Efficacy of an early intervention based on acceptance and commitment therapy for adults with depressive symptomatology: Evaluation in a randomized controlled trial.

OBJECTIVE: The current study examined the efficacy of an early intervention based on acceptance and commitment therapy (ACT) for depressive symptomatology. The ACT intervention is aimed at increasing the acceptance of negative thoughts and emotions and living a mindful and value-based life. METHOD: Adults with mild to moderate depressive symptomatology were randomly assigned to the ACT intervention (n=49) or to a waiting list (n=44). The mean age of the participants was 49 years. The majority of the participants was female and of Dutch origin. All the participants completed measures before and after the intervention, as well as three months later at follow-up to assess depression (CES-D), anxiety (HADS-A), fatigue (CIS), alcohol use and acceptance (AAQ-II). RESULTS: The ACT intervention led to statistically significant reduction in depressive symptomatology (Cohen's d=.60). These reductions were maintained at the three-month follow-up. Also significant reductions in anxiety and fatigue were observed. Moreover, mediational analysis showed that the improvement of acceptance during the intervention mediated the effects of the intervention on depressive symptomatology at follow-up. CONCLUSION: These findings suggest that an early intervention based on ACT, aimed at increasing acceptance, is effective in reducing depressive symptomatology.

Individual-context interaction as a guide in the treatment of personality disorders.

The diagnosis and treatment of personality disorders is strongly influenced by personality theories based on trait models, and the influence of the context is relatively neglected. Developments within psychology and neurobiology have led to the awareness that the manner in which personality characteristics are expressed is strongly determined by interaction with the context. The clinical implications of these developments are set out and Acceptance and Commitment Therapy (Hayes, Strosahl, & Wilson, 1999) is highlighted as a development within psychotherapy that is linked to a contextual diagnosis. Employment reintegration of patients with personality disorders is presented as an example of a context-oriented approach. Neurobiological insights support the idea that active focusing on the outer world reduces negative affects.