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Adv Exp Med Biol ; 1191: 291-329, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32002935


Anxiety disorders are an enormous societal burden given their high lifetime prevalence among adult populations worldwide. A variety of anxiety disorders can be successfully treated with psychological treatments such as cognitive behavioral therapy (CBT), mindfulness-based cognitive therapy (MBCT), and acceptance and commitment therapy (ACT), either as stand-alone individual or group treatment or as adjunctive treatment to pharmacotherapy. Furthermore, a growing body of evidence suggests that therapist-guided Internet-delivered CBT (iCBT) and, to some degree, digitalized mindfulness- and acceptance-based interventions may be an efficacious complement to traditional face-to-face therapy. In view of the current advances regarding the integration of traditional and innovative treatment approaches, this chapter provides an overview on the theory and evidence base for different delivery modes of CBT-related interventions for specific phobia, panic disorder, agoraphobia, social anxiety disorder, and generalized anxiety disorder in adults. Finally, implications for clinical practice and research will be derived, and future directions for the psychological treatment of anxiety disorders will be outlined.

Terapia de Aceitação e Compromisso , Transtornos de Ansiedade/psicologia , Transtornos de Ansiedade/terapia , Terapia Cognitivo-Comportamental , Atenção Plena , Humanos , Transtornos Fóbicos/psicologia , Transtornos Fóbicos/terapia , Resultado do Tratamento
Behav Ther ; 50(6): 1112-1124, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31735246


Traditional cognitive-behavioral therapy (CBT) for anxiety disorders has been designed to target reductions in negative affect (NA) associated with defense-related processes. However, a subset of anxiety disorders, including social anxiety disorder (SAD), are also characterized by low positive affect (PA) resulting from separate deficits in appetitive-related processes. In contrast to CBT, "third-wave" approaches, such as acceptance and commitment therapy (ACT), align more consistently with motivational processes and, as a result, PA. However, the differential effect of CBT and ACT on PA and NA has yet to be investigated. Using secondary data from a randomized controlled trial, the present study sought to compare CBT's (n = 45) and ACT's (n = 35) effect on PA and NA in SAD. Findings were compared to a wait-list (WL) control condition (n = 31), as well as normative data from a general adult sample. Baseline PA and NA were also examined as moderators and predictors of theory-relevant treatment outcomes. NA decreased significantly in both CBT and ACT from pre to posttreatment. Although ACT outperformed WL in reducing NA, this effect was not observed for CBT. PA increased significantly in both CBT and ACT from pre to posttreatment, with neither ACT nor CBT outperforming WL in increasing PA. Neither PA nor NA were found to moderate theoretically relevant treatment outcomes. Findings suggest that ACT and CBT share common treatment mechanisms, making them more similar than distinct. Further efforts should be focused on optimizing CBT's and ACT's influence on threat and reward learning, and elucidating common processes of change.

Terapia de Aceitação e Compromisso/estatística & dados numéricos , Afeto , Transtornos de Ansiedade/terapia , Terapia Cognitivo-Comportamental/estatística & dados numéricos , Adulto , Cognição , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Fobia Social , Resultado do Tratamento , Listas de Espera , Adulto Jovem
J Autism Dev Disord ; 49(12): 4761-4779, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31451967


The current meta-analysis comprehensively reviewed group-design studies of interventions designed to improve ASD caregiver psychosocial outcomes and explored potential moderators of effectiveness. Forty-one unique studies targeting 1771 caregivers met inclusion criteria. Overall, the interventions had a small positive effect in improving psychosocial outcomes in caregivers of individuals with ASD (within-subjects: Hedges' g = .44; between-subjects: Hedges' g = .28). Most intervention approaches demonstrated some evidence of effectiveness. Acceptance and commitment therapy, mindfulness-based interventions, and cognitive behavioral treatments demonstrated the strongest impact in improving caregiver psychosocial outcomes in pre-post comparisons. Although the results provide preliminary support for the effectiveness of caregiver-focused interventions, more studies with larger sample sizes, rigorous research designs, and long-term follow-up assessments are needed.

