requires knowledge about proper self-care in order to prevent health
complications, so hospitals frequently offer courses in diabetes
self-management. However, managing diabetes requires a lot more than simply
knowing what to do, it also takes overcoming the emotional barriers to living
healthy. A recent randomized clinical trial shows how ACT can help with these
of diabetes can be inherently distressing, as the act of monitoring and
treating this condition readily leads to unpleasant thoughts and feelings. As a result, many diabetics neglect their
self-management activities even though the health consequences are known. This
kind of experiential avoidance was targeted in an ACT intervention developed by
Dr. Jennifer Gregg, who provided a 3-hour ACT workshop as part of a standard
7-hour educational seminar for the management of diabetes. This workshop was
compared to a standard educational seminar lacking ACT components. She
administered a self-report measure of acceptance along with the standard
physiological measure of glycated hemoglobin used in diabetes research. Her
results showed a significant improvement in the physiological measure for the
ACT condition but not the education condition. Furthermore, changes in
acceptance predicted these improvements from pre-workshop data to follow up
data 3 months later. This study suggests that adherence to the treatment
regimen for diabetes is facilitated by incorporating acceptance, mindfulness,
and values interventions with the educational package.
our clients are struggling with diabetes or any kind of medical problem, it may
seem like a problem for their physician and they may see psychological work as
irrelevant to this problem. But studies like this show that physical problems
and psychological problems are related, and that treatment of avoidance with
mindfulness and acceptance can facilitate healthier living and more effective
management of medical problems.
For more information:
is a more detailed summary of the study:
range of lifestyle adjustments are recommended for people with Type-2 diabetes.
However, education about this condition and the merited changes are often not
well adhered to, presumably because the act of doing them occasions unpleasant
thoughts and feelings associated with the condition itself. CBT has been
examined as an intervention for augmenting the impact of these experiences, but
the research has provided mixed results in the effectiveness of this treatment,
possibly because eliminating distressing thoughts about diabetes may not be
realistic. Acceptance and Commitment Therapy may offer an alternative to this
agenda, instead focusing on changing one’s relationship to distressing thoughts
and feelings about having diabetes and investing in values-consistent behavior.
intervention was a 3-hour ACT workshop protocol as part of a 7-hour educational
program on diabetes self-management. Her
workshop was compared to the standard 7-hour educational program which lacked
ACT components. Measures included a physiological index of glycated hemoglobin,
the standard measure of diabetes studies, as well as a self-report of
acceptance. Measures were administered at the beginning of the workshops and at
a 3-month follow up.
results showed little-to-no-improvement in the education alone condition, while
the ACT condition generated a significant and medium effect in changes for the
physiological measure and the self-report of acceptance. Furthermore, changes
in the self-report of acceptance significantly predicted outcomes at the
3-month follow up, providing some support for the mediational processes of the
ACT model of treatment. Although this pilot study needs replication, the
results provide strong preliminary support for the usefulness of ACT treatment
in facilitating adherence to the medical regimen recommended for diabetes
J. A., Callaghan, G. M., Hayes, S. C., & Glenn-Lawson, J. L. (2007).
Improving diabetes self-management through acceptance, mindfulness, and values:
A randomized controlled trial. Journal of
Consulting and Clinical Psychology, 75, 336-343.