{"id":3001,"date":"2023-10-17T08:59:27","date_gmt":"2023-10-17T08:59:27","guid":{"rendered":"https:\/\/practicalhealthpsychology.com\/?p=3001"},"modified":"2025-11-04T09:16:11","modified_gmt":"2025-11-04T09:16:11","slug":"acceptance-and-commitment-therapy-a-promising-approach-for-those-living-with-long-covid","status":"publish","type":"post","link":"https:\/\/practicalhealthpsychology.com\/gr\/2023\/10\/acceptance-and-commitment-therapy-a-promising-approach-for-those-living-with-long-covid\/","title":{"rendered":"Acceptance and Commitment Therapy: A promising approach for those living with Long-COVID"},"content":{"rendered":"

By Amy Barradell, University Hospitals of Leicester NHS Trust<\/strong><\/p>\n

If I were to say to you, Long-Covid, what would that mean to you?
\n<\/strong>A sub-set of people that contracted Coronavirus Disease 2019 (COVID-19), have continued to experience debilitating symptoms for more than 4 weeks following their acute infection. They commonly report both physical (e.g., breathlessness, fatigue) and psychological (e.g., anxiety, cognitive impairments) symptoms<\/a>. Those experiencing these symptoms call it \u2018Long-COVID\u2019.<\/p>\n

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In my experience…<\/strong>
\nWorking in a Long-COVID clinic has shown me that people struggle to accept their new symptoms (and the consequences of their symptoms) which puts a road block in the way of their self-management strategies. They focus on what they could do before \u2018Long-COVID\u2019 and how their life has changed for the worse since their diagnosis.\u00a0 This indicates experiential avoidance (i.e., an attempt or desire to suppress unwanted internal experiences, such as emotions, thoughts, memories and bodily sensations) and a tendency for people to focus upon the form of symptoms instead of the function of symptoms (i.e., the body\u2019s indicator to change one\u2019s behaviour). It shows people are not open to these experiences and shy away from living in the present moment.<\/p>\n

Furthermore, more than 25% of people<\/a> who were hospitalised with COVID-19 have ongoing symptoms of depression 6 months after they have been discharged. As depression is linked to activity avoidance<\/a> (i.e., choosing not to enter into a situation), it shows that people may not be engaging in valued actions.<\/p>\n

The role of psychological flexibility in Long-COVID
\n<\/strong>Psychological flexibility is the mechanism of action for Acceptance and Commitment Therapy<\/a> (ACT). It involves three pillars of the therapy:\u00a0 (1) encouraging openness to experience, (2) having awareness of the present moment, and (3) engaging in valued actions. As described above these pillars appear to be imbalanced in people living with Long-COVID and so addressing them is important. ACT can therefore be used to help people change the relationship they have with their distress (i.e., reduce their experiential avoidance), build their acceptance of a new \u2018normal\u2019 (i.e., increase their awareness of the present moment) and motivate and empower them to make behavioural changes that are important to them (i.e. engage in valued actions). ACT in Long-COVID is already making progress<\/a>, participants reported improved wellbeing, still experiencing COVID-related distress, but felt more able to cope with general psychological distress (such as anxiety).<\/p>\n

Using ACT in the Long-COVID clinic: Introducing Jo
\n<\/strong>When I first met with Jo, they were experiencing regular symptom relapses. To maintain anonymity, Jo is a representation of a range of people who I have worked with in the Long-COVID clinic. Their most debilitating symptoms were breathlessness and fatigue which made daily activities very difficult. Jo was afraid of the relapses and made conscious efforts to avoid anything which would aggravate them (i.e., experiential avoidance, avoidance of the present moment). They spent little time on activities that gave them joy and meaning (i.e., avoidance of engaging in valued actions).<\/p>\n

In our sessions together, we addressed each of the components of the ACT:<\/p>\n