Decreasing Impulsivity in Patients with Substance Use Disorder (Methamphetamine) by Using Acceptance and Commitment Therapy (ACT)

The industrialization and alteration of human life structure have led to some serious harms including substance use disorder. Over the past years, various treatment programs have been introduced for the treatment of addiction. The third wave of psychotherapy called Acceptance and Mindfulness based Therapies, came up with the hypothesis that mental harm is associated with trying to control or avoid negative thoughts and emotions. One of the ways to treat problems associated with substance use disorder like impulsivity is Acceptance and Commitment Therapy (ACT). In this regard the study aims to decrease impulsivity in patients with Methamphetamine use disorder by using Acceptance and Commitment Therapy.

The study is a quasi-experimental study with a pretest-posttest-follow-up-control group design.  The study population included all men with Methamphetamine use disorder in2019 currently avoiding any substance use, and all of them were attending narcotics anonymous association sessions in Yazd.  The sampling method was purposeful sampling and the sample size was determined according to the similar studies and also considered to be appropriate for group therapy sessions, ie, 8 to 12 sessions. Thus, among those who scored higher than the cut-point according to Bart's Impulsivity Questionnaire (1994), 12 were randomly assigned to the experimental group and 12 randomly assigned to the control group. Demographic characteristics questionnaire and Barratt Impulsivity Scale (1994) were used to collect data. Inclusion criteria were: 1) Good verbal communication ability 2) Minimum literacy (people able to understand and answer the questionnaire items) 3) Complete abstinence and non-consumption of methamphetamine during at least 6 months before the study. 4) Having passed 6 months after the end of treatment. 5) Being between the ages of 18 and 60 years. 6) Having no mental and physical disabilities (so as not to impede research and evaluation). Exclusion criteria included recurrence and substance use at the time of the study, and addicts with AIDS and Hepatitis C. Descriptive and inferential statistical methods including covariance analysis were used to analyze the data.

The results showed that the value of the parameter (F) belonging to the pre-test variable was 4.9 and it was significant. Therefore, there was a significant difference between the mean scores of impulsivity of the control and experimental groups in the post-test after the pre-test effect was gone  in patients with treated methamphetamine use disorder. The results also showed that the F value of the variable was statistically significant in the post-test. Further, the Wilk’s lambda value was 0.029 with a significance level of 0.000, this means that time has a significant statistical effect. This statistic indicates a difference and change in the impulsivity values of patients with methamphetamine use disorder in patients within the third, sixth and eighth sessions. Also, based on the results, each pair of time periods is compared with each other and indicates that all values ​​with a significant level of less than 0.05 And the impulse rates of patients with methamphetamine use disorder have always been different between the third, sixth and eighth sessions.

Finally based on the results of this study, it can be concluded that Acceptance and Commitment based Therapy as a new and emerging treatment of the third wave of behavioral therapy is a useful intervention for patients with methamphetamine use disorder to reduce their impulsive behaviors.  Given the increasing number of people with addiction, counselors and psychologists need to take non-pharmacological and psychological treatments to address the problems of people with substance use disorder. In particular, Acceptance and Commitment based Therapy for other substance use disorders can also be formulated and implemented to improve relationships between couples with substance use disorder and their relationship with their families.