Acceptance and Commitment Therapy for anxious children and adolescents: study protocol for a randomized controlled trial

Abstract

BackgroundAnxiety disorders affect approximately 10% to 20% of young people, can be enduring if left untreated, and have been associated with psychopathology in later life. Despite this, there is a paucity of empirical research to assist clinicians in determining appropriate treatment options. We describe a protocol for a randomized controlled trial in which we will examine the effectiveness of a group-based Acceptance and Commitment Therapy program for children and adolescents with a primary diagnosis of anxiety disorder. For the adolescent participants we will also evaluate the elements of the intervention that act as mechanisms for change.Methods/designWe will recruit 150 young people (90 children and 60 adolescents) diagnosed with an anxiety disorder and their parent or caregiver. After completion of baseline assessment, participants will be randomized to one of three conditions (Acceptance and Commitment Therapy, Cognitive Behavior Therapy or waitlist control). Those in the Acceptance and Commitment Therapy and Cognitive Behavior Therapy groups will receive 10 × 1.5 hour weekly group-therapy sessions using a manualized treatment program, in accordance with the relevant therapy, to be delivered by psychologists. Controls will receive the Cognitive Behavior Therapy program after 10 weeks waitlisted. Repeated measures will be taken immediately post-therapy and at three months after therapy cessation.DiscussionTo the best of our knowledge, this study will be the largest trial of Acceptance and Commitment Therapy in the treatment of children and young people to date. It will provide comprehensive data on the use of Acceptance and Commitment Therapy for anxiety disorders and will offer evidence for mechanisms involved in the process of change. Furthermore, additional data will be obtained for the use of Cognitive Behavior Therapy in this population and this research will illustrate the comparative effectiveness of these two interventions, which are currently implemented widely in contemporary clinical practice. Anticipated difficulties for the trial are the recruitment and retention of participants, particularly adolescents. To avert these concerns and maximize recruitment, several strategies will be adopted to optimize referral rates as well as reduce participant drop-outs.Trial registrationThis trial is registered with the Australian and New Zealand Clinical Trials Registry, registration number: ACTRN12611001280998

Acceptance and commitment therapy for the treatment of anxiety disorders: a concise review

“…No clinical trials of ACT for children and adolescents have been completed, but there is at least one underway for those with mixed anxiety disorders [22].…”

Brief group‐based acceptance and commitment therapy for stroke survivors

“…ACT aims to increase ‘psychological flexibility’ which allows pursuit of a valued life despite physical limitations, painful thoughts, feelings, or sensations (Harris, ). There is a growing body of research in support of ACT across a wide range of clinical populations (Graham, Gouick, Krahé, & Gillanders, ; Ost., ; Ruiz, ; Swain, Hancock, Dixon, Koo, & Bowman, ; Veehof, Trompetter, Bohlmeijer, & Schreurs, ). Group‐based ACT has been applied to several health conditions including cancer, multiple sclerosis, epilepsy, diabetes, and chronic pain with promising findings in reducing depression, anxiety, and disability and increasing acceptance and other condition‐specific outcomes (Gregg, Callaghan, Hayes, & Glenn‐Lawson, ; Kemani et al ., ; Lundgren, Dahl, Melin, & Kies, ; Lundgren, Dahl, Yardi, & Melin, ; McCracken, Sato, & Taylor, ; Mohabbat‐Bahar, Maleki‐Rizi, Akbari, & Moradi‐Joo, ; Nordin & Rorsman, ; Wetherell et al ., ).…”

The Effectiveness of Acceptance and Commitment Therapy on Anxiety, Depression, and Stress in Patients with Spinal Cord Injuries

“…Among these studies, studying chronic pain with online acceptance and commitment therapy, depression and anxiety, intellectual obsessive-compulsive disorder, the flexibility of managers, auditory hallucination, psychosis and anxiety, depression, and stress can be highlighted. 4,[10][11][12] The statistics designated that spinal cord injuries occurred mainly at young ages. So, more than half (53%) of the spinal cord lesions seen in the age range of 16 to 30 years.…”