Acceptance and Commitment Therapy (ACT)

Scientific Rating:
1
Well-Supported by Research Evidence
See scale of 1-5
Child Welfare System Relevance Level:
Medium
See descriptions of 3 levels

About This Program

The information in this program outline is provided by the program representative and edited by the CEBC staff. Acceptance and Commitment Therapy (ACT) has been rated by the CEBC in the area of: Depression Treatment (Adult).

Target Population: Adults with depression; has also been used with adults with a variety of other mental health disorders and behavioral problems

Brief Description

ACT is a contextually focused form of cognitive behavioral psychotherapy that uses mindfulness and behavioral activation to increase a client’s psychological flexibility—his/her ability to engage in values-based, positive behaviors while experiencing difficult thoughts, emotions, or sensations. ACT establishes this through six core processes: Acceptance of private experiences; cognitive defusion (i.e., alter the undesirable functions of thoughts and other private events); being present, a perspective-taking sense of self; identification of values; and commitment to action. The first four processes define the ACT approach to mindfulness, and the last two define the ACT approach to behavioral activation.

ACT is delivered to clients in one-on-one sessions, in small groups or larger workshops, or in books or other media, through the presentation of information, dialogue, and the use of metaphors, visualization exercises, and behavioral homework. The number, frequency, and length of the sessions and overall duration of the intervention can vary depending on the needs of the client or treatment provider.

Program Goals:

The overall goals of Acceptance and Commitment Therapy (ACT) are:

  • Produce psychological flexibility: the ability to embrace one's thoughts and feelings as they are and shift attention toward chosen values and actions linked to those values
  • Reduce psychopathology
  • Increase work performance
  • Increase physical health
  • Increase quality of life

Essential Components

The essential components of Acceptance and Commitment Therapy (ACT) include:

  • In order to implement ACT with fidelity, it is essential to have a good understanding of ACT’s model of psychological flexibility, and its six component processes:
    • Acceptance of private experiences (i.e., willingness to experience odd or uncomfortable thoughts, feelings, or physical sensations in the service of response flexibility)
    • Cognitive defusion (i.e., observing one's own uncomfortable thoughts without automatically taking them literally or attaching any particular value to them)
    • Being present (i.e., being able to direct attention flexibly and voluntarily to present external and internal events rather than automatically focusing on the past or future)
    • A perspective-taking sense of self (i.e., having good “Theory of Mind” skills, and being in touch with a sense of ongoing awareness, as well as the perspectives of others)
    • Identification of values (i.e., freely choosing directions of personal importance to follow as a way of providing meaning to one’s daily activities)
    • Commitment to action (i.e., deliberately creating patterns of behavior which are personally valued)
  • Those who wish to apply ACT should be able to recognize when these processes are of relevance to a client’s behaviors, formulate an ACT case conceptualization, and apply intervention techniques based on this formulation.
  • ACT has been conducted in individual sessions, as well as small groups containing 3-5 members or large workshops containing over 100 members. There is no specific group size which is recommended. The number of participants in a group, number of sessions, and overall duration of the intervention can vary depending on the needs of the client or the practice of the treatment provider.
  • Since psychological flexibility is viewed as a basic behavioral process, it can be manipulated in many different ways. There is no specific intervention structure which must be followed. There are, however, a number of support materials which provide examples of activities and metaphors which have been found to be effective in influencing psychological flexibility. Support materials (such as manuals and videos) should be studied so that the clinician has a variety of techniques to draw upon.
  • It is highly recommended that clinicians new to ACT seek out some form of supervision or consultation.

Adult Services

Acceptance and Commitment Therapy (ACT) directly provides services to adults (regardless of whether they are parents or caregivers) and addresses the following:

  • Depression, work stress, parenting stress, quality of life, depression, anxiety, obsessive-compulsive disorder, chronic pain, psychosis, phobias, trichotillomania, substance abuse, smoking cessation, weight loss, type 2 diabetes, and more
Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: An ACT intervention does not, by definition, require the involvement of family members or other members of the individual’s support system. However, both family and support systems may be incorporated into treatment when it is functionally important to do so.

Delivery Settings

This program is typically conducted in a(n):

  • Community Agency
  • Hospital
  • Outpatient Clinic
  • Residential Care Facility
  • School

Homework

Acceptance and Commitment Therapy (ACT) includes a homework component:

It is recommended that personalized homework assignments be assigned in order to promote the generalization of newly acquired client behaviors to more diverse contexts encountered in their everyday lives.

