A parallel-group, double-blind, randomized controlled feasibility trial in Pakistan for treatment of self-stigma and shame in substance use disorders through acceptance and commitment therapy

Abstract

Background: Self-stigma and Shame have broadly been studied as related to substance use disorders globally, however interventions have not been examined in randomized double-blind, and parallel-group clinical trials. There have little been known related to the evaluation and treatment of self-stigma and shame in   Pakistani substance user patients. This study examined the effects of acceptance and commitment therapy (ACT) for self-stigma and shame in patients with treatment for substance user disorders.

Methods: Sequential cohort sets  have  been  allocated in a pairwise random style  to get intervention of   the acceptance and commitment therapy (ACT) and  treatment as usual (TAU) in place of six  hours  of a group workshop during a single week and  concentrated on acceptance  in relation to shame and  self-stigma which  would have followed at that similar interval.    

Results: The results of linear mixed-effects models demonstrated that the ACT intervention resulted in minor immediate increases in shame at pre-test however higher reductions were observed  at post-test in  patients with experimental(ACT) group as  comparison  of patients with control group. Further, those patients with the ACT group found less shame in comparison of patients with treatment group at follow-up. Moreover, Effects intervention of the ACT on treatment use at follow-up phase  have statistically been  significant  through  post-treatment stages of shame, these results illustrated that  greater levels of shame were found at post-treatment  phase in patients with treatment groups  at follow-up. Furthermore, effects intervention of the ACT on shame  at follow-up phase  have been  mediated through  treatment use  at follow-up phase, recommending that ACT intervention could  have had its influence, as a minimum in part, by  improving patients in  treatment groups.

 Conclusions: This study’s findings recommended that the ACT therapy was more effective promising intervention toward reducing the shame in patients with substance user disorders. The results of present study would serve as a new model to plan prospect randomized control trail with ACT-related interventions. Further, it would also be cost effective as well as    play important role as prevention to   improve relapse rate in patients with substance user disorders.