Acceptance and Commitment Therapy (ACT): Small to Moderate Effectiveness

Small to moderate effectiveness: 0.46

What is Acceptance and Commitment Therapy?
1. People should have psychological flexibility (what the theory considers positive change in an individual)

2. CBT combined with acceptance and mindfulness strategies

3. Empirically-based

4. Not eliminating difficult feelings

5. Being present

6. Moving toward a desired behavior

7. Being open to unpleasant feelings

8. Don’t overreact to unpleasant emotions

9. Don’t avoid unpleasant situations

10. Work toward personal values and meaning

 

Evidence for:

1. 0.55 medium effect: improved depressive symptoms in older adults (Kishita, Takei, & Stewart, 2017)
2. 0.58 medium effect: reduced anxiety symptoms (Kishita, Takei, & Stewart, 2017)
3. 0.34 small effect: reduced depression symptoms (French, Golijani-Moghaddam, & Schröder, 2017)
4. 0.42 small to medium effect: increased psychological flexibility (positive change in an individual) (French, Golijani-Moghaddam, & Schröder, 2017)
5. 0.29 small effect: overall positive outcome (Louise, Fitzpatrick, Strauss, Rossell, & Thomas, 2017)
6. 0.39 small effect: improved depression symptoms (Louise, Fitzpatrick, Strauss, Rossell, & Thomas, 2017)
7. 0.70 medium to large effect: reduced binge eating behaviors (Godfrey, Gallo, & Afari, 2015)
8. 0.82 large effect: superior treatment to those on a waitlist receiving no treatment (A-Tjak, Davis, Morina, Powers, Smits, & Emmelkamp, 2015)
9. 0.51 medium effect: superior to placebo (A-Tjak, Davis, Morina, Powers, Smits, & Emmelkamp, 2015)
10. 0.64 medium effect: superior to other non-ACT treatments (A-Tjak, Davis, Morina, Powers, Smits, & Emmelkamp, 2015)
11. 0.30 small effect: improved life satisfaction/quality (A-Tjak, Davis, Morina, Powers, Smits, & Emmelkamp, 2015)
12. 0.88 large effect: increased sleep efficiency (Kanen, Nazir, Sedky, & Pradhan, 2015)
13. 0.47 small to medium effect: increased total sleep time (Kanen, Nazir, Sedky, & Pradhan, 2015)
14. 0.84 large effect: improved wake after sleep onset latency (Kanen, Nazir, Sedky, & Pradhan, 2015)
15. 0.42 small to medium effect: improved psychiatric disorders, somatic disorders, and work stress (Öst, 2014)
16. 0.43 small to medium effect: acceptance helped increase pain tolerance (Kohl, Rief, & Glombiewski, 2012)
17. 0.40 small to medium effect: improved overall outcomes (Ruiz, 2012)
18. 0.27 small effect: improved depression (Ruiz, 2012)
19. 0.25 small effect: improved quality of life scores (Ruiz, 2012)
20. 0.37 small effect: improved pain tolerance (Veehof, Oskam, Schreurs, & Bohlmeijer, 2011)
21. 0.32 small effect: improved depression symptoms (Veehof, Oskam, Schreurs, & Bohlmeijer, 2011)
22. 0.42 small to medium effect: better than no treatment (Powers, Zum Vörde Sive Vörding, & Emmelkamp, 2009)
23. 0.68 medium effect: better than waitlist (Powers, Zum Vörde Sive Vörding, & Emmelkamp, 2009)
24. 0.42 small to medium effect: better than treatment as usual (Powers, Zum Vörde Sive Vörding, & Emmelkamp, 2009)

 

Evidence against:

1. 0.46 small to medium effect: group mindfulness was more effective than 0.08 individual Acceptance and Commitment Therapy (Louise, Fitzpatrick, Strauss, Rossell, & Thomas, 2017)
2. 0.56 medium effect: mindfulness was effective but not acceptance (Louise, Fitzpatrick, Strauss, Rossell, & Thomas, 2017)
3. 0.14 no effect: Not more effective than CBT (A-Tjak, Davis, Morina, Powers, Smits, & Emmelkamp, 2015)
4. 0.16 no effect: Not more effective than CBT (Öst, 2014)
5. 0.18 no effect: Not more effective than established treatments (Powers, Zum Vörde Sive Vörding, & Emmelkamp, 2009)
6. 0.03 no effect: No improvement for anxiety/depression distress (Powers, Zum Vörde Sive Vörding, & Emmelkamp, 2009)

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A-Tjak, J. L., Davis, M. L., Morina, N., Powers, M. B., Smits, J. J., & Emmelkamp, P. G. (2015). A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems. Psychotherapy And Psychosomatics, 84(1), 30-36. doi:10.1159/000365764

French, K., Golijani-Moghaddam, N., & Schröder, T. (2017). What is the evidence for the efficacy of self-help acceptance and commitment therapy? A systematic review and meta-analysis. Journal Of Contextual Behavioral Science, 6(4), 360-374. doi:10.1016/j.jcbs.2017.08.002

Godfrey, K. M., Gallo, L. C., & Afari, N. (2015). Mindfulness-based interventions for binge eating: A systematic review and meta-analysis. Journal Of Behavioral Medicine, 38(2), 348-362. doi:10.1007/s10865-014-9610-5

Kanen, J. W., Nazir, R., Sedky, K., & Pradhan, B. K. (2015). The effects of mindfulness-based interventions on sleep disturbance: A meta-analysis. Adolescent Psychiatry, 5(2), 105-115. doi:10.2174/2210676605666150311222928

Kishita, N., Takei, Y., & Stewart, I. (2017). A meta‐analysis of third wave mindfulness‐based cognitive behavioral therapies for older people. International Journal Of Geriatric Psychiatry, 32(12), 1352-1361. doi:10.1002/gps.4621

Kohl, A., Rief, W., & Glombiewski, J. A. (2012). How effective are acceptance strategies? A meta-analytic review of experimental results. Journal Of Behavior Therapy And Experimental Psychiatry, 43(4), 988-1001. doi:10.1016/j.jbtep.2012.03.004

Louise, S., Fitzpatrick, M., Strauss, C., Rossell, S. L., & Thomas, N. (2017). Mindfulness- and acceptance-based interventions for psychosis: Our current understanding and a meta-analysis. Schizophrenia Research, doi:10.1016/j.schres.2017.05.023

Öst, L. (2014). The efficacy of acceptance and commitment therapy: An updated systematic review and meta-analysis. Behaviour Research And Therapy, 61105-121. doi:10.1016/j.brat.2014.07.018

Powers, M. B., Zum Vörde Sive Vörding, M. B., & Emmelkamp, P. M. (2009). Acceptance and commitment therapy: A meta-analytic review. Psychotherapy And Psychosomatics, 78(2), 73-80. doi:10.1159/000190790

Ruiz, F. J. (2012). Acceptance and commitment therapy versus traditional cognitive behavioral therapy: A systematic review and meta-analysis of current empirical evidence. International Journal Of Psychology & Psychological Therapy, 12(3), 333-357.

Veehof, M. M., Oskam, M., Schreurs, K. G., & Bohlmeijer, E. T. (2011). Acceptance-based interventions for the treatment of chronic pain: A systematic review and meta-analysis. Pain, 152(3), 533-542. doi:10.1016/j.pain.2010.11.002