Acceptance and commitment therapy for clients institutionalized for severe substance-use disorder: a pilot study

Figures & data

Table 1 Demographic and diagnostic information for institutionalized participants with SUD (n = 18)

LVM home/participant ID	Age (years)	Gender	Depression	Anxiety	Stress	Diagnosis
LVM home/A
AID02	49	F	−−	−−	−−	Not diagnosed
AID03	49	F	++	++	+	Not diagnosed
AID06	42	F	++	++	++	PTSD
AID07	29	F	++	−	+	PTSD
LVM home/B
BID01	27	M	−−	−−	+−	ADHD
BID02	57	M	++	++	++	PTSD
BID03	59	M	++	++	++	Bipolar disorder
BID05	57	M	+−	++	++	Not diagnosed
BID07	42	M	+−	+	+	Not diagnosed
LVM home/C
CID01	43	M	+	+−	+−	ADHD
CID02	50	M	++	+	++	Social phobia
CID03	32	M	+	+	+	Conductive disorder
CID05	42	M	−−	−−	−−	ADHD, OCD, borderline
CID06	49	M	+−	++	−−	ADHD
CID07	33	M	−	−−	+−	Not diagnosed
CID08	39	M	+	++	−	ADHD, borderline
CID09	60	M	++	+−	++	Not diagnosed
CID10	24	M	−−	−−	−	ADD

Note: See Table 2 for coding key of DASS-21 ranging from ++ high high positive to −− low low negative.

Abbreviations: LVM home, Institution regulated by the Care of Alcoholics and Drug Abuser Act; SUD, substance-use disorder; F, female; PTSD, post-traumatic stress syndrome; M, male; ADHD, attention-deficit/hyperactivity disorder; OCD, obsessive compulsive disorder; ADD, attention-deficit disorder; DASS-21, Depression, Anxiety and Stress Scale – 21.

Table 2 Coding clinical scales and items into common assessment categories

Variable/original clinical scale or item positive	Coding scheme for scores into assessment categories
	High high	High	Medium	Low	Low low negative
	++	+	±	−	−−
DASS−21 – depression (“++” normal and “−−” bad)	Normal 0–4	5–6	7–10	11–13	Bad 14 – up
DASS−21 – anxiety (“++” normal and “−−” bad	Normal 0–3	4–5	6–7	8–9	Bad 10 – up
DASS−21 – stress (“++” normal and “−−” bad)	Normal 0–7	8–9	10–12	13–16	Bad 17 – up
AAQ−II (degree of bad flexibility, range 6–42)	6–12	13–19	20–29	29–35	36–42
BRIEF−A (degree of dysfunction T−score)	−34	35–44	45–54	55–64	65 – up

Abbreviations: DASS-21, Depression, Anxiety and Stress Scale – 21; AAQ-II, Acceptance and Action Questionnaire – II; BRIEF-A, Behavior Rating Inventory of Executive Function – Adult Version.

Table 3 Summary of individual change between pre-intervention and post-intervention for all clinical scales

Column 1	Column 2	Column 3	Column 4	Column 5	Column 6	Column 7	Column 8
Behavior concept	Instrument	Clinical scales/single items – questions in BRIEF-A	Frequency distribution for change between pre-observation and post-observation
			Strong negative trend	Negative tendency	Status quo	Positive tendency	Strong positive trend
Mental health status	DASS-21	Depression	3	l	9	2	3
		Anxiety	2	2	10	3	1
		Stress	1	5	7	3	2
Psychological flexibility	AAQ-II	0. Psychological flexibility	1	1	4	9	3
Executive function – behavioral regulation	BRIEF-A BRI	1. Inhibition	0	0	10	8	0
		2. Shift	0	2	11	1	4
		3. Emotional control	1	1	10	5	1
		4. Self-monitoring	0	3	10	3	2
Executive function – metacognition	BRIEF-A MI	5. Initiate	0	1	12	5	0
		6. Working memory	0	3	12	2	1
		7. Plan/organize	0	1	15	1	1
		8. Task monitoring	0	3	8	7	0
		9. Organization of materials	2	2	11	3	0
Outcome variables only		Sum for scales 0–9 for no. of change observations (n=18)	4	17	103	44	12
		Sum in % for no. of observations=180	2.2	9.4	57.2	24.4	6.7
All clinical scales		Sum for no. of change observations for n=18	10	25	129	52	18
		Sum in % for no. of observations=234	4.3	10.7	55.1	22.2	7.7

Notes: Interpretation key for individual change classified into five categories mirroring the shift in assessment categories from pre-observation to post-observation. Strong negative trend, decreasing two assessment categories; negative tendency, decreasing one assessment category; status quo, the same assessment category; positive tendency, increasing one assessment category; strong positive trend, increasing two assessment categories.

Abbreviations: DASS-21, Depression, Anxiety and Stress Scale – 21; AAQ-II, Acceptance and Action Questionnaire – II; BRIEF-A, Behavior Rating Inventory of Executive Function – Adult Version; BRI, Behavioral Regulation Index; MI, Metacognition Index.

Figure 1 Psychological inflexibility mean trends by LVM home for all participants (n=18).

Note: Low score indicates high psychological flexibility.
Abbreviation: AAQ-II, Acceptance and Action Questionnaire – II.

Figure 2 Executive dysfunction mean T-score trends using the BRIEF-A subscales at pre- and post-intervention time points (n=18).

Note: High T-score represents high executive dysfunction.
Abbreviation: BRIEF-A, Behavior Rating Inventory of Executive Function – Adult Version.