The empirical status of acceptance and commitment therapy: A review of meta-analyses

Gloster, Andrew T.; Walder, Noemi; Levin, Michael E.; Twohig, Michael P.; Karekla, Maria

doi:10.1016/j.jcbs.2020.09.009

Cited by 367 publications

(193 citation statements)

References 34 publications

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“…The study findings support the notion that psychological flexibility and prosociality are promising targets in an intervention for helping the public in navigating the mental health challenges regarding the pandemic. As the psychological flexibility model underpins one of the most promising approaches to cognitive behavioural therapy - Acceptance and Commitment Therapy (ACT) [ 44 , 56 ], it is suggested that ACT can be used as the cornerstone of developing public mental health interventions to combat the impacts of COVID-19, which continue to unfold. Indeed, a growing body of evidence from systematic reviews have indicated the positive effects of ACT for depression [ 56 ], anxiety [ 56 ] and subjective well-being [ 57 ] through fostering psychological flexibility among clinical and non-clinical populations with small-to-medium effect sizes (Cohen’s d = 0.24–0.64) [ 56 ].…”

Section: Discussionmentioning

confidence: 99%

“…As the psychological flexibility model underpins one of the most promising approaches to cognitive behavioural therapy - Acceptance and Commitment Therapy (ACT) [ 44 , 56 ], it is suggested that ACT can be used as the cornerstone of developing public mental health interventions to combat the impacts of COVID-19, which continue to unfold. Indeed, a growing body of evidence from systematic reviews have indicated the positive effects of ACT for depression [ 56 ], anxiety [ 56 ] and subjective well-being [ 57 ] through fostering psychological flexibility among clinical and non-clinical populations with small-to-medium effect sizes (Cohen’s d = 0.24–0.64) [ 56 ]. On the other hand, the significant association between psychological flexibility and prosociality as shown in our model further indicates that prosociality is potentially malleable through ACT leading to better mental health outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Can psychological flexibility and prosociality mitigate illness perceptions toward COVID-19 on mental health? A cross-sectional study among Hong Kong adults

et al. 2021

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Background The negative impact of COVID-19 pandemic on public mental health can be persistent and substantial over a long period of time, but little is known regarding what psychological factors or processes can buffer such impact. The present study aimed to examine the mediating roles of coping, psychological flexibility and prosociality in the impacts of perceived illness threats toward COVID-19 on mental health. Method Five-hundred and fourteen Hong Kong citizens (18 years or above) completed an online survey to measure illness perceptions toward COVID-19, coping, psychological flexibility, prosociality, and mental health, together with their socio-demographic variables. Structural equation modelling was used to explore the explanatory model that was the best-fit to illustrate the relationships between these constructs. Results Serial mediation structural equation model showed that only psychological flexibility (unstandardised beta coefficient, β = − 0.12, 95% CI [− 0.20, − 0.02], p = 0.031) and prosociality (unstandardised β = 0.04, 95% CI [0.01, 0.08], p = 0.001) fully mediated the relationship between illness perceptions toward COVID-19 and mental health. In addition, psychological flexibility exerted a direct effect on prosociality (standardised β = 0.22, 95% CI [0.12, 0.32], p < 0.001). This best-fit model explained 62% of the variance of mental health. Conclusions Fostering psychological flexibility and prosocial behaviour may play significant roles in mitigating the adverse effects of COVID-19 and its perceived threats on public mental health.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Can psychological flexibility and prosociality mitigate illness perceptions toward COVID-19 on mental health? A cross-sectional study among Hong Kong adults

et al. 2021

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“…Psychological flexibility, in particular, provides an empirically supported intervention pathway via ACT which shows potential in addressing the psychosocial and mental health vulnerabilities of youth and families in the context of parental illness. ACT is an empirically supported intervention approach that fosters psychological flexibility [ 31 , 58 , 59 ]. The ACT psychological flexibility framework specifies six therapeutic processes that promote psychological flexibility: (1) acceptance—openness to experience, (2) cognitive defusion—observing thoughts rather than taking them literally, (3) present moment awareness (mindfulness)—open and responsive awareness of the present, (4) self-as-context—flexible self-awareness and perspective-taking, (5) values—freely chosen personally meaningful life directions, (6) committed action—values-guided effective action.…”

