Web-Based Acceptance and Commitment Therapy for Depressive Symptoms With Minimal Support

Abstract

Low-intensity interventions for people suffering from depressive symptoms are highly desirable. The aim of the present study was to investigate the outcomes of a web-based acceptance and commitment therapy (ACT)-based intervention without face-to-face contact for people suffering from depressive symptoms. Participants (N = 39) with depressive symptoms were randomly assigned to an Internet-delivered acceptance and commitment therapy (iACT) intervention or a waiting list control condition (WLC). Participants were evaluated with standardized self-reporting measures (Beck Depression Inventory [BDI-II], Symptom Checklist-90 [SCL-90], Acceptance and Action Questionnaire [AAQ-2], Five Facet Mindfulness Questionnaire [FFMQ], Automatic Thoughts Questionnaire [ATQ], and White Bear Suppression Inventory [WBSI]) at pre- and post-measurement. Long-term effects in the iACT group were examined using a 12-month follow-up. The iACT program comprised home assignments, online feedback given by master's-level students of psychology over a 7-week intervention period, and automated email-based reminders. Significant effects were observed in favor of the iACT group on depression symptomatology (between effect sizes [ESs] at post-treatment, iACT/WLC, g = .83), psychological and physiological symptoms (g = .60), psychological flexibility (g = .67), mindfulness skills (g = .53), and frequency of automatic thoughts (g = .57) as well as thought suppression (g = .53). The treatment effects in the iACT group were maintained over the 12-month follow-up period (within-iACT ES: BDI-II, g = 1.33; SCL-90, g = 1.04; ATQF/B [Frequency/Believability], FFMQ, WBSI, AAQ-II, g = .74-1.08). The iACT participants stated that they would be happy to recommend the same intervention to others with depressive symptoms. We conclude that an ACT-based guided Internet-delivered treatment with minimal contact can be effective for people with depressive symptoms.

The Efficacy and Acceptability of Third-Wave Behavioral and Cognitive eHealth Treatments: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…Therapist guidance was provided in eight of these studies (Buhrman et al, 2013;Hesser et al, 2012;Kristjánsdóttir et al, 2013;Lappalainen et al, 2014;Lappalainen, Langrial, Oinas-Kukkonen, Tolvanen, & Lappalainen, 2015;Pots et al, 2015;Trompetter, Bohlmeijer, Veehof, & Schreurs, 2015;Weineland, Arvidsson, Kakoulidis, & Dahl, 2012), the duration FIGURE 1 Flow diagram of study selection. Note.…”

“…Participants rated the treatments as satisfactory (Trompetter et al, 2015;Lappalainen et al, 2014Lappalainen et al, , 2015, enjoyable (Glick & Orsillo, 2015), useful (Kristjánsdóttir et al, 2013), and helpful (Cukrowicz & Joiner, 2007), as measured by the Client Satisfaction Questionnaire (Attkisson & Zwick, 1982), visual analogue scales, and brief questionnaires, respectively. Four studies administered the Credibility/Expectancy Questionnaire (Borkovec & Nau, 1972;Devilly & Borkovec, 2000) and ratings indicated that participants perceived the third-wave eHealth treatments as credible (Kelly & Carter, 2015;Ljótsson et al, 2010;Ly et al, 2014).…”

Applicability of acceptance and commitment therapy-based mobile app in depression nursing

“…The app was originally designed as a toolkit of exercises to (1) teach psychological flexibility through the ACT processes and skills and (2) support learning ACT as a daily habit. Similar methods and exercises had previously been studied in treatment of depression symptoms with web-based interventions [27,28,37,38]. The app was available for the Android platform at the time of the study (September 2013).…”

A Revision of Preventive Web-based Psychotherapies in Subjects at Risk of Mental Disorders

“…Lappaplainen et al 2015 investigated the effectiveness of an internet based ACT intervention in participants with depression symptoms. Conclusions of the study showed a decrease on depression symptoms which maintained through 12-month follow-up compared to the waitlist group [24].…”