"Light Bulb Moments": Evaluation of a Transdiagnostic Acceptance and Commitment Therapy Group Intervention for Adjustment in Neurological Conditions

Objectives: The World Health Organisation has predicted that by 2020, brain injury will be one of the leading causes of disability in the world (Hyder et al, 2007). Psychological difficulties are common in this population, with up to 60% of individuals experiencing mental health difficulties (Acquired Bain injury Outreach Service, 2012). Therefore, with the rapid rise in referrals, services are under increasing pressure to provide innovative ways of offering effective and cost-efficient care. This research aimed to evaluate a novel transdiagnostic Acceptance and Commitment Therapy group approach for supporting individuals adjusting to life following the diagnosis of a neurological condition. Methods: A mixed-methods waiting-list control design was used and carried out across two sites of Hertfordshire Neurological Outpatients Service. The outcomes of the group were assessed using four outcome measures evaluating acceptance, self-identified difficulties, low mood and anxiety, as well as a semi-structured interview to identify mediators of change. Results: Ten participants from the intervention group completed, equating to a 76.9% completion rate. The results indicated that those in the intervention group made significant improvements across all measures of acceptance, self-identified difficulties and psychological distress. Those in the waiting list groups did not experience any change in these domains. The qualitative feedback from participants was also highly positive. Participants reported the usefulness of the ACT strategies, in addition to valuing being in a group with others with a range of difficulties. Participants reported greater awareness and acceptance, as well as increased activity and improved mood. Conclusions: The ACT group is a potentially effective and cost-efficient method of supporting individuals with adjustment following diagnosis of a neurological condition. Despite these promising findings it is important to acknowledge the limitations, such as the small sample size and research design. Further research would be beneficial in order to evaluate the intervention using more rigorous methods.