Open Access Open Access  Restricted Access Subscription Access

A self-help based Acceptance and Commitment Therapy programme using Internet delivery: effect on adults intending to work who have utilized their sick leave due to depressive symptoms

Maki Tei-Tominaga

Abstract


Rationale: The aim of this study was to develop a self-help based Acceptance and Commitment Therapy (ACT) programme using Internet delivery, which can be practised at the workplace or at home and to examine its effect on adults intending to work who have utilized their sick leave due to depressive symptoms.

Method: A one-group, baseline-to-post-intervention design was utilized with participants in Japan. Among the participants (N = 35), 26 completed the self-help based programme and answered all questionnaire surveys on 3 occasions: baseline (T1), after 3 weeks (T2) and after 6 weeks when the programme ended (T3). As the primary outcome, depressive symptoms were assessed using the Zung Self-Rating Depression Scale. As the secondary outcome, psychological flexibility was assessed using the Japanese version of the revised Acceptance and Action Questionnaire. Additionally, 3 items to assess process were administered and participants’ written comments were organized by content.

Results: Although the number of participants who showed mild and moderate depressed states decreased, depressive symptom scores did not significantly change over time. Psychological flexibility at T3 significantly improved compared to baseline, while the effect size was relatively low (Cohen’s d = 0.35). One of the scores from the process measures showed a significant difference between T2 and T3. There were 5 positive and 5 negative comments.

Conclusions: Along with participants’ comments, the findings suggested the effectiveness of the self-help based ACT programme using Internet delivery. This has the potential to help develop mindfulness and acceptance skills in adults who are intending to return to work after taking sick leave for depressive symptoms.


Keywords


Acceptance and Commitment Therapy (ACT), adult, depressive symptoms, Internet, mental health, mindfulness, person-centered healthcare, psychological flexibility, return to work programme, self-help, sick leave

Full Text:

PDF

References


Lidwall, U. (2015). Sick leave diagnoses and return to work: a Swedish register study. Disability and Rehabilitation 37 (5) 396-410.

Harvey, S.B., Henderson, M., Lelliott, P. & Hotopf, M. (2009). Mental health and employment: much work still to be done. British Journal of Psychiatry 194 (3) 201-203.

Ministry of Health Labor and Welfare, Statistics and Information Department Minister’s Secretariat. (2014). Patient Survey 2014. (Disease and Injury). Available at: http://www.mhlw.go.jp/toukei/saikin/hw/kanja/10syoubyo/dl/h26syobyo.pdf (last accessed April 18th, 2017)

Tange, C. & Yokoyama, K. (2007). Status of mental health problems and care in Japanese business establishments. San Ei Shi 49 (2) 59-66.

Ministry of Health, Labour and Welfare. (2004). Kokoro-no kenkomondai niyori kyugyoshita roudousya-no syokubahukkishien-no tebiki-ni tsuite (Guidance for the support of workers who have taken sick leave because of mental problems upon returning to work). Available at: http://www.mhlw.go.jp/houdou/2004/10/h1014-1.html. (last accessed April 18th, 2017)

Tanaka, K., Kamata, N., Takano, T., Kaku, A. & Nishinoue, S. (2011). A survey report of supports for return-to-work of needs in occupational fields: a report of research project of health science for mental health supported by grants-in-aid for scientific research from Ministry of Health, Labour and Welfare in 2011. Available at: http://mhlw-grants.niph.go.jp/niph/search/NIDD00.do?resrchNum=201027052B. (last accessed May 13th, 2017)

Igarashi, Y. (2012). The present situation and problem of rework program in Japan. Japan Journal of Psychosomatic Medicine 52 (8) 726-733.

Ishikawa, I., Iijimam. Y. & Fukushima, M. (2012). The actual situation of the use of CBT in rework program. Japanese Journal of Clinical Psychiatry 41 (11) 1543-1550.

Tanoue, A., Ito, D., Simizu, K., Ohno, M., Shirai, M., Shimada, H. & Suzuki, S. (2012). Cognitive behavioral group therapy for employees on sick leave due to depression. Japanese Journal of Behavior Therapy 38 (3) 193-202.

Hayes, S.C., Strosahl, K.D., Bunting, K., Twohig, M. & Wilsonl, K.G. (2004). What is Acceptance and Commitment Therapy? In: A practical guide to acceptance and commitment therapy. Ed. Hayes, S.C. pp.1-29. Moxee, Washington: Springer.

