Vick, Geirgina
(2025)
Adapting a self-help acceptance and commitment therapy (ACT)
intervention for adults with a spinal cord injury (SCI).
DClinPsy thesis, University of Nottingham.
Abstract
Portfolio Abstract
The psychological impact of SCI is well known and there is a growing body of evidence supporting the effectiveness of Acceptance and Commitment Therapy (ACT) for people with a spinal cord injury (SCI). However, the acceptability of the ACT approach for those with a SCI and its underlying processes has rarely been considered. Furthermore, well known barriers to accessing mental health support for those with SCI such as, inadequate transportation, financial resources and stigma are significant. Therefore, self-help is suggested as a potentially useful intervention for providing support to this population as it has shown some efficacy in other populations. This study utilised a qualitative design to explore acceptability of an ACT self-help manual via 14 semi-structured interviews with those with a SCI, family members and professionals working with SCI. Furthermore, it aimed to explore and understand the lived experiences of those with a SCI and their relevance to the ACT model. The data gathered was analysed using Reflexive Thematic Analysis. Three main themes were identified: (1) ACT Concepts, with three sub-themes identified (i) Is acceptance important or achievable, (ii) Cognitive Defusion, too airy fairy, (iii) Values important to rehabilitation; (2) Self-help, with three sub-themes identified, (i) Self-help after adjustment, (ii) Self-help too labour intensive, (iii) Language is the key to engagement; (3) Lived Experiences, with three sub-themes identified (i) life is a battle, (ii) deal with it or hide away, (iii) different to the person I was before. The main themes were discussed in the context of the wider literature and suggestions for adaptations to the self-help manual, including simplification, personalisation, amending language use and considering a hybrid approach including both self-directed and professional led modules were considered to improve acceptability of the manual. Generally, participants deemed ACT to be an acceptable and relevant approach based on their experiences after SCI. This study provides information on the acceptability of ACT processes for those with SCI and has supported the development of a self-help manual specifically designed for those with a SCI.
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