Resumen Antecedentes Se estima que el duelo secundario a COVID-19 dejará cerca de 16 millones de personas afectadas mundialmente, y la prevalencia del Trastorno de Duelo Prolongado (TDP) pudiera incrementarse al 40%. Objetivo Revisar los tratamientos susceptibles de aplicar en pacientes con TDP por COVID-19. Método Se realizó la búsqueda en PUBMED y Scholar google con las palabras clave trastorno de duelo prolongado, duelo complicado, duelo y psicoterapia y tratamiento del duelo prolongado o complicado o complejo persistente. Resultados Se revisaron 50 artículos, se refirió la eficacia de la terapia interpersonal, la terapia racional emotiva del comportamiento, la terapia de apoyo, la terapia humanista, la terapia familiar sistémica, la terapia grupal, la terapia de escritura, la intervención basada en internet, y una modalidad de terapia cognitivo conductual aplicada al duelo prolongado, la terapia metacognitiva y la terapia de aceptación y compromiso. Discusión y conclusión No hay consenso sobre el uso preferencial de tratamientos psicoterapéuticos en personas con TDP por la pérdida de una familiar por COVID-19. La terapia grupal es efectiva en disminuir la intensidad del duelo no complicado, la terapia cognitivo conductual es altamente efectiva para disminuir la gravedad del duelo, la Terapia Metacognitiva diseñada específicamente para el TDP impacta positivamente en la depresión, ansiedad y calidad de vida; y la Terapia de Aceptación y Compromiso es útil en el restablecimiento de la espiritualidad. La psicoterapia es más eficaz cuando se combina con terapia farmacológica. Se sugiere la realización de estudios comparativos entre técnicas psicoterapéuticas para el manejo de pacientes con TDP asociado a COVID-19 y la adaptación de estas técnicas a ambientes virtuales.

Abstract Background It has been estimated that COVID-19 grief will affect approximately sixteen million people worldwide, while the prevalence of prolonged grief disorder (PGD) could rise to 40%. Objective To review treatments that can be administered to patients with PGD due to COVID-19. Method PUBMED and Google Scholar were searched with the following keywords: prolonged grief disorder, complicated grief, grief and psychotherapy, and treatment of prolonged grief, complicated grief or persistent complex grief. Results Fifty articles were reviewed on the efficacy of interpersonal therapy, rational emotional-behavioral therapy, supportive therapy, humanistic therapy, systemic family therapy, group therapy, writing therapy, Internet-based intervention, and a modality of cognitive behavioral therapy used with prolonged grief, metacognitive therapy, and acceptance and commitment therapy. Discussion and conclusion There is no consensus on the psychotherapeutic treatment of choice for people with PGD due to the loss of a family member to COVID-19. Group therapy is effective in reducing the intensity of uncomplicated grief, cognitive-behavioral therapy is highly efficacious in reducing the severity of grief, metacognitive therapy specifically designed for PGD has a positive impact on depression, anxiety, stress, rumination, and quality of life while Acceptance and Commitment Therapy is helpful for restoring spirituality. Psychotherapy is most effective when combined with drug therapy. It is suggested that comparative studies be undertaken of psychotherapeutic techniques for managing patients with PGD associated with COVID-19 and the adaptation of these techniques to virtual settings.

Resumen Introducción Son necesarios tratamientos basados en evidencia para mujeres víctimas de violencia de pareja (IPV), con trastornos relacionados con estrés como ansiedad, depresión y riesgo suicida y alteraciones en la reactividad del cortisol. Objetivo Comparar los cambios en la sintomatología depresiva, ansiosa, calidad de vida y reactividad del cortisol después de aplicar Terapia de Aceptación y Compromiso (ACT, basada en la flexibilidad psicológica) o Terapia Interpersonal (IPT, basada en el empoderamiento) en mujeres expuestas a IPV y compararlos en función al pensamiento suicida. Método Una muestra clínica de 50 mujeres (entre 21 y 74 años) fueron asignadas aleatoriamente a recibir ACT o IPT, completaron antes y después, cuestionarios sobre IPV, calidad de vida, depresión y ansiedad, y mediciones de cortisol (basal, 15, 30 y 45 minutos después de un reto cognitivo) en saliva en respuesta a un reto cognitivo. Utilizamos modelos de Ecuaciones de Estimación generalizada para analizar los datos. Resultados Mejoraron significativamente todas las variables, independientemente del tipo de psicoterapia y del pensamiento suicida. Antes de la intervención, las mujeres con ideación suicida presentaron depresión y ansiedad severas, peor calidad de vida e hiper-respuesta de cortisol, en contraste con las mujeres sin ideación, quienes presentaron síntomas moderados y una respuesta de cortisol plana. El cortisol disminuyó en todas las mujeres después de ambas terapias. Discusión y conclusión Ambas terapias IPT y ACT mejoraron la salud mental y calidad de vida de las mujeres con IPV y modificaron la reactividad del cortisol, incluyendo a las pacientes que reportaron ideación suicida.

