Research

Therapies & Interventions | Acceptance and Commitment Therapy

Acceptance and Commitment Therapy (ACT) for people with advanced progressive illness, their caregivers and staff involved in their care: A scoping review

Published: Jul 2023

Authors

Tilly Gibson Watt¹, David Gillanders², Juliet A Spiller³, Anne M Finucane⁴

¹ University of Edinburgh Medical School, University of Edinburgh, Scotland, UK ² Clinical Psychology, School of Health in Social Science, University of Edinburgh, Scotland, UK ³ University of Edinburgh Medical School, University of Edinburgh, Scotland, UK; Marie Curie Hospice Edinburgh, Edinburgh, Scotland, UK ⁴ Clinical Psychology, School of Health in Social Science, University of Edinburgh, Scotland, UK; Marie Curie Hospice Edinburgh, Edinburgh, Scotland, UK

Abstract

Background:

People with an advanced progressive illness and their caregivers frequently experience anxiety, uncertainty and anticipatory grief. Traditional approaches to address psychological concerns aim to modify dysfunctional thinking; however, this is limited in palliative care, as often concerns area valid and thought modification is unrealistic. Acceptance and Commitment Therapy is a mindfulness-based behavioural therapy aimed at promoting acceptance and valued living even in difficult circumstances. Evidence on its value in palliative care is emerging.

Aims:

To scope the evidence regarding Acceptance and Commitment Therapy for people with advanced progressive illness, their caregivers and staff involved in their care.

Design:

Systematic scoping review using four databases (Medline, PsychInfo, CINAHL and AMED), with relevant MeSH terms and keywords from January 1999 to May 2023.

Results:

1,373 papers were identified and 26 were eligible for inclusion. These involved people with advanced progressive illness (n = 14), informal caregivers (n = 4), palliative care staff (n = 3), bereaved carers (n = 3), and mixed groups (n = 2). Intervention studies (n = 15) showed that Acceptance and Commitment Therapy is acceptable and may have positive effects on anxiety, depression, distress, and sleep in palliative care populations. Observational studies (n = 11) revealed positive relationships between acceptance and adjustment to loss and physical function.

Conclusion:

Acceptance and Commitment Therapy is acceptable and feasible in palliative care, and may improve anxiety, depression, and distress. Full scale mixed-method evaluation studies are now needed to demonstrate effectiveness and cost-effectiveness amongst patients; while further intervention development and feasibility studies are warranted to explore its value for bereaved carers and staff.

Access

Web link: https://journals.sagepub.com/doi/10.1177/02692163231183101

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