Acceptance and commitment therapy for couples: A systematic review and meta-analysis

To systematically review existing evidence and assess the effectiveness of Acceptance and Commitment Therapy for people with advanced cancer. Systematic review and meta-analysis of randomized controlled trials. Nine databases, including PubMed, Web of Science, Cochrane Library, Embase, CINAHL, PsycINFO, Chinese National Knowledge Infrastructure, VIP Database and Wanfang, were searched. The search covered the period between the inception of the selected databases and August 2022. Two authors independently examined eligible studies and appraised the methodological quality of the included studies by applying the criteria suggested by the Cochrane Effective Practice and Organization of Care followed by data abstraction. The Template for Intervention Description and Replication (TIDieR) checklist was used to identify intervention characteristics. Meta-analysis was performed using RevMan 5.4 software, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to evaluate the certainty of evidence. Eight studies, involving 488 people with advanced cancer, were included. The results showed significant effects of Acceptance and Commitment Therapy on the improvement of quality of life and the alleviation of anxiety, depression, psychological distress and fatigue in people with advanced cancer. However, its effects in relieving psychological flexibility and pain were not statistically significant. The certainty of the evidence was low to moderate. People with advanced cancer can benefit from Acceptance and Commitment Therapy, which is conducive to improving their health outcomes. This review provides evidence about the effectiveness of Acceptance and Commitment Therapy in people with advanced cancer. Further well-designed studies with larger sample sizes are required. This review may help nurses and researchers to design and implement Acceptance and Commitment Therapy in clinical practice, thereby improving health outcomes in this population. CRD42021244568.

Acceptance and commitment therapy (ACT) is recognised as an effective treatment for a variety of mental illnesses. Several meta-analyses have reported the efficacy of ACT in various mental and physical conditions, including depression, anxiety, and pain, but not for suicidality. This study aimed to determine the therapeutic effectiveness of ACT on suicidality through a systematic review and meta-analysis. Electronic databases such as PubMed, Embase, Scopus, and the Cochrane Library were searched for studies. The primary outcome measure was the effectiveness of ACT for suicidality which includes suicidal ideations and attempts. This systematic review and meta-analysis included eight studies, all of which were judged to have a high risk of bias. In the meta-analysis, the pooled standardised mean difference for suicidal ideations was 1.122 (95% confidence interval (CI) = 0.261 to 1.982). This meta-analysis suggests that ACT is effective for reducing suicidal ideation, but the high risk of bias across studies should be considered as a major limitation. Further well-designed studies are needed to confirm these findings.

BackgroundAcceptance and commitment therapy (ACT) is based on a psychological flexibility model that encompasses 6 processes: acceptance, cognitive defusion, self-as-context, being present, values, and committed action.ObjectiveThis systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to examine the effects of internet-based ACT (iACT) on process measures.MethodsA comprehensive search was conducted using 4 databases. The quality of the included RCTs was assessed using the Cochrane Collaboration Risk of Bias Tool. A random-effects or fixed-effects model was used. Subgroup analyses for each outcome were conducted according to the type of control group, use of therapist guidance, delivery modes, and use of targeted participants, when applicable.ResultsA total of 34 RCTs met the inclusion criteria. This meta-analysis found that iACT had a medium effect on psychological flexibility and small effects on mindfulness, valued living, and cognitive defusion at the immediate posttest. In addition, iACT had a small effect on psychological flexibility at follow-up. The overall risk of bias across studies was unclear.ConclusionsRelatively few studies have compared the effects of iACT with active control groups and measured the effects on mindfulness, valued living, and cognitive defusion. These findings support the processes of change in iACT, which mental health practitioners can use to support the use of iACT.

Objective This systematic review and meta-analysis aimed to examine the effects of acceptance and commitment therapy (ACT) on depressive symptoms, anxiety, pain intensity, quality of life, acceptance, and functional impairment in individuals with neurological disorders. Method A comprehensive search was conducted within four databases to identify relevant randomised controlled trials (RCTs). The quality of the included RCTs was assessed using the Cochrane Collaboration risk of bias tool. Either a random effects model or fixed effects model was used. Subgroup analyses were conducted according to the types of control groups. Results Twenty-four RCTs met the eligibility criteria. This meta-analysis found that ACT had medium-to-large effects in the immediate post-test and follow-up on reducing depressive symptoms, anxiety, pain intensity, and perceived functional impairment and improving quality of life and acceptance in individuals with neurological disorders. The overall risk of bias was unclear. Conclusions Relatively fewer studies were conducted to compare the effects of ACT to active control groups compared to studies involving passive control conditions. Future high-quality studies that compare ACT to active control conditions in individuals with neurological disorders are needed to determine whether practitioners should be routinely providing ACT for this population instead of other evidence-based treatments.

Effect of technology-based acceptance and commitment therapy for smoking cessation: A systematic review and meta-analysis.

Group acceptance and commitment therapy for adolescent anxiety: A systematic review and meta-analysis

IntroductionThe transition into palliative care can cause uncertainty fear and distress. Quality of life can be detrimentally affected and advance planning for end-of-life is often avoided. Acceptance and Commitment Therapy...

