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DOES ACT INCREASE COMMITMENT TO VALUED ACTIVITY IN RELATION TO WORK RELATED STRESS? Maria Stavrinaki, M.Sc. Elena Charalambous, M.Sc. Eleni Karayianni,

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Presentation on theme: "DOES ACT INCREASE COMMITMENT TO VALUED ACTIVITY IN RELATION TO WORK RELATED STRESS? Maria Stavrinaki, M.Sc. Elena Charalambous, M.Sc. Eleni Karayianni,"— Presentation transcript:

1 DOES ACT INCREASE COMMITMENT TO VALUED ACTIVITY IN RELATION TO WORK RELATED STRESS? Maria Stavrinaki, M.Sc. Elena Charalambous, M.Sc. Eleni Karayianni, Psy.D. Maria Karekla, Ph.D. University of Cyprus

2 INTRODUCTION Work stress is a growing issue that influences people worldwide (WHO, 2007) Given the economic crisis, lack of legislation implementation, and limited related research in Cyprus, there is urgent need to address some of these problem areas. CBT is the most effective and well researched evidence-based intervention for work stress (e.g., Richardson & Rothstein, 2008). ACT has a growing evidence base and there is growing support for its effectiveness in the area of work stress (e.g., Bond & Bunce, 2000). University staff seem to be more influenced by work stress in recent years (Hogan et al. 2002).

3 RESEARCH SIGNIFICANCE & INNOVATION Most research involves academic staff as opposed to administrative staff (Fako, 2010). Not much is known about what constitutes effective intervention for this section of the population (Tytherleigh et al. 2007; Winefield et al. 2003). First study examining the effectiveness of ACT on work-related stress using a university administrative staff sample in Cyprus. Previous research: 3 session ACT intervention programme for work stress (2+1; Bond & Bunce, 2000). Current study: 6 sessions plus follow up.

4 NEEDS ASSESSMENT When compared to epidemiological data (Panayiotou and Karekla, 2010), this sample reported above average endorsement of: perceived stress (PSS-10). physical health problems (PHQ). perceived support from friends and partner, not family (SSQ). specific coping styles (e.g., positive reframing, humour) (Brief- COPE). Issues raised: tight work schedules, large work load, problems with colleagues and superiors – especially communication issues. Staff also provided responses to questions pertaining to ways of increasing productivity, ways of dealing with work stress within and outside of the workplace, etc (Report - Karayianni & Panayiotou, 2010).

5 GENERAL RESEARCH GOALS Address needs identified by needs assessment. Establish ACT effectiveness for work-related stress using a 6 week psycho-educational intervention programme. Compare ACT and CBT effectiveness for work stress in administrative staff at a public university. Compare the effectiveness of values-based action as compared to defusion and acceptance. Compare the long term effectiveness of these interventions and impact on QOL.

6 HYPOTHESES Current pilot study: The ACT intervention aimed at: helping people build psychological flexibility. move toward increased value-based action. increased external control. increased job satisfaction. improved mental health. The CBT intervention aimed at: increased internal control. identifying and addressing cognitive distortions. increased coping and use of skills. improved mental health. increased job satisfaction.

7 METHODOLOGY o Sample o Baseline assessment using the ADIS o Random allocation of participants to either ACT or CBT o 4 participants (ACT group) o 2 participants (CBT group) o Procedure o 6 psychoeducational sessions o Once a week o 90 minutes o Two co-leaders – clinical psychology trainees

8 DEMOGRAPHICS SEXAGEEDUJOBMARKID Subject 1 F44High school FTYes Subject 2 F39CollegeFTYes Subject 3 M28MBAFTYes Subject 4 F46MBAFTNo Subject 1 CBT F31MScFTEngagedNo Subject 2 CBT M34MScFTNo

9 INTERVENTION DESIGN Session Outline: 1 st –What is stress, internal and external triggers. 2 nd -“Control” and alternative coping for internal triggers. 3 rd – Diffusion from internal triggers, self as a context, defining values and goals. 4 th – Choice, Acceptance and Value based action. 5 th –Willingness and Value based Action. 6 th – Problem solving obstacles and committed action. Session Outline: 1 st - Introduction to CBT and work-stress. 2 nd -Problem Solving. 3 rd –Automatic Thoughts and Cognitive Distortions. 4 th –Cognitive Restructuring and Relaxation. 5 th -Assertiveness Training. 6 th - Review and Summary of 5 Modules – bringing everything together. ACT GroupCBT Group

