@Article{info:doi/10.2196/mhealth.5437,
author="Batink, Tim
and Bakker, Jindra
and Vaessen, Thomas
and Kasanova, Zuzana
and Collip, Dina
and van Os, Jim
and Wichers, Marieke
and Germeys, Inez
and Peeters, Frenk",
title="Acceptance and Commitment Therapy in Daily Life Training: A Feasibility Study of an mHealth Intervention",
journal="JMIR Mhealth Uhealth",
year="2016",
month="Sep",
day="15",
volume="4",
number="3",
pages="e103",
keywords="mHealth; behavior change; daily life intervention; acceptance and commitment therapy; experience sampling",
abstract="Background: With the development of mHealth, it is possible to treat patients in their natural environment. Mobile technology helps to bridge the gap between the therapist's office and the ``real world.'' The ACT in Daily Life training (ACT-DL) was designed as an add-on intervention to help patients practice with acceptance and commitment therapy in their daily lives. The ACT-DL consists of two main components: daily monitoring using experience sampling and ACT training in daily life. Objectives: To assess the acceptability and feasibility of the ACT-DL in a general outpatient population. A secondary objective was to conduct a preliminary examination of the effectiveness of the ACT-DL.  Methods: An observational comparative study was conducted. The experimental group consisted of 49 patients who volunteered for ACT-DL, and the control group consisted of 112 patients who did not volunteer. As part of an inpatient treatment program, both groups received a 6-week ACT training. Participants went home to continue their treatment on an outpatient basis, during which time the experimental group received the 4-week add-on ACT-DL. Acceptability and feasibility of the ACT-DL was assessed weekly by telephone survey. Effectiveness of the ACT-DL was evaluated with several self-report questionnaires ( Flexibility Index Test (FIT-60): psychological flexibility, Brief Symptom Inventory: symptoms, Utrechtse Coping List: coping, and Quality of life visual analog scale (QoL-VAS): quality of life).  Results: More than three-quarters of the participants (76{\%}) completed the full 4-week training. User evaluations showed that ACT-DL stimulated the use of ACT in daily life: participants practiced over an hour a week (mean 78.8 minutes, standard deviation 54.4), doing 10.4 exercises (standard deviation 6.0) on average. Both ACT exercises and metaphors were experienced as useful components of the training (rated 5 out of 7). Repeated measures ANCOVA did not show significant effects of the ACT-DL on psychological flexibility (P=.88), symptoms (P=.39), avoidant coping (P=.28), or quality of life (P=.15). Conclusions: This is the first study that uses experience sampling to foster awareness in daily life in combination with acceptance and commitment therapy to foster skill building. Adherence to the ACT-DL was high for an intensive mHealth intervention. ACT-DL appears to be an acceptable and feasible mHealth intervention, suitable for a broad range of mental health problems. However, short-term effectiveness could not be demonstrated. Additional clinical trials are needed to examine both short-term and long-term effects. ",
issn="2291-5222",
doi="10.2196/mhealth.5437",
url="http://mhealth.jmir.org/2016/3/e103/",
url="https://doi.org/10.2196/mhealth.5437",
url="http://www.ncbi.nlm.nih.gov/pubmed/27634747"
}