coaching

Introduction
Internet-delivered cognitive and behavioral interventions have been shown to be effective in enhancing university students' well-being and reducing symptoms of stress and depression. However, few studies have examined the active components that may contribute to their effectiveness. The present study aimed to explore what kind of online written coach feedback would be useful on participants’ outcomes and satisfaction in two Acceptance and Commitment Therapy (ACT) blended interventions.

Methods
ACT-trained master's level psychology students offered coach support (n = 50; 88% female, Mage = 26 years) to university students, who were randomly assigned to two parallel groups, each offered three face-to-face sessions and an online five-module ACT-based program. One group (iACTa, n = 61) received free-form personalized, individually tailored written feedback, and the other (iACTb, n = 62) received semi-structured written feedback with minimal personalization options.

Results
Both groups had gains from participating in the interventions across all measures, including well-being, psychological flexibility, mindfulness skills, and reduction of stress and depression symptoms. However, there were no significant differences between the two groups except for well-being, which favored the iACTb. The iACTa group saw mostly small to large effect sizes (d = .44–0.80) while medium to large effect sizes were observed for the iACTb group (d = .69–0.83). The retention rate was good (iACTa: n = 51, 83.6%; iACTb: n = 54, 87.1%). Semi-structured features almost halved the coaches’ written response time for each participant (31 min in iACTa vs. 18 min in iACTb).

Conclusions
The results shed light in the very limited research available and suggest that ACT-based,blendedinternetinterventionswithsemi-structured coachfeedback and minimally tailored features can be as effective as interventions with fully personalized feedback in treatment outcomes and participants’ satisfaction.

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Low social resilience (e.g., susceptibility to social anxiety, and social avoidance) has been associated with poor mental and physical health outcomes, and can lead to ostracism. Support services such as university counselling centres, which deal with non-diagnosable psychological distress, linked to low social resilience, require effective yet brief interventions deliverable by non-experts to meet service demands. As it is not always possible to prevent subjectively negative experiences, acceptance-based interventions aim to change how we respond behaviourally to such experiences. The present study tests the efficacy of an ultra-brief (1hr) non-expert delivered acceptance- and values-based (AV) coaching intervention to increase resilience to negative social interactions. This was compared to a comparable dose of a cognitive restructuring and relaxation-based (CRR) analogue, and a psycho-education and progressive muscle relaxation-based (PE-PMR) control. Participants (N=60) were assessed on perceived burdensomeness, belonging, and 3 scenarios measuring anxiety and likelihood to engage in social situations. Participants then played Cyberball, an ostracising task, before recompleting the aforementioned measures. Physiological measures indicated Cyberball was an aversive experience. In the AV condition only, we observed an improved behavioral intention to engage with social scenarios (dppc2 = .57). Ultra-brief AV-based coaching interventions delivered by non-expert coaches appear promising in increasing participant's likelihood to continue engaging in social interactions after a stressful social experience. We tentatively conclude that gains in committed action may increase the propensity of at-risk individuals to seek social support.

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Objective
To report the theoretical basis and design of a novel digital Acceptance and Commitment Therapy (ACT) intervention for people with chronic pain, the Pain Tracker Self Manager (PTSM), which had promising efficacy in a recent pilot trial.

Methods
Content development by a multidisciplinary panel of experts in psychiatry, clinical psychology, nursing and social work, with feedback from a group of patients with chronic pain and their providers. Materials included paper-based sketching of a story character, visual metaphors, and a series of stories designed to deliver the theory-based components of our behavioral intervention.

Results
This development and design process resulted in 4 digitally delivered clinical modules that combine visual and verbal cues. In addition, it generated a series of novel ACT metaphors specifically tailored to patients with chronic pain: Pain: Injury vs. Threat, Life Navigation System, The Fog of Pain, and Get Rhythm. Consistent with ACT theory and the contextual behavioral science framework, PTSM utilized: perspective-taking, values clarification, acceptance strategies, and nursing and psychological care recommendations.

Discussion
Reports of the design and theoretical basis of digital health interventions are highly needed to increase the rigor of their development process and more progressively advance our body of knowledge. This pilot study developed and tested a series of ACT metaphors that can be readily used by ACT clinicians working with this population.

Conclusion
PTSM is a novel digital ACT intervention for patients with chronic pain with features directly linked to ACT processes and theory.

To find the full text version of this article and others (as well as download a full text .pdf.), ACBS members can visit the ScienceDirect homepage here.