2015 EST Status: Treatment pending re-evaluation Very strong: High-quality evidence that treatment improves symptoms and functional outcomes at post-treatment and follow-up; little risk of harm; requires reasonable amount of resources; effective in non-research settings

Strong: Moderate- to high-quality evidence that treatment improves symptoms OR functional outcomes; not a high risk of harm; reasonable use of resources

Weak: Low or very low-quality evidence that treatment produces clinically meaningful effects on symptoms or functional outcomes; Gains from the treatment may not warrant resources involved

Insufficient Evidence: No meta-analytic study could be identified

Insufficient Evidence: Existing meta-analyses are not of sufficient quality

Treatment pending re-evaluation

1998 EST Status: Modest Research Support Strong: Support from two well-designed studies conducted by independent investigators.

Modest: Support from one well-designed study or several adequately designed studies.

Controversial: Conflicting results, or claims regarding mechanisms are unsupported.

Brief Summary

• Basic premise: Clients learn to re-conceptualize avoided or feared thoughts, feelings, memories, and physical sensations in an adaptive manner.
• Essence of therapy: The use of acceptance and mindfulness strategies help clients to be fully present in the moment and to accept otherwise negative emotions.  Commitment and behavior change strategies help clients to change or persist in behaviors more in line with their own values.  Used together these strategies increase client’s psychological flexibility.
• Length: approx. 12 Sessions

Treatment Resources

Editors: Keith Gunnerson, M.A.; Zac Imel, Ph.D.

Note: The resources provided below are intended to supplement not replace foundational training in mental health treatment and evidence-based practice

Treatment Manuals / Outlines

Treatment Manuals

• ACT for Depression and Anxiety Group (Cornell University Counseling and Psychological Services)
• Group Treatment of Depression (Zettle)
• Pole to Pole: An approach for exploration and communication in bipolar (Walton et al.)
• Postpartum Depression (Klausen)

Books Available for Purchase Through External Sites

• A Practical Guide to Acceptance and Commitment Therapy (Hayes & Strosahl)
• Acceptance and Commitment Therapy, Second Edition: The Process and Practice of Mindful Change (Hayes, Strosahl, & Wilson)
• ACT for Depression: A Clinician’s Guide to Using Acceptance and Commitment Therapy in Treating Depression (Zettle)
• ACT Made Simple: An Easy-To-Read Primer on Acceptance and Commitment Therapy (Harris)
• Learning ACT: An Acceptance and Commitment Therapy Skills-Training Manual for Therapists (Luoma, Hayes, & Walser)

Training Materials and Workshops

• ACT for Depression and Anxiety Disorders (Harris)

Measures, Handouts and Worksheets

• Self-Compassion Scale
• Thought Control Questionnaire
• Automatic Thoughts Questionnaire (ATQ)
• Experiences Questionnaire (EQ)
• Internalized Shame Scale
• White Bear Suppression Inventory (WBSI)
• Acceptance and Action Questionnaire-II

Self-help Books

• Get Out of Your Mind and Into Your Life: The New Acceptance and Commitment Therapy (Hayes & Smith)
• The Happiness Trap: How to Stop Struggling and Start Living: A Guide to ACT (Harris)
• The Little ACT Workbook (Sinclair & Beadman)
• The Mindfulness and Acceptance Workbook for Depression: Using Acceptance and Commitment Therapy to Move Through Depression and Create a Life Worth Living (Robinson & Strosahl)

Important Note: The books listed above are based on empirically-supported in-person treatments. They have not necessarily been evaluated empirically either by themselves or in conjunction with in-person treatment. We list them as a resource for clinicians who assign them as an adjunct to conducting in-person treatment.

Smartphone Apps

• ACT Coach (U.S. Department of Veterans Affairs)
• ACTCompanion The Happiness Trap App (Berrick Psychology)

Video Demonstrations

Videos Available for Purchase Through External Sites

• ACT in Action DVD series (Hayes)

Clinical Trials

• Effectiveness of Acceptance and Commitment Therapy for Depression, Psychological Well-Being and Feeling of Guilt in 7-15 Years Old Diabetic Children. (Ataie et al., 2015)
• A four-session Acceptance and Commitment Therapy based intervention for depressive symptoms delivered by masters degree level psychology students: A preliminary study. (Kohtala et al., 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. (Losada et al., 2015)
• A comparative effectiveness study of Acceptance and Commitment Therapy and group cognitive therapy for major depressive disorder. (Tamannaeifar et al., 2014)
• Effectiveness of acceptance and commitment therapy on depression. (Zhao et al., 2013)
• Acceptance and Commitment Therapy for Depression: A Preliminary Randomized Clinical Trial for Unemployed on Long-Term Sick Leave. (Folke et al., 2012)
• Efficacy of an early intervention based on acceptance and commitment therapy for adults with depressive symptomatology: Evaluation in a randomized controlled trial. (Bohlmeijer et al., 2011)
• Acceptance and Commitment Therapy for the Treatment of Adolescent Depression: A Pilot Study in a Psychiatric Outpatient Setting. (Hayes et al., 2011)
• Treating Inpatients with Comorbid Depression and Alcohol Use Disorders: A Comparison of Acceptance and Commitment Therapy. (Petersen & Zettle, 2009)
• A randomized controlled effectiveness trial of Acceptance and Commitment Therapy and Cognitive Therapy for anxiety and depression.(Forman et al., 2007)
• Group cognitive and contextual therapies in treatment of depression. (Zettle & Rains, 1989)

Internet-Based Clinical Trials

• Acceptance and commitment therapy as a web-based intervention for depressive symptoms: randomized controlled trial. (Pots et al., 2016)
• Web-based Acceptance and Commitment Therapy for depressive symptoms with minimal support: A randomized controlled trial. (Lappalainen et al., 2015)
• ACT Internet-based vs face-to-face? A randomized controlled trial of two ways to deliver Acceptance and Commitment Therapy for depressive symptoms: An 18-month follow-up. (Lappalainen et al., 2014)
• Internet-based behavioral activation and acceptance-based treatment for depression: A randomized controlled trial. (Carlbring et al., 2013)

 

Meta-analyses and Systematic Reviews

• Acceptance and commitment therapy – Do we know enough? Cumulative and sequential meta-analyses of randomized controlled trials. (Hacker et al., 2016)
• A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems (A-Tjak et al., 2015)
• “Third wave” cognitive and behavioural therapies versus treatment as usual for depression (Churchill et al., 2013)
• DBT, FAP, and ACT: How empirically-oriented are the new behavior therapy technologies? (Hayes, et al. 2004)
• Dysfunctional control by client verbal behavior: The context of reason giving. (Zettle & Hayes, 1986)

Other Treatment Resources

• Acceptance and Commitment Therapy (ACT) Made Easy (Fogel)