Abstract Introduction There is a growing need to implement evidence-based psychological treatments for women victims of intimate partner violence (IPV) who commonly experience stress-related disorders such as anxiety, depression, or suicide risk, as well as altered cortisol reactivity. Objective 1. To compare the changes in depressive and anxious symptomatology, quality of life, and cortisol reactivity after two different interventions, Acceptance and Commitment Therapy (ACT, based on psychological flexibility) or Interpersonal Therapy (IPT, based on empowerment) in women exposed to IPV. 2. To compare the changes in relation to the presence of suicide thoughts. Method A clinical sample of 50 women (ages 21-74) randomly assigned to attend ACT or IPT, completed pre- and post-intervention questionnaires about intimate partner violence, quality of life, depression, anxiety, and measurements of salivary cortisol reactivity (basal, 15, 30, and 45 minutes after a cognitive challenge). We used Generalized Estimating Equation Models for data analysis. Results There was a significant improvement post-intervention in all variables, regardless of the type of psychotherapy or the presence of suicide thoughts. Before interventions, women that reported suicide thoughts had severe symptoms of depression, anxiety, worse quality of life, and a cortisol hyper-response profile, in contrast to women without suicide thoughts who had moderate symptoms and no cortisol response. Cortisol response to the cognitive test decreased in all women after both therapies. Discussion and conclusion Although different psychological approach, ACT, and IPT effectively improved mental health, quality of life, and changed cortisol reactivity of women exposed to IPV, including women at suicide risk.

RESUMEN Introducción: La Fusión Cognitiva (FC) es un problema psicológico que constituye un concepto fundamental dentro de la Terapia de Aceptación y Compromiso. La Escala de Fusión Cognitiva (EFC) utilizada para medir este concepto no ha sido adaptada ni validada en Cuba. Objetivo: Evaluar las propiedades psicométricas de la EFC en personas adultas con síntomas de ansiedad. Método: Se combinaron técnicas cualitativas y cuantitativas: consulta a expertos, coeficientes de correlación y concordancia y análisis factorial. Resultados: Se adaptó la EFC desde una perspectiva lingüística y cultural. Se consultaron a 9 expertos y se evaluó el consenso mediante el coeficiente de validez de contenido sobre la suficiencia (0,97). Durante el pilotaje con 35 personas, el test alcanzó un coeficiente α de Cronbach (0,927). Al aplicar el test adaptado en 106 adultos con síntomas de ansiedad se obtuvo un coeficiente α de Cronbach (0,869), lo que evidencia la homogeneidad del test. El Análisis Factorial Exploratorio (KMO = 0,820, X2(338) = 21, p < 0,001) alcanzó unicidades de los ítems menores que 0,6 y cargas factoriales mayores que 0,3. El Análisis Factorial Confirmatorio mostró un buen ajuste del modelo (X2(14) = 45,1, p < 0,001). Se encontró una correlación baja y estadísticamente significativa (Rho = 0,216, p < 0,05) respecto al IDARE (estado). Conclusión: La EFC adaptada fue válida en tanto contenido, mostró altos valores de fiabilidad y se verificó su unidimensionalidad. El instrumento adaptado muestra una correlación entre la FC y los síntomas de ansiedad. Contar con un instrumento como este podría mejorar el diagnóstico de la FC, así como incrementar la calidad del tratamiento que se le brinda al paciente.

ABSTRACT Background: Cognitive Fusion (CF) is a psychological problem that is a fundamental concept within Acceptance and Commitment Therapy. The Cognitive Fusion Scale (CFS), which is used to measure this concept, has not been adapted or validated in Cuba. Objective: To evaluate the psychometric properties of the CFA in adults with anxiety symptoms. Method: Qualitative and quantitative techniques were combined: Expert interview, correlation and concordance coefficients and factor analysis. Result: The CFQ was adapted from a linguistic and cultural perspective. Nine experts were consulted and consensus was assessed using the content validity coefficient of appropriateness (0.97). During piloting with 35 people, the test achieved a Cronbach's α coefficient (0.927). When the adapted test was applied to 106 adults with anxiety symptoms, a Cronbach's α coefficient (0.869) was achieved, demonstrating the homogeneity of the test. The exploratory factor analysis (KMO = 0.820, X2 (338) = 21, p < 0.001) showed item ambiguities of less than 0.6 and factor loadings of more than 0.3. The confirmatory factor analysis showed a good model fit (X2 (14) = 45.1, p < 0.001). A low and statistically significant correlation (Rho = 0.216, p < 0.05) was found in relation to IDARE (state). Conclusion: The adapted CFQ was valid in terms of content, showed high reliability values and its one-dimensionality was verified. The adapted instrument shows a correlation between FC and anxiety symptoms. An instrument like this could improve the diagnosis of CF, as well as increase the quality of care for the patient.

