The Role of increased Psychological Flexibility on Quality of Life and Symptoms of Anxiety and Depression, in a Sample of Patients on Long-Term Sick Leave Receiving Acceptance and Commitment Therapy

Abstract

The present study had two aims. First, it was examined whether a workdirected day rehabilitation program providing Acceptance and Commitment Therapy (ACT) had an effect on quality of life, and symptoms of anxiety and depression in a sample of patients on long-term sick leave. Then, it was investigated if higher levels of improvement in the patients’ levels of psychological flexibility during treatment predicted increases in their quality of life, and decreases in their levels of anxiety and depression at posttreatment. Two-hundred and ten Norwegian patients on sick leave for a minimum of eight weeks received the day rehabilitation program at Hysnes Rehabilitation Center. Quality of life was measured with Short Form 8 (Ware, Kosinski, Dewey, & Gandek, 2001), anxiety and depression were measured with Hospital Anxiety and Depression Scale (Zigmond & Snaith, 1983) and psychological flexibility was measured with the Acceptance and Action Questionnaire II (Bond et al., 2011). The results demonstrated that the rehabilitation program had an effect on the patients’ quality of life, depression and anxiety. It was also confirmed that increases in psychological flexibility predicted the patients’ quality of life and levels of depression at posttreatment. Patients’ anxiety levels at posttreatment were not predicted by changes in psychological flexibility. The results demonstrate that a day rehabilitation program based on ACT is a suitable treatment for improving quality of life and reducing anxiety and depression in patients on long-term sick leave. Although preliminary, the results also imply that psychological flexibility is a central process affecting the change observed in patients’ quality of life and depression after an ACT treatment. This was not true for the patients’ change in anxiety levels during treatment.