10 PROCEDURE o Qualitative and Quantitative Analysis o Time frame and data collection points: 1. Baseline assessment pre-treatment 2. Following each session 3. Post treatment 4. 3 month follow up 5. 6 month follow up

11 MEASURES o Quantitative Measures: o Distribution: 1 st and 6 th session, at 3 and 6 month follow ups. 1. Psychological flexibility - AAQ 2. Health - PHQ 3. Anxiety Sensitivity – ASI 4. Perceived Stress - PSS 5. Job description - JDI 6. Quality of life– WHOQOL-BREF 7. Valued Living Questionnaire – VLQ 8. Willingness Scale - WS 9. Internal Control- ACQ, TCQ 10. Mindfulness – PHLMS

12 MEASURES ACT INTERVENTION: Sessions1-6 o Defusion Stamp (Karekla, 2010). o Values Compass o Group motivation questionnaire Session 6 o Group Satisfaction Questionnaire (Karekla, 2010).

13 D EFUSION S TAMP Existing Stamp Where the person is now High levels of fusion Low levels of fusion

14 ACT GROUP RESULTS Participant 1 Pre Post Participant 2 Pre Post Participant 3 Pre Post Participant 4 Pre Post ADISGAD OCD NonePhobia GAD Phobia GAD Phobia GAD None AAQ30? ACQExt- 69 Int-48 ?Ext-49 Int-49 Ext-51 Int-43 Ext-58 Int-47 Ext-47 Int-46 Ext-68 Int-50 Ext-61 Int-48 WS-WS68? TCQD-19 SC- 17 W-9 P-13 Reap- 15 ?D-22 SC-16 W-17 P-11 Reap-15 D-18 SC-17 W-15 P-11 Reap-15 D-20 SC-9 W-9 P-8 Reap-12 D-16 SC-7 W-9 P-7 Reap-10 D-20 SC-13 W-9 P-14 Reap-18 D-17 SC-15 W-15 P-15 Reap-18 PHLMSAw-31 Ac-25 ?Aw-22 Ac-33 Aw-29 Ac-33 Aw-27 Ac-23 Aw-21 Ac-37 Aw-32 Ac-31 Aw-35 Ac-25 PSS24? PHQ7? ASI20? JDI44/99? WHOQOL-BREFPhH-16.8 Ps-14.6 SR-16 E-16 ?PhH-15 Ps-14 SR-12 E-15.4 PH-13.7 Ps-14.6 SR-14.6 E-15 PhH-14.6 Ps-11.3 SR-12.8 E-10.5 PH-14.2 Ps-10.6 SR-11.2 E-8.5 PhH-16 Ps-14.6 SR-15.2 E-13 PhH-15.1 Ps-14.6 SR-12.8 E-12 VLQ??D-27 I-105 C-78 D-10 I-87 C-80 D-3 I-76 C-74 D-6 I-63 C-57 D-4 I-73 C-93 D-23 I-77 C-71

15 CBT GROUP RESULTS Participant 1 Pre Post Participant 2 Pre Post ADISPanic None GAD IBS SAD OCD Manic D Somatoform PHQ PSS ASI JDI WHOQOL-BREF BRIEF COPEImprovement of 1 in active coping and venting

16 WEEKLY STAMP MEASURES - THOUGHTS Distance in cm

17 WEEKLY STAMP MEASURES - BEHAVIOURS

18 P ARTICIPANT 1 VALUES Values Compass Distance

19 P ARTICIPANT 2 VALUES

20 P ARTICIPANT 3 VALUES

21 P ARTICIPANT 4 VALUES

22 DISCUSSION Improvements in pre and post scores are seen both in CBT and ACT groups. ACT participants seem to improve in flexibility, awareness, have less of a gap between what they consider important and their action (value-based action). CBT seems to be improving in terms of decreasing sensitivity to anxiety and perceived stress at 6 weeks. ACT has better results in QOL, external control and less internal control strategies. ACT better HW completion: ACT 90%, CBT 50% of time. Job satisfaction decreases for both groups in 6 weeks but follow up scores needed. Better satisfaction with ACT compared to CBT.

23 LIMITATIONS & FUTURE WORK 1. Self report questionnaires. 2. No double-blind procedures (assessment and intervention). 3. Small N- Lack of participation. 4. Missed sessions (no drop out) 5. Incomplete assessment pack (1 person). 6. Pilot study, will repeat intervention in order to get more data. 7. More participants in ACT compared to CBT. 8. Anecdotal data/results, no statistical analyses.


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