Topic: Anxiety, Depression, Emotional Competency
Target Population: Adolescents, Adults, Early Childhood, Middle Childhood
Sector: Community-Based
Military Sector: Veterans Affairs
This program is for all individuals.
Acceptance and Commitment Therapy (ACT) is a community-based psychotherapy program that is designed to improve one’s functioning and quality of life by promoting awareness and acceptance of difficult thoughts; emotions; memories; and physical sensations, such as pain.
Numerous studies have evaluated the effectiveness of ACT for a variety of outcomes, and overall results tend to be positive. Recent randomized controlled trials suggest that ACT may help individuals cope with depressive symptoms, anxiety, and physical pain. Long-term, positive results tend to be the strongest for depression. Numerous other studies have suggested possible effects of ACT on psychosis, substance use, stress, somatic complaints, and physical conditions. However, such findings are less consistent than those for depression, anxiety, and pain. ACT has been implemented among veterans and has demonstrated modest effects on levels of general distress. Overall, ACT appears to be beneficial for a variety of outcomes, and effects tend to be stronger when ACT is compared to inactive control groups, relative to active control groups or other therapies such as cognitive behavioral therapy. However, primary concerns with the research on ACT include lack of sustained effects across a range of conditions and a lack of replication of consistent findings across studies.
ACT is designed to enhance psychological flexibility and promote behaviors that are in line with values and goals. Psychological flexibility is developed through the following six core ACT processes:
ACT is based on the premise that changing difficult thoughts, feelings, and sensations is often not realistic, and the use of the therapy's alternate strategies can be more powerful and helpful. Therapists typically integrate the ACT approaches into their practice, and the course of therapy depends on the specific needs of the client.
ACT has been implemented around the world since the 1980s and has been evaluated among veterans to examine its impact on a variety of outcomes including pain, substance use, depression, and post-traumatic stress symptoms.
Professional therapists facilitate this program, and those interested in incorporating ACT into their clinical work can use a variety of self-guided resources including books, DVDs, online consultation and learning opportunities, workshops, peer consultation groups, and phone consultations. Please visit https://contextualscience.org/training for more information.
Considerations for implementing this program include recruiting therapists who have suitable educational and professional backgrounds, acquiring client buy-in and interest in a mindfulness-based approach, understanding costs to implement this program may be substantial, and finding time and space for delivering therapy sessions.
The Clearinghouse can help address these considerations. Please call 1-877-382-9185 or email Clearinghouse@psu.edu
If you are interested in implementing ACT, the Clearinghouse is interested in helping you!
Please call 1-877-382-9185 or email Clearinghouse@psu.edu
The number and duration of ACT sessions vary and depend on the unique needs of individual clients.
Costs associated with implementing ACT vary depending on the availability of trained therapists.
To move ACT to the Promising category on the Clearinghouse Continuum of Evidence, evaluations should consistently demonstrate sustained positive effects on primary program outcomes lasting at least one year from the beginning of the program or at least six months from program completion.
The Clearinghouse can help you develop an evaluation plan to ensure the program components are meeting your goals. Please call 1-877-382-9185 or email Clearinghouse@psu.edu
Contact the Clearinghouse with any questions regarding this program.
Phone: 1-877-382-9185 Email: Clearinghouse@psu.edu
You may also contact the Association for Contextual Behavioral Science by mail P.O. Box 655, Jenison, MI 49429, or visit https://contextualscience.org/contact#
A-Tjak, J., Morina, N., Topper, M., & Emmelkamp, P. M. G. (2021). One year follow-up and mediation in cognitive behavioral therapy and acceptance and commitment therapy for adult depression. BMC Psychiatry, 21, 17. https://doi.org/10.1186/s12888-020-03020-1
Bohlmeijer, E. T., Fledderus, M., Rokx, T. A. J. J., & Pieterse, M. E. (2011). Efficacy of an early intervention based on acceptance and commitment therapy for adults with depressive symptomatology: Evaluation in a randomized controlled trial. Behaviour Research and Therapy, 49(1), 62-67. https://doi.org/10.1016/j.brat.2010.10.003
Fogelkvist, M., Gustafsson, S. A., Kjellin, L., & Parling, T. (2020). Acceptance and commitment therapy to reduce eating disorder symptoms and body image problems in patients with residual eating disorder symptoms: A randomized controlled trial. Body Image, 32, 155-166. https://doi.org/10.1016/j.bodyim.2020.01.002
Forman, E. M., Shaw, J. A., Goetter, E. M., Herbert, J. D., Park, J. A., & Yuen, E. K. (2012). Long-term follow-up of a randomized controlled trial comparing acceptance and commitment therapy and standard cognitive behavior therapy for anxiety and depression. Behavior Therapy, 43(4), 801-811. https://doi.org/10.1016/j.beth.2012.04.004
Jensen, K. B., Kosek, E., Wicksell, R., Kemani, M., Olsson, G., Merle, J. V., … Ingvar, M. (2012). Cognitive behavioral therapy increases pain-evoked activation of the prefrontal cortex in patients with fibromyalgia. Pain, 153(7), 1495-1503. https://doi.org/10.1016/j.pain.2012.04.010
Kohtala, A., Muotka, J., & Lappalainen, R. (2017). What happens after five years?: The long-term effects of a four-session acceptance and commitment therapy delivered by student therapists for depressive symptoms. Journal of Contextual Behavioral Science, 6(2), 230-238. https://doi.org/10.1016/j.jcbs.2017.03.003
Kyllönen, H. M., Muotka, J., Puolakanaho, A., Astikainen, P., Keinonen, K., & Lappalainen, R. (2018). A brief acceptance and commitment therapy intervention for depression: A randomized controlled trial with 3-year follow-up for the intervention group. Journal of Contextual Behavioral Science, 10, 55-63. https://doi.org/10.1016/j.jcbs.2018.08.009
Lang, A. J., Schnurr, P. P., Jain, S., He, F., Walser, R. D., Bolton, E., … Chard, K. M. (2017). Randomized controlled trial of acceptance and commitment therapy for distress and impairment in OEF/OIF/OND veterans. Psychological Trauma: Theory, Research, Practice, and Policy, 9, 74-84. https://doi.org/10.1037/tra0000127
Lillis, J., Dunsiger, S., Thomas, J. G., Ross, K. M., & Wing, R. R. (2021). Novel behavioral interventions to improve long-term weight loss: A randomized trial of acceptance and commitment therapy or self-regulation for weight loss maintenance. Journal of Behavioral Medicine, https://doi.org/10.1007/s10865-021-00215-z
Livheim, F., Tengström, A., Andersson, G., Dahl, J., Björck, C., & Rosendahl, I. (2020). A quasi-experimental, multicenter study of acceptance and commitment therapy for antisocial youth in residential care. Journal of Contextual Behavioral Science, 16, 119-127. https://doi.org/10.1016/j.jcbs.2020.03.008
Vowles, K. E., McNeil, D. W., Gross, R. T., McDaniel, M. L., Mouse, A., Bates, M., … McCall, C. (2007). Effects of pain acceptance and pain control strategies on physical impairment in individuals with chronic low back pain. Behavior Therapy, 38(4), 412-425. https://doi.org/10.1016/j.beth.2007.02.001