Acceptance and commitment therapy (ACT) is a psychotherapy technique, which promotes psychological flexibility and enables patients to change behaviors based on value-directed goals. However, the beneficial effects of ACT on glycemic control, self-care behaviors, acceptance of diabetes, self-efficacy, and psychological burden are still unclear among patients with type 2 diabetes mellitus (T2DM). This study aimed to systematically synthesize scientific evidence to determine the effectiveness of ACT among patients with T2DM on glycemic control, self-care behaviors, acceptance of diabetes, self-efficacy, and psychological burden and identify the optimal characteristics of effective interventions. Nine electronic databases were searched to identify eligible studies of randomized controlled trials from inception to June 2023. Two reviewers independently assessed the study eligibility, extracted the data, and performed the quality appraisal using the Cochrane Risk of Bias 2 Tool. The meta-analysis was conducted using Review Manager 5.3. The certainty of the evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation system. Ten studies involving 712 participants were included. ACT demonstrated significant improvements on patients' glycemic control (mean difference [MD]: 0.95%; p < .001), self-care behaviors (MD: 1.86; p = .03), diabetes acceptance (MD: 7.80; p < .001), self-efficacy (standardized mean difference [SMD]: 1.04; p < .001), anxiety (SMD: -1.15; p = .006), and depression (SMD: -1.10; p = .04). However, favorable but nonsignificant improvements were found in diabetes distress. Subgroup analyses demonstrated that ACT offered more than five sessions using individualized format, with theoretical underpinnings and professional input from multidisciplinary therapists are recommended to yield better results on glycemic control and self-care behaviors. Acceptance and commitment therapy could generate beneficial effectiveness on glycemic control, self-care behaviors, acceptance of diabetes, self-efficacy, anxiety, and depression among patients with T2DM. Large-scale trials with rigorous design and representative samples are warranted to strengthen the current evidence.

Objectives To determine the effects of Acceptance and Commitment Therapy (ACT) among informal caregivers of people with dementia (PwD) on anxiety, depression, and process measures and identify the optimal characteristics of effective interventions. Method Ten electronic databases were searched from the inception of the databases to 5 April 2025. Studies were included if they used a randomized controlled trial (RCT) or quasi-experimental design to assess the effect of ACT on informal caregivers of PwD. Two researchers independently screened eligible studies. The risk of bias was assessed by the Cochrane’s and the Joanna Briggs Institute’s tool. Results Thirteen studies (six RCTs and seven quasi-experimental studies) were included in this review. Results showed that ACT modified anxiety, depression, and experiential avoidance in informal caregivers of PwD. Subgroup analyses indicated that ACT interventions lasting 8 wk, lasting >60 min per session, and implementing four or five processes were more effective in reducing anxiety and depression. Conclusion ACT may be effective in reducing anxiety, depression, and experiential avoidance in informal caregivers of PwD. Future researchers are encouraged to further explore how ACT processes affect anxiety and depression to more effectively implement ACT for informal caregivers of PwD.

What is the evidence for the efficacy of self-help acceptance and commitment therapy? A systematic review and meta-analysis

Acceptance and commitment therapy (ACT) is a third-wave cognitive behavioral therapy that has shown promise as an effective treatment for reducing trauma-related symptoms. Although there have been systematic reviews on the clinical effectiveness of ACT for posttraumatic stress disorder, there are no known meta-analyses published on the impact of ACT in adult populations with trauma-related symptoms. Hence, the purpose of this meta-analysis and systematic review was to update the literature and assess the effectiveness of ACT interventions for decreasing trauma-related distress in adults who have developed trauma symptoms following exposure to one or more traumatic events. A systematic review of the literature was completed, and between-groups random effects meta-analysis was conducted assessing trauma symptom reduction at the initial posttest. Subgroup analyses were also performed to assess differences between groups based on research design, type of trauma, and comparator group. A meta-analysis of 11 studies revealed a moderate and statistically significant overall effect of ACT on symptom reduction at immediate posttest (Hedges' g = -.423, 95% CI [-.605, -.240]; I² = 25.75%), indicating that on average, those who received ACT interventions reported fewer trauma symptoms postintervention than those in various comparison groups. Ultimately, this research provides additional evidence supporting the effectiveness of ACT interventions for clients reporting trauma-related concerns. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective:Acceptance and commitment therapy (ACT) is a third-wave psychological intervention that has attracted considerable clinical and research attention. A previous meta-analysis of ACT trials in psychosis reported a large effect size of ACT against overall psychotic symptomatology. However, there were critical methodological issues in the review that justify replication.Methods:Systematic review and meta-analysis of randomized controlled trials (RCTs) testing ACT vs. any comparator condition in a sample of adults with psychosis. The outcome of interest was overall psychotic symptomatology.Results:The search identified seven published and eight unpublished trials (of which we were able to obtain data from one). Data on symptomatology were extracted from six trials that involved 274 participants. The summary effect size (Hedge’s G) for overall symptomatology was small and not significant (-0.21, 95%CI -0.60-0.18). Trials were generally rated as having a high risk of bias. Safety reporting was inadequate across included trials.Conclusions:Our observed effect size contrasted with that reported in a previous meta-analysis; differences were likely explained by errors in data extraction. The findings of this review suggest that there is currently inadequate evidence to conclude that ACT is a safe and effective treatment against psychotic symptomatology.Systematic review registration:CRD42018097200

The empirical status of the third-wave behaviour therapies for the treatment of eating disorders: A systematic review

A greater understanding of the extent to which the maintenance models underlying mindfulness-based cognitive therapy, acceptance and commitment therapy, and metacognitive therapy, originally developed for adults, are empirically supported in anxious youth is needed to inform theory and treatment. We provide an overview of these models. After systematically searching the literature, we estimated the mean effect sizes of the associations between third-wave cognitive constructs (mindfulness, psychological inflexibility, and metacognitions) and anxiety in youth. There is a medium effect size for mindfulness, a large effect size for psychological inflexibility, and a medium to large effect size for metacognitions and anxiety in youth. Overall, there are many more studies testing metacognition than mindfulness and psychological inflexibility, suggesting reliability and generalizability of the results. Recommendations for future studies investigating the validity of third-wave cognitive components in relation to...

How Can We Best Reduce Pain Catastrophizing in Adults With Chronic Noncancer Pain? A Systematic Review and Meta-Analysis