Acceptance Therapy to Reduce Avoidance Coping in HIV/AIDS
Creators: name: University Of California Office Of The President
Publisher: name: University of California Office of the President
publisherIdentifier: https://ror.org/00dmfq477
publisherIdentifierScheme: ROR
Year: 2024

description: Approximately half of patients with HIV/AIDS have mental health or substance use problems. These problems contribute to the distress and suffering of patients with HIV/AIDS and decrease adherence to antiretroviral medication prescriptions and other self-care behaviors. Currently available treatments are not designed for patients with multiple disorders and are impractical for use in primary care clinics: they require separate lengthy therapies for each diagnosed mental health problem, do not address HIV specific health care issues and do not address the interactions between multiple health problems. Thus, developing innovative treatments that are feasible, acceptable and effective for reducing mental health related problems in patients with HIV/AIDS is crucial for improving long-term management of HIV disease, and increasing quality of life for HIV infected patients. Avoidance coping, a strategy of hiding from or avoiding unpleasant feelings or activities that induce unpleasant feelings, has been shown to be responsible for much of the distress, poor health care behaviors and loss of quality of life associated with mental health problems in patients with HIV/AIDS. Avoidance coping is seen across many mental health problems, including anxiety disorders, depressive disorders, substance use disorders, chronic pain, as well as issues with medical care (e.g., problems with medication adherence). Reducing avoidance coping may improve mental and physical health in patients with a variety of mental health problems. Recently, behavioral acceptance-based treatments, such as Acceptance and Commitment Therapy and Dialectical Behavior Therapy, have been shown to decrease avoidance coping and have been shown to improve a variety of disorders, including depression/anxiety disorders, substance use, and chronic pain, when each disorder is targeted individually. Acceptance based behavioral treatments target unhealthy avoidance behaviors such as using substances or alcohol, engaging in risky sexual behavior, isolating socially, restricting physical activity, failing to comply with medical care and medication regimens, etc.. These interventions also target an increase in acceptance based responding, i.e., helping patients increase their ability to engage in adaptive behaviors, such as health related self-care, even when such actions feel difficult and distressing. We propose to develop an acceptance-based behavioral treatment to empower HIV infected patients to reduce avoidance coping and make constructive behavioral choices consistent with their health needs. Adapting pre-existing acceptance based behavior therapies to the needs of HIV/AIDS patients with various mental health disorders may provide an effective treatment for the complex and mixed groups of multiply diagnosed patients seen in the majority of health care clinics. Thus we propose to develop a novel acceptance based therapy that targets a core behavioral issue relevant to the multiple mental and physical health problems of HIV infected patients. We will pilot test this intervention as an addition to treatment as usual in a public primary care clinic for patients with HIV/AIDS. We will compare the reduction in avoidance coping and increase in mental health quality of life using Acceptance Therapy with treatment as usual. This therapy is innovative in its attempt to treat a patient population with mixed psychiatric diagnoses with a single therapy targeted at a core problem