Terapia de Aceitação e Compromisso/métodos , Transtorno do Espectro Autista/psicologia , Transtorno do Espectro Autista/terapia , Cuidadores/psicologia , Terapia de Aceitação e Compromisso/tendências , Humanos , Resultado do Tratamento
J Altern Complement Med ; 25(7): 753-761, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31314564


Objectives: Nurses and nurse aides experience high rates of physical injury, assault, and abuse compared to other occupations. They also frequently have intersectional identities with other groups that experience higher rates of mental and physical health challenges and problems. In addition to belonging to these multiple vulnerable populations, nurses and nurse aides experience high levels of work stress and burnout. These variables are risk factors for injuries associated with lifting and transferring, as well as assault from residents. Given the focus on present moment awareness, commitment to values, and responding flexibly in difficult situations, Acceptance and Commitment Therapy (ACT) may be an effective approach for this population. Design: Participants were randomly assigned to either the ACT group condition or a wait-list control condition. Participants completed baseline and one-month follow-up outcome measures. Setting/Location: The interventions were provided at participant work sites (nursing homes and assisted living facilities) that were located in multiple locations across Northern Ohio. Subjects: Seventy-one nurses and nurse aides participated in the study. Of these, 37 were randomly assigned to the ACT group intervention and 34 were assigned to the wait-list control group. Intervention: A two-session group-based ACT intervention. Each session was 2.5 hours long and spaced one-week apart. The intervention topics included acceptance, mindfulness, psychological flexibility, willingness to experience discomfort, present-moment focus, self-as-context, values identification, and values-congruent committed action. Outcome measures: Days missed due to injury, frequency of work-based injuries, musculoskeletal complaints, mental health symptoms, and overall satisfaction with the intervention. Results: Participants in the ACT group reported significantly fewer days missed due to injury and a significant reduction in mental health symptoms compared to the control group. Participants in the ACT group rated the intervention very favorably. Conclusion: A group-based ACT intervention can promote improvements in well-being for nurses and nurse aides working in long-term care settings. Further research in this area would benefit from conducting group-based ACT interventions at different organizational levels.

Terapia de Aceitação e Compromisso , Assistência de Longa Duração , Enfermeiras e Enfermeiros , Assistentes de Enfermagem , Traumatismos Ocupacionais/prevenção & controle , Estresse Ocupacional/terapia , Adulto , Atitude do Pessoal de Saúde , Esgotamento Profissional/terapia , Feminino , Humanos , Masculino , Distribuição Aleatória
BMC Psychol ; 7(1): 35, 2019 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-31202270


BACKGROUND: Partners are often the main caregivers in the care for patients with amyotrophic lateral sclerosis (ALS) and progressive muscular atrophy (PMA). Providing care during the progressive and fatal disease course of these patients is challenging and many caregivers experience feelings of distress. A blended psychosocial support program based on Acceptance and Commitment Therapy was developed to support partners of patients with ALS and PMA. The aim of this qualitative study is to gather insight into experiences with different components of the support program (program evaluation) and to discover what caregivers gained from following the program (mechanisms of impact). METHODS: Individual in-depth interviews, about caregivers' experiences with the support program were conducted with 23 caregivers of ALS/PMA patients enrolled in a randomized controlled trial designed to measure the effectiveness of the blended psychosocial support program. The program, performed under the guidance of a psychologist, consists of psychoeducation, psychological and mindfulness exercises, practical tips and information, and options for peer contact. Interviews were audio-recorded, transcribed verbatim and analyzed thematically. RESULTS: The program evaluation showed that caregivers perceived each component of the program as beneficial but ambivalent reactions were expressed about the mindfulness exercises and peer contact functions. Caregivers expressed the need for a more personalized program with respect to the order and timing of the modules and wanted to continue the support program for a longer time. The main mechanism of impact of the program that caregivers reported was that they became more aware of their own situation. They further indicated that the program helped them to perceive control over the caregiving situation, to accept negative emotions and thoughts, to be there for their partner and feel acknowledged. CONCLUSIONS: The blended psychosocial support program for caregivers of patients with ALS/PMA is valued by caregivers for enhancing self-reflection on their challenging situation which stimulated them to make choices in line with their own needs and increased their feeling of control over caregiving. The different components of the program were overall appreciated by caregivers, but the mindfulness and peer support components should be further adapted to the needs of the caregivers. TRIAL REGISTRATION: Dutch Trialregister NTR5734 , registered 28 March 2016.

