| 1. |
- Choque Olsson, Nora, et al.
(författare)
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Treatment satisfaction with cognitive-behavioral therapy among children and adolescents with anxiety and depression : A systematic review and meta-synthesis
- 2021
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Ingår i: Journal of Behavioral and Cognitive Therapy. - : Elsevier BV. - 2589-9791. ; 31:2, s. 147-191
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Tidskriftsartikel (refereegranskat)abstract
- Recent reviews estimated that the worldwide prevalence of anxiety and depression in children and adolescents is increasing, which has led to rising demands for treatment. Studies on clinical outcomes have shown positive effects of cognitive-behavioral therapy (CBT) in children and adolescents with anxiety and depression. However, there is a limited body of studies on the perspectives and experiences of the treatment participants. The objective of this review was to investigate treatment satisfaction with CBT among children and adolescents with anxiety and depression. We focused on the reporting quality of the treatment satisfaction and experiences of participants in the selected studies. From 1379 identified studies, 35 were selected based on inclusion and exclusion criteria. The results of a meta-synthesis and proportional meta-analysis suggest moderate to high treatment satisfaction with CBT in depressed and anxious children and adolescents. The included studies showed moderate to good reporting quality on treatment satisfaction. The measurements used varied, indicating a risk of different evaluations under the concept of “treatment satisfaction”. The common topics measured for treatment satisfaction were acceptability, treatment usefulness, alliance, barriers, recommendation, and others, leading to uncertainty concerning generalization. A wide variety of measures were used, indicating the need for standardized measures for treatment satisfaction in future research.
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| 2. |
- Fogelkvist, Maria, 1983-, et al.
(författare)
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Acceptance and commitment therapy to reduce eating disorder symptoms and body image problems in patients with residual eating disorder symptoms : A randomized controlled trial
- 2020
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Ingår i: Body image. - : Saunders Elsevier. - 1740-1445 .- 1873-6807. ; 32, s. 155-166
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Tidskriftsartikel (refereegranskat)abstract
- Body image problems are central aspects of eating disorders (ED), and risk factors both for the development of and relapse into an ED. Acceptance and commitment therapy (ACT) aims at helping patients accept uncomfortable internal experiences while committing to behaviors in accordance with life values. The aim of the present study was to compare the effectiveness of a group intervention, consisting of 12 sessions, based on ACT to treatment as usual (TAU) for patients with residual ED symptoms and body image problems. The study was a randomized controlled superiority trial. Patients with residual ED symptoms and body image problems were recruited from a specialized ED clinic in Sweden. The final sample consisted of 99 women, randomized to ACT or TAU. At the two-year follow-up, patients who received ACT showed a significant greater reduction in ED symptoms and body image problems and received less specialized ED care than patients in TAU. In conclusion, ACT was superior in reducing ED symptoms and body image problems.
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| 3. |
- Fogelkvist, Maria, 1983-
(författare)
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Body image in patients with residual eating disorder symptoms : treatment effects of acceptance and commitment therapy and participants' reflections
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to evaluate an acceptance and commitment (ACT) group intervention targeting body image in patients with residual eating disorder (ED) symptoms, including treatment effects and participants’ reflections on body image and the intervention. Studies I, II and III are based on a randomized controlled trial including 99 patients that were randomized to the ACT intervention or to continue treatment as usual (TAU). Different self-assessment questionnaires were administered before and after the intervention and at follow up by one and two years. Study IV is based on interviews with patients that had completed the intervention, and did not participate in the trial. From written evaluations in study I body image was shown to mean different things for different individuals. This was also shown by different expectations on treatment. Study II showed that the ACT intervention was superior to TAU in reducing ED symptoms and body dissatisfaction, while care consumption was lower. In addition, ratings of dropout was low. In study III, it was shown that symptom improvement from the ACT intervention rather than TAU was more pronounced in participants with restrictive ED psychopathology. Participants who displayed binge eating and/or purging ED psychopathology, showed improvement on ED symptoms regardless of intervention. Participants younger than 25, and with lower ratings at baseline, showed no improvement on ED symptoms if continuing with TAU. From interviews with participants in study IV, the intervention was described as demanding, and participants described the importance of their own efforts. Specific processes of the intervention were helpful and the context of the group and context outside of treatment could facilitate or hinder progress. Perceived changes in body image differed between participants in study I, showing the potential breadth of the intervention.Conclusions from this thesis was that an intervention based on ACT targeting body image was suitable and helpful for patients with residual EDsymptoms. Though the intervention was demanding, dropout was low, and specific processes were described as helpful.
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| 4. |
- Fogelkvist, Maria, 1983-, et al.
