Online acceptance and commitment therapy for patients with diabetes and depression: An exploratory study of Chinese patients’ perspectives

Sherry Xue Yang; Marcus Yu Lung Chiu

doi:10.1921/swssr20252594

Authors

Sherry Xue Yang Chinese University of Hong Kong https://orcid.org/0000-0001-7892-2994
Marcus Yu Lung Chiu University of Bolton https://orcid.org/0000-0002-6676-8886

DOI:

https://doi.org/10.1921/swssr20252594

Keywords:

online intervention, diabetes, depression, diapression, qualitative study, patient perspectives, China, acceptance and commitment therapy

Abstract

Background: The global prevalence of diabetes mellitus is rising, with a significant comorbidity of depression, a condition called “diapression”. Acceptance and Commitment Therapy (ACT) is a transdiagnostic approach that may benefit this population, and online delivery can improve accessibility. However, qualitative insights into the experiences of patients with diapression undergoing online ACT are lacking. Objective: This exploratory qualitative study aimed to investigate the perspectives of Chinese patients with type 2 diabetes and comorbid depression on an online, self-help ACT intervention, focusing on its acceptability and potential improvements. Methods: Semi-structured interviews were conducted with eight participants one month after they completed an 8-week online ACT program delivered via WhatsApp/WeChat. Data were analyzed using inductive thematic analysis. Results: Five key themes were identified: (1) the perceived usefulness of ACT techniques for improving self-management and reducing distress; (2) difficulties in understanding certain abstract ACT concepts; (3) a preference for brief, succinct intervention components; (4) the benefits of online delivery for flexibility and accessibility; and (5) need for more personalized interaction and prompt feedback Conclusion: Online ACT was generally acceptable to patients with diapression. The intervention was valued for its practical skills and flexible format but could be enhanced by incorporating more real-life examples, culturally adapting concepts, and integrating methods for increased interaction, such as AI chatbots. These findings provide crucial insights for refining online self-help psychotherapies for this population before conducting larger-scale trials.

Author Biographies

Sherry Xue Yang, Chinese University of Hong Kong

Xue Yang is an Assistant Professor at The Chinese University of Hong Kong, Hong Kong. She is a health coach and health psychologist. Her research interests include Addiction, Internet gaming disorder, Adolescent mental health, and Digital mental health. E-mail sherryxueyang@cuhk.edu.hk. ORCID: 0000-0001-7892-2994.

Marcus Yu Lung Chiu, University of Bolton

Marcus Yu Lung Chiu is a Research Professor of the Saint Francis University, Hong Kong, and a Visiting Professor of the University of Greater Manchester, UK. He was a mental health social worker by training and Marcus’ major research interests are stigma and help-seeking, mental health recovery, psychoeducation, and programme evaluation. E-mail M. Chiu@bolton.ac.uk. ORCID: 0000-0002-6676-8886

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