Does an acceptance-focussed guided self-help programme reduce depressive symptoms in patients with vision impairment?

We will integrate "third wave" cognitive-and-behavioural components of the Acceptance and Committment Therapy (ACT) Triflex into a guided self-help programme (i.e., the three functional units of ACT – be present, do what matters, and open up) with the aim to increase psychological flexibility. Our six modules are: (1) Understanding emotional well-being in vision impairment, (2) Being present, (3) Doing what matters, (4) Opening up, (5) Effective communication, and (6) Wellness planning. The programme will be delivered in three individual face-to-face and three individual telephone consultations, of up to 50 minutes in duration per session, by a clinical psychologist. Sessions are administered once a week for 6 weeks. Two face-to-face visits will be followed by a telephone consultation, which is then followed by one face-to-face session and the remaining two telephone consultations. The weekly manual content is to be followed sequentially when the participant chooses, which is followed by guidance from the clinical psychologist in their sesisons. Each intervention session will be recorded and the clinical psychologist will write a reflection on what was or was not effective following each session, with a view to developing a list of key intervention activities. We will record the number and duration of the face-to-face and telephone visits performed by the clinical psychologist. We will also record the time it took participants to follow the intervention (i.e., how long it took to complete each weekly session). After each session, the clinical psychologist will ask participants to describe how, and the extent to which they have used any strategies or intervention materials (i.e., the self-help manual provided in large print or for use with adaptive technology, includes readings, worksheets, and a description of skills to be practiced). In the evaluation interview, we will ask participants to describe the manner in which they followed the self-help course and the manner and extent to which they practiced their skills (in writing, cognitively, discussion etc.). Together, this information will be used to develop a measure of fidelity that will explore adherence to the programme and translation of therapy into daily life.