SUMMARY OBJECTIVE: The purpose of this study was to investigate the relationship between psychological inflexibility, depression, anxiety, and quality of life in patients with chronic tinnitus without hearing loss. METHODS: The study was carried out involving 85 patients with chronic tinnitus without hearing loss and a control group of 80 individuals. All participants completed the Acceptance and Action Questionnaire-II, the State-Trait Anxiety Inventory-Trait, the Beck Depression Inventory, and Short Form-36. RESULTS: The patient group exhibited higher Acceptance and Action Questionnaire-II (t=5.418, p<0.001), State-Trait Anxiety Inventory-Trait (t=6.592, p<0.001), and Beck Depression Inventory (t=4.193, p<0.001) scores and lower physical component summary (t=4.648, p<0.001) and mental component summary (t=-5.492, p<0.001) scores than the control group. Psychological inflexibility predicted depression, anxiety, and impairment of quality of life. The effect of psychological inflexibility on physical component summary was mediated by depression (β=−0.15, [95%CI −0.299 to −0.017]), while its effect on mental component summary was mediated by anxiety and serial anxiety and depression (β=−0.17 [95%CI −0.344 to −0.055] and β=−0.06 [95%CI −0.116 to −0.100], respectively). CONCLUSION: Psychological inflexibility plays an important role in patients with chronic tinnitus without hearing loss. It is associated with increased levels of anxiety and depression and decreased quality of life. OBJECTIVE METHODS 8 individuals QuestionnaireII, QuestionnaireII Questionnaire II, II StateTrait State Trait InventoryTrait, InventoryTrait Trait, Form36. Form36 Form 36. 36 Form-36 RESULTS t=5.418, t5418 t 5 418 (t=5.418 p<0.001, p0001 p p<0.001 , 0 001 t=6.592, t6592 6 592 (t=6.592 t=4.193, t4193 4 193 (t=4.193 t=4.648, t4648 648 (t=4.648 t=5.492, t5492 t= 5.492, 492 (t=-5.492 β=−0.15, β015 β 15 (β=−0.15 95%CI 95CI CI 95 0299 299 −0.29 −0.017, 0017 −0.017 017 −0.017]) β=−0.17 β017 17 (β=−0.1 0344 344 −0.34 −0.055 0055 055 β006 06 β=−0.0 0116 116 −0.11 −0.100, 0100 −0.100 100 −0.100] respectively. respectively . respectively) CONCLUSION Form3 3 Form-3 t=5.418 t541 41 (t=5.41 p000 p<0.00 00 t=6.592 t659 59 (t=6.59 t=4.193 t419 19 (t=4.19 t=4.648 t464 64 (t=4.64 t=5.492 t549 5492 5.492 49 (t=-5.49 β=−0.15 β01 1 9 029 29 −0.2 −0.01 01 −0.017] β=−0.1 (β=−0. 034 34 −0.3 −0.05 005 05 β00 β=−0. 011 11 −0.1 010 −0.10 10 Form- t=5.41 t54 (t=5.4 p00 p<0.0 t=6.59 t65 (t=6.5 t=4.19 t41 (t=4.1 t=4.64 t46 (t=4.6 t=5.49 549 5.49 (t=-5.4 β0 02 2 −0. −0.0 (β=−0 03 β=−0 t=5.4 t5 (t=5. p0 p<0. t=6.5 t6 (t=6. t=4.1 t4 (t=4. t=4.6 54 5.4 (t=-5. −0 (β=− β=− t=5. (t=5 p<0 t=6. (t=6 t=4. (t=4 5. (t=-5 − (β= β= t=5 (t= p< t=6 t=4 (t=- (β (t