Languages

Acceptance and Commitment Therapy (ACT) has materials available in languages other than English:

Chinese, Danish, Dutch, Finnish, French, German, Italian, Japanese, Korean, Norwegian, Portuguese, Spanish, Swedish

For information on which materials are available in these languages, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

Resources Needed to Run Program

The typical resources for implementing the program are:

There are no resource requirements.

Minimum Provider Qualifications

Mandated state licensure to deliver psychotherapeutic services is required in order to become trained as an ACT therapist. There is no ACT certification process.

Education and Training Resources

There is a manual that describes how to implement this program, and there is training available for this program.

Training Contact:
Training is obtained:

There is no specific set of requirements for ACT in training. Generally, it is recommended that those wishing to learn and apply ACT seek out a combination of training resources, including manuals, workshops, online videos, and on-going consultation.

A general list of resources and recommendations regarding training can be found at http://contextualscience.org/list_of_resources_for_learning_act

A calendar of upcoming of ACT trainings can be found at http://contextualscience.org/events

A list of treatment protocols can be found at http://contextualscience.org/treatment_protocols

Number of days/hours:

There is no specific set of requirements for ACT in training.

Additional Resources:

There currently are additional qualified resources for training:

The Association for Contextual Behavioral Science maintains a website filled with information about ACT training: http://contextualscience.org/

A list of highly skilled peer-reviewed ACT trainers, and information about how to contact them can be found at http://contextualscience.org/act_training

Also, a general list of resources and recommendations regarding training can be found at http://contextualscience.org/list_of_resources_for_learning_act

Other useful websites include:
http://www.actmindfully.com.au
http://www.learningACT.com

Implementation Information

Since Acceptance and Commitment Therapy (ACT) is rated on the Scientific Rating Scale, information was requested from the program representative on available pre-implementation assessments, implementation tools, and/or fidelity measures.

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Pre-Implementation Materials

There are no pre-implementation materials to measure organizational or provider readiness for Acceptance and Commitment Therapy (ACT).

Formal Support for Implementation

There is no formal support available for implementation of Acceptance and Commitment Therapy (ACT).

Fidelity Measures

There are fidelity measures for Acceptance and Commitment Therapy (ACT) as listed below:

Fidelity measures have been developed in conjunction with ACT clinical trials. Some information about these can be found at http://contextualscience.org/treatment_adherence_and_competence

In addition, the book Learning ACT: An Acceptance & Commitment Therapy Skills-Training Manual for Therapists contains a therapist competency ratings scale to promote dissemination with fidelity.

Implementation Guides or Manuals

There are implementation guides or manuals for Acceptance and Commitment Therapy (ACT) as listed below:

Many protocols and books have been written which can support the implementation of ACT. Lists of books and downloadable protocols can be found at http://contextualscience.org

Some examples of ACT implementation tools include:

Eifert, G. H., & Forsyth, J. P. (2005). Acceptance & Commitment Therapy for anxiety disorders: A practitioner's treatment guide to using mindfulness, acceptance, and values-based behavior change strategies. Oakland, CA: New Harbinger Publications.

Hayes, S. C. (2007). ACT in action [6-DVD series]. Oakland, CA: New Harbinger Publications.

Hayes, S. C. (2008). Acceptance and Commitment Therapy [DVD]. In J. Carlson (Host), Series 1--Systems of psychotherapy. Washington, DC: American Psychological Association.

Hayes, S. C., & Strosahl, K. D. (Eds.). (2004). A practical guide to Acceptance and Commitment Therapy. New York: Springer-Verlag.

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and Commitment Therapy (Second Edition): The Process and Practice of Mindful Change. New York: Guilford.

Luoma, J., Hayes, S. C., & Walser, R. (2007). Learning ACT: An Acceptance & Commitment Therapy skills-training manual for therapists. Oakland, CA: New Harbinger Publications.

Research on How to Implement the Program

Research has not been conducted on how to implement Acceptance and Commitment Therapy (ACT).

Relevant Published, Peer-Reviewed Research

This program is rated a "1 - Well-Supported by Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The program must have at least two rigorous randomized controlled trials with one showing a sustained effect of at least 1 year. The article(s) below that reports outcomes from an RCT showing a sustained effect of at least 1 year has an asterisk (*) at the beginning of its entry. Please see the Scientific Rating Scale for more information.

Child Welfare Outcome: Child/Family Well-Being

Show relevant research...

