Search Results (84)

Background/Objectives: Incorporating parent training into cognitive-behavioral therapy for anxious youth has not been shown to significantly improve outcomes perhaps because these interventions have not addressed potential interfering psychological barriers to implementing parenting changes and rarely offer between-session support. There is growing evidence that Acceptance and Commitment Therapy (ACT) can target these psychological barriers and generate more flexible and adaptive behavioral repertoires in parents of children with a variety of presenting challenges. Methods: Following a pilot trial of “Acceptance and Commitment Therapy for Parents of Anxious Children (ACT-PAC)” a six-week group-based intervention focused on targeting psychological barriers to parenting change using mindfulness and acceptance approaches, we collected qualitative feedback from participants in two post-treatment phases by conducting individual interviews and a focus group with participants that completed the intervention. Results: Analysis of interview responses revealed that parents found ACT principles and processes to be helpful, and many also appreciated the ACT-PAC group setting that allowed parents to recognize their experiences were shared by others and to self-disclose in a non-judgmental space. Feedback from the focus group further provides preliminary evidence that ACT-PAC is acceptable to and feasible for parent participants and suggests modifications such as involving additional caregivers, making resources more readily available, and creative structural changes that may facilitate between-session practice. Conclusions: Results suggest that the group-based intervention can be both maintained and improved for future participants. Limitations to generalizability in light of possible selection bias and the small focus group sample size are addressed. Full article

This study conceptualizes the theological principle declared by the Apostle Paul in 2 Corinthians 12:9–10—“My power is made perfect in weakness” (ἡ γὰρ δύναμίς μου ἐν ἀσθενείᾳ τελεῖται)—as the Perfection in Weakness Paradox (PIW) and examines it through an integrative lens with contemporary third-wave psychotherapies. A Reformed theological exegesis of 2 Corinthians 12:9–10 identifies two foundational axes: sola gratia (grace alone) and the acknowledgment of weakness. The core mechanisms of Self-Compassion (Neff), Acceptance and Commitment Therapy (ACT; Hayes), Post-Traumatic Growth (PTG; Tedeschi and Calhoun), and Rumination-Focused Cognitive Behavioral Therapy (RFCBT; Watkins) are then analyzed for their systematic parallels with PIW’s theological structure—acceptance of weakness, dissolution of self-criticism, meaning-making through suffering, and transformation of rumination. The evidence-based framework of Spiritual Psychiatry is applied to examine the relationship between spiritual practices and mental health from neuroscientific and clinical perspectives. The central thesis is bidirectional: (1) the revelatory principle of 2 Corinthians provides theological foundations for the healing mechanisms of third-wave psychotherapies, and (2) the empirical evidence of these psychotherapeutic theories offers convergent support for and strengthens the theological interpretation of 2 Corinthians in a contemporary clinical context. This integrative framework proposes a new model for interdisciplinary dialogue between theology and psychiatry and discusses implications for clinical practice. Full article

Background: Children with ADHD exhibit deficits not only with attentional control but also with emotional dysregulation and experiential avoidance. Acceptance and Commitment Therapy (ACT) directly targets these processes by enhancing psychological flexibility and reducing maladaptive responses to internal experiences. Functional Near-Infrared Spectroscopy (fNIRS) offers a feasible and reliable method for assessing cortical hemodynamics in the ADHD population due to its portability and robustness to motion. This study aimed to investigate the immediate effects of a single-session ACT intervention on resting-state prefrontal hemodynamic activity in children with ADHD. Methods: Twenty children with ADHD underwent a single session of emotion regulation-focused ACT intervention. Resting-state fNIRS data were acquired immediately before and after the intervention. Changes in oxygenated (HbO) and deoxygenated hemoglobin (HbR) concentrations were statistically compared using paired t-tests. Results: All participants completed the protocol, and fNIRS acquisition was well tolerated. Post-intervention analyses revealed significant hemodynamic alterations after the session, marked by increased HbO at 0–240 s in the right lateral prefrontal cortex. HbO levels after the intervention were associated with SNAP hyperactivity scores. Conclusions: These findings provide preliminary evidence that single-session ACT intervention may be associated with short-term changes in resting hemodynamic activity in children with ADHD. fNIRS may demonstrate utility as a sensitive modality for detecting short-term intervention-related changes in neural activity. Given the exploratory nature of the study, future research with larger, controlled, and longitudinal designs is needed to evaluate the reproducibility of these findings and the clinical relevance of the observed hemodynamic changes. Full article

