Skip to main content
Top
Published in: BMC Oral Health 1/2020

Open Access 01-12-2020 | Caries | Technical advance

A behavioural intervention for young adults with dental caries, using acceptance and commitment therapy (ACT): treatment manual and case illustration

Authors: Helene Werner, Celia Young, Magnus Hakeberg, Ulla Wide

Published in: BMC Oral Health | Issue 1/2020

Login to get access

Abstract

Background

There is a need for effective behavioural interventions in dentistry. This paper presents an innovative behavioural intervention for young adults with dental caries, in an interdisciplinary collaboration between dental personnel and licensed psychologist in general dental care. The intervention has been evaluated in an RCT, with positive effects on oral health behaviour.

Method

The intervention, Acceptance and Commitment Therapy (ACT), a recent form of cognitive behaviour therapy (CBT), was adapted to young adult patients (18–25 years of age) with high dental caries activity.

Results

The intervention included two individual sessions, provided by a clinical psychologist at general dental clinics. The rationale for selecting ACT as the theory base is presented, together with the treatment manual and a case illustration.

Conclusions

ACT may be a promising alternative for behavioural interventions in dentistry for patients with oral diseases, specifically dental caries. Interprofessional collaboration between psychologists and dental personnel opens up for new possibilities to help and treat patients with various health issues in public dental care.