When more than 10 research articles have been published in peer-reviewed journals, the CEBC reviews all of the articles as part of the rating process and identifies the 10 most relevant articles, with a focus on randomized controlled trials (RCTs) and controlled studies that have an impact on the rating. The 10 articles chosen for Acceptance and Commitment Therapy (ACT) are summarized below:

Bond, F. W., & Bunce, D. (2000). Mediators of change in emotion-focused and problem-focused worksite stress management interventions. Journal of Occupational Health Psychology, 5(1), 156-163.

Type of Study: Randomized controlled trial
Number of Participants: 90

Population:

  • Age — 19-58 years
  • Race/Ethnicity — 60 Caucasian, 9 Hispanic, 3 African American, 2 Native American, and 1 Southeast Asian
  • Gender — 45 Male and 45 Female
  • Status — Participants were volunteer employees of a large media organization.

Location/Institution: Not specified

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The present study allocated participants to an Acceptance and Commitment Therapy (ACT) group, an Innovation Promotion Program (IPP), or a waitlist control group. Measures utilized include Acceptance and Action Questionnaire (AAQ), Dysfunctional Attitude Survey (DAS), General Health Questionnaire-12 (GHQ), Beck Depression Inventory (BDI), the Work change measure, the Intrinsic Job Motivation scale, the Intrinsic Job Satisfaction measure, and the Propensity to Innovate measure. Results indicated that ACT significantly improved mental health outcomes (GHQ and BDI) and a work-related variable, and propensity to innovate. General mental health also improved in the ACT intervention group. The problem-focused IPP intervention also significantly improved a mental health (BDI) and a work-related (propensity to innovate) variable. However, neither intervention influenced job satisfaction or motivation and there were also no significant change, in the control group. Changes in the ACT condition were mediated only by the acceptance of undesirable thoughts and feelings. In the IPP condition, outcome change was mediated only by attempts to modify stressors. Limitations include small sample size, selection bias due to the voluntary nature of participation, and attrition.

Length of postintervention follow-up: Approximately 3 months.

Blackledge, J. T., & Hayes, S. C. (2006). Using Acceptance and Commitment Training in the support of parents of children diagnosed with autism. Child & Family Behavior Therapy, 28(1), 1-18.

Type of Study: One group pretest/posttest study
Number of Participants: 20

Population:

  • Age — 18 - 52 years (mean age=27.87 years)
  • Race/Ethnicity — 12 Caucasian, 6 Hispanic, and 2 Asian/Pacific Islander
  • Gender — 15 Female and 5 Male
  • Status — Participants were parents of children with autism.

Location/Institution: 3 geographical regions surrounding Reno, Nevada; Sacramento, and San Francisco, California

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study tested the effects of a 2-day (14-hour) group Acceptance and Commitment Therapy (ACT) workshop on normal parents/guardians of children diagnosed with autism. Measures utilized include the Beck Depression Inventory-II (BDI-II), the Global Severity Index (GSI) of the Brief Symptom Inventory (BSI), the Acceptance and Action Questionnaire 9 (AAQ), Automatic Thoughts Questionnaire (ATQ), and the General Health Questionnaire 12 (GHQ). Results indicated that ACT improved psychological outcomes of parents with children with autism. Limitations include small sample size and lack of a control group.

Length of postintervention follow-up: 1 week and 3 months.

Forman, E. M., Herbert, J. D., Moitra, E., Yeomans, P. D., & Geller, P. A. (2007). A randomized controlled effectiveness trial of Acceptance and Commitment Therapy and Cognitive Therapy for anxiety and depression. Behavior Modification, 31(6), 772-799.

Type of Study: Randomized controlled trial
Number of Participants: 101

Population:

  • Age — 18-52 years (mean age = 27.87 years)
  • Race/Ethnicity — 64.4% Caucasian, 12.4% Black, 10.9% Asian, and 3% Latino
  • Gender — 80.2% Women
  • Status — Participants were from a university student counseling center.

