(PS14-72) Exploring the Role of Stigma, Valued Action and Psychological Flexibility Following a Single-day Acceptance and Commitment Therapy Workshop

Stigma concerning mental health diagnoses and treatment seeking is a common barrier to engagement with mental health care. Stigma has been linked to poorer outcomes such as increased depression and anxiety, decreased engagement with family and relationships, and increased risk for hypertension. However, psychological flexibility, or the ability to shift mindsets and commit to actions that align with values, may serve as a buffer between the negative effects of stigma on value-driven behaviors. Acceptance and Commitment Therapy (ACT) offered in primary care may target these concerns by delivering interventions in the same location as regular medical services. The aim of this research was to explore the impact of a single-day ACT workshop for Veteran’s on stigma, valued action, and psychological flexibility at post-treatment. We also investigated if psychological flexibility moderated the relationship between stigma and valued action.

Data were taken from a pilot trial which tested the effectiveness of a single-day ACT Workshop versus VA Primary Care Mental Health Integration Treatment as Usual (PCMHI-TAU) services in rural VA clinics. The present study (n = 14) included Veterans who screened positive for anxiety, depression and/or PTSD, were randomized to receive the Workshop and completed their post-treatment assessment. The sample was predominately male (81.3%), white (87.5%) and participants ranged in age from 22 to 77 years [M = 51.94(18.83)]. Stigma was assessed using the Endorsed an Anticipated Stigma Inventory (EASI) Belief about Treatment Seeking subscale, and valued action was assessed via the Valued Living Questionnaire (VLQ). Psychological Flexibility was measured using the Acceptance and Action Questionnaire-II (AAQ-II).

A paired-sample t-test was conducted to evaluate the impact of the ACT intervention on scores on the EASI, AAQ-II and VLQ from pre to post treatment. There was a significant decrease in stigma scores from Pre [M=18.50(4.18)] to Post [M = 16.50(4.01)], t (13) = 1.86, p < .05 (one-tailed). Cohen’s d statistic (.49) indicated a small to medium effect size.  A multiple regression model was conducted which examined whether the relationship between stigma and valued action was moderated by psychological flexibility. Results suggested that stigma was not significantly associated with valued action, and the interaction term for this model was not significant. Findings suggest that ACT interventions may influence stigma immediately following engagement with services. Previous research suggests that targeting mental health stigma may lead to positive psychological health outcomes. Given that this research was exploratory, larger studies should aim to examine how stigma, psychological flexibility, and valued action relate to one another temporally in more depth. For example, psychological flexibility theory posits that targeting valued action in ACT interventions right away, prior to addressing mental health symptoms or stigma, may lead to greater reductions in suffering.