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- Dahl, JoAnne, et al.
(författare)
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Behavior analysis of epilepsy: conditioning mechanisms, behavior technology and the contribution of ACT. Let us gird up the loins, sow dragon’s teeth, and move forward
- 2005
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Ingår i: The Behavior Analyst Today. - 1539-4352. ; 6:3, s. 191-202
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Forskningsöversikt (populärvet., debatt m.m.)abstract
- The conditioning mechanisms involved in the epileptic seizure behavior along with subsequent effective behavioral treatment have been known for more than a half a century. The behavior technology of seizure control provides low-cost, drug free treatment alternative for individual already suffering from seizures and the stigmatization of epilepsy. Despite this substantial amount of research, behavior therapy for seizures is not available to most people. This aim of this paper is to present the history of the behavior analysis and therapy developed in the last century. In addition to the established behavioral technology, a third wave contextual behavior therapy, Acceptance and Commitment therapy is shown in a recent study to contribute to new dimensions of treatment. Whereas, previous behavioral treatment regimens have aimed at seizure control, ACT aims at creating psychological flexibility around all of the experiential avoidance patterns associated with epilepsy and builds repertoire towards the individuals valued life. A treatment model that includes both the behavioral analysis and seizure control techniques alongwith ACT components: acceptance, defusion skills, mindfulness, and committed action in valued direction may have greater success than behavioral treatments alone. While behavioral control strategies may be used for preventing, predicting and actually interrupting seizure behavior, acceptance-based skills are used for creating flexibility around “resistance” to having seizures. While more research is needed, this combination represents a viable alternative and or compliment to drug and surgical therapy.
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- Lundgren, Tobias, et al.
(författare)
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Acceptance and Commitment Therapy and yoga for drug-refractory epilepsy : A randomized controlled trial
- 2008
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Ingår i: Epilepsy & Behavior. - : Elsevier BV. - 1525-5050 .- 1525-5069. ; 13:1, s. 102-108
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Tidskriftsartikel (refereegranskat)abstract
- Objective. There is a need for controlled outcome studies on behavioral treatment of epilepsy. The purpose of this study was to evaluate Acceptance and Commitment Therapy (ACT) and yoga in the treatment of epilepsy. Methods. The design consisted of a randomized controlled trial with repeated measures (N = 18). All participants had an EEG-verified epilepsy diagnosis with drug-refractory seizures. Participants were randomized into one of two groups: ACT or yoga. Therapeutic effects were measured using seizure index (frequency x duration) and quality of life (Satisfaction with Life Scale, WHOQOL-BREF). The treatment protocols consisted of 12 hours of professional therapy distributed in two individual sessions, two group sessions during a 5-week period, and booster sessions at 6 and 12 months posttreatment. Seizure index was continuously assessed during the 3-month baseline and 12-month follow-up. Quality of life was measured after treatment and at the 6-month and 1-year follow-ups. Results. The results indicate that both ACT and yoga significantly reduce seizure index and increase quality of life over time. ACT reduced seizure index significantly more as compared with yoga. Participants in both the ACT and yoga groups improved their quality of life significantly as measured by one of two quality-of-life instruments. The ACT group increased their quality of life significantly as compared with the yoga group as measured by the WHOQOL-BREF, and the yoga group increased their quality of life significantly as compared with the ACT group as measured by the SWLS. Conclusions. The results of this study suggest that complementary treatments, such as ACT and yoga, decrease seizure index and increase quality of life.
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- Lundgren, Tobias, et al.
(författare)
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Evaluation of acceptance and commitment therapy for drug refractory epilepsy : A randomized controlled trial in South Africa - A pilot study
- 2006
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Ingår i: Epilepsia. - : Wiley. - 0013-9580 .- 1528-1167. ; 47:12, s. 2173-2179
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Psychological interventions in the treatment of epilepsy have been developed and evaluated for many years but the amount of research has hardly made an impact on how epilepsy is treated. The purpose of this study was to develop and evaluate a psychological treatment program consisting of Acceptance and Commitment Therapy together with some behavioral seizure control technology shown to be successful in earlier research. Methods: The method consisted of a RCT group design with repeated measures (N= 27). All participants had an EEG verified epilepsy diagnosis with drug refractory seizures. Participants were randomized into one of two conditions, ACT or Supportive therapy (ST). Therapeutic effects were measured by examining changes in quality of life (SWLS and WHOQOL) and seizure index (frequency * duration). Both treatment conditions consisted of only 9 hours of professional therapy distributed in two individual and two group sessions during a four-week period. Results: The results showed significant effects over all of the dependent variables for the ACT group as compared to the ST group at 6 and twelve-month follow ups. Conclusions: The results from this study suggest that a short-term psychotherapy program combined with anticonvulsant drugs may help to prevent the long-term disability that occurs from drug refractory seizures.
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- Lundgren, Tobias, et al.
(författare)
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Evaluation of mediators of change in the treatment of epilepsy with Acceptance and Commitment Therapy
- 2008
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Ingår i: Journal of behavioral medicine. - : Springer Science and Business Media LLC. - 0160-7715 .- 1573-3521. ; 31:3, s. 225-235
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Tidskriftsartikel (refereegranskat)abstract
- The present study examined the mediators of change accounting for outcomes of a previously published study on Acceptance and Commitment Therapy for the self-management of epilepsy and its life restricting impact. Conducted with 27 poor South Africans, a nine-hour ACT protocol that included seizure management methods was shown to greatly reduce epileptic seizures and to increase quality of life over the next year as compared to an attention placebo control. A series of bootstrapped non-parametric multiple mediator tests showed that pre to follow-up changes in: seizures, quality of life, and well-being outcomes were mediated to a degree by ACT process measures of epilepsy-related acceptance or defusion, values attainment, persistence in the face of barriers, or their combination. The results of this study contribute to the understanding of the contextual conditioning mechanisms at work for those suffering from epilepsy and may show that helping people live vital lives may also help to reduce seizures.
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