Abstract Objective Chronic pain is an important health problem and affects both quality of life and mental health. This study assessed psychological inflexibility, pain intensity, quality of life, anxiety and depression symptoms, self-efficacy, and social support among patients with chronic pain. Method A quasiexperimental design was used to assess six adult participants pre- and post-group intervention (eight sessions) based on acceptance and commitment therapy. Results After the intervention, the patients experienced a reduction in psychological inflexibility, pain, and depression and anxiety symptoms and improvements in quality of life and self-efficacy. The quality of life and depression symptoms and the domains of quality of life and psychological inflexibility were negatively correlated. Conclusion Acceptance and commitment therapy is a promising treatment for the interdisciplinary treatment of the Pain Clinic. intensity selfefficacy, selfefficacy self efficacy, efficacy self-efficacy pre postgroup post group eight sessions selfefficacy. efficacy. correlated Clinic

Resumo Objetivo Dor crônica é um problema de saúde prevalente que acarreta prejuízos para qualidade de vida e saúde mental. Este estudo avaliou inflexibilidade psicológica, intensidade da dor, qualidade de vida, sintomas de ansiedade e de depressão, autoeficácia e suporte social em pacientes com dor crônica. Método Utilizou delineamento quase-experimental e os seis participantes adultos foram avaliados por meio de instrumentos no pré e pós-intervenção em grupo (oito sessões) com Terapia de Aceitação e Compromisso. Resultados Após a intervenção houve redução da inflexibilidade psicológica e da dor, melhora da qualidade de vida, redução dos sintomas de ansiedade e de depressão e aumento da autoeficácia. Houve correlação inversa entre qualidade de vida e sintomas de depressão e entre domínios da qualidade de vida e inflexibilidade psicológica. Conclusão Conclui-se que a Terapia de Aceitação e Compromisso é um tratamento promissor a ser integrado no atendimento interdisciplinar da Clínica de dor. mental quaseexperimental quase experimental pósintervenção pós oito sessões Concluise Conclui se

Abstract The pathophysiology of non-pulsatile chronic tinnitus is unclear, but it is recognized a relevant psychological component. In this sense, different psychotherapeutic approaches have been studied. Cognitive behavioral therapy is the psychotherapy with the most evidence. It considers the restructuring of dysfunctional cognitions that favor the presence of tinnitus. Its efficacy has been verified on distress, quality of life, severity, associated depressive symptoms and insomnia. Eye movement desensitization and reprocessing includes some conceptions of cognitive behavioral therapy and considers techniques such as bilateral stimulation. Its results in chronic somatic pathologies have suggested its application in tinnitus, corroborating its efficacy in quality of life, distress, and depressive symptoms. Two mindfulness-based psychotherapies applied in tinnitus are mindfulness-based stress reduction and mindfulness-based cognitive therapy. The first has shown efficacy on quality of life and reduction and reinforcement of negative and positive cognitions, respectively. The second is effective on severity, loudness, distress, anxiety, depression and disability associated with tinnitus. Finally, acceptance and commitment therapy promote acceptance as a central component of the treatment of chronic conditions, considering the control exerted by the context over the experience of these conditions and the therapeutic commitment. This therapy is effective on quality of life. We foster the research on psychotherapeutic approaches to tinnitus, which will make it possible the application of more specific interventions and, at the same time, elucidate its pathophysiology.

Resumen La fisiopatología del tinnitus crónico no pulsátil es poco clara, pero se reconoce un componente psicológico relevante, por tanto, existen distintas aproximaciones psicoterapéuticas que han sido estudiadas. La terapia cognitivo conductual es la que cuenta con mayor evidencia. Ella contempla la reestructuración de las cogniciones disfuncionales que favorecen la presencia del tinnitus. Se ha verificado su eficacia en los niveles de distrés, calidad de vida, severidad, sintomatología depresiva e insomnio asociados. La desensibilización y reprocesamiento por movimientos oculares recoge algunos presupuestos de la terapia cognitivo conductual, pero considera técnicas como la estimulación bilateral. Sus resultados en patologías crónicas somáticas han sugerido la aplicación en tinnitus, corroborando su eficacia en calidad de vida, distrés y sintomatología depresiva. Dos psicoterapias basadas en mindfulness aplicadas en tinnitus son la reducción del estrés basado en el mindfulness y la terapia cognitiva basada en mindfulness. La primera ha demostrado eficacia en la calidad de vida y en la disminución y el refuerzo de cogniciones negativas y positivas, respectivamente. La segunda, es eficaz en la severidad, intensidad, distrés, ansiedad, depresión y discapacidad asociadas a tinnitus. Finalmente, la terapia de aceptación y compromiso promueve la aceptación como componente central del tratamiento de condiciones crónicas, considerando el control que ejerce el contexto sobre la vivencia de estas condiciones y el compromiso terapéutico. Esta terapia es eficaz en calidad de vida. Se promueve la investigación en aproximaciones psicoterapéuticas para el tinnitus, lo que posibilitará la aplicación de terapias más específicas y la clarificación de su fisiopatología.

