Acceptance Commitment Therapy (ACT) for distress associated with inflammatory bowel disease

INTERVENTION: Our intervention is consistent with the core principles of acceptance and commitment therapy (ACT) and tailored to IBD. The ACTforIBD program includes eight fully‐scripted modules, each addressing a different ACT theme or principle. Module 1 introduces ACT and explores the client’s experiences and struggles. Module 2 explores the client’s avoidance behaviours. Module 3 focuses on exploring the personal values the client holds. Module 4 introduces mindfulness practice. Module 5 explores cognitive fusion and defusion. Module 6 focuses on willingness and acceptance. Module 7 revisits the client’s values and establishes goals. Module 8 focuses on commitment and overcoming barriers moving forward. ACTforIBD has a blended design: the first three sessions and the last session are therapist‐led (via Zoom/Skype), and the between sessions are self‐led (using a website designed specifically for this study). The website includes interactive modules consisting of text, short videos and audio recordings. It also has in‐built website analytics, including participant login times to monitor adherence. The sessions occur weekly for 8 weeks and take 1 hour (duration established as effective). The goals of treatment with this program broadly include: assisting clients to define valued directions and take committed action in the direction of their identified values, increasing understanding and insight into the client’s personal experiences by promoting presence and increasing cognitive defusion; improved coping with physical symptoms through the process of acceptance and cognitive defusion; and increasing psychological flexibility around psychological distress associated with IBD. The specific goals of treatment with each person will vary depending on their symptoms, life experiences and i CONDITION: crohn's disease;ulcerative colitis;indeterminate colitis;inflammatory bowel disease;distress;anxiety;depression; ; crohn's disease ; ulcerative colitis ; indeterminate colitis ; inflammatory bowel disease ; distress ; anxiety ; depression Mental Health ‐ Anxiety Mental Health ‐ Depression Mental Health ‐ Other mental health disorders Oral and Gastrointestinal ‐ Crohn's disease Oral and Gastrointestinal ‐ Inflammatory bowel disease Oral and Gastrointestinal ‐ Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon PRIMARY OUTCOME: Feasibility of recruitment assessed based on data from study database[8 weeks after starting treatment] Feasibility of retention in the study based on data from study database[8 weeks after starting treatment] INCLUSION CRITERIA: Diagnosis of IBD: Crohn’s disease, ulcerative colitis or indeterminate colitis established by a health professional using standard criteria (evidence can include a letter from a doctor, results of endoscopy or any other medical document confirming the diagnosis); Distress: scores 16‐29 on K10 (screening for distress will take place after consent has been obtained); Age: 18 years and older; Language: Able to read and write in English; Residence: Live in Australia or New Zealand; Other: Access to the internet SECONDARY OUTCOME: Change in patient disease activity based on PRO2[8 weeks and 3 months after starting treatment] Change in patient disease activity based on PRO3[8 weeks and 3 months after starting treatment] Change in patient disease activity based on the IBD Control Scale[8 weeks and 3 months after starting treatment] Change in patient disease activity based on the Manitoba Index[8 weeks and 3 months after starting treatment] Change in patient distress level based on Depression Anxiety Stress Scale (DASS)[8 weeks and 3 months after starting treatment] Change in patient fatigue based on Fatigue Symptom Inventory[8 weeks and 3 months after starting treatment] Change in patient pain based on Pain Numeric Rating Scale [8 weeks and 3 months after starting treatment] Change in patient quality of life based on EQ5D5L[8 weeks and 3 months after starting treatment] Change in patient resilience based on Brief Resilience Scale[8 weeks and 3 months after starting treatment] Change in patient self‐efficacy based on General Self‐efficacy Scale[8 weeks and 3 months after starting treatment] Patient satisfaction assessed by one to one semi‐structured interviews with a purposive selection (representatives of different genders, age groups, urban/rural location, IBD types, group allocation) of 20 participants[8 weeks and 3 months after starting treatment] Patient satisfaction based on a Satisfaction Numeric Rating Scale [8 weeks after starting treatment] Preliminary cost‐effectiveness based on healthcare utilisation resource questionnaire designed specifically for this study[8 weeks and 3 months after starting treatment]