Feasibility and acceptability of a brief online acceptance and commitment therapy intervention to reduce fear of childbirth: A novel application of a third-wave cognitive behavioral therapy focused on psychological flexibility and acceptance.

Introduction: Fear of childbirth (FOC) is a significant issue for many women. However, findings from studies of psychological interventions to reduce FOC are equivocal. Resource constraints highlight the need for brief interventions. Previous research demonstrated that a face-to-face single session acceptance and commitment therapy (ACT) intervention showed promise. The National Health Service (NHS) Long Term Plan for England highlights a wish to increase digitalization. There is a need to test online adaptations of interventions. This study aimed to assess the feasibility and acceptability, and preliminary indications of effectiveness of an online ACT group intervention for individuals who experience FOC in their first pregnancy.

Material and methods: Participants were recruited via an NHS maternity service to attend an online two-session, small group, ACT intervention. Information on recruitment, retention, and qualitative and quantitative feedback on the sessions was gathered. Primary outcome measures (FOC and anxiety) and secondary measures (psychological flexibility and coping style) to identify potential mechanisms of change were completed pre-intervention and 2 weeks following the second session.

Results: Seven two-session groups ran with 25 individuals participating in both sessions, indicating good feasibility. All participants were retained and provided follow-up data. Feedback information suggested that the intervention was highly acceptable. Statistical and clinical reductions in FOC and anxiety were found. Statistically significant changes in psychological flexibility and coping style offer preliminary hypotheses regarding potential mechanisms of change.

Conclusions: A two-session online ACT group intervention tailored for FOC appears feasible and acceptable and shows promise in terms of impact. A pilot randomized controlled trial is warranted.