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Third-Wave Therapies for Long-Term Neurological Conditions: A Systematic Review to Evaluate the Status and Quality of Evidence

Published online by Cambridge University Press:  13 February 2019

Paula L. Robinson Open the ORCID record for Paula L. Robinson [Opens in a new window] ,
Ailsa Russell  and
Leon Dysch
Paula L. Robinson*
Affiliation:
Department of Psychology, University of Bath, Bath BA2 7AY, UK
Ailsa Russell
Affiliation:
Department of Psychology, University of Bath, Bath BA2 7AY, UK
Leon Dysch
Affiliation:
Community Neuro and Stroke Service, St Martin's Hospital, Bath BA2 5RP, UK
*
Address for correspondence: Dr Paula Robinson, Complex Psychological Interventions, Weavers Croft, Field Road, Stroud GL5 2HZ, UK. E-mail: [email protected]
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Abstract

Background: Adults with long-term neurological conditions can face complex challenges including anxiety and depression. Emerging research suggests the utility of third-wave approaches (the third development of psychotherapies) in working transdiagnostically with these difficulties.

Aims: This systematic review sought to summarise and appraise the quality of published empirical studies using third-wave therapies such as Compassion Focused Therapy; Acceptance and Commitment Therapy; and Mindfulness-Based Cognitive Therapy or Mindfulness-Based Stress Reduction.

Method: Review procedures followed PRISMA guidelines, with 437 abstracts screened, 24 full-text articles retrieved and 19 studies found to meet inclusion criteria. Six out of seven randomised studies had unclear or high risk of bias, whilst the majority of non-randomised studies were considered moderate quality.

Results: Overall, studies reported a statistically significant reduction in emotional distress. Of the 13 studies that used model-specific process measures, 10 found statistically significant improvements in transdiagnostic factors.

Discussion: The findings indicate that third-wave therapies show promise in addressing transdiagnostic difficulties within neurological conditions. A number of methodological and conceptual issues for the included studies were highlighted during the quality appraisal process. Clinical implications include consideration of intervention length and use of outcome measures. Research implications are discussed by considering the progressive stages of development for behavioural treatments.

Keywords

Third-wave therapiesacceptance and commitment therapymindfulnesstransdiagnosticneurological conditionsystematic review
Type
Review Article
Information
Brain Impairment , Volume 20 , Issue 1 , March 2019 , pp. 58 - 80
Copyright
Copyright © Australasian Society for the Study of Brain Impairment 2019 

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