Background/Objectives: Children and young people (CYP) with long-term physical health conditions (LTCs) are at greater risk of psychosocial difficulties. Systematic reviews on adults with LTCs have supported acceptance and commitment therapy (ACT) in improving several psychosocial outcomes. This systematic review aimed to investigate the effectiveness of ACT for CYP-reported psychosocial outcomes among CYP with LTCs. It also examined the factors associated with the effects and the quantitative acceptability of the included ACT interventions. Methods: Eligible studies used a quantitative experimental design to evaluate ACT for CYP-reported psychosocial outcomes in CYP (≤18 years old) with LTCs. Only studies published in English in peer-reviewed journals, from any year, were included. CINAHL (EBSCO), Cochrane Library, Embase (Ovid), MEDLINE (Ovid) and PsycInfo (Ovid) were systematically searched. Google Scholar and Web of Science were also searched, and forward and backward citation searching was completed for included papers. Research quality was appraised using Cochrane risk-of-bias tools. Results were narratively synthesised. Results: Sixteen studies (nine randomised controlled trials (RCTs) and seven non-RCTs) from 19 reports met inclusion criteria, with 777 participants and five LTCs (chronic pain, diabetes, cancer, obesity and visual impairment). Findings provided preliminary support for the effectiveness of ACT on most CYP-reported psychosocial outcomes studied. Seven studies considered factors associated with intervention effects, with mixed findings. Acceptability was supported in the three studies that assessed it quantitatively. However, almost all studies had overall high/serious risk-of-bias ratings. Conclusions: There is preliminary evidence supporting potential benefits of ACT for improving psychosocial outcomes in CYP with LTCs, with limited but supportive findings for its acceptability. However, findings are constrained by high/serious risk of bias and small sample sizes. Larger, high-quality trials with active controls and longer follow-ups are needed to inform future care pathways. Registration: This systematic review was pre-registered (PROSPERO registration number: CRD42023425918). Full article

Process-based cognitive behavioral therapy (PB-CBT) seeks to identify kernels that are equally efficacious in treating various disorders. While both metacognitive therapy (MCT) and acceptance and commitment therapy (ACT) represent evidence-based interventions for generalized anxiety disorder (GAD), it remains unclear if there are specific components within each that are comparable in managing meta-worrying characteristic of GAD. A subclinical sample of college students received a brief session targeting a single, personally relevant meta-worry of either metacognitive restructuring as practiced in MCT or an extension of ACT defusion exercises. Both were equally effective in impacting believability, distress, and willingness ratings of the targeted worry as well as untargeted worries. However, significantly longer metacognitive defusion sessions suggest that metacognitive restructuring may represent a more cost-effective option. Levels of generalized anxiety, dispositional worrying, and depression did not moderate treatment responsivity. Implications of findings for PB-CBT research and practice are discussed within the context of study limitations. Full article

Overweight and obesity during pregnancy are associated with increased maternal and neonatal risks, yet scalable interventions addressing the psychological processes underlying health behaviours remain limited. This study describes the development and formative evaluation of DEMETRA, a chatbot delivering an Acceptance and Commitment Therapy (ACT)-informed intervention to promote healthier lifestyles in pregnant women. In line with Phase 1 of the Obesity-Related Behavioral Intervention Trials framework, a multidisciplinary team developed a six-session digital program delivered via a rule-based virtual assistant. A mixed-methods design was employed to assess acceptability, usability, and perceived relevance among a heterogeneous stakeholder sample. Sixteen stakeholders (psychologists, communication experts, nutritionists, clinicians, and non-overweight, expectant women or those who had recently delivered) participated in iterative testing; 15 completed quantitative measures (Semantic Differential scales, uMARS, BUS-11) and 16 completed semi-structured interviews. Non-parametric analyses indicated significantly positive evaluations across most communication and content domains, particularly clarity and language appropriateness, whereas session duration and several engagement-related dimensions did not significantly differ from neutrality. Qualitative findings confirmed strengths in clarity, non-stigmatising tone, and multimedia support, while identifying limited personalisation and message pacing as key areas for refinement. Overall, findings provide formative evidence that ACT-informed principles can be translated into a chatbot-delivered antenatal program and highlight concrete priorities for optimisation (e.g., personalisation and message pacing). Because end-user testing did not include overweight/obese pregnant women and the sample was small and heterogeneous, conclusions regarding acceptability/feasibility in the intended clinical population remain preliminary; the results primarily support iterative refinement and subsequent proof-of-concept testing in the target group. Full article

