A randomized controlled trial for symptoms of anxiety and depression: Effects of a one 1-day acceptance and commitment training workshop

Dindo, Lilian; Fiedorowicz, Jess G.; Boykin, Derrecka M.; Wooldridge, Nealy A; Myers, Janie; Ajibewa, Tiwaloluwa A.; Stroud, Amy; Kuwaye, Daren; Liu, Zhuangzhuang; Pierce, Gary L.

doi:10.12788/acp.0046

Cited by 4 publications

(3 citation statements)

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“…In this study, we found that psychological flexibility mediated the improvement of anxiety and depression symptoms in nurses through the web- and mobile-based ACT intervention, and this finding is consistent with the theoretical framework of ACT and supports previous research results [ 32 , 57 ]. Psychological flexibility has been found to be a more effective strategy for emotion regulation than experiential avoidance, allowing nurses to reduce anxiety and depression symptoms by accepting painful thoughts, emotions, and feelings instead of overavoiding or controlling them in a way that leads to inflexibility [ 58 ].…”

Section: Discussionsupporting

confidence: 91%

Effects and Mechanisms of a Web- and Mobile-Based Acceptance and Commitment Therapy Intervention for Anxiety and Depression Symptoms in Nurses: Fully Decentralized Randomized Controlled Trial

Lu,

Li,

Huang

et al. 2023

J Med Internet Res

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Background Acceptance and commitment therapy (ACT) is a promising intervention for improving mental health. However, there is limited evidence on its effectiveness for nurses, particularly in web- and mobile-based intervention forms, in mitigating anxiety and depression symptoms. Objective In this study, we aimed to examine the effect and underlying psychological mechanisms of a web- and mobile-based ACT intervention on nurses’ anxiety and depression symptoms. Methods In this fully decentralized randomized controlled trial, nurses were recruited nationwide across China through advertisements and posters. They were randomly assigned to either the 5-week fully automated intervention or the waiting group. Primary outcomes (anxiety and depression symptoms); secondary outcomes (sleep quality, burnout, and work performance); and mediators (psychological flexibility, cognitive defusion, mindfulness, and values) were assessed using the Wenjuanxing platform. Data collectors were blinded to the group assignments throughout the study period. Results A total of 145 nurses with anxiety or depression symptoms were randomly assigned to either the intervention group (n=72, 49.7%) or the control group (n=73, 50.3%); 97.2% (n=141) were female. During the study, 36 (24.8%) nurses were lost to follow-up, and 53 (73.6%) completed the entire intervention. Nurses in the intervention group showed significant improvement in anxiety (d=0.67, 95% CI 0.33-1.00) and depression symptoms (d=0.58, 95% CI 0.25-0.91), and the effects were sustained for 3 months after the intervention (anxiety: d=0.55, 95% CI 0.22-0.89; depression: d=0.66, 95% CI 0.33-1.00). Changes in psychological flexibility, cognitive defusion, and values mediated the effect of the intervention on anxiety and depression symptoms, while mindfulness did not have a mediating effect. Conclusions The web- and mobile-based ACT intervention used in this study significantly improved nurses’ anxiety and depression symptoms by improving psychological flexibility, cognitive defusion, and values. The results provide new ideas for hospital administrators to prevent and intervene in nurses’ psychological issues. Trial Registration Chinese Clinical Trial Register ChiCTR2200059218; https://tinyurl.com/4mb4t5y9

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Section: Discussionsupporting

confidence: 91%

Effects and Mechanisms of a Web- and Mobile-Based Acceptance and Commitment Therapy Intervention for Anxiety and Depression Symptoms in Nurses: Fully Decentralized Randomized Controlled Trial

Lu,

Li,

Huang

et al. 2023

J Med Internet Res

View full text Add to dashboard Cite

show abstract

“…Because this was a feasibility pilot, we elected a single-arm design, recognizing that it would be difficult to discern whether clinical improvements were an effect of treatment or due to extraneous variables (e.g., timing of assessments, changes in life stressors). Nevertheless, these preliminary results are consistent with earlier findings from larger efficacy trials comparing the 1-day ACT workshop (in-person) to a wait list or education-only control condition [ [38] , [39] , [40] ]. Larger randomized, multisite trials will be needed to establish the efficacy of the virtual workshop.…”

Section: Discussionsupporting

confidence: 88%

“…It is notable that veterans participating in the virtual 1-day ACT workshop demonstrated small, nonsignificant changes in psychological flexibility. This contrasts with mounting evidence that in-person 1-day ACT workshops yield significant improvements in psychological flexibility that mediate changes in symptom severity [ 18 , [38] , [39] , [40] ]. Web-based and remotely delivered ACT intervention studies have not all produced statistically or clinically significant changes in psychological flexibility (as measured by the AAQ-II [ [47] , [48] , [49] ]).…”

Section: Discussionmentioning

confidence: 85%

Feasibility of delivering a virtual 1-day acceptance and commitment therapy workshop to rural veterans through community partnerships

Dindo,

Chaison,

Rodrigues

et al. 2023

Contemporary Clinical Trials Communications

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One-day acceptance and commitment therapy (ACT) workshop improves anxiety but not vascular function or inflammation in adults with moderate to high anxiety levels in a randomized controlled trial

Fiedorowicz

Dindo

Ajibewa

et al. 2021

General Hospital Psychiatry

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A randomized controlled trial for symptoms of anxiety and depression: Effects of a one 1-day acceptance and commitment training workshop

Cited by 4 publications

References 0 publications

Effects and Mechanisms of a Web- and Mobile-Based Acceptance and Commitment Therapy Intervention for Anxiety and Depression Symptoms in Nurses: Fully Decentralized Randomized Controlled Trial

Effects and Mechanisms of a Web- and Mobile-Based Acceptance and Commitment Therapy Intervention for Anxiety and Depression Symptoms in Nurses: Fully Decentralized Randomized Controlled Trial

Feasibility of delivering a virtual 1-day acceptance and commitment therapy workshop to rural veterans through community partnerships

One-day acceptance and commitment therapy (ACT) workshop improves anxiety but not vascular function or inflammation in adults with moderate to high anxiety levels in a randomized controlled trial

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