Date of Award

8-2025

Degree Name

Doctor of Philosophy

Department

Psychology

First Advisor

Scott Gaynor, Ph.D.

Second Advisor

Amy Naugle, Ph.D.

Third Advisor

Amy Damashek, Ph.D.

Fourth Advisor

Taylor Weststrate, Ph.D.

Keywords

Acceptance and commitment therapy, alcohol use disorder, residential treatment

Abstract

Residential treatment for Substance Use Disorders (SUD) is a common treatment modality. However, the literature is sparse on modifiable predictors that affect change during the residential treatment stay. Acceptance and Commitment Therapy (ACT) has been shown to be an effective treatment for SUDs. Weststrate et al. (2023), in a randomized controlled effectiveness trial, compared ACT plus medication management to medication management during detoxification. The addition of ACT increased consumer satisfaction and ACT skills use, while decreasing psychological inflexibility and reducing withdrawal symptoms.

This study explored whether the brief ACT intervention had impacts during participants' subsequent residential stay. Forty out of 45 participants (Mage = 43.35 years, 50% female, 85% white) from Weststrate et al. were able to be matched to de-identified medical records taken during residential stay. Between group analyses did not show significant difference between groups for any outcome measure: total length of stay (t = -0.28, p = .608) as well as measures of depression (F = 0.11, p = .74), anxiety (F = 0.29, p = .59), and cravings (F = 0.92, p = .35). In fact, both groups significantly improved during residential treatment (F = 82.3, p < .001; F = 32.6, p < .001; F = 82.3, p < .001; F = 128.8, p < .001). Withdrawal symptom change during detox best predicted anxiety score changes into residential (r = .439, p = .011), exit withdrawal symptoms best predicted depression score changes into residential (r = .300, p = .116), but no withdrawal symptoms predicted changes in cravings. Change on the Acceptance and Action Questionnaire for Substance Abuse during detox was the most consistent ACT-related predictor of change in depressive symptoms (r = .238., p [1 tailed] = 0.91), anxiety (r = .310, p = .085), and cravings (r = .360, p = .039). Results suggest the effects of brief ACT during detoxification did not extend into residential treatment. Potential reasons for the failure to detect a robust enduring effect, both conceptual and methodological, are discussed.

Comments

Fifth Advisor: Christopher Briggs, Ph.D.

Access Setting

Dissertation-Open Access

Download

Share

COinS