Module | Key module contents | Focused ACT techniques |
0 | Introduction to the structure and basic ideas of the ACT training, explanation of the SMS coach, presentation of accompanying case vignettes of the training; sources and evidence | Psychoeducation* |
1 | Fostering of treatment expectations and motivation, psychoeducation on diabetes and its complications, diabetes distress and associations between diabetes and mental health; development of the individual diabetes history and coping mechanisms; introduction to the ideas of ACT; elaboration of a good reason for processing through ACTonDiabetes; clarification of individual objectives for the training; introduction to mindfulness and conscious breathing; elaboration of the individuals′ previous handling of diabetes distress, previous strategies with short-term and long-term success; presentation of possible different approaches alongside ACT | Psychoeducation* Acceptance Generation of creative hopelessness |
2 | Introduction to the concepts of control and acceptance, development of the idea of mindfulness: the body; introduction of the diabetes diary within which the focus is on components of the SORC-model95 (Behavioral analysis model, acronym: Situation, Organism, Reaction, Contingency/ Consequence); diabetes distress and (un-)influenceable variables in life; primary and secondary suffering; introduction to behavioural experiments, self-observation tasks, homework, ACT metaphors and mindfulness exercises. Further optional diaries are offered to support self-observational processes/tracking behaviour (eg, acceptance diary, mindfulness diary) | Experiential acceptance* Recognising malfunctions of control strategies; acceptance as alternative concept |
3 | Elaboration of and differentiation between thoughts and feelings; development of the idea of mindfulness regarding thoughts; dealing with negative thoughts and feelings; language processes and vocabulary tips to support defusion processes | Defusion,* recognising the meaning of language; creating distance from own thoughts |
4 | Self-conceptualisations; three senses of self; being the observing self; development of the idea of mindfulness regarding all senses | Self as context* Defusing from implicit evaluations; getting to know the observing self |
5 | Introduction to values; values as chosen life directions; choosing values; goal-setting strategies, mindfulness regarding feelings | Values;* developing value awareness |
6 | Commitment and its influence on a value-driven life, mindfulness in the everyday life, ACT formula; begin to take action | Committed action, ACT formula;* learning ways to act in accordance to values |
7 | Development of the way forward; commitment; conclusion and future perspective, skills overview and maintenance | Committed action, mindfulness;* sustainable anchoring of the learning content in everyday life |
Every module starts with a review of key elements from the last session and ends with a summary and outlook.
*Inclusion of metaphors (eg, man in the fountain; playing tug of war with unchangeable aspects in life), tasks and exercises to make contents experienceable.
ACT, Acceptance and Commitment Therapy; SMS, short message service.