Trial registration

TRN ISRCTN15009620www.​isrctn.​com, retrospectively registered 14/03/2018.
Literature
1.
go back to reference Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C. The global burden of oral diseases and risks to oral health. Bull World Health Organ. 2005;83:661–9.PubMedPubMedCentral Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C. The global burden of oral diseases and risks to oral health. Bull World Health Organ. 2005;83:661–9.PubMedPubMedCentral
3.
go back to reference Watt RG. Strategies and approaches in oral disease prevention and health promotion. Bull World Health Organ. 2005;83:711–8.PubMedPubMedCentral Watt RG. Strategies and approaches in oral disease prevention and health promotion. Bull World Health Organ. 2005;83:711–8.PubMedPubMedCentral
4.
go back to reference Abraham C, Kelly MP, West R, Michie S. The UK National Institute for health and clinical excellence public health guidance on behaviour change: a brief introduction. Psychol Health Med. 2009;14:1–8.CrossRef Abraham C, Kelly MP, West R, Michie S. The UK National Institute for health and clinical excellence public health guidance on behaviour change: a brief introduction. Psychol Health Med. 2009;14:1–8.CrossRef
5.
go back to reference Al Rawahi SH, Asimakopoulou K, Newton JT. Theory based interventions for caries related sugar intake in adults: systematic review. BMC Psychol. 2017;5:25.CrossRef Al Rawahi SH, Asimakopoulou K, Newton JT. Theory based interventions for caries related sugar intake in adults: systematic review. BMC Psychol. 2017;5:25.CrossRef
6.
go back to reference Asimakopoulou K, Newton JT. The contributions of behaviour change science towards dental public health practice: a new paradigm. Community Dent Oral Epidemiol. 2015;43:2–8.CrossRef Asimakopoulou K, Newton JT. The contributions of behaviour change science towards dental public health practice: a new paradigm. Community Dent Oral Epidemiol. 2015;43:2–8.CrossRef
8.
go back to reference Werner H, Hakeberg M, Dahlstrom L, Eriksson M, Sjogren P, Strandell A, et al. Psychological interventions for poor Oral health: a systematic review. J Dent Res. 2016;95:506–14.CrossRef Werner H, Hakeberg M, Dahlstrom L, Eriksson M, Sjogren P, Strandell A, et al. Psychological interventions for poor Oral health: a systematic review. J Dent Res. 2016;95:506–14.CrossRef
9.
go back to reference Hayes SC, Strosahl KD, Wilson KG. Acceptance and committment therapy. New York: Guilford; 1999. Hayes SC, Strosahl KD, Wilson KG. Acceptance and committment therapy. New York: Guilford; 1999.
10.
go back to reference Barnes-Holmes Y. Relational frame theory: a post-skinnerian account of human language and cognition. In: Reese HW, Kail R, editors. Advances in child development and behavior. New York: Academic; 2001. p. 101–38. Barnes-Holmes Y. Relational frame theory: a post-skinnerian account of human language and cognition. In: Reese HW, Kail R, editors. Advances in child development and behavior. New York: Academic; 2001. p. 101–38.
11.
go back to reference A-tjak JG, Davis ML, Morina N, Powers MB, Smits JA, Emmelkamp PM. A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems. Psychother Psychosom. 2015;84:30–6.CrossRef A-tjak JG, Davis ML, Morina N, Powers MB, Smits JA, Emmelkamp PM. A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems. Psychother Psychosom. 2015;84:30–6.CrossRef
12.
go back to reference Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J. Acceptance and commitment therapy: model, processes and outcomes. Behav Res Ther. 2006;44:1–25.CrossRef Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J. Acceptance and commitment therapy: model, processes and outcomes. Behav Res Ther. 2006;44:1–25.CrossRef
13.
go back to reference Powers MB, MB ZVSV, Emmelkamp PM. Acceptance and commitment therapy: a meta-analytic review. Psychother Psychosom. 2009;78:73–80.CrossRef Powers MB, MB ZVSV, Emmelkamp PM. Acceptance and commitment therapy: a meta-analytic review. Psychother Psychosom. 2009;78:73–80.CrossRef
14.
go back to reference Ost LG. Efficacy of the third wave of behavioral therapies: a systematic review and meta-analysis. Behav Res Ther. 2008;46:296–321.CrossRef Ost LG. Efficacy of the third wave of behavioral therapies: a systematic review and meta-analysis. Behav Res Ther. 2008;46:296–321.CrossRef
15.
go back to reference Ost LG. The efficacy of acceptance and commitment therapy: an updated systematic review and meta-analysis. Behav Res Ther. 2014;61:105–21.CrossRef Ost LG. The efficacy of acceptance and commitment therapy: an updated systematic review and meta-analysis. Behav Res Ther. 2014;61:105–21.CrossRef
16.
go back to reference Hayes SC, Pistorello J, Levin ME. Acceptance and commitment therapy as a unified model of behavior change. Couns Psychol. 2012;40:976–1002.CrossRef Hayes SC, Pistorello J, Levin ME. Acceptance and commitment therapy as a unified model of behavior change. Couns Psychol. 2012;40:976–1002.CrossRef
17.
go back to reference Strosahl K, Robinson P, Gustavson T. Brief interventions for radical change: principles and practice of focused acceptance and commitment therapy. Oakland: New Harbinger; 2012. Strosahl K, Robinson P, Gustavson T. Brief interventions for radical change: principles and practice of focused acceptance and commitment therapy. Oakland: New Harbinger; 2012.
18.
go back to reference Biglan A, Hayes SC, Pistorello J. Acceptance and commitment: implications for prevention science. Prev Sci. 2008;9:139–52.CrossRef Biglan A, Hayes SC, Pistorello J. Acceptance and commitment: implications for prevention science. Prev Sci. 2008;9:139–52.CrossRef
19.
go back to reference Gregg JA, Callaghan GM, Hayes SC, Glenn-Lawson JL. Improving diabetes self-management through acceptance, mindfulness, and values: a randomized controlled trial. J Consult Clin Psychol. 2007;75:336–43.CrossRef Gregg JA, Callaghan GM, Hayes SC, Glenn-Lawson JL. Improving diabetes self-management through acceptance, mindfulness, and values: a randomized controlled trial. J Consult Clin Psychol. 2007;75:336–43.CrossRef
