Focused acceptance and commitment therapy in an integrated family health centre : service utilization, outcomes and follow-up : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University
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Date
2019
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Massey University
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Abstract
Many New Zealanders experience mental health difficulties each year, however the majority do not receive professional support to cope with their distress. One strategy for reducing this treatment gap is to increase access to mental health supports through the provision of evidence-based ultra-brief psychotherapy in primary care settings. The current study investigated the delivery of Focused Acceptance and Commitment Therapy (FACT; Strosahl, Robinson, & Gustavsson, 2012) in a New Zealand primary care setting. Referral, service use and outcome data from the first twelve months of the service was analysed, along with follow-up data from a small sub-sample of patients. A total of 708 people were referred to the FACT service during the first 12 months. Clients attended an average of 2.00 (SD 1.50) sessions with the majority of sessions lasting 30 minutes or less (M = 37.45, SD 11.94). Analysis of available first and last scores on the Hospital Anxiety and Depression Scale, Outcome Rating Scale, Acceptance and Action Questionnaire II, and client reported severity of target issue indicated statistically significant improvements in target issue, anxiety, depression, global distress and psychological flexibility with medium to large effect sizes. Thirty participants provided follow-up data approximately two months after their last session of FACT. Statistically significant improvements in target issue severity and global distress were maintained at follow-up. No statistically significant change was found between first, last and follow-up scores on the measures of anxiety, depression or psychological flexibility. Overall, the results of this study provide support for the effectiveness of FACT delivered in primary care. Limitations of this study included lack of control conditions, participant sampling issues, and lower than ideal fidelity to the FACT model.