During pregnancy, women are more inclined to modify their habits and lifestyle to find a new balance and promote well-being for themselves and the child-to-be. However, the availability of nutritional and psychological support is often limited by stigma, geographic barriers, and a lack of services. Digital health tools are emerging as possible solutions to cover these needs. This study explores the acceptability, feasibility, and user experience of Demetra, a virtual coach based on Acceptance and Commitment Therapy (ACT), designed to promote healthy lifestyles and mental well-being. Fifty pregnant women will be enrolled in the feasibility study of the intervention. It starts with an educational part on the foundations of healthy eating and suggestions about lifestyle habits, followed by a six-week psychoeducational module. Content is delivered through text, audio, and video formats. User experience and engagement will be measured through validated questionnaires and semi-structured interviews. Psychological well-being will be evaluated both before and after the program. The intervention is expected to be well-received, with high levels of satisfaction and engagement, leading to a greater awareness of healthy behaviors, improved psychological flexibility, and enhanced overall well-being. Demetra offers an accessible solution to support women through the transformative experience of motherhood with a multidisciplinary and innovative approach. Full article

Substance use disorder (SUD) is a global problem with serious psychological, physiological, and social consequences. Seeking professional help is often delayed due to a lack of self-recognition of addiction, frequently sustained by self-deception. Although self-deception is a core feature of SUD, the mechanisms underlying it remain insufficiently studied. This research examines the role of impulsivity and self-efficacy in predicting self-deceptive behaviors—manipulation and mystification—in individuals undergoing addiction rehabilitation. The sample consisted of 122 Spanish participants from therapeutic communities (Mage = 44.99, SD = 10.58; 82.8% male) who completed the Self-Deception Questionnaire (SDQ-12), the Impulsive Control Scale Ramón y Cajal (ECIRyC), and the Drug Taking Confidence Questionnaire (DTCQ). Results showed that impulsivity significantly predicted both manipulation and mystification. Manipulation was also associated with self-efficacy in managing temptation and duration of addiction, highlighting its multifaceted nature. In contrast, mystification was predicted solely by impulsivity, suggesting a stronger dependence on internal psychological processes rather than contextual factors. These findings underscore the importance of targeting impulsivity and enhancing self-efficacy in addiction treatment. Interventions such as Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and mindfulness-based approaches may be particularly effective in reducing self-deceptive behaviors and supporting long-term recovery. Full article

Background: Experiential avoidance (EA) refers to the tendency to evade or suppress unpleasant internal experiences, such as distressing thoughts, emotions, or bodily sensations. Increasing evidence indicates that EA plays a central role in the onset and maintenance of addictive behaviours. Objective: To synthesise quantitative evidence on the association between experiential avoidance (EA), operationalised as psychological inflexibility, and psychoactive substance use (PSU) outcomes, including substance use frequency/quantity, craving, dependence severity, relapse/abstinence, and treatment response, and to characterise putative pathways (EA as predictor/mediator) and correlates (e.g., affect regulation and trauma-related factors). Methods: A systematic search was conducted in SCOPUS, Web of Science, PubMed, and APA PsycNet, following PRISMA 2020 guidelines. Eligible studies included experimental and observational designs, clinical and non-clinical populations, and publications from January 2000 to January 2026 in English or Spanish. Primary outcomes were PSU behaviour and severity (frequency/quantity, craving, dependence symptoms, relapse/abstinence) and treatment outcomes; secondary outcomes included emotional and behavioural correlates linked to EA. Results: Across studies, higher levels of EA were consistently associated with greater substance use—particularly alcohol, tobacco, cannabis, and other illicit drugs. EA frequently mediated the relationships between emotional dysregulation, trauma exposure, and addictive behaviour. Elevated EA was also linked to impulsivity, psychiatric comorbidity, and poorer treatment adherence and outcomes. Interventions explicitly targeting EA—most notably Acceptance and Commitment Therapy (ACT)—showed promising effects in reducing avoidance and substance use. Conclusions: Experiential avoidance emerges as a transdiagnostic process underlying vulnerability to, and persistence of, substance use disorders. Integrating third-wave behavioural interventions that promote psychological flexibility may enhance the efficacy of addiction treatment. Future research should explore these mechanisms in culturally diverse and under-represented contexts. Full article