Abstract The Multidimensional Psychological Flexibility Inventory (MPFI) is a new 60-item self-report scale developed to assess the specific components of psychological flexibility and inflexibility proposed in the Hexaflex model of Acceptance and Commitment Therapy (ACT). The present study sought to examine the psychometric properties of the Persian version of the MPFI-60 in a community sample of 307 Iranian adults. The original study supported a 12-factor second-order structure consisting of 6 dimensions for psychological flexibility and 6 dimensions for psychological inflexibility. The Persian MPFI-60 demonstrated acceptable semantic and test content, internal structure, correlations with other variables, and internal consistency. It also evidenced in relation to anxiety, stress, depression, and self-compassion. Overall, the results indicate that the Persian MPFI-60 is a psychometrically sound measure in the Iranian context that enables researchers and clinicians to comprehensively assess the components of psychological flexibility and inflexibility within the Hexaflex model.

Resumo Estima-se que um a cada cinco estudantes universitários ao redor do mundo apresenta algum tipo de transtorno psicológico, dentre os quais os transtornos de ansiedade são os mais prevalentes. Este estudo consiste em um ensaio clínico randomizado com o objetivo de avaliar a eficácia e efetividade de um protocolo semiestruturado de psicoterapia em grupo baseado nos princípios da Terapia de Aceitação e Compromisso (ACT) para o tratamento de ansiedade entre estudantes universitários. Os participantes foram alocados aleatoriamente entre os grupos intervenção e controle. Os níveis de ansiedade pré e pós-intervenção foram avaliados por meio do instrumento General Anxiety Disorders-7 (GAD-7). A amostra final do estudo foi composta por 15 pessoas, dentre as quais 10 foram alocadas no grupo intervenção e 5, no grupo controle. Os resultados foram analisados de duas formas: a) por protocolo (Per-protocol analysis); e b) por intenção de tratar (Intention-to-treat Analysis). Este tratamento reduziu a sintomatologia ansiosa em 39,7% entre os pacientes que completaram o tratamento (por protocolo, p=0,030) e em 30,8% entre todos alocados para o grupo intervenção (i.e., por intenção de tratar, incluindo os dropouts, p=0,035), enquanto os controles não tiveram redução significativa no mesmo período. Portanto, recomenda-se a utilização deste protocolo dentro do contexto universitário como uma alternativa viável ao acompanhamento individual em situações de transtornos de ansiedade. Pesquisas futuras com amostras maiores podem contribuir na consolidação deste protocolo.

Abstract One in every five university students around the world is estimated to have some type of psychological disorder, considering anxiety disorders as the most prevalent. This study consists in a randomized clinical trial aimed to evaluate efficacy and effectiveness of a semi-structured group psychotherapy protocol based on the principles of Acceptance and Commitment Therapy (ACT) for the treatment of anxiety among university students. Participants were randomly allocated in the intervention and control groups. Pre- and post-intervention anxiety levels were measured using the General Anxiety Disorders-7 (GAD-7) questionnaire. The study sample was composed of 15 people, 10 of whom were allocated to the intervention group and 5 to the control group. Results were analyzed in two ways: 1) Per protocol analysis; and 2) Intention-to-treat analysis. This treatment reduced anxiety symptoms by 39.7% among patients who completed treatment (Per protocol, p=0.003) and by 30.8% among all those allocated to the intervention group (i.e., by Intention-to-treat, including dropouts, p=0.035), whereas controls showed no significant reduction in same period. Therefore, we recommend the use of this protocol within the university context as a viable alternative to individual counselling in situations of anxiety disorders. Future research with larger samples may contribute to consolidate this protocol.

