What is NEUROACT?
NEUROACT® – stress management for flexibility & health is a 12-session manual-based method for stress management and skills training for individuals on the autism spectrum or other neurodevelopmental and complex conditions, where executive and adaptive function is a concern. The program has been developed to meet challenges with stressful situations, such as sensory overload (e.g., sounds, smell, and tactile experiences), emotional and bodily unawareness and dysregulation, unfamiliar occasions and changes in the environment, and events that exceed the individual’s social capacity.
Figure 1. NeuroACT aims and treatment content.
NEUROACT® has been shown to be scientifically feasible and effective for adolescents and adults with an autism diagnosis and comorbid conditions such as ADHD, high stress levels, and mental health problems (see below for scientific articles). The method is based on acceptance and commitment therapy (ACT), a form of cognitive-behavior therapy (CBT), and includes psychoeducation about stress, emotions, sensory impressions, and body signals, alongside motivation enhancement techniques.
The overall goal is to teach skills that increase the participants’ psychological flexibility, which is the ability to deal with thoughts, emotions, and body sensations, reduce behavioral avoidance, and fulfill personally chosen goals, commonly leading to a sense of purposefulness improving mental health and well-being.
Below are two examples of how NEUROACT® techniques can help reduce obstacles and reach long-term goals.
Figure 2. Example of NeuroACT for adults on the autism spectrum (Man on the bus).
Figure 3. Example of NEUROACT® for adolescents on the autism spectrum (Girl avoiding school).
The NEUROACT® material is adapted into three levels depending on the participants’ executive and cognitive levels of functioning. Level 1 corresponds to normal (IQ=>70) or above cognitive ability and relatively high adaptive functioning. Level 2 corresponds to normal cognitive ability (IQ=>70) but more severe executive and adaptive challenges. Level 3 corresponds to cognitive ability below normal (IQ=<70) and significant executive and adaptive challenges.
The NEUROACT® material has a pedagogical approach and is adapted to suit the learning processes common in autism and other neurodevelopmental (NDDs) and complex conditions. For example, using image support, simple and straightforward writing exercises, and short mindfulness and acceptance audio exercises with an explanatory rationale before each exercise. The method primarily consists of practical exercises of stress management skills during and between group sessions, to enable experiential learning.
The NEUROACT® program can be used as a whole package or by separating modules, for example, assisting psychotherapy or motivating students in school. The sessions are grouped into six modules, each containing specific treatment targets. To use NEUROACT® in a group or individually, you must complete the NEUROACT® professional training course (NEUROACT® International, see below). The course is given to ensure the quality of the method so that it is used in the manner intended and researched.
What is NEUROACT’s evidence base?
NEUROACT® has been evaluated at Karolinska Institute in three studies.
- The first study was conducted on 28 autistic adolescents and young adults in a school setting. We compared students who received NEUROACT® to those who had teaching as usual. All students completed the NEUROACT® training. The method proved to be valuable and suitable for the students. The results showed a statistically significant reduction in self- and teacher-experienced stress. We also observed reduced self-rated mental illness (primarily anger and depression), reduced hyperactivity and inattention, and increased self-perceived prosociality. These results were within medium to large effect size ranges (d = 0.67-0.81, 95 % CI) in the NEUROACT® group compared to the control group. We did not observe effects pertaining to conduct problems, peer relation problems, or anxiety symptoms. Authors: Pahnke, J, Lundgren, T., Hursti, T., & Hirvikoski, T. (2014). Published in the journal Autism. Download the article here.
- The second study was an open pilot with ten autistic adults in outpatient psychiatric care. Nine participants completed the NEUROACT® program. Again, the method proved to be useful and suitable. The results showed a statistically significant reduction in perceived stress and depression as well as increased quality of life, psychological flexibility, and cognitive defusion (ability to manage thoughts), with small to large effect sizes (d = 0.27-0.92, 95 % CI). The study also indicated that the participants’ perceived social ability had increased. However, there was no improvement in anxiety and work- or family-related functioning. Authors: Pahnke, J., Hirvikoski, T., Bjureberg, J., Bölte, S., Jokinen, J., Bohman, B., & Lundgren, T. (2019). Published in the Journal of Contextual Behavioral Science. Download the article here.