Esclerose Amiotrófica Lateral/psicologia , Cuidadores/psicologia , Atrofia Muscular Espinal/psicologia , Sistemas de Apoio Psicossocial , Cônjuges/psicologia , Terapia de Aceitação e Compromisso , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa
Int. j. psychol. psychol. ther. (Ed. impr.) ; 19(2): 173-188, jun. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-183855


No disponible

Evidence about using Acceptance and Commitment Therapy (ACT) with children and adolescents is reviewed. ACT is introduced as the most representative contextual therapy. Functional-Contextual basis of ACT and the Relational Framework Theory (RFT) are described. It is also described in a briefly manner the clinical proposal as regards the conception of psychological disorders as a psychological inflexibility problem, and to promote psychological flexibility as its main therapeutic aim. ACT is a therapy relying on sufficient evidence regarding its clinical utility within a diverse range of disorders, although most of this evidence is provided by research conducted within an adult population. Thus, the aim of this review is the search of papers describing the application of ACT to children and adolescents, with the purpose of analysing its effectiveness in such field of application. A total of 42 studies are analysed, being notable the increase in studies over the last 5 years, the great variety of disorders addressed, the reduced number of sessions over time and the favourable clinical results obtained. It is concluded about the effectiveness of ACT when applied to children and young people

Humanos , Masculino , Feminino , Criança , Adolescente , Terapia de Aceitação e Compromisso/métodos , Transtornos do Neurodesenvolvimento/terapia , Transtornos Mentais/terapia , Teoria Psicológica , Resultado do Tratamento , Psicoterapia Breve/métodos
Womens Health Issues ; 29(3): 267-273, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31060890


BACKGROUND: Most of our knowledge base regarding treatment response among veterans comes from predominantly male samples. Evidence suggests, however, that women and men use different coping strategies, which may impact how effective treatments are for people of different genders. The purpose of this investigation was to examine gender differences in response to acceptance and commitment therapy, an empirically supported transdiagnostic psychotherapy. METHODS: Data were drawn from a multisite, randomized, controlled trial of acceptance and commitment therapy as compared with a psychotherapy control, namely, present-centered therapy (PCT), in veterans with emotional distress who served in Operations Enduring Freedom, Iraqi Freedom, or New Dawn (OEF/OIF/OND). Although the original trial did not find a difference between acceptance and commitment therapy and present-centered therapy, we were interested in examining whether gender differences may have been obscured in the original analyses. This secondary analysis included 117 participants for whom at least one post-baseline data point was available and examined the role of gender in treatment response. RESULTS: Gender differences were not observed on the primary outcome of general distress, but were observed in post-traumatic stress disorder symptoms (p < .01). CONCLUSIONS: These preliminary results suggest the possibility of gender differences in psychotherapy response and should motivate additional study of gender-specific care.

Terapia de Aceitação e Compromisso/estatística & dados numéricos , Adaptação Psicológica , Fatores Sexuais , Transtornos de Estresse Pós-Traumáticos/terapia , Veteranos/psicologia , Adulto , Campanha Afegã de 2001- , Feminino , Humanos , Guerra do Iraque 2003-2011 , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Estados Unidos
Psychiatr Clin North Am ; 42(2): 219-229, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31046924


The authors present the theoretic model, structure of treatment, and preliminary evidence for several emerging treatments that are increasingly being used and studied in eating disorders treatment, including dialectical behavior therapy, acceptance and commitment therapy, integrative cognitive-affective therapy, and neuromodulation. In addition, the article discusses treatments that address mindfulness, interpersonal factors, and habit.

