(PS1-D82) Group Acceptance and Commitment Therapy for Older Adult Veterans: Initial Efficacy and Feasibility

Older adults are a rapidly growing portion of the population across the globe (Livingston, 2015), with complex mental health needs (Smith, 2007). Acceptance and commitment therapy (ACT; Hayes et al., 2012) is a promising treatment in older adults, given initial research with older adults (e.g., Davison et al., 2015) and broader evidence of efficacy on areas relevant to older adult well-being including mental health (e.g., Twohig & Levin, 2017), physical health (A-Tjak et al., 2015), and grief (Jones et al., 2021). Group ACT for older adults may be particularly beneficial as a method to efficiently improve well-being in older adults but has not been previously evaluated. This poster presents results of two small, open trials of group ACT for older adults. Participants were Veterans 60 years of age or older who received group ACT in a geropsychology clinic within a VA Medical Center in Salem, Virginia. Exclusion criteria were scoring less than 23 on the Montreal Cognitive Assessment (MoCA; Nasreddine, 2005), active psychosis, and acute suicidal or homicidal ideation. Participants were largely non-Hispanic White and male, with an average age of 69. Cohort 1 (n = 19) received 10 sessions of ACT, while Cohort 2 (n = 9) received 20 sessions. Initial efficacy was assessed across a range of outcomes of interest (depression, anxiety, PTSD symptoms, resilience, psychological inflexibility, and mindfulness), as well as treatment retention. Efficacy was evaluated with paired-samples t-tests and Cohen’s d effect sizes. Unexpectedly, mindfulness significantly declined in Cohort 1 (t(18) = 2.60, p = .02, d = -0.61), while it significantly increased in Cohort 2 (t(3) = -3.55, p = .04, d = 2.05). Depression, generalized anxiety, PTSD symptoms, resilience, and psychological inflexibility did not significantly change in either cohort, although in Cohort 2, medium-to-large nonsignificant effects were found for depression (d = -1.20) and anxiety (d = -0.56). Adherence varied across the two cohorts; the median participant in Cohort 1 attended 9 of 10 sessions, while the median participant in Cohort 2 attended 15 of 20 sessions. Overall, our findings are mixed regarding the efficacy and feasibility of group ACT for older adult Veterans. While improvements were observed in Cohort 2, mindfulness actually declined in Cohort 1, despite being a focus of the intervention. While findings are tentative given the small samples, these results suggest that a relatively longer course of ACT may be necessary for older adults to see benefits. Completion rates for group sessions were overall adequate to good across the two cohorts. Further evaluation of group ACT for older adults in larger and more diverse samples is needed. In the future, it would be beneficial to directly test whether a longer protocol is more effective when providing group ACT to older adults.