Pilot study of acceptance and commitment therapy for irritable bowel syndrome: A preliminary analysis of treatment outcomes and processes of change

Abstract

Background The aim of this study was to investigate the efficacy and proposed processes of change of acceptance and commitment therapy (ACT) in improving the outcomes of irritable bowel syndrome (IBS). Methods A total of 56 consecutive patients recruited from a specialist clinic were included in the study and completed an ACT treatment protocol (one‐day group workshop plus self‐help manual). Assessments of process (acceptance of IBS) and outcome variables (symptom severity, avoidance behaviours, quality of life, and gastrointestinal anxiety) were carried at four time points (assessment, pre‐treatment, post‐treatment, and follow‐up). Results A significant increase in the acceptance of IBS and improvement in all outcome variables was observed from pre‐ to post‐treatment and follow‐up (effect sizes medium to large). Improvements in all outcomes were associated with increases in acceptance of IBS. Changes in acceptance of IBS from pre‐ to post‐treatment were a significant predictor of improvements in outcomes from pre‐treatment to follow‐up. Conclusions Results support the efficacy of a brief ACT protocol in improving IBS outcomes and maintaining therapy effects at six‐month follow‐up. Preliminary support for the treatment process proposed was also found.

Feasibility of group-based acceptance and commitment therapy for adolescents (AHEAD) with multiple functional somatic syndromes: a pilot study

“…Moreover, we found clinically relevant improvements in physical health (primary outcome) as well as significant improvements on most secondary outcomes. The findings are in accordance with the previously reported positive impact of psychological treatment on symptom load and functioning in children and adolescents with FSS [24][25][26]28] and of ACT-based interventions in adults with FSS [29][30][31]. However, it can be questioned whether the positive changes seen in this uncontrolled study can be explained solely by the Mean at different time points as well as change from baseline to follow-up and from group-start to follow up with inclusion of effect sizes Abbreviations alphabetically presented: AFQ-Y8 avoidance and fusion questionnaire, thorough assessment and psychoeducation, as seen in an RCT in youth with CFS [83].…”

“…Recent reviews show that psychological interventions, particularly based on cognitive behavioural therapy (CBT) principles, are effective for FSS in children and adolescents in reducing symptom load, disability and school absence [24,25]. Acceptance and commitment therapy (ACT) is a newer development within CBT that has shown promising results in children and adolescents with chronic pain [26][27][28] and in adults with various FSS [28][29][30][31]. The overall aim of ACT is to change how the individual reacts to unwanted inner experiences by broadening the behavioural repertoire, to facilitate more adaptive strategies.…”

Moderating effect of IBS acceptance on psychosocial mediators of Irritable Bowel Syndrome

“…Therefore, given that acceptance is a highly trainable behavioural construct through Acceptance and Commitment Therapy, it stands to reason that the development and use of this intervention in IBS would prove of great clinical benefit. Two preliminary studies focusing on ACT for IBS (Ferreira, Gillanders, Morris, & Eugenicos, 2018;Gillanders et al, 2017) do seem to suggest that changes in IBS acceptance are at the core of improvements in the quality of life of IBS patients. In fact treatment related changes in IBS specific avoidance behaviours and Gastrointestinal anxiety in Ferreira, Gillanders, Morris, & Eugenicos (2018) are both dependent on changes in IBS acceptance, which would fit with the proposed model of this paper.…”

“…Two preliminary studies focusing on ACT for IBS (Ferreira, Gillanders, Morris, & Eugenicos, 2018;Gillanders et al, 2017) do seem to suggest that changes in IBS acceptance are at the core of improvements in the quality of life of IBS patients. In fact treatment related changes in IBS specific avoidance behaviours and Gastrointestinal anxiety in Ferreira, Gillanders, Morris, & Eugenicos (2018) are both dependent on changes in IBS acceptance, which would fit with the proposed model of this paper. In Gillanders et al (2017) only Gastrointestinal anxiety was shown to be affected by IBS acceptance, however this seemed to be constricted by the findings that only the IBS willingness component of acceptance was significantly changing.…”

“…Recent evidence from Ferreira, Gillanders, Morris, & Eugenicos (2018) found that as a process of change, increase in IBS acceptance is associated with improved quality of life outcomes, reduced avoidant behaviours and reduced gastrointestinal anxiety. A subsequent component study using self-help resources aimed to IBS acceptance replicated some of these outcomes, specifically reductions in gastrointestinal anxiety and symptom severity (Gillanders, Ferreira, Angioni, Carvalho, & Eugenicos, 2017).…”