Abstract:
Background: In New Zealand, approximately 67% of adults and 33% of children live with a
chronic health condition (CHC). The COVID-19 pandemic is likely to heighten psychological
distress for this population. Online interventions have the potential for greater reach and
accessibility to psychologically support people living with CHCs. To date, there are no known
studies that have tested a brief online Acceptance and Commitment Therapy (ACT)
intervention during a pandemic for people with CHCs.
Aim: This study aimed to examine whether a one-week online psychological intervention
(ACT2COPE) could reduce depression, anxiety and stress symptoms and improve wellbeing
and psychological flexibility in adults living with CHCs during the COVID-19 pandemic in
New Zealand. We also wanted to explore the relationships between these psychological
outcomes and whether psychological flexibility was mediating the relationship between the
intervention and reduced depressive symptoms.
Method: This pilot randomised waitlist controlled trial investigated the effects of ACT2COPE
on psychological outcomes (depression, anxiety, stress, wellbeing, and psychological
flexibility) among 40 adults living with CHCs during the COVID-19 pandemic in New
Zealand. Independent samples t-tests, Pearson’s correlations, repeated measures ANOVAs,
and linear regression analyses were used to examine relationships and the effects of
ACT2COPE. Additionally, qualitative data was gathered (using focus groups and
questionnaires) to explore participants' experiences of the intervention.
Results: Depressive symptoms significantly decreased over time compared to the waitlist
group while anxiety, stress, wellbeing, and psychological flexibility did not demonstrate
changes over time relative to the waitlist group. Exploratory analyses demonstrated that
participants with higher adherence to the intervention showed improvements in depression,
anxiety, and stress over time in comparison to the control group. Lastly, psychological
flexibility was not found to be a significant mediator between ACT2COPE and depression
scores. Qualitative findings suggested that participants found ACT2COPE acceptable and
engaging.
Conclusion: The novel ACT2COPE intervention presents a promising, scalable intervention
that may reduce depressive symptoms in adults living with CHCs during the COVID-19 pandemic. Future research is needed to confirm these findings in a larger RCT to establish
whether ACT2COPE is equally effective post pandemic and in a more diverse population.