Review2018

Identifying the Underlying Mechanisms of Change During Acceptance and Commitment Therapy (ACT): A Systematic Review of Contemporary Mediation Studies

Daniel Stockton · Stephen Kellett · Raúl Berríos · Fuschia M. Sirois · Nic Wilkinson

193 citations0/0 files storedBehavioural and Cognitive Psychotherapy

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Mindfulness and Compassion Interventions Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Psychotherapy Techniques and Applications

Abstract

BACKGROUND: Mediation studies test the mechanisms by which interventions produce clinical outcomes. Consistent positive mediation results have previously been evidenced (Hayes et al., 2006) for the putative processes that compromise the psychological flexibility model of acceptance and commitment therapy (ACT). AIMS: The present review aimed to update and extend the ACT mediation evidence base by reviewing mediation studies published since the review of Hayes et al. (2006). METHOD: ACT mediation studies published between 2006 and 2015 were systematically collated, synthesized and quality assessed. RESULTS: Twelve studies met inclusion criteria and findings were synthesized by (a) the putative processes under investigation, and (b) the outcomes on which processes were tested for mediation. Mediation results were found to be generally consistent with the psychological flexibility model of ACT. However, studies were limited in methodological quality and were overly focused on a small number of putative processes. CONCLUSIONS: Further research is required that addresses the identified methodological limitations and also examines currently under-researched putative processes.

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References

2009The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration 2009The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration 1968Weighted kappa: Nominal scale agreement provision for scaled disagreement or partial credit.2004Confidence Limits for the Indirect Effect: Distribution of the Product and Resampling Methods 2005Acceptance and Commitment Therapy: Model, processes and outcomes 2003Testing Mediational Models With Longitudinal Data: Questions and Tips in the Use of Structural Equation Modeling.1996Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment.2007Mediators and Mechanisms of Change in Psychotherapy Research

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2019Acceptance and Commitment Therapy in group format for anxiety and depression. A systematic review 2023The evidence-base for positive psychology interventions: a mega-analysis of meta-analyses 2024Examining domains of psychological flexibility and inflexibility as treatment mechanisms in acceptance and commitment therapy: A comprehensive systematic and meta-analytic review

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