Background: Executive functions, notably attention and processing speed, are essential for athletic performance, especially in sports that require quick reactions and decision-making under pressure. The current study aims to assess the impact of the SmartACT program—a psychological intervention that includes acceptance and commitment therapy, hypnosis, and guided imagery—on attentional processes and psychological flexibility in adolescent student-athletes. Methods: This 7-week quasi-experimental controlled study investigated the efficacy of SmartACT in adolescent student-athletes aged 15 to 18. A total of 309 individuals were divided into three groups using convenience sampling: SmartACT (n = 93), MAC (Mindfulness–Acceptance–Commitment, the standardized Gardner & Moore technique; n = 109), and control (n = 107). The d2 test was used to examine attention and visual processing, while the Acceptance and Action Questionnaire—II (AAQ-II) was used to assess psychological flexibility, both before and after the intervention. The data were analyzed using mixed-design repeated-measures ANOVA and paired-samples t-tests. Results: The SmartACT group showed significant improvement on both tests, specifically in the total number of items processed in the d2 test (457.83 to 600.24; p < 0.001), and experiential avoidance, measured by AAQ-II, decreased (18.48 to 12.80; p < 0.001), indicating increased psychological flexibility. Conclusions: The main findings of our study suggest that integrating ACT with hypnosis and imagery may enhance cognitive attentional functions and psychological flexibility in adolescent student-athletes. Full article

This study illustrates the application of Acceptance and Commitment Therapy (ACT) for a 12-year-old boy with separation anxiety and his mother. Over 23 sessions, ACT strategies promoted psychological flexibility, values-based parenting, and adaptive behaviors. The intervention reduced the child’s experiential avoidance, anxiety, and depressive symptoms, while increasing value-oriented actions, while the mother showed improved psychological flexibility and life satisfaction. The results were sustained at a three-month follow-up. This case study highlights the potential of ACT in treating childhood separation anxiety by simultaneously involving parents, demonstrating its feasibility and efficacy. The findings provide guidance for adapting ACT for families and child populations. Full article

Acceptance and Commitment Therapy (ACT) has been widely applied in clinical contexts; however, its systematic adaptation to elite sports, particularly precision-based disciplines such as shooting, remains underexplored. The present study aimed to develop and preliminarily validate an ACT-based psychological training program—the Acceptance and Commitment Performance Training for Shooters (ACPT-S)—by reframing ACT from a therapeutic intervention into a performance-oriented training framework. Using a multiphase formative evaluation design, a needs assessment was first conducted with 28 elite and collegiate shooters to identify sport-specific psychological demands. Based on these findings, a ten-session ACPT-S program was developed by integrating the six core ACT processes with shooter-specific routines, embodied exercises, and performance-relevant metaphors. The program was subsequently examined through two pilot studies: Phase 1 with four collegiate/corporate athletes and Phase 2 with 15 national-level shooters. Data were collected via session reflections, focus group interviews, and expert panel evaluations, and the Content Validity Ratio (CVR) analysis was used to assess conceptual clarity and implementation feasibility. The results indicated that ACPT-S was perceived as both feasible and contextually appropriate, with athletes reporting improvements in attentional focus, emotional acceptance, value-based motivation, and reduced anxiety. Qualitative analyses demonstrated strong engagement with ACT principles and their functional integration into shooting performance contexts, while all program components achieved CVR scores of ≥0.80, indicating a strong expert consensus. Program refinements were guided by feedback related to activity sequencing, metaphor resonance and personalization strategies. Overall, this study reconceptualizes ACT as a performance-enhancement framework rather than a purely clinical approach and introduces the ACPT-S as a novel, theory-driven, and scalable psychological training model for precision sports, providing a robust foundation for future longitudinal and comparative research. Full article