Terapia de Aceitação e Compromisso , Anorexia Nervosa/terapia , Transtorno da Compulsão Alimentar/terapia , Bulimia Nervosa/terapia , Atenção Plena , Psicoterapia , Humanos
Int. j. clin. health psychol. (Internet) ; 19(2): 97-106, mayo 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-184931


Background/Objective: Cancer and its treatment can have a detrimental impact on psychological well-being. Acceptance as the basis of acceptance and commitment therapy (ACT) has shown beneficial effects on depression and anxiety. However, its elationship to fatigue and cognitive impairment has not been investigated. A protective effect of acceptance may open up a new target for psychological intervention. Method: A cross-sectional postal survey was undertaken. 922 hematological cancer survivors (≥ 2.5 years post diagnosis) were recruited through two regional cancer registries in Germany. Acceptance (AAQ-II), fatigue (BFI) and subjective cognitive impairment (AFI) were assessed. Results: Higher levels of acceptance were negatively associated with fatigue and subjective cognitive impairment (R2= .34 and R2= .26, respectively). The relationship between fatigue and fatigue-related impairment of daily life was weaker for survivors with high acceptance. Conclusions: Acceptance is strongly associated with fatigue and subjective cognitive impairment. ACT may be useful to reduce symptoms of fatigue and subjective cognitive impairment in cancer survivors

Antecedentes/Objetivo: El cáncer y su tratamiento pueden tener un impacto perjudicial sobre el bienestar psicológico. La aceptación, base de la terapia de aceptación y compromiso (ACT), ha mostrado efectos beneficiosos sobre la depresión y la ansiedad. Sin embargo, su relación con la fatiga y el deterioro cognitivo no ha sido investigada. Un efecto protector de la aceptación puede abrir un nuevo objetivo para la intervención psicológica. Método: Se llevó a cabo un estudio transversal de encuesta por correo. Un total de 922 supervivientes al cáncer hematológico (≥ 2,5 años después del diagnóstico) fueron reclutados a través de dos registros regionales en Alemania. Se evaluaron la aceptación (AAQ-II), la fatiga (BFI) y el deterioro cognitivo subjetivo (AFI). Resultados: Los niveles elevados de aceptación se asociaron negativamente con la fatiga y el deterioro cognitivo subjetivo (R2= 0,34 y R2= 0,26, respectivamente). La relación entre fatiga y deterioro ede la vida diaria relacionado con la fatiga fue más débil en supervivientes con una mayor aceptación. Conclusiones: La aceptación se asocia fuertemente con la fatiga y el deterioro cognitivo subjetivo. La ACT puede ser útil para reducir los síntomas de fatiga y el deterioro cognitivo subjetivo en supervivientes al cáncer

Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Neoplasias Hematológicas/psicologia , Disfunção Cognitiva/psicologia , Fadiga Mental/psicologia , Sobreviventes/psicologia , Terapia de Aceitação e Compromisso , Estudos Transversais , Escolaridade , Inquéritos e Questionários
Trials ; 20(1): 198, 2019 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-30953556


BACKGROUND: Suicide amongst Australian Aboriginal and Torres Strait Islander communities occurs at twice the rate of the general population and, with significant barriers to treatment, help-seeking prior to a suicide attempt is low. This trial aims to test the effectiveness of an app (iBobbly) designed with Aboriginal and Torres Strait Islander people for reducing suicidal ideation. METHODS/DESIGN: This is a two-arm randomised controlled trial that will compare iBobbly to a wait-list control condition. The trial aims to recruit Aboriginal and Torres Strait Islander participants aged 16 years and over to test iBobbly, which is a self-help app delivering content based on acceptance and commitment therapy. The primary outcome for the study is suicidal ideation, and secondary outcomes include depression, hopelessness, distress tolerance, perceived burdensomeness and thwarted belonging, and help-seeking intentions. Data will be collected for both groups at baseline, post-intervention (after 6 weeks of app use), and at 6 months post-baseline (with a final 12-month follow-up for the iBobbly group). Primary analysis will compare changes in suicidal ideation for the intervention condition relative to the wait-list control condition using mixed models. An examination of the cost-effectiveness of the intervention compared to the control condition will be conducted. DISCUSSION: If effective, iBobbly could overcome many barriers to help-seeking amongst a group of people who are at increased risk of suicide. It may provide a low-cost, accessible intervention that can reach more people. This trial will add to a sparse literature on indigenous suicide prevention and will increase our knowledge about the effectiveness of e-health interventions for suicide prevention. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry, ACTRN12614000686606 . Registered on 30 June 2014.