20.
go back to reference Hayes SC, Bissett R, Roget N, Padilla M, Kohlenberg BS, Fisher G, et al. The impact of acceptance and commitment training and multicultural training on the stigmatizing attitudes and professional burnout of substance abuse counselors. Behav Ther. 2004;35:821–53.CrossRef Hayes SC, Bissett R, Roget N, Padilla M, Kohlenberg BS, Fisher G, et al. The impact of acceptance and commitment training and multicultural training on the stigmatizing attitudes and professional burnout of substance abuse counselors. Behav Ther. 2004;35:821–53.CrossRef
21.
go back to reference Wide U, Hagman J, Werner H, Hakeberg M. Can a brief psychological intervention improve oral health behaviour? A randomised controlled trial. BMC Oral Health. 2018;18:163.CrossRef Wide U, Hagman J, Werner H, Hakeberg M. Can a brief psychological intervention improve oral health behaviour? A randomised controlled trial. BMC Oral Health. 2018;18:163.CrossRef
22.
go back to reference Swift JK, Greenberg RP. Premature discontinuation in adult psychotherapy: a meta-analysis. J Consult Clin Psychol. 2012;80:547–59.CrossRef Swift JK, Greenberg RP. Premature discontinuation in adult psychotherapy: a meta-analysis. J Consult Clin Psychol. 2012;80:547–59.CrossRef
23.
go back to reference Lundgren J, Wide BU. Multimodal cognitive behavioural treatment. In: Öst L-G, Skaret E, editors. Cognitive behaviour therapy for dental phobia and anxiety. West Sussex UK: Wiley-Blackwell; 2013. p. 109–18.CrossRef Lundgren J, Wide BU. Multimodal cognitive behavioural treatment. In: Öst L-G, Skaret E, editors. Cognitive behaviour therapy for dental phobia and anxiety. West Sussex UK: Wiley-Blackwell; 2013. p. 109–18.CrossRef
24.
go back to reference Hayes SC, Levin ME, Plumb-Vilardaga J, Villatte JL, Pistorello J. Acceptance and commitment therapy and contextual behavioral science: examining the progress of a distinctive model of behavioral and cognitive therapy. Behav Ther. 2013;44:180–98.CrossRef Hayes SC, Levin ME, Plumb-Vilardaga J, Villatte JL, Pistorello J. Acceptance and commitment therapy and contextual behavioral science: examining the progress of a distinctive model of behavioral and cognitive therapy. Behav Ther. 2013;44:180–98.CrossRef
25.
go back to reference Hayes SC, Wilson KG, Gifford EV, Follette VM, Strosahl K. Experimental avoidance and behavioral disorders: a functional dimensional approach to diagnosis and treatment. J Consult Clin Psychol. 1996;64:1152–68.CrossRef Hayes SC, Wilson KG, Gifford EV, Follette VM, Strosahl K. Experimental avoidance and behavioral disorders: a functional dimensional approach to diagnosis and treatment. J Consult Clin Psychol. 1996;64:1152–68.CrossRef
26.
go back to reference Louma JB, Hayes SC, Robyn D, Walser. Learning ACT: an acceptance & commitment therapy skills-training manual for therapists. Oakland: New Harbinger; 2007. Louma JB, Hayes SC, Robyn D, Walser. Learning ACT: an acceptance & commitment therapy skills-training manual for therapists. Oakland: New Harbinger; 2007.
27.
go back to reference Lundgren T, Luoma JB, Dahl J, Strosahl K, Melin L. The bull's-eye values survey: a psychometric evaluation. Cogn Behav Pract. 2012;19:518–26.CrossRef Lundgren T, Luoma JB, Dahl J, Strosahl K, Melin L. The bull's-eye values survey: a psychometric evaluation. Cogn Behav Pract. 2012;19:518–26.CrossRef
28.
go back to reference Harris R. Act Made Simple. An easy-to-read primer on acceptance and commitment therapy. Oakland: New Harbinger; 2009. Harris R. Act Made Simple. An easy-to-read primer on acceptance and commitment therapy. Oakland: New Harbinger; 2009.
29.
go back to reference Cooper JO, Heron TE, Heward WL. Applied behavior analysis. 2nd ed. Upper Saddle River, NJ: Pearson; 2007. Cooper JO, Heron TE, Heward WL. Applied behavior analysis. 2nd ed. Upper Saddle River, NJ: Pearson; 2007.
30.
go back to reference Wolitzky-Taylor KB, Horowitz JD, Powers MB, Telch MJ. Psychological approaches in the treatment of specific phobias: a meta-analysis. Clin Psychol Rev. 2008;28:1021–37.CrossRef Wolitzky-Taylor KB, Horowitz JD, Powers MB, Telch MJ. Psychological approaches in the treatment of specific phobias: a meta-analysis. Clin Psychol Rev. 2008;28:1021–37.CrossRef
31.
go back to reference Ruiz FJ. Acceptance and commitment therapy versus traditional cognitive behavioral therapy: a systematic review and meta-analysis of current empirical evidence. Rev Int Psiscol Ter Psicol. 2012;12:333–57. Ruiz FJ. Acceptance and commitment therapy versus traditional cognitive behavioral therapy: a systematic review and meta-analysis of current empirical evidence. Rev Int Psiscol Ter Psicol. 2012;12:333–57.
32.
go back to reference Bartholomew LK, Mullen PD. Five roles for using theory and evidence in the design and testing of behavior change interventions. J Publ Health Dent. 2011;71(Suppl 1):S20–33.CrossRef Bartholomew LK, Mullen PD. Five roles for using theory and evidence in the design and testing of behavior change interventions. J Publ Health Dent. 2011;71(Suppl 1):S20–33.CrossRef
33.
go back to reference Michie S, Prestwich A. Are interventions theory-based? Development of a theory coding scheme. Health Psychol. 2010;29:1–8.CrossRef Michie S, Prestwich A. Are interventions theory-based? Development of a theory coding scheme. Health Psychol. 2010;29:1–8.CrossRef
34.
go back to reference Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci. 2011;6:42.CrossRef Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci. 2011;6:42.CrossRef
Metadata
Title
A behavioural intervention for young adults with dental caries, using acceptance and commitment therapy (ACT): treatment manual and case illustration
Authors
Helene Werner
Celia Young
Magnus Hakeberg
Ulla Wide
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Caries
Published in
BMC Oral Health / Issue 1/2020
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-020-01213-4

Other articles of this Issue 1/2020

BMC Oral Health 1/2020 Go to the issue