Location/Institution: Not specified

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study compared the relative effectiveness of Cognitive Therapy (CT) and Acceptance and Commitment Therapy (ACT) in the treatment of patients presenting with combinations of anxiety and mood disorders in an outpatient clinic. Participants presented as follows: 33.7% with a depressive disorder, 31.9% with an anxiety disorder, and 11.0% with an adjustment disorder. Measures utilized include therapists conducted semistructured interviews using an instrument based on the Diagnostic and Statistical Manual of Mental Disorders–IV–Text Revision (DSM-IV-TR), the Reaction to Treatment Questionnaire (RTQ), the Beck Anxiety Inventory, Global Assessment of Functioning Scale (GAF), Clinical Global Impression Scale (CGI), Quality of Life Index (QOLI), Satisfaction with Life Scale (SLS), the Kentucky Inventory of Mindfulness Skills (KIMS), the Beck Depression Inventory (BDI–II), the Acceptance and Action Questionnaire (AAQ), and the Outcome Questionnaire (OQ). Results indicated participants receiving CT and ACT evidenced large, equivalent improvements in depression, anxiety, functioning difficulties, quality of life, life satisfaction, and clinician-rated functioning. Whereas improvements were equivalent across the two groups, the mechanisms of action appeared to differ. Changes in “observing” and “describing” one’s experiences appeared to mediate outcomes for the CT group relative to the ACT group, whereas “experiential avoidance,” “acting with awareness,” and “acceptance” mediated outcomes for the ACT group. Overall, the results suggest that ACT is a viable treatment that can be disseminated, the effectiveness of which appears equivalent to that of CT. Limitations include high attrition rate, modest sample size, overlap of therapeutic techniques across the two approaches, and lack of adequate follow-up.

Length of postintervention follow-up: Not specified.

Petersen, C. L., & Zettle, R. D. (2009). Treating inpatients with comorbid depression and alcohol use disorders: A comparison of Acceptance and Commitment Therapy versus treatment as usual. The Psychological Record, 59(4), 521-536.

Type of Study: Randomized controlled trial
Number of Participants: 24

Population:

  • Age — 36-39 years
  • Race/Ethnicity — 15 Caucasian, 8 African American, and 1 Other
  • Gender — 12 Female and 12 Male
  • Status — Participants were individuals involuntarily committed to a chemical dependency unit a southern state hospital.

Location/Institution: Not specified

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study describes inpatients involuntarily committed to a chemical dependency unit and exhibiting a co-occurring depressive disorder received either individual sessions of Acceptance and Commitment Therapy (ACT) or treatment as usual (TAU) within the context of an ongoing 12-step program. Measures utilized include the Hamilton Rating Scale (HRS), the Beck Depression Inventory–Second Edition (BDI–II), the Acceptance and Action Questionnaire (AAQ), the Problems Assessment for Substance-Using Psychiatric Patients (PASUPP), and The Alcohol Timeline Followback interview (Alcohol TFLB). Results indicated significant, but equivalent, reductions in levels of depression for both treatment conditions. However, participants randomly assigned to receive ACT required a shorter treatment phase and smaller dose of individual therapy to meet criteria for discharge compared to their TAU counterparts. Limitations include small sample size and lack of post-treatment follow-up.

Length of postintervention follow-up: None.

Twohig, M. P., Hayes, S. C., Plumb, J. C., Pruitt, L. D., Collins, A. B., Hazlett-Stevens, H., & Woidneck, M. R. (2010). A randomized clinical trial of Acceptance and Commitment Therapy versus Progressive Relaxation Training for obsessive-compulsive disorder. Journal of Consulting and Clinical Psychology, 78(5), 705-716.

Type of Study: Randomized controlled trial
Number of Participants: 79

Population:

  • Age — Mean age = 37 years
  • Race/Ethnicity — 89% Caucasian, 5% Latino/a, 2.5 % Asian American, 2.5% Native American, and 1% African American
  • Gender — 66% Female
  • Status — Participants were individuals with obsessive compulsive disorder (OCD).

Location/Institution: Two western states within the U.S.

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study investigated the effectiveness of eight sessions of Acceptance and Commitment Therapy (ACT) for adult obsessive compulsive disorder (OCD) compared to Progressive Relaxation Training (PRT). Subjects participated in 8 sessions of ACT or PRT with no in-session exposure. Measures utilized include the Structured Clinical Interview Scale for DSM-IV (SCID), the Yale-Brown Obsessive Compulsive Scale (YBOCS), Beck Depression Inventory-II, Quality of Life Scale, Acceptance and Action Questionnaire, Thought Action Fusion Scale, Thought Control Questionnaire, and the Treatment Evaluation Inventory-Short Form. Results indicate both treatments were equally credible and treatment integrity data were good for both conditions, but results showed greater improvement at post treatment and at follow-up in OCD symptoms for ACT as compared to PRT. ACT resulted in a greater number of participants showing clinically significant improvement compared to PRT and had a significantly greater effect on depression among those reporting at least mild depression before treatment. Limitations include self-reports on measures, generalizability to other ethnic populations due to the racial/ethnic distribution, changes to the PRT intervention, and lack of long-term follow-up.