Terapia de Aceitação e Compromisso/instrumentação , Telefone Celular , Saúde Mental , Aplicativos Móveis , Grupo com Ancestrais Oceânicos/psicologia , Ideação Suicida , Suicídio/prevenção & controle , Telemedicina/instrumentação , Terapia de Aceitação e Compromisso/métodos , Austrália , Feminino , Acesso aos Serviços de Saúde , Humanos , Masculino , Estudos Multicêntricos como Assunto , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Suicídio/etnologia , Suicídio/psicologia , Telemedicina/métodos , Fatores de Tempo , Resultado do Tratamento
Encephale ; 45(3): 263-270, 2019 Jun.
Artigo em Francês | MEDLINE | ID: mdl-30961969


Obesity has become a public health problem. But care, mainly diets, is often ineffective over the long term. Emotional therapies seem to be an interesting track especially for emotional eating. After defining two key concepts of emotional eating and acceptance, the theoretical frameworks of the different emotional therapies used in the treatment of overweight or obesity will be presented: Mindfulness-Based for Eating Disorder (MB-EAT), Acceptance and Commitment Therapy, and Acceptance-Based Behavioral Treatment for Weight Loss (ABT). The goal is to understand their usefulness in the treatment of overweight or obesity and perhaps avoid using contradictory techniques such as dieting with mindfulness. If current results are promising, the effectiveness of these therapies needs to be confirmed by new studies. Finally, the article points to the emergence of new "integrative" therapies that resemble the others presented and are related but are in fact the exact opposite. Control and acceptance are indeed antithetical.

Emoções , Obesidade/psicologia , Obesidade/terapia , Sobrepeso/psicologia , Sobrepeso/terapia , Terapia de Aceitação e Compromisso , Terapia Comportamental , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Humanos , Atenção Plena , Psicoterapia
Behav Cogn Psychother ; 47(6): 686-696, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30992093


BACKGROUND: Acceptance and commitment therapy (ACT) is a psychological treatment that has been found to increase weight loss in adults when combined with lifestyle modification, compared with the latter treatment alone. However, an ACT-based treatment for weight loss has never been tested in adolescents. METHODS: The present pilot study assessed the feasibility and acceptability of a 16-week, group ACT-based lifestyle modification treatment for adolescents and their parents/guardians. The co-primary outcomes were: (1) mean acceptability scores from up to 8 biweekly ratings; and (2) the percentage reduction in body mass index (BMI) from baseline to week 16. The effect size for changes in cardiometabolic and psychosocial outcomes from baseline to week 16 also was examined. RESULTS: Seven families enrolled and six completed treatment (14.3% attrition). The mean acceptability score was 8.8 for adolescents and 9.0 for parents (on a 1-10 scale), indicating high acceptability. The six adolescents who completed treatment experienced a 1.3% reduction in BMI (SD = 2.3, d = 0.54). They reported a medium increase in cognitive restraint, a small reduction in hunger, and a small increase in physical activity. They experienced small improvements in most quality of life domains and a large reduction in depression. CONCLUSIONS: These preliminary findings indicate that ACT plus lifestyle modification was a highly acceptable treatment that improved weight, cognitive restraint, hunger, physical activity, and psychosocial outcomes in adolescents with obesity.

Terapia de Aceitação e Compromisso , Obesidade/psicologia , Obesidade/terapia , Perda de Peso , Programas de Redução de Peso , Adolescente , Índice de Massa Corporal , Criança , Depressão/complicações , Depressão/prevenção & controle , Exercício , Feminino , Estilo de Vida Saudável , Humanos , Masculino , Obesidade/complicações , Pais , Projetos Piloto , Qualidade de Vida
Psychotherapy (Chic) ; 56(1): 16-20, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30816758


This article describes the initial phase of acceptance and commitment therapy (ACT). The article begins with a review of ACT's theoretical orientation. Basic empirical support for ACT and its model are covered. A case description follows that highlights the initial phases of ACT. The article concludes with practical recommendations for starting therapy using ACT. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Terapia de Aceitação e Compromisso/métodos , Transtornos de Ansiedade/terapia , Depressão/terapia , Relações Profissional-Paciente , Adulto , Transtornos de Ansiedade/complicações , Transtornos de Ansiedade/psicologia , Depressão/complicações , Depressão/psicologia , Feminino , Humanos
Psicol. ciênc. prof ; 39: 1-13, jan.-mar.2019.
Artigo em Português | LILACS, Index Psicologia - Periódicos técnico-científicos | ID: biblio-1016767


