References for our practice - ACT
ACT stands for "Acceptance and Commitment Therapy," which is one of the most prominent contextual behavioral therapies. Created by Steven C. Hayes, Kirk D. Strosahl, and Kelly G. Wilson in 1999, it has a substantial body of scientific research supporting its effectiveness and is recommended for various clinical conditions.
The processes of this approach have been applied in various contexts and groups. A notable example is the stress management protocol "Doing What Matters in Times of Stress" by Russ Harris and colleagues, which is endorsed by the World Health Organization.
We utilize these processes derived from modern behavioral psychology to create interventions for large groups.
Intervention
The intervention is called "Self Help Plus" (SH+), also known as "Doing what Matters in Times of Stress." It is a five-session program, with each session lasting 90 minutes, conducted weekly in a group setting. It is the stress management intervention provided by the World Health Organization for individuals in adverse conditions. SH+ was created by Russ Harris (2016) and developed by his team, including Kenneth Carswell and JoAnne Epping-Jordan in project management, Teresa Au, Felicity Brown, Claudette Foley, Claudia Garcia-Moreno, Cary Kogan, and Mark van Ommeren in conceptualization and development, Julie Smith for illustrations, David Wilson for text editing, Alessandro Mannochi for graphic design, Sanjo Ogunseye for English audio narration, and Ophel Riano for administrative support.
The Portuguese version was translated by Maria Heleneide Carlos Maia and adapted by Michaele Terena Saban-Bernauer, who also created the Portuguese audio narration. The Portuguese language review was done by Jonas Filho.
Empirical Evidence
Here are some recent research studies using the "Doing What Matters in Times of Stress" protocol:
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Tol, W.A. et al. (2020) investigated the effect of the protocol on Sudanese refugee women in Uganda. The randomized clinical trial studied 694 refugee women divided into two groups: those who received the group intervention with 20 to 30 women (331 participants), and the rest who received usual care (363 participants). The intervention consisted of the audio protocol, a facilitator who mediated the proposed exercises, and a support book. The five weekly 90-minute sessions were conducted, and measurements were collected one week before the intervention, one week after, and at a 3-month follow-up. The primary measures were stress (using the Kessler 6 scale) and secondary measures included reported personal problems, post-traumatic stress, symptoms of depression, feelings of anger, social interactions with other ethnic groups, functionality in daily life, and well-being. The results showed significant improvement in stress after 3 months of the intervention (compared to the control group) and in five out of eight secondary measures, also at the 3-month follow-up. They concluded that the protocol had a significant effect on reducing stress in South Sudanese refugee women in Uganda, regardless of stress level and traumatic conditions (Tol, W.A. et al., 2020).
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Acarturk, C. et al. (2022) investigated the protocol in Turkey with newly arrived Syrian refugees due to the war. The aim of the intervention was to prevent psychological disorders due to the stress experienced by this population. The research took place in two regions of Turkey, involving 642 Syrian refugee adults who experienced stress but did not have a diagnosis of psychiatric disorders. The randomized clinical trial was divided into a group that received the five-session intervention conducted by two facilitators in addition to usual care (322 participants) and a group that received only usual care (320 participants). The primary measures were the presence of psychological disorders six months after the intervention (measured by the Mini International Neuropsychiatric Interview), and secondary measures included the presence of psychiatric disorders after the intervention, stress, symptoms of post-traumatic stress, depression, personal goals, functionality in daily life, well-being, and quality of life after the intervention and at a six-month follow-up. The findings concluded that the protocol is a highly valid intervention for the prevention of psychiatric disorders, reducing their development by almost 50% after six months of intervention compared to the group that received only usual care (Acarturk, C. et al., 2022). Regarding the secondary measures, there were no significant differences post-intervention, but at the six-month follow-up, there were benefits in depressive symptoms, personal goals, and quality of life (Acarturk, C. et al., 2022).