Hoel Sydney, Victory Amanda, Sagorac Gruichich Tijana, Stowe Zachary N, McInnis Melvin G, Cochran Amy, Thomas Emily B K
Psychiatry, University of Wisconsin-Madison, Madison, WI, United States.
Psychiatry, University of Michigan, Ann Arbor, MI, United States.
Front Digit Health. 2022 May 12;4:869143. doi: 10.3389/fdgth.2022.869143. eCollection 2022.
Mobile transdiagnostic therapies offer a solution to the challenges of limited access to psychological care. However, it is unclear if individuals can actively synthesize and adopt concepts and skills via an app without clinician support.
The present study measured comprehension of and engagement with a mobile acceptance and commitment therapy (ACT) intervention in two independent cohorts. Authors hypothesized that participants would recognize that behaviors can be flexible in form and function and respond in an ACT process-aligned manner.
Mixed-methods analyses were performed on open-ended responses collected from initial participants ( = 49) in two parallel micro-randomized trials with: 1) first-generation college students (FGCSs) ( = 25) from a four-year public research university and 2) individuals diagnosed with bipolar disorder (BP) ( = 24). Twice each day over six weeks, participants responded to questions about mood and behavior, after which they had a 50-50 chance of receiving an ACT-based intervention. Participants identified current behavior and categorized behavior as values-based or avoidant. Interventions were selected randomly from 84 possible prompts, each targeting one ACT process: engagement with values, openness to internal experiences, or self-awareness. Participants were randomly assigned to either exploratory (10 FGCS, 9 BP) or confirmatory (15 FGCS, 15 BP) groups for analyses. Responses from the exploratory group were used to inductively derive a qualitative coding system. This system was used to code responses in the confirmatory group. Coded confirmatory data were used for final analyses.
Over 50% of participants in both cohorts submitted a non-blank response 100% of the time. For over 50% of participants, intervention responses aligned with the target ACT process for at least 96% of the time (FGCS) and 91% of the time (BP), and current behavior was labeled as values-based 70% (FGCS) and 85% (BP) of the time. Participants labeled similar behaviors flexibly as either values-based or avoidant in different contexts. Dominant themes were needs-based behaviors, interpersonal and family relationships, education, and time as a cost.
Both cohorts were engaged with the app, as demonstrated by responses that aligned with ACT processes. This suggests that participants had some level of understanding that behavior can be flexible in form and function.
移动跨诊断疗法为心理护理获取受限的挑战提供了解决方案。然而，尚不清楚个体能否在没有临床医生支持的情况下通过应用程序积极综合并采用相关概念和技能。
本研究在两个独立队列中测量了对移动接受与承诺疗法（ACT）干预的理解和参与情况。作者假设参与者会认识到行为在形式和功能上可以是灵活的，并以与ACT过程一致的方式做出反应。
对从两项平行微随机试验的初始参与者（n = 49）收集的开放式回答进行混合方法分析，这两项试验的参与者分别为：1）来自一所四年制公立研究型大学的第一代大学生（FGCSs）（n = 25）和2）被诊断患有双相情感障碍（BP）的个体（n = 24）。在六周时间里，参与者每天两次回答关于情绪和行为的问题，之后他们有50%的机会接受基于ACT的干预。参与者识别当前行为并将行为分类为基于价值观的或回避型的。干预措施从84个可能的提示中随机选择，每个提示针对一个ACT过程：参与价值观、对内部体验保持开放或自我意识。参与者被随机分配到探索性组（10名FGCS，9名BP）或验证性组（15名FGCS，15名BP）进行分析。探索性组的回答用于归纳得出一个定性编码系统。该系统用于对验证性组的回答进行编码。编码后的验证性数据用于最终分析。
两个队列中超过50%的参与者在100%的时间里提交了非空白回答。对于超过50%的参与者，干预回答在至少96%的时间里（FGCS）和91%的时间里（BP）与目标ACT过程一致，并且当前行为在70%（FGCS）和85%（BP）的时间里被标记为基于价值观的。参与者在不同情境下灵活地将类似行为标记为基于价值观的或回避型的。主要主题是基于需求的行为、人际关系和家庭关系、教育以及时间成本。
两个队列都参与了该应用程序，这通过与ACT过程一致的回答得到证明。这表明参与者在一定程度上理解行为在形式和功能上可以是灵活的。