Este trabalho teve como objetivo descrever um relato de experiência a partir de um Programa de Intervenção com mulheres em situação de infertilidade. Tal Programa faz parte do Projeto de Extensão da UEL/PR, na área da Psicologia, com fundamento na Análise do Comportamento. Foram realizados dois grupos, compostos por sete mulheres cada, de Londrina e região, entre 31 e 42 anos, em situação de infertilidade conjugal. Realizou-se 10 sessões, de aproximadamente duas horas cada, semanalmente. Após dois meses do término, realizou-se sessões de followup. Os procedimentos utilizados foram técnicas de dinâmica de grupo, técnicas da Análise do Comportamento, como modelagem e modelação, Terapia de Aceitação e Compromisso (ACT) e Psicoterapia Analítica funcional (FAP). Realizou-se avaliações qualitativas por meio de dados obtidos com os relatos das participantes. A partir da fala das participantes, puderam ser percebidas mudanças em seus comportamentos, tanto dentro das sessões quanto em seu ambiente natural, de acordo com seus relatos verbais. A intervenção grupal tem o potencial de promover a aprendizagem de um repertório de enfrentamento das dificuldades relacionadas à infertilidade, o fortalecimento de aspectos positivos no relacionamento conjugal e social, além da aceitação emocional e seu manejo. Durante as sessões de follow-up, quatro participantes relataram estar dando início ao processo de adoção e, cinco participantes conseguiram atingir a gravidez. Sugere-se a replicação deste Programa com este tipo de população, bem como estudos com controle de variáveis....(AU)

This study aimed to report a clinical intervention, based on the principles of Behavior Analysis, in two groups of women in infertility situation. This program is part of the Extension Project of UEL/PR, in the field of Psychology, based on Behavior Analysis. Each group assisted seven women, between 31 and 42 years, in situation of conjugal infertility. Eleven sessions were held, approximately two hours each, once a week. After two months of the end of the groups, follow-up sessions were realized to monitor the changes observed. The procedures were group dynamics, problem solving and decision making techniques, Social Skills Training, Acceptance and Commitment Therapy (ACT) and Functional Analytic Psychotherapy (FAP). To this end, it was sought to do Functional Analysis of the behaviors of each participant. Quantitative and qualitative evaluation, from data obtained with the session reports was realized. The group intervention led to the learning of a behavioral repertoire of coping with the difficulties related to infertility, the strengthening of positive aspects in the marital and social relationship, besides the emotional acceptance and its handling. During and after the follow-up sessions, four participants reported being starting the process of adoption and five participants were able to achieve pregnancy. It is suggested that further studies with wider control variables should be conducted to test the effectiveness of the procedures used....(AU)

El objetivo de este trabajo fue describir un relato de experiencia proveniente del programa de intervención con mujeres en situación de infertilidad. El programa forma parte de un Proyecto de Extensión, de la Universidad Estatal de Londrina (UEL), Provincia de Paraná, en el área de la Psicología, con base en el Análisis del Comportamiento. Se formaron dos grupos con siete mujeres, entre 31 y 42 años, en situación de infertilidad. Se llevaron a cabo 10 sesiones de aproximadamente dos horas semanales. Dos meses después del término, se realizaron sesiones de follow-up. Los procedimientos utilizados fueron técnicas de dinámica de grupo, técnicas de Análisis de Comportamiento tales como el modelado y modelado, Terapia de Aceptación y Compromiso (ACT) y Psicoterapia Analítica Funcional (FAP). Se realizaron evaluaciones cualitativas por medio de datos obtenidos con los relatos de las participantes. A partir del habla de las participantes, se pudieron percibir cambios en sus comportamientos, tanto dentro de las sesiones y en su ambiente natural, de acuerdo con sus relatos verbales. La intervención grupal tiene el potencial de promover el aprendizaje de un repertorio de enfrentamiento de las dificultades relacionadas a la infertilidad, el fortalecimiento de aspectos positivos en la relación conyugal y social, además de la aceptación emocional y su manejo. Durante las sesiones de follow up, cuatro participantes relataron que estaban dando inicio al proceso de adopción y cinco participantes lograron el embarazo. Se sugiere la replicación de este Programa con este tipo de población, así como estudios con control de variables....(AU)

