Acceptance and commitment therapy guided self-help for psychogenic non-epileptic seizures

Barrett-Naylor, Ruth (2017) Acceptance and commitment therapy guided self-help for psychogenic non-epileptic seizures. DClinPsy thesis, University of Nottingham.

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Abstract

Psychogenic non-epileptic seizures (PNES) are a relatively common condition, however, seizures can be debilitating for patients and are associated with high levels of psychological distress, reduced quality of life and reduced functionality. Despite the debilitating effects of the condition, there is thus far no recommended treatment. Although psychological therapy is often sought following the diagnosis of PNES, there remains relatively little research in the area comparing treatment efficacy. Nevertheless, many treatment efficacy studies focus on the application of cognitive behavioural therapy to PNES and the results produced so far appear promising, however, the psychotherapeutic mechanisms of change for such therapies are less clear.

Acceptance and Commitment Therapy (ACT) is a third-wave behavioural approach based on theoretical mechanisms of change. ACT may have benefits over other traditional therapies, as its contextual approach may be more acceptable to individuals with PNES, especially if they have had difficulty in adjusting to the concept that their seizures are caused by psychological, rather than physical processes.

A single case experimental design was carried out to assess the efficacy of an ACT guided self-help intervention on psychological flexibility, psychological distress, quality of life and seizure frequency. Participants also completed a qualitative change interview at one-month follow up. The intervention was replicated six times.

All participants demonstrated an increase in psychological flexibility following the ACT self-help intervention. Four of the six participants demonstrated reliable improvements in quality of life and psychological distress. The same four participants also reported a significant decrease in seizure frequency following the intervention, with three participants reporting that they were seizure free at one-month follow-up. Triangulation of the quantitative time-series data and qualitative change interviews indicated that openness to awareness processes (acceptance and cognitive defusion) were key mechanisms of change for individuals with PNES.

The study demonstrated the utility of an ACT treatment approach delivered in a self-help format for individuals with PNES. The implications of the study findings for future research and clinical practice are discussed.

Item Type: Thesis (University of Nottingham only) (DClinPsy)
Supervisors: Dawson, David
Gresswell, Mark
Keywords: Acceptance and commitment therapy; Convulsions; Seizures; Psychogenic non-epileptic seizures; 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: 44238
Depositing User: BARRETT-NAYLOR, Ruth
Date Deposited: 15 Dec 2017 04:40
Last Modified: 02 Jul 2018 13:00
URI: http://eprints.nottingham.ac.uk/id/eprint/44238

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