1c improvement is the individualised perspective. The intervention in the study by Amsberg et al 48 included individual meetings,25 and Alho et al 62 conducted interviews regarding expectations prior to the intervention 62. Moreover, participants called for more individualisation in a feasibility trial of a web-based ACT programme 34.…”

Section: Discussionmentioning

confidence: 99%

“…65 Reflections have been made regarding the connection between the content of the psychological intervention and diabetes self-management in explaining outcomes in similar studies. 57 62 Gregg et al 53 evaluated the impact of an educational intervention with and without ACT components in type 2 diabetes. 53 The current study did not focus on self-management and did not involve elements of diabetes education, which may have been a disadvantage.…”

Section: Open Accessmentioning

confidence: 99%

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Impact of an Acceptance and Commitment Therapy programme on HbA1c, self-management and psychosocial factors in adults with type 1 diabetes and elevated HbA1c levels: a randomised controlled trial

Wijk,

Amsberg,

Johansson

et al. 2023

BMJ Open

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ObjectiveTo evaluate the impact of an Acceptance and Commitment Therapy (ACT) programme, tailored for people living with type 1 diabetes, on glycated haemoglobin (HbA1c), self-management and psychosocial factors among individuals with HbA1c>60 mmol/mol compared with treatment as usual (TAU).SettingAn endocrinologic clinic in Sweden.ParticipantsIn this randomised controlled trial, 81 individuals with type 1 diabetes, aged 18–70 years with HbA1c>60 mmol/mol, were randomly assigned to either an ACT group intervention or TAU. Exclusion criteria were: unable to speak Swedish, untreated or severe psychiatric disease, cortisone treatment, untreated thyroid disease and newly started insulin pump therapy. At the 2-year follow-up, HbA1c was measured in 26 individuals.InterventionThe ACT programme comprised seven 2-hour sessions held over 14 weeks and focused on acceptance of stressful thoughts and emotions, and to promote value-based committed action.OutcomesThe primary outcome was HbA1c, and the secondary outcomes were measures of depression, anxiety, general stress, fear of hypoglycaemia, diabetes distress, self-care activities, psychological flexibility (general and related to diabetes) and quality of life. The primary endpoint was HbA1c 2 years after the intervention programme. Linear mixed models were used to test for an interaction effect between measurement time and group.ResultsLikelihood ratio test of nested models demonstrated no statistically significant interaction effect (χ2=0.49, p=0.485) between measurement time and group regarding HbA1c. However, a statistically significant interaction effect (likelihood ratio test χ2=12.63, p<0.001) was observed with improved scores on The Acceptance and Action Questionnaire in the intervention group after 1 and 2 years.ConclusionsNo statistically significant difference was found between the groups regarding the primary outcome measure, HbA1c. However, the ACT programme showed a persistent beneficial impact on psychological flexibility in the intervention group. The dropout rate was higher than expected, which may indicate a challenge in this type of study.Trial registration numberNCT02914496.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Open Accessmentioning

confidence: 99%

See 2 more Smart Citations

Impact of an Acceptance and Commitment Therapy programme on HbA1c, self-management and psychosocial factors in adults with type 1 diabetes and elevated HbA1c levels: a randomised controlled trial

Wijk,

Amsberg,

Johansson

et al. 2023

BMJ Open

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“…ACT emphasizes adjusting how someone responds to and tolerates distressing thoughts and emotions, aiming to promote behaviors that align with someone's values, and encouraging a flexible and compassionate approach toward oneself [35]. Limited existing studies of ACT with individuals with T1D have demonstrated preliminary benefits for HbA1c, anxiety, depression, sleep, and psychological flexibility [35,36,45]. These studies did not assess general or diabetes-specific self-compassion, so it is unknown whether ACT's benefits are also associated with increases in self-compassion.…”

Section: Self-compassion and T1d: A Review Of Existing Literaturementioning

confidence: 99%

The Promising Role of Self-Compassion in Managing Type 1 Diabetes

Kaelberer

Tanenbaum

2023

Endocrines

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Given the demanding daily regimen for type 1 diabetes (T1D) and emphasis on personal responsibility for self-management, people with T1D can experience self-criticism and diabetes distress. How an individual responds to and copes with diabetes-related feedback may influence self-care, health outcomes, and overall well-being. Self-compassion in the context of diabetes has limited but promising research on its ability to alleviate distress in people with T1D. This narrative review captures relevant, existing literature on self-compassion, compassion-based interventions, and T1D and describes four topic areas where diabetes-specific self-compassion and compassion-based interventions may be particularly relevant: (1) diabetes technology use; (2) relationship with eating and body image; (3) social interactions; and (4) healthcare interactions. Compassion-based interventions have the potential to enhance positive coping skills and to alleviate diabetes distress; more research is needed to understand the role of diabetes-specific self-compassion and to develop high-quality evidence-based interventions.

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