- A third controlled randomized study was performed on 39 autistic adults in outpatient psychiatry. In the NEUROACT® group, 85% completed the training. NEUROACT® proved to be valuable and suitable for autistic adults in outpatient psychiatric care. The results showed statistically and clinically significantly improved perceived stress and quality of life (primary outcome measures) in the NEUROACT® group compared with autistic adults who received regular mental health care. The results also showed a statistically significant decrease in perceived avoidance behaviors and improved perceived quality of sleep, psychological flexibility, cognitive defusion (ability to manage thoughts), and a statistical trend regarding reduced depressive symptoms compared with autistic adults receiving regular mental health care. In addition, there was a statistically significant improvement in perceived cognitive inflexibility (autistic mannerism) and a statistical trend for perceived improved social motivation. The results were within medium to large effect size ranges (d = 0.57-1.24, 95 % CI) in the NEUROACT® group compared to the group that received regular care. There was no statistically significant difference or trend regarding perceived sleep-related breathing problems, fatigue during the day or awakening problems, or perceived functional level (social, work, and family-related), social awareness, social cognition, or communication compared with the control group. Intention-to-treat (ITT) analyses indicated a statistical trend for improved perceived executive functions compared with the control group. Authors: Pahnke, J., Jansson-Fröjmark, M., Andersson, G., Bjureberg, J., Jokinen, J., Bohman, B., & Lundgren, T. (2022). Published in the journal Autism. Download the article here.
- The three articles are included in the doctoral thesis Acceptance and Commitment Therapy for Autism Spectrum Disorder: Evaluation of feasibility, effectiveness, and validity of a novel contextual behavioral treatment. Download the dissertation here: Johan Pahnke’s complete dissertation – digital version.
What is the content and structure of the course?
NEUROACT® International is given in English and consists of three days of theoretical and practical training using the NEUROACT® material. The course content includes:
- The connection between stress and NDDs such as autism, ADHD, and intellectual disability.
- Executive functions in autism.
- The neuroanatomical aspects of autism.
- Acceptance and commitment therapy (ACT) and its adaption to autistic individuals and NDDs and other complex conditions.
- Theoretical review and rationale for NEUROACT® as stress management and skills training for individuals with an autism diagnosis and/or others NDDs.
- Practical and experience-based training using the NeuroACT manual.
- Review of the session material in the NEUROACT® manual, including group leadership skills.
What will I be able to do after the course?
- The aim is to offer high-quality education in the manual-based method NEUROACT® – stress management for flexibility & health, delivered in an efficient way.
- Following training, you will be able to hold your own groups or individual treatment using NEUROACT®.
- You will have an in-depth understanding of the relationship between executive functions, the neuroanatomical base of autism, and everyday stressors related to neurodevelopmental conditions.
- You will have deepened your theoretical and practical understanding of acceptance and commitment therapy (ACT) and basic skills for stress management and skills training.
- You will have developed a theoretical and practical understanding of the NEUROACT® program. You will enhance your group leadership skills.
Who can attend the training?
The training is aimed at professionals who want to become a NEUROACT® provider or deepening their knowledge of how ACT can be adapted to autism and other NDDs, such as ADHD or intellectual disability, where executive and adaptive function is a concern. It will also suit mental health professionals who need to provide stress management for autistic individuals or individuals with other NDDs and complex conditions. Professionals attending the training are, for example, psychologists, psychotherapists, medical doctors, nurses, physiotherapists, special educators, teachers, counselors, occupational therapists, or other mental health professionals.
Who is the course manager and lecturer?
Dr. Johan Pahnke has a doctoral degree (Ph.D.) in medicine from Karolinska Institutet and is an experienced clinical neuropsychologist. Johan has evaluated NEUROACT® as part of his doctoral thesis Acceptance and Commitment Therapy for Autism Spectrum Disorder: Evaluation of feasibility, effectiveness, and validity of a novel contextual behavioral treatment. In addition, Johan provides education in ACT, CBT, neuropsychology, and stress management. He has worked as a psychologist in primary care and outpatient psychiatric care and has previously worked as a teacher in special education. Johan has supervised professionals since 2003 and is a trained clinical supervisor. Questions can be sent to email@example.com.
Is the course provided as tailored professional training?
Yes, the NEUROACT® training can also be provided as tailor-made professional training for staff at your clinic, company, school, or similar. If this is an option that suits you better, please use the contact form below. Also, if you have any questions, please send an email to firstname.lastname@example.org or directly to email@example.com.