(författare)
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Live with your body - participants' reflections on an acceptance and commitment therapy group intervention for patients with residual eating disorder symptoms
- 2021
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Ingår i: Journal of Contextual Behavioral Science. - : Elsevier. - 2212-1447. ; 20, s. 184-193
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Tidskriftsartikel (refereegranskat)abstract
- Acceptance and commitment therapy (ACT) is a transdiagnostic approach to human suffering that has been trialed in a range of different contexts. This study aimed to examine participants' view of helpful and hindering aspects of an in person ACT group intervention targeting body image in patients with residual eating disorder (ED) symptoms. Thirteen women who completed the intervention were interviewed, and transcripts were analyzed through thematic analysis. Nine themes were identified and sorted into three main themes. The first main theme, "Taking the plunge", pointed to the importance of participants own effort, and included subthemes of self-efficacy, self as description, and self-exploration. The second main theme, "A push towards valued ends", indicated that content of the intervention was helpful, and included subthemes of commitment and behavioral change processes, mindfulness and acceptance processes, and assignments in and between sessions. The third main theme, "The context matters", described the importance of the contexts of the intervention and life outside of treatment, and included subthemes of the group format, the context outside of treatment, and the timing of the intervention. Through the description of specific content, we conclude that ACT seems to help women with residual ED symptoms and body image issues by fostering motivation to engage in avoided situations and behaviors while striving to live a more valued life.
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| 5. |
- Fogelkvist, Maria, 1983-, et al.
(författare)
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Predictors of outcome following a body image treatment based on acceptance and commitment therapy for patients with an eating disorder
- 2022
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Ingår i: Journal of Eating Disorders. - : BioMed Central. - 2050-2974. ; 10:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: It is important to target body image in individuals with an eating disorder (ED). Acceptance and commitment therapy (ACT) has been trialed in a few studies for individuals with an ED. Although ACT outcomes in ED patients hold promise, studies of predictors are scarce. The aim of the present study was to explore differences in ED symptom outcome at two-year follow-up in subgroups of participants attending either treatment as usual (TAU), or a group intervention based on ACT targeting body image. Additionally, we aimed to compare subjective recovery experiences between groups.METHODS: The study took place at a specialized ED outpatient clinic, and included patients diagnosed with an ED that had received prior treatment and achieved a somewhat regular eating pattern. Study participants were randomly assigned to continue TAU or to participate in a group intervention based on ACT for body image issues. Only participants that completed the assigned intervention and had completed follow up assessment by two-years were included. The total sample consisted of 77 women.RESULTS: In general, ACT participants showed more favorable outcomes compared to TAU, and results were more pronounced in younger participants with shorter prior treatment duration and lower baseline depression ratings. Participants with restrictive ED psychopathology had three times higher ED symptom score change if participating in ACT in comparison to TAU.CONCLUSIONS: An ACT group intervention targeting body image after initial ED treatment may further enhance treatment effects. There is a need for further investigation of patient characteristics that might predict response to body image treatment, particularly regarding ED subtypes and depression ratings.
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| 6. |
- Larsson, Cornelia, et al.
(författare)
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Acceptance and Commitment Therapy for inpatients with psychosis -an acceptability and feasibility single case AB designed study
- 2022
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Ingår i: Journal of Contextual Behavioral Science. - : Elsevier. - 2212-1447. ; 25, s. 44-60
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is a lack of research on psychological treatments for psychosis in the inpatient setting. Acceptance and Commitment Therapy for psychosis (ACTp) is a diagnose specific adaptation of the transdiagnostic ACT treatment model which has shown promising results in patients with psychosis. Aim: The aim was to explore treatment effects of ACTp on inpatients with psychosis on symptoms, level of functioning, level of activity, psychological flexibility, -health-related quality of life, valued living, and to explore the acceptability and feasibility of ACTp. Method: Twelve inpatients with psychosis were treated with 3-10 daily sessions of ACTp in a non-concurrent single case AB design with additional pre-post and mid-measures. The mean age at clinic A was 48.88 (SD = 11.59) and 48.75 (SD = 16.07) at clinic B. We calculated non - overlap of all pairs (NAP) in daily measures, and reliable change index (RCI), and clinical significance in pre-post measures. Results: Half of the participants improved significantly on health-related quality of life and depression in daily measures and on depression and anxiety in pre-post measures. ACTp was quite acceptable and recruitment and the deliverance of therapy in the inpatient setting was feasible. Conclusion: In the present study, participants found the ACTp treatment to be comprehensive and helpful. Recruitment and treatment of inpatients were feasible, however, since most participants were discharged before ACTp protocol was completed, fewer sessions or having sessions more frequently needs further investigation. Daily measurement showed a significant improvement in health-related quality of life and depression for a majority of the participants.
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| 7. |
- Lundgren, Tobias, et al.
(författare)
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Acceptance and Commitment Training for Ice Hockey Players : A Randomized Controlled Trial
- 2021
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Ingår i: Frontiers in Psychology. - : Frontiers Media SA. - 1664-1078. ; 12
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Tidskriftsartikel (refereegranskat)abstract
- Recent systematic reviews on the topic of mindfulness- and acceptance-based approaches in sport psychology conclude that there is a need for further trials using a more robust research methodology with direct performance as outcome. Acceptance and Commitment Training (ACT) is a contextual behavioral change method that focuses on facilitating psychological processes such as values, committed action, acceptance and mindfulness. In the present study designed as a randomized controlled trial, 34 junior elite ice hockey players were allocated into either an ACT group intervention or a wait list control group. Results showed significant effects on both objective performance outcomes (goals, assists, and taken shots) and blinded coach ratings of players' performance, focus and commitment to their development in favor of the ACT group. Effects lasted at 3-month follow-up for the coach ratings, but not for the objective performance measures. All ACT trained players recommended ACT to other players and considered the training as important for their development as ice hockey players. The results add to the growing body of evidence on ACT interventions for athletes and its effect on performance. Future studies should investigate the maintenance of effects from the psychological training over time, using robust research methodology and investigate theoretical coherent potential mediating variables.