Resumen Se estima que uno de cada cinco estudiantes universitarios en todo el mundo tiene algún tipo de trastorno psicológico, entre los cuales los trastornos de ansiedad son los más frecuentes. Este estudio consiste en un ensayo clínico aleatorizado cuyo objetivo fue evaluar la eficacia y efectividad de un protocolo de psicoterapia grupal semiestructurada basado en los principios de la Terapia de Aceptación y Compromiso (ACT) para el tratamiento de la ansiedad en estudiantes universitarios. Se asignaron aleatoriamente a los participantes en los grupos de intervención y control. Los niveles de ansiedad antes y después de la intervención se midieron utilizando el instrumento General Anxiety Disorders-7 (GAD-7). La muestra final del estudio estuvo compuesta por 15 personas, de las cuales 10 fueron asignadas al grupo de intervención y 5 al grupo de control. Los resultados se analizaron de dos maneras: 1) por protocolo (Per protocol analysis); y 2) por intención de tratar (Intention-to-treat Analysis). Con este tratamiento los síntomas de ansiedad se redujeron en un 39,7% entre los pacientes que completaron el tratamiento (por protocolo, p=0,030) y en un 30,8% entre todos los asignados al grupo de intervención (es decir, por intención de tratar, incluidos los dropouts, p=0,035), mientras que los controles no tuvieron una reducción significativa en el mismo periodo. Por lo tanto, se recomienda utilizar este protocolo dentro del contexto universitario como una alternativa viable a lo asesoramiento individual en situaciones de trastornos de ansiedad. La investigación futura con muestras más grandes puede contribuir a la consolidación de esta modalidad.

ORIENTATION: Mental health distress is on the rise, which has significant implications for labour productivity. Industrial psychologists, who are equipped to offer work-based counselling, can play a vital role in alleviating this burdenRESEARCH PURPOSE: This study was an investigation of current literature on industrial psychologists as counsellors, with a focus on acceptance and commitment therapy (ACT) as a framework to deliver brief work-based counselling. The aim was to offer a practical model of counselling, derived from the literature, for industrial psychologists to perform work-based counsellingMOTIVATION FOR THE STUDY: There is a paucity of literature pertaining to evidence-based guidelines that industrial psychologists can follow to provide counselling. This study attempts to expand industrial psychologists' counselling skill set by proposing an ACT intervention that can be applied as a brief counselling process in the workplaceRESEARCH APPROACH/DESIGN AND METHOD: A systematic literature review of three separate literature streams yielded 1297 publications. After further analysis, 25 publications that met the criteria for relevance and quality were considered to create a model for workplace counsellingMAIN FINDINGS: Attention to the role of industrial psychologists as counsellors dwindled after the 1960s but has recently been given renewed attention by South African scholars. The literature review of experimental ACT designs revealed evidence-based guidelines that were combined to create the ACT for Work Well-being ModelPRACTICAL/MANAGERIAL IMPLICATIONS: The ACT for Work Well-being Model is a brief counselling protocol to offer systematic steps that industrial psychologists can implement during brief work-based counselling to address anxiety and depressive symptomsCONTRIBUTION/VALUE-ADD: The proposed model is designed to stimulate further empirical validation and ensure evidence-based practice

Objective: To evaluate a protocol for acceptance and commitment therapy-based behavioral intervention for insomnia (ACT-BBI-I) in adults compared to cognitive behavioral therapy for insomnia (CBT-I). Methods: Forty-five adults with chronic insomnia were randomized to ACT-BBI-I or CBT-I. Both interventions were performed in six weekly group sessions. The common treatment elements in both protocols included stimulus control and sleep restriction. CBT-I is focused on the cognitive restructuring of maladaptive beliefs about sleep and the daytime effects of insomnia. ACT-BBI-I focuses on therapeutic processes of acceptance, availability, values, defusion, and commitment. The results were evaluated through the following instruments: a sleep diary, the Insomnia Severity Index, the Epworth Sleepiness Scale, the Hospital Anxiety and Depression Scale, the Acceptance and Action Questionnaire-II, and the Dysfunctional Beliefs and Attitudes about Sleep scale. Results: Both interventions had a significant positive impact on sleep patterns, insomnia, anxiety, beliefs about sleep, and psychological flexibility. All improvement was maintained at the 6-month follow-up. Conclusion: The results suggest that integrating principles of ACT with behavioral techniques may be useful for treating insomnia. Further research should identify whether the principles of ACT result in added effectiveness compared to behavioral components alone. Clinical trial registration: RBR-7nc5wq

Resumo O envelhecimento da população aponta à necessidade de novas formas de cuidado às demandas que começam a surgir. Em idosos, a depressão se apresenta a partir do isolamento, sentimento de desesperança, irritabilidade e baixa tolerância à frustração. A partir disso, este estudo teve como objetivo avaliar um protocolo de psicoterapia para depressão geriátrica desenvolvido a partir da integração da Terapia de Aceitação e Compromisso com outros modelos teóricos. Trata-se de um ensaio clínico randomizado-controlado, paralelo, aberto, com um braço, sem grupo controle. Contou-se com nove idosas, submetidas a 12 sessões. Foram mensurados os níveis de depressão geriátrica, positividade, satisfação com a vida e ansiedade. As testagens ocorreram na primeira sessão, na sexta, na última e três meses após o fim da intervenção e foram analisadas através do teste de Wilcoxon. Os resultados apontam diminuição nos níveis de depressão (T = 0,09) e ansiedade (T = 0,04) e aumento da Positividade (T = 0,09) e da satisfação com a vida (T = 0,09). Concluiu-se que o protocolo Kairós apresenta evidências de eficácia para tratamento da depressão geriátrica, apesar da não generalização dos dados. Faz-se necessária a realização de novos estudos com populações maiores.

