Telephone-supported acceptance and commitment bibliotherapy for people with multiple sclerosis and psychological distress: a randomised controlled feasibility study

Proctor, Barnaby Justin (2016) Telephone-supported acceptance and commitment bibliotherapy for people with multiple sclerosis and psychological distress: a randomised controlled feasibility study. DClinPsy thesis, University of Nottingham.

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Abstract

Objective: Telephone-supported self-help Acceptance and Commitment Therapy (ACT) may be a way of providing accessible and effective psychotherapy to people with Multiple Sclerosis (MS). The aim of this trial was to determine the feasibility of a randomised controlled trial (RCT) of telephone-supported ACT bibliotherapy compared to treatment-as-usual (TAU), explore the effectiveness of the intervention and track individual changes.

Design: The study was a randomised controlled feasibility trial. The intervention consisted of eight weekly support calls guiding participants through an ACT self-help text. Participants were assessed at baseline and post-intervention using the Generalised Anxiety Disorder measure (GAD) and the Patient Health Questionnaire (PHQ) as primary outcome measures. The EuroQol (EQ-5D-5L) and Multiple Sclerosis Impact Scale (MSIS-29) were secondary measures, and the Acceptance and Action Questionnaire (AAQ-II) was a process measure. A sample of participants were interviewed and analysed using framework analysis to assess RCT feasibility.

Results: Twenty seven participants with MS with anxiety and/or depression were recruited from an outpatient MS clinic and an MS charity. The majority of participants found all components of the RCT acceptable. Overall attrition was 33%, and 64% in the intervention group. Linear mixed model analysis and effect size calculation found a significant effect (p=0.004) and large effect size (0.84 (95% confidence intervals 0.02-1.66)) at post-intervention in favour of the intervention on anxiety. Smaller non-significant positive effects were found on other measures. Participants in both groups exhibited clinically significant improvements and deteriorations. Intervention completers had significantly lower baseline scores on the MSIS and the AAQ-II.

Conclusions: Telephone-supported ACT bibliotherapy delivered in a RCT format may be a feasible research method for people with MS if significant changes to the method of delivery are made. The intervention has the potential to be effective in reducing anxiety, however there are limitations in sample size. Future research directions and the applicability of ACT in this population are discussed. Finally, personal reflections on methodology and intervention delivery are made.

Item Type: Thesis (University of Nottingham only) (DClinPsy)
Supervisors: das Nair, R.
Moghaddam, N.
Keywords: Acceptance and commitment therapy, Multiple sclerosis, Teletherapy, Bibliotherapy, Randomised controlled trial, Guided self-help
Subjects: W Medicine and related subjects (NLM Classification) > WL Nervous system
Faculties/Schools: UK Campuses > Faculty of Medicine and Health Sciences > School of Medicine
Item ID: 36091
Depositing User: Proctor, Barnaby
Date Deposited: 16 Dec 2016 06:40
Last Modified: 12 Oct 2017 14:06
URI: http://eprints.nottingham.ac.uk/id/eprint/36091

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