1. Acceptance and Commitment Therapy (ACT) for Substance Use Disorder | Qualitative Review Acceptance and Commitment Therapy (ACT) for Substance Use Disorder | Qualitative Review Cognitive Behavioral Therapy (CBT) has been widely used for Substance Use Disorders (SUD). However the NICE guidelines recommend CBT only if SUD is complicated with other psychiatric disorders. Meanwhile evidences for Acceptance and commitment Therapy (ACT) are now on the increase. 1) I n this review, we will first describe the features of ACT and the reasons for its effectiveness for SUD, and will subsequently examine Randomized Controlled Trials (RCT) for SUD. E-mail: tshtk.ii@gmail.com Trans-diagnostic Value-based ACT may be effective for SUD patients Introduction Discussion Review of Acceptance and Commitment Therapy for Substance Use Disorder StudiesNPatientsComparison intervention Outcome detection Stop using rate (at 6 month) Hayes et.al 4) 144Methadone dependenceTreatment as UsualUrine Negative61% vs 28% 12 stepsUrine Negative61% vs 50% Smout et al 5) 104Methadone dependenceCBTHair Negative50% vs 36% Stotts et al 6) 56Methadone dependenceCounselingNo relapse67% vs 58% Villagrá et al 7) 50SUD at prisonCBTStop using44% vs 29% Waitlist controlStop Using44% vs 18% Luoma et al 8) 133Various SUDTreatment as UsualStop Using81% vs 60% ACT may be more effective than treatment as usual or control interventions in SUD treatment. ACT even may be more effective than CBT or counseling; however, which was not statistically significant. Further confirmatory research is needed to establish a rigorous evidence base in this area. So far, we have been conducting the Cochrane Systematic Review for “Acceptance and Commitment Therapy for Substance Use Disorder”. 1)Psychiatry and Cognitive-Behavioral Medicine Nagoya City University Graduate School of Medical Sciences 2)Translational Medical Center, National Center of Neurology and Psychiatry, Japan Method : We searched Cochrane Central Register of Controlled Trials and found 162 RCTs with the term "Acceptance and Commitment Therapy". After checking the titles of these RCTs, we found that 5 of them were meant for SUD and reviewed these 5 RCTs. Trans-diagnostic therapyNon-symptom reducing therapy Value-based therapy Patients with SUD tend to have the highest rate of comorbid psychiatric conditions. Since CBT for SUD gives no specific method for treating comorbidity of psychiatric disorders the drop out rate becomes high. 2) On the other hand, ACT is considered to be trans- diagnostic intervention, which will thus be effective for SUD with comorbid psychiatric conditions and will decrease the drop out rate. According to the ACT theory, people tends to avoid unwanted experiences. Previous studies have shown the relationship between this experiential avoidance and SUD. 3) ACT does not focus on symptom reduction However changes avoidance behavior, 1), ACT may thus improve SUD without involving in experiential avoidance. Belief interventions focusing on motivation are recommended in NICE guidelines. whereas ACT focuses on value- based actions, that is, what patients want to do. 1) During ACT, patients think about what they want to do if they did not have SUD. This may activate motivation and decrease the drop out rate. References 1) スティーブン・ C ・ヘイズら ( 著 ), 武藤 崇ら ( 監訳）. 伊井俊貴ら ( 訳 ) 星和書店 2014 2)Carroll KM et al. Am J Psychiatry. 2005;162(8):1452-60. 3)Spinhoven P et al. Behav Ther 2014;45(6):840-850 4)Hayes SC et al. Behav Ther, 2004;35(4):667-688 5)Smout M et al. Subst Abus, 2010;31(2):98-107 6)Stotts AL et al. Drug Alcohol Depend, 2012;125(3):215-22 7)Villagrá P et al. J Clin Psychol,2014;70(7):644-57 8)Jason B Luoma et al. J Consalt Clin Psychol, 2012;80(1):43-53 Note: The 12-step program is a structured, manualized, and psychosocially emphasized spirituality intervention designed to accommodate a 12-step perspective. Hirohumi Sato 1） Norio Watanabe 2) Tatsuo Akechi １） Toshitaka Ii １）