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| 8. |
- Lundgren, Tobias, et al.
(författare)
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Acceptance and Commitment Training to Promote Psychological Flexibility in Ice Hockey Performance : A Controlled Group Feasibility Study
- 2020
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Ingår i: Journal of Clinical Sport Psychology. - : Human Kinetics. - 1932-9261 .- 1932-927X. ; 14:2, s. 170-181
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Tidskriftsartikel (refereegranskat)abstract
- Despite the growing popularity of mindfulness and acceptance-based performance enhancement methods in applied sport psychology, evidence for their efficacy is scarce. The purpose of the current study is to test the feasibility and effect of a psychological training program based on Acceptance and Commitment Training (ACT) developed for ice hockey players. A controlled group feasibility designed study was conducted and included 21 elite male ice hockey players. The ACT program consisted of four, once a week, sessions with homework assignments between sessions. The results showed significant increase in psychological flexibility for the players in the training group. The outcome was positive for all feasibility measures. Participants found the psychological training program important to them as ice hockey players and helpful in their ice hockey development. Desirably, future studies should include objective performance data as outcome measure to foster more valid evidence for performance enhancement methods in applied sport psychology.
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| 9. |
- Maathz, Pernilla
(författare)
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Application of the psychological flexibility model in the context of vulvar pain and sexual dysfunction
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Psychological processes are known to influence the development and impact of chronic pain. Moreover, psychological treatments have been shown to reduce the suffering that people with chronic pain experience. Still, limited work has considered the role of psychological processes in vulvar pain, and many aspects of vulvar pain remain largely unexplored. Given the relevance of psychological flexibility and ACT in chronic pain, the applicability of the psychological flexibility model to vulvar pain appears worth exploring. The overarching aim of this thesis was to explore the psychological flexibility model in the context of vulvar pain and develop an intervention based on this model, for women living with vulvodynia. Study I aimed specifically to examine the contribution of psychological inflexibility to sexual dysfunction over time, among women with vulvar pain. Findings demonstrated that psychological inflexibility predicted later sexual dysfunction. The aim of Study II was to examine the contribution of mindfulness during sexual activity to sexual wellbeing among women who experience pain with sexual activity as compared to women who do not. Study II found that higher levels of mindfulness during sexual activity was associated with better sexual functioning and less sexual distress. Additionally, the contribution of mindfulness to sexual function and distress was similar in the two groups. Study III aimed specifically to examine the feasibility of a larger trial investigating the efficacy of online ACT for vulvodynia and conduct a preliminary examination of the effects of the intervention. Findings largely suggest that a full scale randomized controlled trial is feasible and indicate that women with provoked vestibulodynia could potentially benefit from receiving ACT.This thesis contributes to the understanding of vulvar pain and sexual dysfunction by demonstrating that psychological flexibility is associated with the personal impact of pain. It provides initial evidence of the potential value of the psychological flexibility model in the context of vulvodynia, and encourage further studies entailing a contextual behavioural approach.
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| 10. |
- Maathz, Pernilla, et al.
(författare)
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Women, Painful Sex, and Mindfulness
- 2022
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Ingår i: Mindfulness. - : Springer Nature. - 1868-8527 .- 1868-8535. ; 13:4, s. 917-927
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Mindfulness-based approaches to treatment of sexual dysfunction associated with vulvar pain appear promising, but little is known about the specific processes of mindfulness in sexual interactions or if mindfulness may be of particular benefit to women who experience pain associated with sexual activity. This study aimed to examine the associations between sexual mindfulness and sexual function and distress among women who currently experience pain with sexual activity as compared to women who do not. Methods: Women over the age of 18 were invited to complete an online survey, including measures of mindfulness in sexual activity, pain associated with sexual activity, sexual function, and sexual distress. Of the participants, 134 (42.1%) were experiencing pain and 184 (57.9%) were pain free.Results: Higher levels of mindfulness during sexual activity were associated with greater sexual functioning and less sexual distress both among women with and without pain. However, the associations between Observing skills and sexual functioning among women with pain was weaker if the capacity for nonreactivity was low. Sexual mindfulness contributed significantly to the explanation of sexual function and distress in both groups. Of the mindfulness facets, Acting with awareness consistently contributed, beyond the other facets, to the explanation of sexual outcomes.Conclusions: The capacity to stay mindful in sexual interactions appear to be important to sexual functioning both among women who experience pain with sexual activity and among women who do not. These findings encourage further examination of the role of mindfulness and its facets in sexual outcomes.
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