The goal of this clinical trial is to examine the efficacy of this manual for mental health in people with mixed neurological disorders, including post-COVID. These conditions are often associated with cognitive impairment, which may hamper the effects of psychoterapy. Executive functioning and especially the ability to abstract thinking may be useful for individuals using Acceptance and Commitment Therapy. Therefore, the main questions research questions are: * Is this intervention effective in improving mental health? * Do executive functions predict the extent of social participation and mental health at the end of therapy? Participants will take part in 8 weekly group therapy sessions of 100 minutes each.
Mental health issues, especially depression, anxiety, and stress, are common in people with neurological disorders and post-COVID but often neglected and hence, remain untreated. Acceptance and Commitment Therapy (ACT) is a promising approach to assist people in adapting to their conditions by improving "psychological flexibility". A previous study translated an adapted group psychotherapy manual for stroke survivors into German and demonstrated its feasibility. This pilot study also gave first indications on the manual's efficacy in reducing symptoms of anxiety, depression, and stress. The aim of this study is to investigate the efficacy of this ACT-based group therapy. People with neurological disorders may have impairments in executive functions, which can affect the psychotherapeutic process. Since ACT often uses metaphors and imagery, executive functions, particularly the ability to abstract, could influence the efficacy of the therapy and are therefore being investigated in this study. The program includes 8 weekly sessions with a session length of 100 minutes.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
44
ACT-based group therapy based on the manual "Living Well with Neurological Conditions" published by Hill et al. (2017; NHS Fundation Trust; available: https://goo.gl/aX6qB5). The manual was translated into German and adapted by shortening sessions, simplifying language and adapting exercises based on clinical experience. The publication of the feasibility study for the adapted manual is currently in preparation. The group therapy includes eight weekly sessions with a duration of 100 minutes each. Three to six individuals participate in a group. The therapy is delivered by at least one licensed psychotherapists. A co-therapist might be included based on individual needs of the group members.
Neuropsychologische Hochschulambulanz Bielefeld
Bielefeld, Germany
RECRUITINGDepression and Anxiety Stress Scales-21 (Lovibond, 1995)
Measure of psychological burden to investigate efficacy. Scores range from 0 to 63 with higher values indicating higher burden.
Time frame: Before waiting list condition; and pre- and post-intervention (pre and post are presumably 8 weeks apart)
Acceptance and Action Questionnaire-Acquired Brain Injury (Sylvester, 2011)
Measure of psychological flexibility to investigate efficacy. Scores range from 0 to 36 with higher values indicating higher inflexibility.
Time frame: Before waiting list condition; and pre- and post-intervention (pre and post are presumably 8 weeks apart)
Wechsler Adult Intelligence Scale - Fourth Edition (Similarities subtest; Wechsler, 2008)
Measure of individual's ability to recognize and articulate the commonalities between different objects, reflecting their abstraction ability. This will be used to examine the influence of the ability of abstract thinking. Scores range from 0 to 36 with higher values indicating higher ability of abstraction.
Time frame: pre- and post-intervention (pre and post are presumably 8 weeks apart)
Patient Health Questionnaire-9 (Kroenke, 2001)
Measure of depressive symptoms to investigate efficacy. Scores range from 0 to 27 with higher values indicating more severe depressive symptoms.
Time frame: Before waiting list condition; and pre- and post-intervention (pre and post are presumably 8 weeks apart)
Generalized Anxiety Disorder Scale-7 (GAD-7; Spitzer et al., 2007)
Measure of anxiety symptoms to investigate efficacy. Scores range from 0 to 21 with higher scores indicating higher anxiety.
Time frame: Before waiting list condition; and pre- and post-intervention (pre and post are presumably 8 weeks apart)
Valuing Questionnaire (Smout, 2014)
Measure of valued living to investigate efficacy. Scores range from 0 to 60 with higher values indicating higher value-congruent living.
Time frame: Before waiting list condition; and pre- and post-intervention (pre and post are presumably 8 weeks apart)
Self-as-context scale (Zettle, 2018)
Measure of self as context to investigate efficacy. Scores range from 10 to 70 with higher values indicating a perspective closer to self-as-context.
Time frame: Before waiting list condition; and pre- and post-intervention (pre and post are presumably 8 weeks apart)
World Health Organization Disability Assessment Schedule 2.0 (V.S. Üstün, 2010; Plain German)
Measure of functional impairments and disabilities.
Time frame: Before waiting list condition; and pre- and post-intervention (pre and post are presumably 8 weeks apart)
Regensburg Word Fluency Test (Aschenbrenner, 2001)
Measure of verbal fluency.
Time frame: pre- and post-intervention (pre and post are presumably 8 weeks apart)
Stroop Test in Vienna Test System (Müller & Ziegler, 2001)
Measure of cognitive flexibility and inhibition of irrelevant stimuli.
Time frame: pre- and post-intervention (pre and post are presumably 8 weeks apart)
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