Acceptance and Commitment Therapy as a Psychological Intervention for Primary Caregivers of Patients With Decompensated Cirrhosis: A Randomized Controlled Trial

Aim: This study aimed to evaluate the effects of Acceptance and Commitment Therapy, relative to usual care, on psychological flexibility, resilience, caregiving burden, anxiety and depression in primary caregivers of patients with decompensated cirrhosis. Background: Primary caregivers of decompensated cirrhosis patients face high rates of anxiety and depression due to long-term caregiving stress, financial burdens and disease uncertainty. Acceptance and Commitment Therapy improves mental health in other chronic disease caregivers, but its effects on cirrhosis caregivers in China remain unstudied. Design: This was a randomized, assessor-blinded, parallel-group trial comparing Acceptance and Commitment Therapy-enhanced care with routine care alone in primary caregivers during hospitalization. Method: A total of 120 caregivers were recruited at a Chinese hospital (January–April 2023) and randomly allocated to control (routine care) or intervention (routine care plus six-session Acceptance and Commitment Therapy) groups. Validated scales assessed psychological flexibility, resilience, burden, anxiety and depression at admission, discharge and 1 month postdischarge. Data were analysed using chi-square tests, independent t-tests for baseline comparisons and repeated-measures ANOVA with Bonferroni post hoc tests for pairwise comparisons. Results: Compared to controls, the intervention group showed significantly lower scores in caregiving burden, anxiety, depression and psychological rigidity, alongside higher psychological resilience at discharge and 1-month follow-up. No adverse events were recorded in either group. Conclusion: In this single-centre trial, Acceptance and Commitment Therapy reduced psychological rigidity and caregiving burden and improved psychological resilience. Its emphasis on accepting uncontrollable realities and acting on personal values may be well suited to the volatile context of cirrhosis caregiving, but multicentre trials with longer follow-up are needed before wider implementation. Trial Registration: Chinese Clinical Trial Registry: ChiCTR2600131432.