ACT and the Smartphone

phone-hands-against-dark-background

An exuberantly-decorated website titled ACTCompanion.com enumerates the features of the Happiness Trap App, designed around the ideas of Dr. Russ Harris, whose book, The Happiness Trap, was published in 2008. It’s all about “simple defusion and acceptance techniques, easy values-clarification and goal-setting tools, powerful ‘observing self’ and self-compassion exercises.”

As time went on, the ACT Companion was developed for use with the book, or with a clinician or an ACT coach. The tools include mindfulness recordings, notifications, the ACTometer, Mindful Moments, the Crisis Tool, and the Weekly Check-In.

Not unique

Acceptance and Commitment Therapy seems exceptionally amenable to administration via smartphone. Terms like “guided self-help” and “long-term motivation” are quite appropriate, because therapeutic results can be obtained with minimal participation by a human therapist, or even with none.

Last year, New Zealand researchers published their report on a product called SmartQuit, designed to promote smoking cessation. Its basis is ACT, described here as “a behavioral therapy that encourages individuals to accept internal experiences, such as cravings to smoke, without acting on those experiences or urges.” That a therapy known as ACT is largely concerned with not acting, is just one of those strange paradoxes.

The methodology of their very small study (10 people) is, in keeping with tradition, explained in detail. Here is what they ended up with:

Using SmartQuit reduced our participants’ daily cigarette intake significantly in the short-term and three individuals remained smoke-free up to 13 months later… Our results suggest that SmartQuit provides another readily accessible intervention to help people stop smoking…

After analyzing previous trials, a different group of researchers tested SmartQuit 2.0 with a largely female subject pool. The results sound promising:

Regarding receptivity, 84% of participants were satisfied with SmartQuit 2.0 (vs. 59% for SmartQuit1.0), 73% would recommend it to a friend (vs. 48% for SmartQuit1.0), 81% found the ACT exercises useful for quitting… The revised app had high user receptivity, modest quit rates, and high smoking reduction rates.

The authors also add that program completion “may be key to boosting the app’s effectiveness.” May be key? If improvement is to be gained, common sense suggests that program completion would be an absolute necessity. But human psychology being what it is, there are indications from various quarters that even incomplete exposure, partial participation, and non-completion do not stand in the way of some people benefitting from some programs. Sorting out the complexities of that paradox is another research field ripe for exploration.

In progress

Sweden’s Karolinska Institutet and Karolinska University Hospital are collaborating on an intervention study to be completed almost exactly a year from now, investigating the impact smartphone-delivered ACT. The problem to be addressed is long-standing pain in adolescents. The protocol involves eight weeks of ACT delivered by smartphone, plus internet-delivered parental support for young person’s parent or parents.

The outcome measures, or the aimed-for reactions that will tell if the modality works, are (for the adolescents) change in pain interference, diminishment of insomnia and depression, and gains in psychological flexibility and general quality of life. For parents, the scientists are looking for changes in pain reactivity, depression, anxiety, and psychological flexibility.

Your responses and feedback are welcome!

Source: “The Happiness Trap App,” ACTCompanion.com
Source: “Using SmartQuit, an Acceptance and Commitment Therapy Smartphone application, to reduce smoking intake,” SagePub.com, 2017
Source: “Single-arm trial of the second version of an acceptance & commitment therapy smartphone application for smoking cessation,” NIH.gov, January 2017
Source: “Smartphone Delivered Acceptance and Commitment Therapy for Adolescents With Longstanding Pain — a Pilot Study,” ClinicalTrials.gov, 03/21/18
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Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
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Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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