Acceptance and commitment therapy for late-life treatment-resistant generalised anxiety disorder : a feasibility study

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Gould, Rebecca L. and Wetherell, Julie Loebach and Kimona, Kate and Serfaty, Marc A. and Jones, Rebecca and Graham, Christopher D. and Lawrence, Vanessa and Livingston, Gill and Wilkinson, Philip and Walters, Kate and Le Novere, Marie and Leroi, Iracema and Barber, Robert and Lee, Ellen and Cook, Jo and Wuthrich, Viviana M. and Howard, Robert J. (2021) Acceptance and commitment therapy for late-life treatment-resistant generalised anxiety disorder : a feasibility study. Age and Ageing, 50 (5). pp. 1751-1761. ISSN 0002-0729 (https://doi.org/10.1093/ageing/afab059)

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Abstract

Background: Generalised anxiety disorder (GAD) is the most common anxiety disorder in older people. First-line management includes pharmacological and psychological therapies, but many do not find these effective or acceptable. Little is known about how to manage treatment-resistant generalised anxiety disorder (TR-GAD) in older people. Objectives: To examine the acceptability, feasibility and preliminary estimates of the effectiveness of acceptance and commitment therapy (ACT) for older people with TR-GAD. Participants: People aged ≥65 years with TR-GAD (defined as not responding to GAD treatment, tolerate it or refused treatment) recruited from primary and secondary care services and the community. Intervention: Participants received up to 16 one-to-one sessions of ACT, developed specifically for older people with TR-GAD, in addition to usual care. Measurements: Co-primary outcomes were feasibility (defined as recruitment of ≥32 participants and retention of ≥60% at follow-up) and acceptability (defined as participants attending ≥10 sessions and scoring ≥21/30 on the satisfaction with therapy subscale). Secondary outcomes included measures of anxiety, worry, depression and psychological flexibility (assessed at 0 and 20 weeks). Results: Thirty-seven participants were recruited, 30 (81%) were retained and 26 (70%) attended ≥10 sessions. A total of 18/30 (60%) participants scored ≥21/30 on the satisfaction with therapy subscale. There was preliminary evidence suggesting that ACT may improve anxiety, depression and psychological flexibility. Conclusions: There was evidence of good feasibility and acceptability, although satisfaction with therapy scores suggested that further refinement of the intervention may be necessary. Results indicate that a larger-scale randomised controlled trial of ACT for TR-GAD is feasible and warranted.

ORCID iDs

Gould, Rebecca L., Wetherell, Julie Loebach, Kimona, Kate, Serfaty, Marc A., Jones, Rebecca, Graham, Christopher D. ORCID logoORCID: https://orcid.org/0000-0001-8456-9154, Lawrence, Vanessa, Livingston, Gill, Wilkinson, Philip, Walters, Kate, Le Novere, Marie, Leroi, Iracema, Barber, Robert, Lee, Ellen, Cook, Jo, Wuthrich, Viviana M. and Howard, Robert J.;
  • Item type:Article
    ID code:84600
    Dates:
    Date
    Event
    1 September 2021
    Published
    13 April 2021
    Published Online
    4 February 2021
    Accepted
    Notes:Publisher Copyright: © 2021 The Author(s). Published by Oxford University Press on behalf of the British Geriatrics Society. Rebecca L Gould, Julie Loebach Wetherell, Kate Kimona, Marc A Serfaty, Rebecca Jones, Christopher D Graham, Vanessa Lawrence, Gill Livingston, Philip Wilkinson, Kate Walters, Marie Le Novere, Iracema Leroi, Robert Barber, Ellen Lee, Jo Cook, Viviana M Wuthrich, Robert J Howard, on behalf of the FACTOID group, Acceptance and commitment therapy for late-life treatment-resistant generalised anxiety disorder: a feasibility study, Age and Ageing, Volume 50, Issue 5, September 2021, Pages 1751–1761, https://doi.org/10.1093/ageing/afab059
    Subjects:Medicine
    Philosophy. Psychology. Religion > Psychology
    Department:Faculty of Humanities and Social Sciences (HaSS) > Psychological Sciences and Health > Psychology
    Depositing user: Pure Administrator
    Date deposited:09 Mar 2023 10:19
    Last modified:14 Dec 2024 01:34
    Related URLs:
    URI:https://strathprints.strath.ac.uk/id/eprint/84600
CORE (COnnecting REpositories)