Acceptance and Commitment Therapy in group format for anxiety and depression. A systematic review

Coto-Lesmes, Rocío; Fernández-Rodríguez, Concepción; González-Fernández, Sonia

doi:10.1016/j.jad.2019.11.154

Cited by 89 publications

(65 citation statements)

References 37 publications

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“…Given that research into the longer-term mental health impacts of prior pandemics show lingering elevated trauma, anxiety, and depressive symptoms (e.g., after the SARS quarantine; Hawryluck et al, 2004 ; Taylor, 2019 ), it is anticipated that when this pandemic abates, mental health services will face significant demands. The evidence emerging from the burgeoning literature on psychological flexibility (see reviews Coto-Lesmes et al, 2019 ; Apolinário-Hagen et al, 2020 ; Bai et al, 2020 ) provides strong support for the use of ACT-based interventions to promote psychological flexibility and mental health during the COVID-19 pandemic ( Gloster et al, 2017 ; Polizzi et al, 2020 ; Presti et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

Health Anxiety and Mental Health Outcome During COVID-19 Lockdown in Italy: The Mediating and Moderating Roles of Psychological Flexibility

et al. 2020

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The COVID-19 emergency has severely affected the Italian population. During a pandemic, those with high health anxiety are at risk of adverse mental health outcomes, including peritraumatic distress and mood disturbance. No prior research has explored the role of psychological flexibility in protecting people at high risk of poorer mental health impacts due to health anxiety during a pandemic. Psychological flexibility is the cornerstone of psychological health and resiliency. According to acceptance and commitment therapy (ACT), it involves behaving consistently with one’s chosen values even in the presence of emotional and mental discomfort. This study examined the mediating and moderating roles of psychological flexibility in the link between trait health anxiety and three mental health outcomes: COVID-19 peritraumatic distress, anxiety, and depression. We hypothesized that higher psychological flexibility would decrease the negative impacts of trait health anxiety on mental health outcomes. During the mandatory national lockdown ( M = 35.70 days, SD = 8.41), 944 Italian adults (75.5% female, M = 38.86 years, SD = 13.20) completed an online survey consisting of standardized measures of psychological flexibility, trait health anxiety, COVID-19 distress, anxiety, and depression. Results indicated that psychological flexibility did not moderate the link between trait health anxiety and mental health outcomes. Rather, greater psychological flexibility mediated decreases in the adverse effects of trait health anxiety on COVID-19 distress, anxiety, and depression. In particular, two psychological flexibility processes, observing unhelpful thoughts rather than taking them literally (defusion) and values-based action (committed action), mediated decreases in the negative effects of trait health anxiety on all mental health outcomes. In contrast, the psychological flexibility process acceptance, which involves openness to inner discomfort, mediated increases in negative mental health outcomes. Overall, the combination of these processes mitigated the detrimental impacts of trait health anxiety on mental health during the emergency mandatory COVID-19 nationwide lockdown. Consistent with the ACT conceptualization of psychological flexibility, findings suggest embracing (rather than avoiding) inner discomfort and observing associated unhelpful thoughts, while also engaging in values-based action, increases resilience during adversity. Evidenced-based large-scale online public health interventions that target psychological flexibility in those experiencing health anxiety in the context of a pandemic are urgently needed. Many empirically-based ACT interventions are suited for this purpose.

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Section: Discussionmentioning

confidence: 99%

Health Anxiety and Mental Health Outcome During COVID-19 Lockdown in Italy: The Mediating and Moderating Roles of Psychological Flexibility

et al. 2020

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“…ACT is an acceptance-based approach that aims at increasing psychological flexibility by targeting several processes that the developers theorize to be relevant for change: acceptance, cognitive defusion, self as context, values, and committed action (Hayes et al 1999(Hayes et al , 2006. While earlier meta-analyses questioned the evidence-base for ACT (Ost 2008(Ost , 2014, newer meta-analyses have strengthened ACT's evidence base for treating anxiety disorders, depression, addiction, and somatic health problems with similar outcomes as established psychological interventions (A-Tjak et al 2015;Bai et al 2020;Coto-Lesmes et al 2020;Hacker et al 2016). The flexibility in which ACT principles are applied to various disorders highlights the transdiagnostic nature of ACT (Dindo et al 2017).…”

Section: Metacognitive Therapy (Mct)mentioning

confidence: 99%

CBT at the Crossroads: The Rise of Transdiagnostic Treatments

et al. 2020

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Transdiagnostic treatments span a heterogeneous group of interventions that target a wider range of disorders and can be applied to treat several disorders simultaneously. Several meta-analyses have highlighted the evidence base of these novel therapies. However, these meta-analyses adopt different definitions of transdiagnostic treatments, and the growing field of transdiagnostic therapies has become increasingly difficult to grasp. The current narrative review proposes a distinction of “one size fits all” unified and “my size fits me” individualized approaches within transdiagnostic therapies. Unified treatments are applied as “broadband” interventions to a range of disorders without tailoring to the individual, while individualized treatments are tailored to the specific problem presentation of the individual, e.g., by selecting modules within modular treatments. The underlying theoretical foundation and relevant empirical evidence for these different transdiagnostic approaches are examined. Advantages and limitations of the transdiagnostic treatments as well as future developments are discussed.

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“…In ACT interventions, positive changes are thought to be derived from changes in processes related to psychological flexibility (Hayes et al, 2006;Hayes et al, 2012). At the same time, psychological flexibility has been shown to be an important determinant of mental health (Bai et al, 2019;Coto-Lesmes, Fernández-Rodríguez, & González-Fernández, 2020). Thus, studying the detailed relationship between psychological flexibility and mental health is important.…”

Section: Discussionmentioning

confidence: 99%

Preliminary Validation of a Chinese Version of the Comprehensive Assessment of Acceptance and Commitment Therapy Processes

Chen¹,

Luo²,

Wang³

et al. 2020

Preprint

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Civil servants are bridges that connect the general public and the government in China. Because their mental health may influence the rise and fall of the country, it is important to study their mental health and living conditions. The Comprehensive Assessment of Acceptance and Commitment Therapy Processes (CompACT) is a general measure of ACT processes and reflects individual psychological flexibility. We investigated the psychometric properties of CompACT in a non-clinical sample of civil servants. The Chinese CompACT demonstrated acceptable internal consistency (Cronbach α = 0.87) and reliability (Guttman split-half coefficient = 0.69). Confirmatory factor analysis provided support for the three-factor model. Our findings suggest that the Chinese version of the CompACT has acceptable psychometric properties and is a valid instrument for the assessment of psychological flexibility.

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Acceptance and Commitment Therapy in group format for anxiety and depression. A systematic review

Cited by 89 publications

References 37 publications

Health Anxiety and Mental Health Outcome During COVID-19 Lockdown in Italy: The Mediating and Moderating Roles of Psychological Flexibility

Health Anxiety and Mental Health Outcome During COVID-19 Lockdown in Italy: The Mediating and Moderating Roles of Psychological Flexibility

CBT at the Crossroads: The Rise of Transdiagnostic Treatments

Preliminary Validation of a Chinese Version of the Comprehensive Assessment of Acceptance and Commitment Therapy Processes

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