Abstract The aging of the population leads us to think about the need for new forms of care to the demands that start to emerge. Geriatric. In the elderly, depression comes from isolation, feelings of hopelessness, irritability and low tolerance for frustration. From that, this study aimed to evaluate a psychotherapy protocol for geriatric depression developed from the integration of Acceptance and Commitment Therapy with other models. It is a randomized, open, controlled, parallel, one-arm clinical trial with no control group. A total population of nine elderly women who underwent 12 sessions. To assess its effectiveness, levels of geriatric depression, positivity, life satisfaction and anxiety. The tests occurred at four moments: the first session, the sixth, the last, and three months after the end of the intervention and were analyzed using the Wilcoxon test. The results show a decrease in depression (T = 0.09) and anxiety (T = 0.04) and an increase in Positivity (T = 0.09) and satisfaction with life (T = 0.09). It was concluded that the Kairós protocol presents evidence of efficacy, despite the non-generalization of the data. Further studies with larger populations are required.

Objective: Acceptance and commitment therapy (ACT) is a third-wave psychological intervention that has attracted considerable clinical and research attention. A previous meta-analysis of ACT trials in psychosis reported a large effect size of ACT against overall psychotic symptomatology. However, there were critical methodological issues in the review that justify replication. Methods: Systematic review and meta-analysis of randomized controlled trials (RCTs) testing ACT vs. any comparator condition in a sample of adults with psychosis. The outcome of interest was overall psychotic symptomatology. Results: The search identified seven published and eight unpublished trials (of which we were able to obtain data from one). Data on symptomatology were extracted from six trials that involved 274 participants. The summary effect size (Hedge’s G) for overall symptomatology was small and not significant (-0.21, 95%CI -0.60-0.18). Trials were generally rated as having a high risk of bias. Safety reporting was inadequate across included trials. Conclusions: Our observed effect size contrasted with that reported in a previous meta-analysis; differences were likely explained by errors in data extraction. The findings of this review suggest that there is currently inadequate evidence to conclude that ACT is a safe and effective treatment against psychotic symptomatology. Systematic review registration: CRD42018097200

Abstract: Child and Adolescent Inpatient Psychiatric Units are resources for the treatment of acute psychopathological decompensation. Their main objectives are the global care and the stabilization of the patient. Psychotherapeutic interventions in this specific context, as well as the characteristics of the child and adolescent population, have certain particularities that should be addressed in order to maximize the psychotherapeutic effects of the intervention during hospital admission. This paper describes the experience of a group psychotherapeutic intervention in the Adolescent Inpatient Psychiatric Unit of Puerta de Hierro-Majadahonda University Hospital (Madrid). The characteristics of the intervention model, based both on Acceptance and Commitment Therapy and Functional Analytic Psychotherapy, are described throughout this manuscript. Additionally, its integration with other activities of the Unit is detailed. Potential difficulties during the intervention, as well as main dynamics and challenges when working with adolescents in this specific context, are also presented.

Resumen: Las Unidades de Hospitalización Breve de Niños y Adolescentes son dispositivos para el tratamiento de menores en situación de descompensación psicopatológica aguda cuyo objetivo principal es la contención y estabilización del paciente. Las intervenciones psicoterapéuticas en este tipo de recursos, así como las características de la propia población infanto-juvenil, poseen una serie de particularidades a tener en cuenta de cara a maximizar el potencial psicoterapéutico del ingreso. En el presente trabajo se describe la experiencia de una intervención psicoterapéutica grupal en la Unidad de Hospitalización Breve de Adolescentes del Hospital Universitario Puerta de Hierro-Majadahonda (Madrid). A lo largo del manuscrito se exponen las características del modelo de intervención, basado en la Terapia de Aceptación y Compromiso y la Psicoterapia Analítica Funcional, así como su integración con otras actividades de la Unidad. Además, se ilustran las principales dinámicas, dificultades y desafíos que implica la intervención en este contexto psicoterapéutico específico.

