Lundgren, 2004

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APA Citation: 

Lundgren, T. (2004) A development and evaluation of an integrative health model in the treatment of epilepsy. Masters thesis, Department of psychology, University of Uppsala.

Publication Topic: 
ACT: Empirical
Behavior Analysis: Empirical
Publication Type: 
Dissertation
Language: 
English
Keyword(s): 
Epilepsy, ACT, Psychological treatment, Empowerment, yoga, RCT
Abstract: 

Epilepsy has been considered an illness requiring treatment only in recent times. Prior to the turn of this century, the epileptic seizure was seen by some as a special blessing. The beginning of the 1900’s marked the start of approaching epilepsy as an illness and the use of antiepileptic drugs (AED) as the treatment of choice. AED treatment creates many negative side effects as they influence all brain cells and in addition, they are very expensive. In developing countries such as India and South Africa, many people with refractory seizures will not have access to modern state of the art medical treatment for epilepsy. The medication available may not be as effective and may cause more side effects. For these reasons it could be more important to develop psychological treatment of epilepsy, based on empowerment of human resources, for persons suffering from refractory seizures in the developing countries.

The purpose of this study is to develop and evaluate an integrative health model in treatment of epilepsy. The method consisted of two consecutive RCT group design with repeated measures studies done in India (study 1) and in South Africa (study 2). Inclusion criteria for both studies included a minimum of 3 seizures in the past 3 months. There were 18 participants in India and 28 in the South African study all with an EEG verified epilepsy diagnosis. Participants were randomized into two conditions; In India either ACT or Yoga and in South Africa ACT or attention control (AC). Both studies examined the effect of a brief psychological intervention following the principles of Acceptance and Commitment Therapy and behavior modification. All treatment conditions consisted of three sessions, two individual and one group session. Treatment effects were measured in the form of seizure index (seizure frequency X duration) quality of life, acceptance and action and life functions. Results from the Yoga condition in study one are not presented due to lack of control in the post measure procedure. Results from ACT condition in study one are presented as a combination of study one and two compared to attention control in study two. The results showed significant effects in seizure index, experiential avoidance, life quality and functioning. Results of study 2 showed significant effects of seizure index, experiential avoidance, life quality and functioning for the ACT group as compared to the attention control group. The preliminary results shown here are taken immediately following treatment. Follow-up measures will be necessary to be able to draw any conclusions from these two studies. The results presented here do suggest, however, that is may be worthwhile to develop an integrative model of health care treatment for persons suffering from chronic illness where modern western medicine is not readily accessible or desirable.

Comments: 
Two small RCTs (N = 18; and N = 28) comparing a three session ACT protocol (two individual; one group) to two other conditions. As compared to yoga, significantly reduced seizures in the ACT condition; as compared to attention control, significantly reduced seizures and experiential avoidance, and significantly increased quality of life in the ACT condition at a one year follow up.
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