Svanberg Gabriella, Munck Ingrid, Levander Maria
Department of Substance Abuse, The Swedish National Board of Institutional Care, Stockholm.
Department of Education and Special Education, University of Gothenburg, Gothenburg.
Subst Abuse Rehabil. 2017 Jul 26;8:45-51. doi: 10.2147/SAR.S132255. eCollection 2017.
Individuals with substance-use disorder (SUD) often have co-occurring mental health disorders and decreased executive function, both of which are barriers to sustained rehabilitation. Clients with severe SUD can be institutionalized in The Swedish National Board of Institutional Care but are difficult to engage and dropout rates remain high. Recent studies suggest that acceptance and commitment therapy (ACT) is an effective treatment for mental health and SUD.
The overall aims of the present pilot study were to explore a manual-based ACT intervention for clients institutionalized for severe SUD and to describe the effects on mental health, psychological flexibility, and executive function. This pilot study is the first to use a manual-based ACT intervention within an inpatient context.
Eighteen participants received a seven-session ACT intervention tailored for SUD. Statistical analyses were performed for the complete data (n=18) and on an individual level of follow-up data for each participant. In order to follow and describe changes, the strategy was to assess the change in 13 clinical scales from pre-intervention to post-intervention.
Results suggested that there was no change in mental health and a trend implying positive changes for psychological flexibility and for 9 of 10 executive functions (e.g., inhibitory control, task monitoring, and emotional control).
The pilot study suggests clinical gains in psychological flexibility and executive functions both at the Institution regulated by the Care of Alcoholics and Drugabuser Act (also known as LVM home) and at the individual level. Since the sample size does not provide adequate statistical power to generalize and to draw firm conclusions concerning intervention effects, findings are descriptive and preliminary in nature. Further development and implementation of ACT on a larger scale study, including the maintenance phase and a follow-up, is needed.
患有物质使用障碍（SUD）的个体通常同时存在心理健康障碍且执行功能下降，这两者都是持续康复的障碍。患有严重SUD的患者可被安置在瑞典国家机构护理委员会，但难以参与治疗且退出率仍然很高。最近的研究表明，接受与承诺疗法（ACT）是一种治疗心理健康和SUD的有效方法。
本试点研究的总体目标是探索一种基于手册的ACT干预措施，用于因严重SUD而被安置的患者，并描述其对心理健康、心理灵活性和执行功能的影响。这项试点研究是首次在住院环境中使用基于手册的ACT干预措施。
18名参与者接受了为期七节的针对SUD量身定制的ACT干预。对完整数据（n = 18）以及每个参与者的个体随访数据进行了统计分析。为了跟踪和描述变化，策略是评估从干预前到干预后13个临床量表的变化。
结果表明，心理健康没有变化，心理灵活性以及10项执行功能中的9项（例如抑制控制、任务监控和情绪控制）有积极变化的趋势。
该试点研究表明，在《酗酒者和药物滥用者护理法》规定的机构（也称为LVM之家）以及个体层面，心理灵活性和执行功能均有临床改善。由于样本量不足以提供足够的统计效力来进行推广并就干预效果得出确凿结论，因此研究结果本质上是描述性的和初步的。需要在更大规模的研究中进一步开发和实施ACT，包括维持阶段和随访。
