Acceptance and Commitment Therapy (ACT) for people with advanced progressive illness, their caregivers and staff involved in their care: A scoping review.

Publisher: SAGE Publications Country of Publication: England NLM ID: 8704926 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1477-030X (Electronic) Linking ISSN: 02692163 NLM ISO Abbreviation: Palliat Med Subsets: MEDLINE

Publication: London : SAGE Publications
Original Publication: London : New York, NY : Cambridge University Press, North American distributors, Edward Arnold ; c1987-

Caregivers*/psychology ; Acceptance and Commitment Therapy*; Humans ; Palliative Care/psychology ; Grief ; Anxiety/therapy

Background: People with an advanced progressive illness and their caregivers frequently experience anxiety, uncertainty and anticipatory grief. Traditional approaches to address psychological concerns aim to modify dysfunctional thinking; however, this is limited in palliative care, as often concerns area valid and thought modification is unrealistic. Acceptance and Commitment Therapy is a mindfulness-based behavioural therapy aimed at promoting acceptance and valued living even in difficult circumstances. Evidence on its value in palliative care is emerging.
Aims: To scope the evidence regarding Acceptance and Commitment Therapy for people with advanced progressive illness, their caregivers and staff involved in their care.
Design: Systematic scoping review using four databases (Medline, PsychInfo, CINAHL and AMED), with relevant MeSH terms and keywords from January 1999 to May 2023.
Results: 1,373 papers were identified and 26 were eligible for inclusion. These involved people with advanced progressive illness ( n  = 14), informal caregivers ( n  = 4), palliative care staff ( n  = 3), bereaved carers ( n  = 3), and mixed groups ( n  = 2). Intervention studies ( n  = 15) showed that Acceptance and Commitment Therapy is acceptable and may have positive effects on anxiety, depression, distress, and sleep in palliative care populations. Observational studies ( n  = 11) revealed positive relationships between acceptance and adjustment to loss and physical function.
Conclusion: Acceptance and Commitment Therapy is acceptable and feasible in palliative care, and may improve anxiety, depression, and distress. Full scale mixed-method evaluation studies are now needed to demonstrate effectiveness and cost-effectiveness amongst patients; while further intervention development and feasibility studies are warranted to explore its value for bereaved carers and staff.

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Keywords: Acceptance and Commitment Therapy; bereavement; caregivers; palliative care; scoping review; staff; terminally ill

Date Created: 20230725 Date Completed: 20230915 Latest Revision: 20231007

20240829

PMC10503261

10.1177/02692163231183101

37489074