A single-session Acceptance and Commitment Therapy intervention targeting shame in people experiencing homelessness: A randomized multiple baseline design
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Background and Objectives: Individuals experiencing homelessness are frequently discriminated against, such as through reduced employment opportunities and interpersonal rejection, creating a vicious cycle that sustains homelessness. These external conditions of stigma often result in individuals developing an internal sense of self-stigma and intense shame, which can result in negative psychological and behavioral consequences. Psychological intervention may contribute to disrupting this vicious cycle. Acceptance and Commitment Therapy (ACT) has been demonstrated to treat shame and self-stigma in other domains, but never homelessness. Methods: We developed a single-session intervention suitable for this population, and tested it within a randomized multiple-baseline Single Case Experimental Design (SCED). Shame and experiential avoidance were measured daily via SMS messages for eighty-nine days in 9 individuals experiencing homelessness. Results: SCED analysis and meta-analysis across participants indicated that the intervention showed significant improvements in experiential avoidance and shame both within and between participants. Limitations: Limitations include a lack of assessment of overt behavior change and the results of single case studies may have limited generalizability. Conclusions: Results demonstrate the efficacy of a brief ACT intervention in reducing shame and experiential avoidance in a homeless population, as well as the general benefits of single case design methodologies when working with populations that are difficult to reach or recruit from.
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The ACT intervention protocol was informed by previous research employing ACT for IBD and single-session ACT interventions.
“The ACT intervention protocol was developed by the first and last authors and was informed by previous research employing ACT for IBD and single-session ACT interventions [9,34,35,37,70].”
The daily experiential avoidance measure was drawn from prior research on a single-session ACT intervention for people experiencing homelessness and was designed to capture experiential avoidance while minimizing burden.
“An item to measure experiential avoidance (EA) was drawn from the third author’s research on a single-session ACT intervention for people experiencing homelessness [70]. The measure was designed to capture EA while minimizing the burden on participants (taking approximately one minute to complete) due to daily assessment across 59 days and maximizing consistent responding.”
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Lavelle, J., Storan, D., Eswara Murthy, V., De Dominicis, N., Mulcahy, H. E., & McHugh, L. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm11102757 · Cited by 23 · see citing works
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- Authors
- Eswara Murthy, V., Hussey, I., & McHugh, L.
- Affiliations
- Ghent University (BE)
- Publisher
- Center for Open Science
- Published
- 2020-05-18
- OpenAlex
- W4247068298
- Cited by
- 6
- References
- 42
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 1
- Type
- posted content
- Language
- en
- Open access
- green
- doi.org
- Locations
- PsyArXiv (OSF Preprints) (submittedVersion, cc-by)
- PsyArXiv (OSF Preprints) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- acceptance and commitment therapy, shame, homelessness, self-stigma, experiential avoidance, single-session intervention, brief psychological intervention, stigma, interpersonal rejection
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