Group-Based Acceptance and Commitment Therapy for Nurses and Nurse Aides Working in Long-Term Care Residential Settings
Abstract
Objectives: Nurses and nurse aides experience high rates of physical injury, assault, and abuse compared to other occupations. They also frequently have intersectional identities with other groups that experience higher rates of mental and physical health challenges and problems. In addition to belonging to these multiple vulnerable populations, nurses and nurse aides experience high levels of work stress and burnout. These variables are risk factors for injuries associated with lifting and transferring, as well as assault from residents. Given the focus on present moment awareness, commitment to values, and responding flexibly in difficult situations, Acceptance and Commitment Therapy (ACT) may be an effective approach for this population. Design: Participants were randomly assigned to either the ACT group condition or a wait-list control condition. Participants completed baseline and one-month follow-up outcome measures. Setting/Location: The interventions were provided at participant work sites (nursing homes and assisted living facilities) that were located in multiple locations across Northern Ohio. Subjects: Seventy-one nurses and nurse aides participated in the study. Of these, 37 were randomly assigned to the ACT group intervention and 34 were assigned to the wait-list control group. Intervention: A two-session group-based ACT intervention. Each session was 2.5 hours long and spaced one-week apart. The intervention topics included acceptance, mindfulness, psychological flexibility, willingness to experience discomfort, present-moment focus, self-as-context, values identification, and values-congruent committed action. Outcome measures: Days missed due to injury, frequency of work-based injuries, musculoskeletal complaints, mental health symptoms, and overall satisfaction with the intervention. Results: Participants in the ACT group reported significantly fewer days missed due to injury and a significant reduction in mental health symptoms compared to the control group. Participants in the ACT group rated the intervention very favorably. Conclusion: A group-based ACT intervention can promote improvements in well-being for nurses and nurse aides working in long-term care settings. Further research in this area would benefit from conducting group-based ACT interventions at different organizational levels.
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Acceptance and commitment therapy (ACT) has been reported to be effective in reducing burnout and depression among a variety of healthcare professionals as well as medical students.
“Acceptance and commitment therapy (ACT), a psychotherapy that targets the facilitation of psychological flexibility, has been used and reported to be effective in reducing burnout and depression among a variety of healthcare professionals as well as medical students [23, 32–35].”
Nurses in the ACT intervention group reported a significant reduction in the number of leaves taken due to injury and fewer mental health symptoms after the intervention than did the control group.
“Another study found that nurses in the ACT intervention group reported a significant reduction in the number of leaves taken due to injury and fewer mental health symptoms after the intervention than did the control group [16].”
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- Authors
- O'Brien, W. H., Singh, R. (., Horan, K., Moeller, M. T., Wasson, R., & Jex, S. M.
- Affiliations
- Department of Psychology, Bowling Green State University, Bowling Green, Ohio.
- Bowling Green State University (US)
- University of Central Florida (US)
- Venue
- The Journal of Alternative and Complementary Medicine
- Publisher
- SAGE Publications
- Published
- 2019-07
- Volume
- 25
- Issue
- 7
- Pages
- 753-761
- ISSN
- 1075-5535 (ISSN-L)
- 1557-7708
- OpenAlex
- W2957435813
- Cited by
- 71
- References
- 29
- Citations by year
- 2026: 4 · 2025: 7 · 2024: 14 · 2023: 18 · 2022: 16 · 2021: 7 · 2020: 3 · 2019: 2
- FWCI
- 8.18
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Alternative and Complementary Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ohio Bureau of Workers' Compensation
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Burnout
- Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
- Keywords
- acceptance and commitment therapy, group intervention, nurses, nursing assistants, long-term care, nursing homes, assisted living, occupational injuries, musculoskeletal symptoms, workplace violence, burnout, occupational stress, psychiatric symptoms, mindfulness, psychological flexibility, values-based action, employee well-being
- MeSH terms
- Occupational Stress, Adult, Attitude of Health Personnel, Burnout, Professional, Female, Humans, Long-Term Care, Male, Nurses, Nursing Assistants, Random Allocation, Occupational Injuries, Acceptance and Commitment Therapy
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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