Online delivered acceptance and commitment therapy (ACT) for managing anxiety in adolescents with acquired brain injury

The intervention being evaluated is the Discoverer, Noticer, Advisor –Vitality program (DNA-V; Hayes & Ciarrochi, 2015) which is based on the acceptance and commitment therapy (ACT) model. The program focuses on developing three main skills: Discovering, Noticing and Advising. Key components of the program include helping adolescents to notice and connect with their feelings (Noticing skills), use their thoughts or self-talk in useful ways (Advising skills), and engage in new behaviours that are consistent with their values (Discovering skills). For example, adolescents focus on how to use their self-talk in helpful ways. They learn to listen when their self-talk is helpful, and defuse (distance themselves) from it when it is not helpful. The activities used in the program have been adapted to address the cognitive difficulties experienced by people with TBI. Information will be presented both verbally and visually whenever possible. The skills will be learnt in structured sessions with the opportunity to apply them in their everyday life. For the adaptation, our clinical team reviewed the activities within the DNA-V program and identified those which may be most suitable for this population. For example, activities which rely more on visual prompts or have written aids like card sorting activities. These activities were identified as a pool of learning tools for the implementation of the program. The program will consist of eight 1 hour weekly sessions delivered via video call and provided on a one-to-one format. It will be delivered by a registered psychologist experienced in working with children and adolescents with TBI. A hard copy of the workbook, worksheets, and other materials will be provided to the participant at the beginning of the program. The online share screen and white board function will be used to work through session materials when needed. The workbook and worksheets are based on materials available from the DNA-V program (Hayes & Ciarrochi, 2015). The adolescent will be required to complete worksheets/activities between sessions. Time to complete these activities will vary week to week but they will typically take 20-25 minutes to complete throughout the week. To support adherence to the home tasks, at the end of each session, the therapist will go through the home task for the week ahead to plan how the adolescent will complete the task. Consistency of the delivery of the program will be ensured as all therapists will be working from a therapy manual with each session planned. A ‘Therapy Session Log’ will be completed by the therapist after each session documenting the content covered during the session. Adherence to the program will be ensured through the independent evaluation of the ‘Therapy Session Log’. At the end of the data collection period, an independent member of the research team will review the Therapy Session Log and rate each session using a study adherence checklist. The checklist will assess whether the therapist and participant have covered each of the key components of the therapy program. Reference: Hayes, L., & Ciarrochi, J. (2015). The thriving adolescent: Using acceptance and commitment therapy and positive psychology to help young people manage emotions, achieve goals and build positive relationships. Oakland, CA: Context Press.