1. Evaluation of Acceptance and Commitment Therapy delivered by Psychologists and Non- Psychologists in Community Adult Mental Health Dr. Thomas Richardson Principal Clinical Psychologist (Research Lead) Mental Health Recovery Teams, Portsmouth

2. Acceptance and Commitment Therapy (ACT)  Attempts to avoid emotional distress cause many psychological problems  People become very fused with thoughts  Aims to open up/accept emotions  Defuse from thoughts  Live in line with values despite problems Introduction: What is ACT?

3.  ACT part of depression and transdiagnostic pathway Training:  Psychological therapists  Non-psychologist practitioners (nurses, OTs, SWs) ● Training delivered by two experts, fortnightly supervision afterwards ● 12-16 sessions of individual ACT ACT in our service

4.  Aims: Determine if ACT effective and if differences in psychologists versus non-psychologists  Case series: measures given pre and post therapy, 3-month follow up. Method

5.  CORE: Global mental health (I have felt OK about myself)  PHQ-9: Depression (Little pleasure in doing things)  Valued Living Questionnaire: how important values are, how much currently living in line  Cognitive Fusion Questionnaire: (I struggle with my thoughts) Method: Measures

6. Statistical analysis ● General Linear Model (Mixed Factorial ANOVA) ● Time X Clinician ● All subscales analysed ● Intent to Treat Analysis ● Follow-Up: Last Observation Carried Forward Method

7.  23 participants so far  17 women, 6 men  Recurrent depression most common primary diagnosis, three bipolar disorder  Most had co-morbidity: Anxiety Disorder, Personality Disorder, Physical Health, Alcohol.  One Anorexia and Two Bulimia cases  Majority had previous therapy Sample Characteristics

8.  Statistically significant improvement for: ◦ CORE: F=17, p<.001 ◦ PHQ (Depression): F=19, p<.001 ◦ Valued Living: Action: F=5, p<.05 ◦ Cognitive fusion: F=19, p<.001  Trend for: ◦ Valued Living: Importance: F=4, p<.1 Results: Post-Treatment (n=23)

9.  Statistically significant improvement for: ◦ CORE Total: F=11, p<.01 ◦ PHQ (Depression): F=12, p<.01 ◦ Cognitive fusion: Valued: F=20, p<.05  No improvement for: ◦ Valued Living: Importance: F=1, p<.05 ◦ Valued Living: Action: F=1, p<.05 Results: Three-Month (n=21)

10.  No significant difference in outcomes between psychologists and non-psychologists  Drop out higher: ◦ Non-psychologists: 33% (n=4) dropped out ◦ Psychologists: 9% (n=1) dropped out  Psychologists took on the more complex cases Results: By Clinician

11.  ACT effective intervention in our service  Improvements in global mental health, depression, cognitive fusion  Outcomes maintained at follow- up  Higher drop out for non-psychologist staff, but similar outcomes Conclusions