Length of postintervention follow-up: 3 months.

Muto, T., Hayes, S. C., & Jeffcoat, T. (2011). The effectiveness of Acceptance and Commitment Therapy bibliotherapy for enhancing the psychological health of Japanese college students living abroad. Behavior Therapy, 42, 323–335.

Type of Study: Randomized controlled trial
Number of Participants: 70

Population:

  • Age — 20-26 years (Mean age = 23.6 years)
  • Race/Ethnicity — 100% Japanese
  • Gender — 44 Female
  • Status — Participants were Japanese international students.

Location/Institution: University of Nevada, Reno

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study discusses results of the effects of Acceptance and Commitment Therapy (ACT) on half of the population of Japanese international students in a western university in the United States. Participants were assigned to a wait-list or to receive a Japanese translation of a broadly focused ACT self-help book. Measures utilized include individual emails with coded links were sent to participants to complete questionnaires or quizzes, the General Health Questionnaire 12-item (GHQ-12), the Depression Anxiety Stress Scales (DASS-21), and the Acceptance and Action Questionnaire (AAQ-II). Participants read the book for two months, completed exercises and quizzes, and after postassessment were followed for 10 weeks; wait list participants were then also given the book with two months to complete it. Results indicate students receiving the book showed significantly better general mental health at post and follow up. Moderately depressed or stressed, and severely anxious students showed improvement compared to those not receiving the book. These patterns were repeated when the wait-list participants finally received the book. Improvements in primary outcomes were related to how much was learned about an ACT model from the book. Limitations include generalizability to other ethnic and gender populations and lack of long-term follow-up.

Length of postintervention follow-up: 2 months.

Jeffcoat, T., & Hayes, S. C. (2012). A randomized trial of ACT bibliotherapy on the mental health of K-12 teachers and staff. Behaviour Research and Therapy, 50, 571-579.

Type of Study: Randomized controlled trial
Number of Participants: 236

Population:

  • Age — 30-60 years
  • Race/Ethnicity — Not specified
  • Gender — 91% Female
  • Status — Participants were teachers and administrators.

Location/Institution: Washoe County School District (WCSD)

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study discusses K–12 school personnel responding to a wellness-oriented program announcement were randomized to receive an Acceptance and Commitment Therapy (ACT) self-help volume or to a wait list. Measures utilized include individual emails with coded links were sent to participants to complete questionnaires or quizzes, the General Health Questionnaire 12-item (GHQ-12), the Depression Anxiety Stress Scales (DASS-21), the Kentucky Inventory of Mindfulness Skills (KIMS), and the Acceptance and Action Questionnaire (AAQ-II). Participants read the book for two months, completed exercises and quizzes, and after postassessment were followed for 10 weeks; wait list participants were then also given the book with two months to complete it. Results indicate that participants showed significant improvement in psychological health. Significant preventive effects for depression and anxiety were observed along with significant ameliorative effects for those in the clinical ranges of depression, anxiety and stress. Follow-up general mental health, depression, and anxiety outcomes were related to the manner in which participants used the workbook and to post levels of psychological flexibility. Limitations include generalizability due to population being 90% female and lack of long-term follow-up.

Length of postintervention follow-up: 10 weeks.

*Folke, F., Parling, T., & Melin, L. (2012). Acceptance and Commitment Therapy for depression: A preliminary randomized controlled trial for unemployment on long-term sick leave. Cognitive and Behavioral Practice, 19(4), 583-594.

Type of Study: Randomized controlled trial
Number of Participants: 34

Population:

  • Age — Mean age = 43 years
  • Race/Ethnicity — 100% Caucasian
  • Gender — 88.2% Female
  • Status — Participants were citizens unable to earn their income due to disability or illness (i.e., individuals on sick leave or disability pension) who also met criteria for unipolar depression.

Location/Institution: Regional Social Insurance Office in Sweden

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study examined a brief version of Acceptance and Commitment Therapy (ACT) in a sample of individuals on long-term sick leave due to depression. Participants were randomized to the ACT condition consisting of 1 individual and 5 group sessions or to services as usual. Measures included the Beck Depression Inventory, the General Health Questionnaire, the Perceived Stress Scale, and the World Health Organization Quality of Life assessment. From pretreatment to 18-month follow-up, the ACT participants improved significantly on measures of depression, general health, and quality of life compared to participants in the control condition. The conditions did not differ regarding sick leave and employment status at any time point. Limitations include the lack of standardized diagnosis procedure, lack of information on services received by the usual care group, and small sample size.