Abstract Objective: Breast cancer is the most common cancer in women worldwide. Many of these patients suffer from multiple psychological symptoms. The present study aimed to investigate the impact of acceptance and commitment therapy (ACT) on depression, pain acceptance, and psychological flexibility in married women with breast cancer. Methods: The present study was a pre- and post-test clinical trial with intervention and control groups. The research population consisted of women with breast cancer referred to the Ayatollah Yasrebi and Shahid Beheshti Hospitals in Kashan in 2018. Through a purposive sampling method, 40 women were selected and randomly divided into two groups, namely, intervention (n = 20) and control (n = 20). The applied tools included the Depression, Anxiety and Stress Scale (DASS-21), Chronic Pain Acceptance Questionnaire 8 (CPAQ-8), and Acceptance and Action Questionnaire - II (AAQ-II). Data were analyzed by SPSS 16 using descriptive statistics and analysis of variance (ANOVA). Results: The results showed that ACT treatment significantly reduced the mean scores of depression compared to the control group (F = 107.72, p < 0.001). The mean scores of pain acceptance (F = 9.58, p < 0.05) and psychological flexibility (F = 10.61, p < 0 .05) significantly increased in comparison with the control group. Conclusion: ACT can be considered as an effective therapeutic approach to reduce depression and increase pain acceptance and psychological flexibility in women with breast cancer. These changes appear to be due to improved acceptance of thoughts and feelings associated with cancer and increased psychological flexibility, which is the primary goal of ACT treatment. Clinical trial registration: Iranian Registry of Clinical Trials (IRCT), IRCT20190518043620N1.

Resumo O uso prejudicial de substâncias psicoativas tem sido considerado um dos maiores problemas de saúde pública. Diversas abordagens são utilizadas para o tratamento dos transtornos relacionados ao uso de substâncias diante dos desafios impostos. O presente estudo teve por objetivo identificar os trabalhos empíricos que utilizaram a ACT para o tratamento do uso de substâncias e seus respectivos resultados no que diz respeito à aceitação, viabilidade e redução da gravidade da dependência, bem como nos resultados relacionados às comorbidades e demais aspectos associados ao uso através de uma revisão sistemática da literatura acerca do tema, utilizando-se das recomendações do guia Preferred Report Items for Systematic Reviews and Meta-Analyses (PRISMA) e buscas nas bases Pubmed, APA PsycNET, SciELO, ScienceDirect, Web of Science, BVS e LILACS. Foram analisados 17 estudos, permitindo observar aumento da flexibilidade psicológica, atenuação das taxas de abandono do tratamento e redução do consumo de substâncias nas intervenções analisadas.

Abstract The harmful use of psychoactive substances has been considered one of the biggest public health issues. Several approaches are used for the treatment of disorders related to substance use in the face of the challenges imposed. This study aimed to identify the empirical works that used ACT for the treatment of substance use and their respective results regarding acceptance, feasibility, and reduction in the severity of dependence, as well as the results related to comorbidities and other aspects associated with drugs use by a systematic review of the literature on the subject, using the recommendations of the Preferred Report Items for Systematic Reviews and Meta-Analyses (PRISMA) guide and searches in PubMed, APA PsycNET, SciELO, ScienceDirect, Web of Science, VHL, and LILACS. In total, 17 studies were analyzed, allowing the observation of an increase in psychological flexibility, attenuation of treatment dropout rates, and a reduction in substance use in the analyzed interventions.

Resumen El uso nocivo de sustancias psicoactivas se ha considerado como uno de los mayores problemas de salud pública. Se utilizan varios enfoques para el tratamiento de los trastornos relacionados con el consumo de sustancias frente a los desafíos impuestos. Este estudio tuvo como objetivo identificar los trabajos empíricos que utilizaron ACT para el tratamiento del consumo de sustancias y sus respectivos resultados en cuanto a la aceptación, viabilidad y reducción de la gravedad de la dependencia, así como los resultados relacionados con las comorbilidades y otros aspectos asociados al uso, desde una revisión sistemática de la literatura sobre el tema y utilizando las recomendaciones de la guía Preferred Report Items for Systematic Reviews and Meta-Analyzes (PRISMA) y búsquedas en PubMed, APA PsycNET, SciELO, ScienceDirect, Web of Science, VHL y LILACS. Se analizaron 17 estudios, lo que permitió observar un aumento de la flexibilidad psicológica, una atenuación de las tasas de abandono del tratamiento y una reducción del consumo de sustancias en las intervenciones analizadas.