Acceptance and Commitment Therapy Delivered via Telehealth for the Treatment of Co-Occurring Depression, PTSD, and Nicotine Use in a Male Veteran

Abstract

Symptoms of depression, posttraumatic stress, and substance use disorders commonly co-occur and are a tremendous health burden among the U.S. military veteran population. Acceptance and Commitment Therapy (ACT) is an evidence-based, transdiagnostic, integrated approach that has been used to treat these problems. Delivering psychotherapy via telehealth helps to break down barriers to care. This case study describes the application of ACT via telehealth with a male veteran with co-occurring symptoms of depression, PTSD and nicotine addiction. His depressive symptoms, PTSD symptoms, and nicotine use decreased substantially over the course of therapy. He demonstrated increased willingness to experience negatively evaluated internal experiences such as emotions and urges to use nicotine, defusion from self-critical and other unhelpful thoughts, more consistent engagement in values-consistent behaviors, and increased behavioral engagement in his social life. Treatment implications and unique aspects of the telehealth modality are discussed. Recommendations are made for training clinicians who may be considering providing services via telehealth or using ACT.

Acceptance and commitment therapy for co-occurring gambling disorder and posttraumatic stress disorder in veterans: a narrative review

“…PCL-5: M = −18.12 ( SD 15.49), d = 1.19. 25.4%−28.3% (were below the PTSD clinical cut-off) Avoidance significantly reduced ( M = −6.86, SD 9.30, d = 0.88) Smith et al ( 2021 ), US, technology based 1 Late 20s 1/0 Veteran PTSD – DSM-5/ PCL-5 Single case study; individual ‘telehealth’ video conferencing setting, manualised treatment, 19 60-minute sessions, duration 5 months. Pre-test, during, post-test, 1 month follow up ACT Global PTSD, experiential avoidance.…”

A Case-Series Study Examining Acceptance and Commitment Therapy for Experiential Avoidance-Related Mixed Anxiety and Depression in a Telehealth Platform

“…Acceptance and commitment therapy (ACT; Hayes et al, 2012) is one such approach to treatment that offers potential for implementation within this process-based framework. As demonstrated in the case-series study presented below, ACT is also amenable to delivery via telehealth (e.g., Herbert et al, 2017; Smith et al, 2021) and thus may represent a promising approach to treatment in the current and post-COVID-19 pandemic era.…”

Clinician Perception of the Utility of the Hierarchical Taxonomy of Psychopathology (HiTOP) System

“…Publications that suggested some level of case complexity instead of a single diagnosis (e.g., titles referencing transdiagnostic treatment or diagnostic comorbidity) were screened for consideration as a vignette template. The three case studies that provided the most detail about psychosocial history and psychiatric symptoms were selected as the bases for the vignettes: Lui, 2017;Scheiderer et al, 2017;and Smith et al, 2020. Multiple vignettes were developed to ensure observed effects were not attributable to the characteristics of a certain case.…”