Abstract
Youth with chronic medical conditions need accessible and effective mental health interventions to address high levels of disruption in their psychological, social, and emotional development. Acceptance and Commitment Therapy (ACT) is an empirically supported psychotherapy based on behavioral interventions that combines the principles of Relational Frame Theory and Mindfulness. ACT has been shown to be effective in populations of youth with various chronic conditions. As telehealth use has increased, ACT has been administered virtually on an individual level to adults and adolescents with chronic conditions, including chronic pain and Type II diabetes. However, few studies have incorporated a group-based element to the virtual delivery of ACT, which may be more accessible, cost-effective and may have additional therapeutic value in the form of peer connection and cohesion. To investigate the potential benefits of a virtual group model, we developed a web-based virtual ACT (vACT) group intervention for youth with chronic illness aged 14-21. The 6-week virtual group consisted of 1.5-hour sessions that each focused on a unique ACT concept: acceptance, values, mindfulness, cognitive defusion, experiential avoidance, and willingness/commitment. Additionally, the sessions included exercises to engage group members and teach skills. Baseline, post-, and follow-up data were collected on stress, mental health, functional outcomes, and satisfaction from one participant, “Kasey”, a 14-year-old Latina adolescent with comorbid Type I diabetes, depression, and anxiety. This case report details the procedures for the vACT group, discusses the barriers, and provides examples and recommendations for future administration of the group model. The report also describes Kasey’s experience during the group and presents quantitative/qualitative data supporting her improvement. Kasey’s perceived stress declined across sessions, while her anxiety sensitivity and depressive symptoms improved from the moderate range to the mild range, with sustained improvements at follow-up. Additionally, Kasey reported improvements in her peer relations with sustained improvements at follow-up, which was initially a significant concern. This case report provides promising preliminary data for the virtual administration of a group-based ACT intervention. We hope that clinicians can use this approach to provide evidence-based services that can reach a wider range of youth with chronic illnesses who may not otherwise have access to care and/or are estranged from their peers.