Section: Discussionmentioning

confidence: 99%

A Model of the Effects of Parental Illness on Youth Adjustment and Family Functioning: The Moderating Effects of Psychological Flexibility on Youth Caregiving and Stress

Landi

Pakenham

Benassi

et al. 2021

IJERPH

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Parental chronic illness may adversely impact youth and family functioning. This study examined a moderated mediation model of the effects of parental illness on youth and family functioning derived from the Family Ecology Framework. Consistent with this model, we predicted that youth caregiving and stress would serially mediate the adverse impacts of parental illness on youth adjustment and family functioning and that psychological flexibility would moderate these mediational mechanisms. A total of 387 youth, with parents affected by chronic illness, completed a questionnaire assessing parental illness severity, youth caregiving and stress, psychological flexibility, youth adjustment (i.e., internalizing and externalizing problems and psychological wellbeing), and family functioning. Path analyses indicated that the adverse effects of parental illness on youth adjustment and family functioning were serially mediated by youth caregiving and stress. Psychological flexibility buffered the adverse effects of these serial mediators on youth internalizing problems and psychological wellbeing. These findings identified three potential intervention targets: youth caregiving, related stress appraisals, and psychological flexibility. Given the large body of evidence showing that acceptance and commitment therapy fosters psychological flexibility, this intervention approach has the potential to address the psychosocial and mental health vulnerabilities of youth in the context of parental illness, which constitutes a serious public health issue.

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“…In literature, psychological flexibility has been regarded as a typical model of clinical psychological treatment, comprising the psychological processes related to acceptance, mindfulness and committed actions based on values [ 16 , 32 , 45 ]. Meta-analyses of clinical trials have highlighted the positive impacts of fostering psychological flexibility on mental health in clinical population groups such as diabetes [ 46 ], cancer [ 47 ], depression [ 48 ], anxiety spectrum disorders [ 48 ] and non-clinical population groups [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

Patterns of Psychological Responses among the Public during the Early Phase of COVID-19: A Cross-Regional Analysis

Chong

Chien

Cheng

et al. 2021

IJERPH

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This study aimed to compare the mediation of psychological flexibility, prosociality and coping in the impacts of illness perceptions toward COVID-19 on mental health among seven regions. Convenience sampled online survey was conducted between April and June 2020 from 9130 citizens in 21 countries. Illness perceptions toward COVID-19, psychological flexibility, prosociality, coping and mental health, socio-demographics, lockdown-related variables and COVID-19 status were assessed. Results showed that psychological flexibility was the only significant mediator in the relationship between illness perceptions toward COVID-19 and mental health across all regions (all ps = 0.001–0.021). Seeking social support was the significant mediator across subgroups (all ps range = <0.001–0.005) except from the Hong Kong sample (p = 0.06) and the North and South American sample (p = 0.53). No mediation was found for problem-solving (except from the Northern European sample, p = 0.009). Prosociality was the significant mediator in the Hong Kong sample (p =0.016) and the Eastern European sample (p = 0.008). These findings indicate that fostering psychological flexibility may help to mitigate the adverse mental impacts of COVID-19 across regions. Roles of seeking social support, problem-solving and prosociality vary across regions.

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The empirical status of acceptance and commitment therapy: A review of meta-analyses

Cited by 367 publications

References 34 publications

Can psychological flexibility and prosociality mitigate illness perceptions toward COVID-19 on mental health? A cross-sectional study among Hong Kong adults

Can psychological flexibility and prosociality mitigate illness perceptions toward COVID-19 on mental health? A cross-sectional study among Hong Kong adults

A Model of the Effects of Parental Illness on Youth Adjustment and Family Functioning: The Moderating Effects of Psychological Flexibility on Youth Caregiving and Stress

Patterns of Psychological Responses among the Public during the Early Phase of COVID-19: A Cross-Regional Analysis

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