Hayes, S.C., Luoma, J.B., Bond, F.W., Masuda, A. & Lillis, J. (2006). Acceptance and Commitment Therapy: model, processes and outcomes. Behaviour Research and Therapy 44 (1) 1-25.

Hayes, S.C. & Smit, S. (2005). Get Out of your Mind and into Your Life: The New Acceptance and Commitment Therapy. Oakland, CA: New Harbinger Publications.

Flaxman, P.E. & Bond, F.W. (2010). Worksite stress management training: moderated effects and clinical significance. Journal of Occupational Health Psychology 15 (4) 347-358.

Bohlmeijer, E.T., Fledderus, M., Rokx, T.A.J.J. & Pieterse, M.E. (2011). Efficacy of an early intervention based on Acceptance and Commitment Therapy for adults with depressive symptomatology: evaluation in a randomized controlled trial. Behaviour Research and Therapy 49 (1) 62-67.

Cavanagh, K., Strauss, C., Forder, L. & Jones, F. (2014). Can mindfulness and acceptance be learnt by self-help?: a systematic review and meta-analysis of mindfulness and acceptance-based self-help interventions. Clinical Psychology Review 34 (2) 118-129.

Newman, M.G., Szkodny, L.E., Llera, S.J. & Przeworski, A. (2011). A review of technology-assisted self-help and minimal contact therapies for drug and alcohol abuse and smoking addiction: is human contact necessary for therapeutic efficacy? Clinical Psychology Review 31 (1) 178-186.

Reid, D.T. (2013). Teaching mindfulness to occupational therapy students: pilot evaluation of an online curriculum. Canadian Journal of Occupational Therapy 80 (1) 42-48.

Christensen, H., Griffiths, K.M., Mackinnon, A.J. & Brittliffe, K. (2006). Online randomized controlled trial of brief and full cognitive behaviour therapy for depression. Psychological Medicine 36 (12) 1737-1746.

Hedman, E., Ljótsson, B., Rück, C., Furmark, T., Carlbring, P., Lindefors, N. & Andersson, G. (2010). Internet administration of self-report measures commonly used in research on social anxiety disorder: a psychometric evaluation. Computers in Human Behavior 26 (4) 736-740.

Kessler, R.C., Barker, P.R. & Colpe, L.J., Epstein, J.F., Hiripi, E., Howes, M.J., Normand, S.L., Manderscheid, R.W., Walters, E.E. & Zaslavsky, A.M. (2003). Screening for serious mental illness in the general population. Archives of General Psychiatry 60 (2) 184-189.

Cuijpers, P., Smit, F. & van Straten, A. (2007). Psychological treatments of subthreshold depression: a meta-analytic review. Acta Psychiatrica Scandinavica 115 (6) 434-441.

Cuijpers, P., van Straten, A., Smit, F., Mihalopoulos, C. & Beekman, A. (2008). Preventing the onset of depressive disorders: a meta-analytic review of psychological interventions. American Journal of Psychiatry 165 (10) 1272-1280.

Faul, F., Erdfelder, E., Lang, A.G. & Buchner, A. (2007). G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods 39 (2) 175-191.

The British Psychological Society, The Royal College of Psychiatrists. (2004). Depression: management of depression in primary and secondary care. National Clinical Practice Guideline Number 23. Leicester; The British Psychological Society and Gaskell.

Bach, P.A. & Moran, D.J. (2008). ACT in practice: case conceptualization in Acceptance and Commitment Therapy. Oakland, CA: New Harbinger Publication.

Forsyth, J.P. & Eifert, G.H. (2007). The mindfulness and acceptance workbook for anxiety: a guide to breaking free from anxiety, phobias, and worry using Acceptance and Commitment Therapy. Oakland, CA: New Harbinger Publication.

Harris, R. & Hayes, S.C. (2009). ACT made simple: an easy-to-read primer on acceptance and commitment therapy. Oakland, CA (Japanese place published: Tokyo): New Harbinger Publication (Japanese edition: Seiwa Shoten Publishers).

Muto, T., Hayes, S.C. & Jeffcoat, T. (2011). The effectiveness of Acceptance and Commitment Therapy bibliotherapy for enhancing the psychological health of Japanese college students living abroad. Behavior Therapy 42 (2) 323-335.

