Acceptance and commitment therapy with a community older adult sample: a feasibility study investigating mechanisms of change

McGraw, David (2019) Acceptance and commitment therapy with a community older adult sample: a feasibility study investigating mechanisms of change. D Clin Psy thesis, University of Glasgow.

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Abstract

Background: Older people have specific health needs, different to those of working age adults. Acceptance and Commitment Therapy (ACT) may be useful for older adults who often face unchangeable difficulties, and can show a higher motivation to live in line with values. The evidence base is in the early stages, and more information on feasibility and how easy or difficult it is to change behaviour and put the therapy into practice. The COM-B model of behaviour change posits capability, opportunity and motivation as necessary prerequisites for behaviour change.
Aims: To investigate the feasibility of an ACT group intervention; exploring acceptability and suitability. Moreover, using the COM-B model of behaviour change this study aimed to investigate the facilitators and barriers to living in line with values.
Methods/Results: Participants were recruited from a community older adult psychology service, and seeking treatment for mental health disorders such as anxiety and/or depression. Of the 16 participants recruited, 12 attended four or more sessions. Of 20 participants invited to a post intervention qualitative group, 16 attended. Using a mixed methods design, the study also included quantitative measures (e.g. Hospital Anxiety and Depression Scale) at different time points (pre, post & 12 week follow up), and post group interviews with a topic guide derived from the COM-B model. Qualitative data were analysed using Framework Analysis.
Findings suggest that 12 weeks after the intervention finished there was a reduction in anxiety, depression and cognitive fusion scores, and a positive increase in behaving in in line with values. From interviews, barriers to behaviour change include: difficult emotions and negative views of ageing. Memory problems were not reported as
a significant factor, but social supports was reported as being an influential factor in relation to living in line with values.
Conclusions:
The group treatment appears to be feasible with older people as there were positive rates of group completion and questionnaire completion. Additional preliminary data from measures of mood and ACT processes suggests these measures are responsive to change following the intervention. Qualitative data provided an insight into the factors which may facilitate or discourage behaviour change for older people in relation to living in line with one’s values.

Item Type: Thesis (D Clin Psy)
Qualification Level: Doctoral
Keywords: Acceptance and commitment therapy, older adults, feasibility study, behaviour change, COM-B.
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Colleges/Schools: College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
Supervisor's Name: McLeod, Professor Hamish
Date of Award: 2019
Depositing User: Mr David McGraw
Unique ID: glathesis:2019-75059
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 09 Oct 2019 08:07
Last Modified: 09 Oct 2019 10:16
Thesis DOI: 10.5525/gla.thesis.75059
URI: http://theses.gla.ac.uk/id/eprint/75059

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