Acceptance and commitment therapy : application in a real-world alcohol and other drug community setting : a thesis presented in partial fulfilment of the requirements for the degree of Doctorate in Clinical Psychology, Massey University, Wellington, New Zealand
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Date
2018
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Massey University
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Abstract
Treating addictive behaviours in alcohol and drug populations in real-world settings carries a range of issues: standardised treatment approaches have been criticised for their complexity and inaccessibility, their failure to retain clients over the course of therapy, and their inability to address the range of coexisting difficulties present. The development of transdiagnostic third wave therapies has recently emerged as an alternative to traditional approaches. One such therapeutic approach is Acceptance and Commitment Therapy (ACT). ACT has proven to be effective in the treatment of several mental illnesses such as anxiety disorders, mood disorders, psychotic symptoms, and personality disorders; it has been found to be effective with medical issues such as chronic pain, cancer, epilepsy, and weight loss; and, importantly, it has been applied across a variety of challenging conditions and evidence of its effectiveness in treatment of addictive behaviours is promising and growing. The current study aims to examine the effectiveness of a manualised ACT-based group treatment programme applied in a real-world Alcohol and Other Drug (AOD) community setting. It was hypothesised that ACT would lead to reductions in alcohol use, substance use and cravings, and common co-occurring symptomology such as anxiety and stress. It was also hypothesised that there would be an increase in mood management skills and mindfulness tendencies. Findings suggest ACT is a promising approach to treating AOD communities as it is well-regarded by clients and it elicits a reduction in several substance use behaviours; however, several outcomes were not statistically significant for many of the comparisons which is likely due to the study being underpowered. In addition, most coexisting problems reduced by post-group and improvements to mood management were evident. However, a rebound effect was found at the three-month follow-up in which the mood management skills reduced, and coexisting stress and anxiety increased. Mindfulness tendencies demonstrated an accumulative effect and showed significant increases by follow-up. These results, although not statistically significant, still provide support for future development and implementation of transdiagnostic approaches such as ACT, particularly in AOD services that commonly deal with dual diagnosis.
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Appendices A & B in Appendix J (Ethical approval) and Appendix K (Memorandum of understanding) have been removed.
Keywords
Acceptance and commitment therapy, Alcoholism, Drug abuse, Treatment, New Zealand