Imamura, K., Kawakami, N., Furukawa, T.A., Matsuyama, Y., Shimazu, A., Umanodan, R., Kawakami, S. & Kasai, K. (2014). Effects of an Internet-based cognitive behavioral therapy (iCBT) program in Manga format on improving subthreshold depressive symptoms among healthy workers: a randomized controlled trial. PLoS One 9 (5) e97167.

Japan Industrial Safety and Health Association. (2014). Guideline for industrial safety and health of visual display terminal. In: General guidebook on Industrial Health. Eds. Japan Industrial Safety and Health Association. pp.232-236. Tokyo: Japan Industrial Safety and Health Association.

Zung, W. (1965). A self-rating depression scale. Archives of General Psychiatry 12 63-70.

Chida, F., Okayama, A., Nishi, N. & Sakai, A. (2004). Factor analysis of Zung Scale scores in a Japanese general population. Psychiatry and Clinical Neurosciences 58 (4) 420-426.

Kinoshita, N., Yamamoto, T. & Shimada, H. (2008). Nihongoban Acceptance and Action Questionnaire-II sakuseino kokoromi (Development of Japanese version of Acceptance and Action Questionnaire-II). The 21st congress of the Japanese Association of Health Psychology 46.

Bond, F.W., Hayes, S.C., Baer, R.A., Carpenter, K.M., Guenole, N., Orcutt, H.K., Waltz, T. & Zettle, R.D. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: a revised measure of psychological inflexibility and experiential avoidance. Behavior Therapy 42 (4) 676-688.

Lappalainen, P., Granlund, A., Siltanen S, Ahonen, S., Vitikainen, M., Tolvanen, A. & Lappalainen, R. (2014). ACT Internet-based vs face-to-face? A randomized controlled trial of two ways to deliver Acceptance and Commitment Therapy for depressive symptoms: an 18-month follow-up. Behaviour Research and Therapy 61 43-54.

Forman, E.M., Herbert, J.D., Moitra, E., Yeomans, P.D. & Geller, P.A. (2007). A randomized controlled effectiveness trial of Acceptance and Commitment Therapy and cognitive therapy for anxiety and depression. Behavior Modification 31 (6) 772-799.

Carlbring, P., Hägglund, M., Luthström, A., Dahlin, M., Kadowaki, Å., Vernmark, K. & Andersson, G. (2013). Internet-based behavioral activation and acceptance-based treatment for depression: a randomized controlled trial. Journal of Affective Disorders 148 (2-3) 331-337.

Fledderus, M., Bohlmeijer, E.T., Fox, J.P., Schreurs, K.M. & Spinhoven, P. (2013). The role of psychological flexibility in a self-help Acceptance and Commitment Therapy intervention for psychological distress in a randomized controlled trial. Behaviour Research and Therapy 51 (3) 142-151.

Gellatly, J., Bower, P., Hennessy, S., Richards, D., Gilbody, S. & Lovell, K. (2007). What makes self-help interventions effective in the management of depressive symptoms? Meta-analysis and meta-regression. Psychological Medicine 37 (9) 1217-1228.

Andersson, G. & Cuijpers, P. (2009). Internet-based and other computerized psychological treatments for adult depression: a meta-analysis. Cognitive Behaviour Therapy 38 (4) 196-205.

Spek, V., Cuijpers, P., Nyklicek, I., Riper, H., Keyzer, J. & Pop, V. (2007). Internet-based cognitive behaviour therapy for symptoms of depression and anxiety: a meta-analysis. Psychological Medicine 37 (3) 319-328.

A-Tjak, J.G.L., Davis, M.L., Morina, N., Powers, M.B., Smits, J.A.J. & Emmelkamp, P.M.G. (2015). A meta-analysis of the efficacy of Acceptance and Commitment Therapy for clinically relevant mental and physical health problems. Psychotherapy and Psychosomatics 84 (1) 30-36.

Ost, L.G. (2014). The efficacy of Acceptance and Commitment Therapy: an updated systematic review and meta-analysis. Behaviour Research and Therapy 61, 105-121.

Cuijpers, P. (2015). Psychotherapies for adult depression: recent developments. Current Opinion in Psychiatry 28 (1) 24-29.




DOI: http://dx.doi.org/10.5750/ejpch.v5i4.1358

Refbacks

  • There are currently no refbacks.