Humanos , Feminino , Psicoterapia de Grupo , Terapia de Aceitação e Compromisso , Infertilidade , Psicoterapia
Psicooncología (Pozuelo de Alarcón) ; 16(1): 101-125, mar. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-184802


Introducción: Aunque se han publicado muchos estudios que han intentado demostrar la eficacia de diferentes tratamientos psicológicos en pacientes con cáncer; hasta la fecha no se ha revisado la evidencia disponible sobre la eficacia de la Terapia de Aceptación y Compromiso (ACT) en estos pacientes. Objetivo: se pretende analizar sistemáticamente la evidencia empírica sobre la ACT en el tratamiento psicológico de los enfermos con cáncer. Método: se ha realizado una búsqueda en las bases de datos PubMed, Science Direct, Medline, Psychology and Behavioral Sciences Collection, Journal of Contextual Psychology y Cochrane Biblioteca. Resultados: De los 108 artículos encontrados, se han seleccionado para la revisión un total de 8, que seguían un diseño experimental o cuasiexperimental en pacientes adultos diagnosticados de cáncer tratados con ACT. Conclusiones: Los resultados, aunque heterogéneos, sugieren mejorías a medio - largo plazo en las variables de ansiedad, depresión, aceptación, calidad de vida, distrés y flexibilidad psicológica. Además, la ACT ha resultado ser más eficaz que otras terapias psicológicas. De este modo, a pesar de las limitaciones encontradas en este estudio, se han obtenido resultados prometedores para futuras revisiones y/ o metaanálisis

Introduction: Although many studies have been published that have tried to demonstrate the efficacy of different psychological treatments in patients with cancer; to date, the available evidence on the effectiveness of Acceptance and Commitment Therapy (ACT) in these patients has not been reviewed. Objetive: The aim is to systematically analyze the empirical evidence on ACT in the psychological treatment of patients with cancer. Method: A search was made in PubMed, Science Direct, Medline, Psychology and Behavioral Sciences Collection, Journal of Contextual Psychology, and Cochrane Library databases. Results: Among the 108 articles found, a total of 8 were selected for the review, which followed an experimental or quasi-experimental design in adult patients diagnosed with cancer treated with ACT. Conclusions: The results, although heterogeneous, suggest improvements in the medium -long term after ACT intervention in the symptoms of anxiety, depression, acceptance quality of life, distress and psychological flexibility. In addition, ACT has been found to be more effective compared to other psychological therapies. Thus, despite the limitations found in this study, promising results have been obtained for future reviews and / or meta-analyzes

Humanos , Neoplasias/psicologia , Terapia de Aceitação e Compromisso , Medicina Baseada em Evidências
BMJ Open ; 9(1): e025115, 2019 01 09.
Artigo em Inglês | MEDLINE | ID: mdl-30782749


INTRODUCTION: Despite the importance of regular moderate-intensity to vigorous-intensity physical activity (MVPA) for health benefits and long-term weight management, current comprehensive lifestyle interventions have focused on providing MVPA prescriptions and goals but with only minimal and intermittent focus on psychosocial theoretical constructs and novel strategies, perhaps explaining the often modest impact on adoption and maintenance of higher levels of MVPA. An intervention based on acceptance and commitment therapy (ACT) targeting the increase of values-based autonomous motivation could improve the adoption and maintenance of habitual MVPA among insufficiently active overweight or obese adults in a brief intervention format. METHODS AND ANALYSIS: The overall aim of this study is to develop and test the feasibility, acceptability and preliminary efficacy of an ACT-based brief workshop intervention for increasing bouted MVPA for inactive adults with overweight/obesity using a single-arm design. A total of 48 inactive adults with overweight/obesity will be recruited and attend a 4-hour, ACT-based workshop followed by weekly emails and monthly phone calls for 3 months. The workshop will teach values clarification and acceptance-based skills to increase values-based autonomous motivation and bouted MVPA. Participants will self-monitor minutes of MVPA and personal values and report on progress via weekly emails and monthly phone calls. Assessments will be conducted at baseline and at 3 and 6 months. ETHICS AND DISSEMINATION: Study procedures have been approved by the Institutional Review Board. Consent is given in writing and in person. Data collection and storage separates study data from personally identifying information. Two safety officers who are not connected to the study monitor study progress and participant safety. TRIAL REGISTRATION NUMBER: NCT03565731; Pre-results.

