Date of Award

8-2022

Degree Name

Doctor of Philosophy

Department

Psychology

First Advisor

Scott Gaynor, Ph.D.

Second Advisor

Amy Naugle, Ph.D.

Third Advisor

Brooke Smith, Ph.D.

Fourth Advisor

Christopher Briggs, Ph.D.

Keywords

ACT, alcohol, detox, psychological flexibility

Abstract

Alcohol detoxification inevitability involves physical and emotional discomfort. Common withdrawal symptoms include experiences of nausea, muscle pain, stomach and headaches, shakiness, restlessness, anxiety, and agitation. Rarer, but more severe, withdrawal symptoms can include hallucinations, seizures, and delirium tremens. Pharmacologic treatment of withdrawal symptoms is the primary, and often only, approach to intervention. The current study examined the incremental efficacy of adding a psychotherapeutic program based in Acceptance and Commitment Therapy (ACT) for individuals struggling with withdrawal during alcohol detoxification in a residential rehabilitation center. This study compared the standard of care, medication management, which was treatment as usual (TAU) at the facility, to TAU plus the ACT protocol. The ACT protocol included two 30-minute sessions, based on the ACT matrix, and brief (5-10 minute) coaching skills sessions. Forty-five adults (Mage = 42.4 years, 47% female, 84% white) were randomized to either ACT+TAU (n=22) or TAU (n=23) and spent an average of 4 days in detoxification. Effects generally favored the ACT condition across measures including: consumer satisfaction (t = -1.63, p[1 tailed] = .05, d = .48), connection with chosen values (t = 2.01, p [1 tailed] = .03, d = .60), increased use of ACT skills (F = 4.62, p = .04), decreased psychological inflexibility (F = 7.97, p = .01 and F = 2.92, p = .10), but not increased flexibility (F = .21, p = .65), and reduced withdrawal symptoms (F = 4.02, p = .05 and F =3.42, p = .07). The number of ACT coaching sessions correlated significantly with use of ACT skills (r = .44, p = .049). Increased use of ACT skills mediated the relationship between condition and increased consumer satisfaction (point estimate = 1.05, p = .03), and on one measure of symptom withdrawal reduction (point estimate = -.23, p <.05) but not the other. Results suggest the potential benefit of adding an acceptance-based psychosocial intervention, as an augment to medication management, in acute alcohol detoxification protocols.

Access Setting

Dissertation-Open Access

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Psychology Commons

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