Stroke survivors often experience psychological difficulties, yet specialist provision is limited. The Wellbeing After Stroke (WAterS) study co-developed a nine-week, online Acceptance and Commitment Therapy (ACT) group programme designed to be delivered by non-specialist practitioners using structured, script-informed session clinical protocols. This study explored whether fidelity of delivery could be assessed, both to the clinical protocol (what was delivered) and to ACT therapeutic processes (how it was delivered). Eight practitioners were trained, and four delivered the intervention to three groups of four stroke survivors. Fidelity was assessed using a bespoke WAterS checklist, completed by practitioners after each session, and the ACT-Fidelity Measure (ACT-FM), completed by researchers rating a sub-set of recorded sessions. Practitioners delivered 92–100% of planned content, indicating high fidelity to protocol. ACT-FM ratings suggested some consistency with ACT processes, though there was variability across practitioners. These findings provide preliminary, proof-of-principle evidence that non-specialists can deliver a structured ACT-based group intervention with fidelity to protocol, and that both self-completed and observer-rated methods can feasibly assess fidelity. However, the small sample size means these results should be considered exploratory. The study highlights the potential value of these methods for informing training and fidelity assessment in future research. Full article

Postpartum depression (PPD) affects up to 15% of mothers, yet access to preventive psychological interventions during pregnancy remains limited. Acceptance and Commitment Therapy (ACT) has demonstrated efficacy in promoting psychological flexibility and preventing mental distress. Nevertheless, no studies have yet evaluated its use for the prevention of PPD through a chatbot-based digital intervention. The present study describes the development and preliminary evaluation of an ACT-based chatbot intervention (REA) to support women during late pregnancy and the early postpartum period. Nineteen participants interacted with the low-fidelity REA prototype, explored its features, completed two questionnaires, and then participated in semi-structured interviews. Quantitative data were analysed using the Wilcoxon signed-rank test; qualitative data were analysed using thematic analysis. Quantitative analysis revealed significantly elevated scores for the majority of variables, including empathy and listening, fluency, lexicon, clarity, engagement, functionality, aesthetics, information, and perceived impact. The interview findings demonstrated a notable level of appreciation for the intervention. The participants described the chatbot as engaging and supportive, highlighting a smooth interaction flow, content-appropriate language, and messages of suitable length. The REA prototype demonstrated high acceptability, usability, and perceived usefulness among a diverse range of stakeholders, thus supporting its potential as a scalable, stigma-reducing tool for the prevention of PPD. Subsequent research endeavours will focus on refining the chatbot’s personalisation features and conducting comprehensive clinical trials to evaluate its efficacy. Full article

Background: Poor mental health is a major contributor to absenteeism and turnover among nurses. Psychological flexibility may act as a protective factor for work-related well-being. This early-phase feasibility study explored the delivery of an online adaptation of Acceptance and Commitment Therapy (ACT) training for UK nursing professionals. Methods: A self-guided, 4-week online adaptation of an ACT training course was delivered via Moodle. Measures of professional quality of life, work engagement, and work-related psychological flexibility were collected at baseline and post-intervention (6 weeks). Feasibility outcomes included recruitment, retention, intervention adherence, and user engagement, assessed through platform usage statistics and user experience feedback. Results: A total of 43 participants enrolled in this single-group pre–post feasibility study. Recruitment targets were met, and completion of baseline measures was high. Engagement with course content was acceptable for an early-stage digital intervention. Among the well-being outcomes, work engagement showed the clearest indication of potential measure responsiveness. Retention was acceptable for the post-intervention survey but low for the usability survey and follow-up interview, limiting further exploration of engagement drivers. Conclusions: This study supports the feasibility of delivering online ACT training to nursing professionals. Key areas for refinement were identified, including closer integration with existing workplace communication and professional development systems, ongoing stakeholder involvement across study phases, and workplace-embedded engagement mechanisms to improve retention. Future research should further explore how workplace context influences intervention acceptability in larger feasibility trials. Full article