Journal List > J Korean Acad Psychiatr Ment Health Nurs > v.28(1) > 1119806

Kim and Lee: Effects of Acceptance Commitment Therapy Based Recovery Enhancement Program on Psychological Flexibility, Recovery Attitude, and Quality of Life for Inpatients with Mental Illness

Abstract

Purpose

The purpose of this study was to (1) develop an acceptance commitment therapy (ACT) based recovery enhancement program for inpatients with mental illness and (2) test the effects of the program on patients’ psychological flexibility, recovery attitude, and quality of life.

Methods

A mixed methods design was used: a combination of a repeated-measure design with a non-equivalent control group and qualitative data collection. The participants were 41 inpatients with mental illness (experimental group: 20, control group: 21). The ACT based recovery enhancement program was conducted over four sessions for a total of two weeks. Data were collected from December 2018 to January 2019.

Results

Study results revealed that the ACT based recovery enhancement program was effective for psychological flexibility (F=150.71, p<.001), recovery attitude (F=60.22, p<.001), and quality of life (F=31.59, p<.001) for inpatients with mental illness.

Conclusion

The results of this study suggest that the ACT based recovery enhancement program can be used as an effective mental health nursing intervention for psychological flexibility, recovery attitude, and quality of life of inpatients with mental illness.

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Figure 1.
Conceptual framework of this study.
jkapmhn-28-79f1.tif
Table 1.
Acceptance-Commitment Therapy based Recovery Enhancement Program
Session Themes Purpose Contents of program Time (minutes)
1 Paradox of control Accepting through creative despair ․ ACT program introduction 10
․ Activities using metaphor 20
․ Avoiding thinking about the food you want to eat 20
․ Breathing meditation 10
2 Self acceptance and willing to experience Accepting and experiencing is my choice ․ Activities using metaphor 20
․ Choosing coffee and green tea 20
․ Eating meditation 20
3 The mind hears and believes as we think and speak Getting away from stereotypes and looking at it objectively ․ Education that breaks away from the fusion of thought and language 15
․ Watching videos related to stereotypes 10
․ Watermelon words follow game 15
․ Looking at the mind train 10
․ Breathing meditation 10
4 Focus on finding my value Separating thoughts from the actual and understanding ․ Watching videos of people who have overcome mental illness 20
․ Having lecture on the difference between value and goal 15
․ Activities using metaphor 15
․ Finding values and conducting action table activity  
․ Breathing meditation 10
Table 2.
Homogeneity of General Characteristics between Experimental and Control Groups (N=41)
Characteristics Categories Exp. (n=20)
Cont. (n=21)
x2 or t p
n (%) or M±SD n (%) or M±SD
Gender Men 12 (60.0) 11 (52.4) 0.24 .756
Women 8 (40.0) 10 (47.6)    
Age (year) <40 7 (35.0) 8 (38.1) 0.42 >.999
≥40 13 (65.0) 13 (61.9)    
  42.55±12.91 43.86±12.96 -0.32 .748
Marital status Married 1 (5.0) 4 (19.0) 1.89 .343
Single 19 (95.0) 17 (81.0)    
Education level ≤High school 13 (65.0) 15 (71.4) 0.20 .744
≥College 7 (35.0) 6 (28.6)    
Religion Have 15 (75.0) 12 (57.1) 1.45 .326
Have not 5 (25.0) 9 (42.9)    
Diagnosis Schizophrenia 16 (80.0) 14 (66.7) 0.93 .484
Bipolar disorder 4 (20.0) 7 (33.3)    
Types of admission Voluntary 13 (65.0) 18 (85.7) 2.38 .159
Involuntary 7 (35.0) 3 (14.3)    

Exp.=experimental group; Cont.=control group;

Fisher's exact test.

Table 3.
Homogeneity of Dependent Variables in Pretest (N=41)
Variables Exp. (n=20)
Cont. (n=21)
t p
M±SD M±SD
Psychological flexibility 27.25±4.95 28.29±6.83 -0.55 .583
Recovery attitude 100.55±11.66 94.76±18.11 1.21 .234
Quality of life 16.95±6.38 17.86±5.64 -0.48 .632

Exp.=experimental group; Cont.=control group.

Table 4.
Change of Psychological Flexibility, Recovery Attitude, and Quality of Life between Two Groups (N=41)
Variables Group
Pretest
Posttest 1
Posttest 2
Sources F (p)
Group M±SD M±SD M±SD
Psychological flexibility Exp. (n=20) 27.25±4.95 41.30±5.20 43.20±5.46 Group 41.46 (<.001)
Cont. (n=21) 28.29±6.83 26.24±6.48 24.05±6.41 Time 62.03 (<.001)
        G×T 150.71 (<.001)
Recovery attitude Exp. (n=20)
Cont. (n=21)
100.55±11.66
94.76±18.11
127.60±9.75
99.67±18.78
129.50±10.30
101.67±17.72
Group Time 20.90 (<.001)
143.21 (<.001)
        G×T 60.22 (<.001)
Quality of life Exp. (n=20) 16.95±6.38 22.50±6.02 24.20±4.84 Group 3.66 (.063)
Cont. (n=21) 17.86±5.64 18.10±6.66 17.00±7.64 Time 23.20 (<.001)
        G×T 31.59 (<.001)

Exp.=experimental group; Cont.=control group; G×T=interaction term between group and time.

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