Length of postintervention follow-up: 18 months.

Karlin, B. E., Walser, R. D., Yesavage, J., Zhang, A., Trockel, M., & Barr, T. (2013). Effectiveness of acceptance and commitment therapy for depression: Comparison among older and younger veterans. Aging & Mental Health, 17 (5), 555-563.

Type of Study: One group pretest/posttest study
Number of Participants: 746

Population:

  • Age — 22-90 years
  • Race/Ethnicity — 73.5% Caucasian, 13.1% African American/Black, 6% Hispanic, 5.9% Asian Indian, Asian, American Indian, Alaskan Native, Pacific Islander, or other race/ethnicity, 4.8% multiracial, and 2.7% did not indicate race/ethnicity
  • Gender — 77.6% Male, 21.0% Female, and 1.3% did not indicate their gender
  • Status — Participants were veterans of the United States Armed Forces.

Location/Institution: Veterans Health Administration

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study examined Acceptance and Commitment Therapy for depression in a sample of veterans. Measures included the Beck Depression Inventory–Second Edition and the World Health Organization Quality of Life-BREF. Therapeutic alliance was assessed using the Working Alliance Inventory-Short Revised. Mean depression scores declined significantly from the start to the end of treatment for both younger and older veterans. Quality of life and therapeutic alliance also increased during treatment. Limitations include the lack of a control or comparison group and the lack of information on co-morbid medical and mental health conditions.

Length of postintervention follow-up: None.

Losada, A., Márquez-González, M., Romero-Moreno, R., Mausbach, B. T., López, J., Fernández-Fernández, V., & Nogales-González, C. (2015). Cognitive–Behavioral Therapy (CBT) versus Acceptance and Commitment Therapy (ACT) for dementia family caregivers with significant depressive symptoms: Results of a randomized clinical trial. Journal of Consulting and Clinical Psychology, 83(4), 760-772.

Type of Study: Randomized controlled trial
Number of Participants: 135

Population:

  • Age — 61-62 years
  • Race/Ethnicity — Not specified
  • Gender — 84% Female
  • Status — Participants were recruited from internet advertisement and Social and Health Care Centers.

Location/Institution: Madrid, Spain

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study compared the differential efficacy of Acceptance and Commitment Therapy (ACT) and Cognitive–Behavioral Therapy (CBT) for dementia family caregivers. Participants were caregivers with high depressive symptomatology who were randomly allocated to ACT, CBT, or a control group (CG). Measures utilized include the Global Deterioration Scale for Assessment of Primary Degenerative Dementia, Barthel Index, Revised Memory and Behavior Problems Checklist, CES–D, Profile of Mood States (POMS), Leisure Time Satisfaction Scale, Experiential Avoidance in Caregiving Questionnaire, and the Dysfunctional Thoughts About Caregiving Questionnaire. Results indicate ACT and CBT interventions seem to be superior to CG in terms of statistical and clinically significant reduction of distress (e.g., depression and anxiety). Regarding depressive symptomatology, the results of the study suggest that both ACT and CBT interventions are superior to CG at postintervention (with large effect sizes), although they are only maintained in CBT at follow-up (medium effect size). Limitations include caregivers who volunteered to participate and may not be representative of the overall caregiver population; participants in the ACT and CBT conditions had eight weekly individual sessions with a therapist, whereas the CG had a single 2-hour group workshop; and generalizability due to gender.

Length of postintervention follow-up: 6 months.

References

Hayes, S. C., Luoma, J., Bond, F., Masuda, A., & Lillis, J. (2006). Acceptance and Commitment Therapy: Model, processes, and outcomes. Behaviour Research and Therapy, 44(1), 1-25.

Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and Commitment Therapy (Second Edition): The process and practice of mindful change. New York: Guilford.

Luoma, J., Hayes, S. C., & Walser, R. (2007). Learning ACT: An Acceptance & Commitment Therapy skills-training manual for therapists. Oakland, CA: New Harbinger Publications.

Contact Information

Agency/Affiliation: Association for Contextual Behavioral Science
Website: contextualscience.org
Email:

Date Research Evidence Last Reviewed by CEBC: July 2017

Date Program Content Last Reviewed by Program Staff: May 2017

Date Program Originally Loaded onto CEBC: December 2013