ACT for Depression

Depression is extremely prevalent in the world; more so in the middle and high income countries. Experiential avoidance (EA) is a mechanism that is found to be involved in depression. EA is difficulty remaining in contact with feelings, thoughts and bodily sensations.

One of the interventions targeting EA in patients with depression is Acceptance and Commitment Therapy (ACT), which is a behavioural therapy focussed on decreasing EA and increasing value based behaviour. A group course based on ACT “Living to the full” was developed and presented to the public.

Meant for adults 18 and above with mild or moderate psychological distress and for those wanting to live life fully but hindered by depressive symptoms, 140 subjects were studied during the research.

For process measure, assessments included depression as primary; anxiety, fatigue alcohol and EA as secondary measures. Participants completed measures at 3 stages; baseline, post treatment 2months and 5 months.

The intervention “Living to the full” is based on 6 processes of ACT:

-willingness to experience negative thoughts and emotions

- cognitive defusion

- contact with present moment

- self as context

- values

- committed actions

Participants were encouraged to think what they wanted in life and then reflect on the avoidance and control strategies. Then on how to come into contact with present experience without trying to avoid or control them. Then to focus on how to be aware of personal values and make decisions based on the values.

The final outcome showed significant differences at post treatment and follow up period with more reduction in depression in the ACT intervention group. A reduction in anxiety and fatigue were also found, post treatment.

Depression being one of the most prevalent disorders in the world, ACT has beneficial effects on a broad spectrum of psychological distress. Apart from proving as an intervention in treating depression and its related anxiety and fatigue, ACT suits as a preventive and public health model rather than a disease model.

Bohlmeijer, E.T., Fledderus, M., Rokx T.A.J.J, Pieterse, M.E. (2011). Efficacy of an early intervention based on acceptance and commitment therapy for adults with depressive symptomatology: Evaluation in a randomized controlled trial. Behaviour Research and Therapy 49: 62-67.