Neuroact stress management course

NEUROACT® is a 12-part manual-based program for teenagers and adults focused on stress management to help reduce stress and increase quality of life in autistic and other neurodivergent individuals. 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.

NEUROACT® has been shown to be scientifically feasible and effective for adolescents and adults with an autism diagnosis and co-occurring conditions such as ADHD, high stress levels, and mental health problems (see below for scientific articles). The method is based on (1) contextual behavioral science, specifically acceptance and commitment therapy (ACT), a form of cognitive-behavior therapy (CBT), and (2) neuroscience, particularly neuropsychology and knowledge about executive function. The program aims at enhancing stress management skills to reduce avoidance and making it possible to do meaningful behaviors and activities, in such a way increasing quality of life. It includes (1) motivation techniques, such as finding out what’s really important to oneself (not what parents, peers, or society say is important) and creating clear behavior goals, (2) adversity skills, such perspective-taking on thoughts and acceptance of emotions and bodily reactions, and (3) psychoeducation on typical neurodivergent challenges, such as stress, emotions, sensory impressions, and body signals.

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.

The NEUROACT® material has a pedagogical approach and is adapted to suit the learning processes common in neurodivergent individuals. 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.

What versions of the program are available?

The program has been developed into different versions to meet specific challenges and settings. The available versions are presented below. 

NEUROACT® SCHOOL

NEUROACT® SCHOOL is designed for easy integration into the classroom setting. Through engaging with the material, students will develop improved skills in recognizing and managing stressful situations, including emotions, and gain a clearer perspective on their goals. Additionally, educators will gain enhanced tools to boost student motivation, facilitate discussions about stress management, and effectively tailor the classroom environment to accommodate neurodivergent students.

NEUROACT® ADOLESCENTS

NEUROACT® Adolescents is tailored to assist adolescents in managing everyday stressors. By engaging with the material, they will develop improved abilities to identify and navigate stressful situations, encompassing emotions, thoughts, and bodily sensations, while also gaining clarity regarding their objectives. NEUROACT® Providers will be equipped with an effective resource to enhance motivation and impart efficient stress management techniques to children and adolescents.

NEUROACT® ADULTS

NEUROACT® ADULTS is customized to aid adults in navigating daily stressors. Through active engagement with the content, individuals will cultivate enhanced skills to recognize and address stress-inducing situations, encompassing emotions, thoughts, and physical sensations, thereby gaining clarity regarding their goals. NEUROACT® Providers will be furnished with a valuable tool to bolster motivation and deliver effective stress management strategies tailored to adults. 

NEUROACT® ID

NEUROACT® ID is designed to support individuals with intellectual challenges in coping with daily stressors. Through interaction with the concret and adapted material, they will enhance their skills in recognizing and navigating stressful situations, including understanding emotions, thoughts, and physical sensations, while also gaining clarity about what they want. NEUROACT® Providers will have access to a valuable resource to boost motivation and teach effective stress management techniques tailored to individuals with intellectual challenges.

NEUROACT®’s Research

NEUUROACT® 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.