Files
Abstract
Over 60 million Americans live in rural areas with comorbid psychiatric-medical conditions. On average, rural residents are more impoverished, lack health insurance, fail to receive healthcare due to factors such as economic burdens and poor transportation, and are at higher risk for adverse health outcomes. Furthermore, studies are encouraging researchers and practitioners to adapt interventions to meet the unique needs of rural-based clients. This study examined the feasibility, acceptability, and effectiveness of acceptance and commitment therapy-spirituality (ACT-S) skills training for underserved, low-income, uninsured rural individuals seeking medical treatment in primary care settings. Spirituality is a salient cultural factor for many rural residents, often impacting their self-construct and healthcare decisions. For the purpose of this study, ACT-S expanded upon the traditional ACT six core processes (acceptance, cognitive defusion, present moment, self-as-context, defining valued directions, and committed action) by including spirituality, with attention to purpose in life and self-compassion, to address the unique behavioral health needs of low-income, uninsured, rural primary care patients. The pilot intervention took place over seven consecutive 90-minute sessions. The main objective of this project was to determine if tailoring ACT for the population of this study would demonstrate reduced psychological distress, increased health-promoting behaviors, and increased positive well-being outcomes.