The effectiveness of a workplace ACT intervention compared to MBSR - - PowerPoint PPT Presentation

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The effectiveness of a workplace ACT intervention compared to MBSR - - PowerPoint PPT Presentation

Sep 11, 2023 12 likes •235 views

The effectiveness of a workplace ACT intervention compared to MBSR training for sleep outcomes and mechanisms Joe Oliver Vasiliki Christodoulou Paul Flaxman & Eric Morris Reading RFT The morning after In bed actually Purple the

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The effectiveness of a workplace ACT intervention compared to MBSR training for sleep –

  • utcomes and mechanisms

Joe Oliver Vasiliki Christodoulou Paul Flaxman & Eric Morris

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Reading RFT Purple Book The morning after the Follies In bed actually trying to sleep

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Problems with workplace sleepiness

  • 2008 'sleep in America' poll - 65% of people experienced

sleep problems a few nights per week.

  • Amount of sleep workers get has been declining steadily
  • ver past 30 years as working hours have increased

(declined around 7% between 1999 and 2009 alone)

  • Estimated economic burden of sleepiness (figures

from US): $16 billon in medical expense; $53 to $69 in vehicle accidents, $18 - to $24 billion in work-related accidents

(Source: Mullins et al. 2014; Welsh et al. 2014)

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  • Common

mental health problems; unethical work behaviour (due to reduction in self-regulatory resources); poor mood; incivility in workplace; various physical health problems (obesity, hypertension, CVD), increased absence rates, reduced work performance

A Range of Consequences Linked to Poor Sleep

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ACT Vs Mindfulness-Based Training

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Research Questions

  • Comparing ACT training to Mindfulness-based training

(low-dose) on sleep outcomes for working individuals.

  • Do the interventions operate via the expected

mechanisms of change?

  • ACT (values-based action)
  • MBSR (mindfulness)
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Participants

  • Staff from an NHS mental health trust.
  • 26% nursing, 15% psychology, 11% administrative,

8% allied health & other professions.

  • N=200; ACT(n)=66; Mindfulness(n)=58; Waiting

list(n)=75

  • Dropout by T5: T5 waitlist: 22.6% T5 Act: 25.7%

T5 Mindfulness training:29.3%

  • 77% female
  • Mean age=42 (sd=10.4)
  • 58.6%:Above clinical level of distress at T1.
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Protocol

  • 4 sessions (3, 2-hour sessions in consequent

weeks; one session after 6 weeks).

  • Randomised controlled trial (ACT, Mindfulness-

based training, Waiting list).

  • Completion of measures at pre (T1), post 4

weeks (T2), post 10 weeks (T3), post 16 weeks (T4), follow-up 22 weeks (T5).

  • Groups: 5-12 participants
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ACT worksite protocol

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MBSR worksite protocol

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Questionnaires

  • General Health Questionnaire-12
  • Perceived Stress Scale
  • Work Limitations Questionnaire
  • Sleep Scale (from physical health questionnaire)
  • Activity and Circumstances Change

Questionnaire

  • Acceptance & Action Questionnaire-7
  • Five Factor Mindfulness Questionnaire
  • Behavioural Activation Scale
  • Valuing Questionnaire
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Questionnaires

  • Sleep Scale (from physical health questionnaire)
  • “How often have you had difficulty getting to sleep?”
  • “How often have you woken up during the night?”
  • Activity and Circumstances Change

Questionnaire (4 item)

  • “Please rate the extent to which you have adopted some

significant positive new goal or activity over the last 4 weeks”

  • Five Factor Mindfulness Questionnaire
  • Act with Awareness
  • Non-judgement
  • Non-reactivity
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Analysis and Results

  • Latent growth curve modelling
  • Rate of change across 5 time points in outcome
  • Rate of change of mediators
  • Does rate of change of goal directed behaviour

and mindfulness mediate the effect of the interventions on sleep?

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= 237.78, df = 127, p < .0001, CFI = .92, TLI = .92, RMSEA = .066 (.053, .079)

χ2

FFMQ Intercept ¡ FFMQ Slope ¡ ¡

t2 t3 t1

Goals & activities Intercept ¡ Goals & activities Slope ¡ ¡

t2 t3 t1 ACT t4 t5 t4 t5

Sleep Intercept ¡ Sleep Slope ¡ ¡

t2 t3 t1 t4 t5 Mindfulness training

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Main ¡Results ¡

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Main ¡Effects ¡

Mindfulness ¡

¡ ¡

¡ Goals ¡& ¡ Activities ¡ ¡ ¡ ACT ¡

Mindfulness training

Sleep ¡ Problems ¡ ¡ ¡

  • .49
  • .54

.27 .47 .43 .40

  • .60
  • .70
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Indirect ¡Effects ¡

Mindfulness ¡

¡ ¡

¡ Goals ¡& ¡ Activities ¡ ¡ ¡ ACT ¡

Mindfulness training

Sleep ¡ Problems ¡ ¡ ¡

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Indirect ¡Effects ¡-­‑ ¡ACT ¡

Mindfulness ¡

¡ ¡

¡ Goals ¡& ¡ Activities ¡ ¡ ¡ ACT ¡

Mindfulness training

Sleep ¡ Problems ¡ ¡ ¡

  • .33
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Indirect ¡Effects ¡-­‑ ¡ Mindfulness ¡

Mindfulness ¡

¡ ¡

¡ Goals ¡& ¡ Activities ¡ ¡ ¡ ACT ¡

Mindfulness training

Sleep ¡ Problems ¡ ¡ ¡

  • .28
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Summary

  • Both ACT training & Mindfulness-based training

appear to be suitable and effective for poor sleep

  • Programs can be brief.
  • ACT impacts more on behavioural changes
  • MBSR impacts more on mindfulness
  • Change in both interventions appears to be

mediated through increases in goal directed behaviour

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Summary (2)

  • Behavioural change important in sleep outcomes
  • Change to routines
  • Increased self care
  • More values guided behaviour
  • Evidence that impact is not via “relaxation”

processes

  • Next steps to look more closely at rates of change of

variables

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Thank you! Any questions?