Terapia de Aceitação e Compromisso , Exercício , Promoção da Saúde/métodos , Obesidade/terapia , Sobrepeso/terapia , Ensaios Clínicos como Assunto , Humanos , Estilo de Vida , Motivação , Análise de Regressão , Rhode Island , Comportamento Sedentário
Obesity (Silver Spring) ; 27(4): 565-571, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30806492


OBJECTIVE: In the Mind Your Health Trial, acceptance-based behavioral treatment (ABT) for obesity outperformed standard behavioral treatment (SBT) at posttreatment. This trial compared effects over 2 years of follow-up. METHODS: Participants with overweight or obesity (n = 190) were randomized to 25 sessions of SBT or ABT over 1 year and assessed at months 12 (i.e., posttreatment), 24 (1 year posttreatment), and 36 (2 years posttreatment). RESULTS: Weight-loss differences previously observed at 12 months attenuated by follow-up, though a large difference was observed in the proportion of treatment completers who maintained 10% weight loss at 36 months (SBT = 17.1% vs. ABT = 31.6%; P = 0.04; intent-to-treat: SBT = 14.4% vs. ABT = 25.0%; P = 0.07). The amount of regain between posttreatment and follow-up did not differ between groups. ABT produced higher quality of life at 24 and 36 months. Autonomous motivation and psychological acceptance of food-related urges mediated the effect of condition on weight. No moderator effects were identified. CONCLUSIONS: Overall, results suggest that infusing SBT for weight loss with acceptance-based strategies enhances weight loss initially, but these effects fade in the years following the withdrawal of treatment. Even so, those receiving ABT were about twice as likely to maintain 10% weight loss at 36 months, and they reported considerably higher quality of life.

Terapia de Aceitação e Compromisso/métodos , Terapia Comportamental/métodos , Obesidade/terapia , Adolescente , Adulto , Idoso , Peso Corporal , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/psicologia , Sobrepeso/terapia , Qualidade de Vida , Resultado do Tratamento , Perda de Peso , Adulto Jovem
Alcohol Alcohol ; 54(2): 159-166, 2019 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30796777


AIMS: Third wave therapies have shown efficacy for treating emotional disorders and potential for treating substance use disorders. There is developing interest in whether they can more specifically be used for treating alcohol use disorders (AUDs). We were interested in whether third wave therapies have value alongside current evidence-based psychosocial treatments for AUDs. METHOD: We conducted systematic reviews of third wave therapies for AUDs. We searched PsycINFO, Embase and Medline for peer reviewed journal articles where mindfulness or Acceptance and Commitment Therapy (ACT) were used to treat adults with AUDs or alcohol use that caused impairment. RESULTS: We identified 11 studies where mindfulness was used for treating AUDs and 6 where ACT was used for AUDs. The studies identified included RCTs, non-randomized controlled studies and uncontrolled studies. We found preliminary support that both third wave therapies are better than no treatment, treatments of minimal efficacy, as well as some evidence they are comparable to effective psychosocial treatments for AUDs. CONCLUSIONS: We conclude ACT and mindfulness provide an alternative to existing treatments, particularly for patients who have not responded to, or have disengaged from, standard treatments. We also found some evidence ACT and mindfulness are useful for comorbid mental health conditions. Yet while these results are promising, further research is needed to determine their utility, ideally employing randomized-controlled designs, larger clinical samples and longer follow-ups. Furthermore, few studies in this review directly compared third wave therapies to first line treatments, making it difficult to determine their relative efficacy.

Terapia de Aceitação e Compromisso , Alcoolismo/terapia , Atenção Plena , Humanos