Acceptance and mindfulness-based stress management for support staff caring for individuals with intellectual disabilities. The use of acceptance and commitment therapy to prevent the rehospitalization of psychotic patients: a randomized controlled trial. Guided internet-delivered acceptance and commitment therapy for chronic pain patients: a randomized controlled trial. Randomized trial of telephone-delivered acceptance and commitment therapy versus cognitive behavioral therapy for smoking cessation: a pilot study. Cognitive behavioural therapy in multiple sclerosis: a randomized controlled pilot study of acceptance and commitment therapy. Engagement and Retention: Measuring Breadth and Depth of Participant Use of an Online Intervention Acceptance and Commitment Therapy and Selective Optimization with Compensation for Institutionalized Older People with Chronic Pain. Acceptance and commitment therapy as a web-based intervention for depressive symptoms: randomised controlled trial. Feasibility of a Personal Health Technology-Based Psychological Intervention for Men with Stress and Mood Problems: Randomized Controlled Pilot Trial Web-Based Acceptance and Commitment Therapy for Depressive Symptoms With Minimal Support Internet-Based Therapy for Mild to Moderate Depression in Swedish Primary Care: Short Term Results from the PRIM-NET Randomized Controlled Trial Web-Based Self-Help for Preventing Mental Health Problems in Universities: Comparing Acceptance and Commitment Training to Mental Health Education. A randomised worksite comparison of acceptance and commitment therapy and stress inoculation training. Feasibility of a Prototype Web-Based Acceptance and Commitment Therapy Prevention Program for College Students 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. Internet-based guided self-help intervention for chronic pain based on Acceptance and Commitment Therapy: A randomized controlled trial Computerized, interactive, multimedia cognitive-behavioural program for anxiety and depression in general practice. Acceptance and Commitment Therapy as a Novel Treatment for Eating Disorders Pilot randomized controlled trial of web-based acceptance and commitment therapy for smoking cessation. Internet-based behavioral activation and acceptance-based treatment for depression: a randomized controlled trial. Web-Based Acceptance and Commitment Therapy Smoking Cessation Treatment for Smokers With Depressive Symptoms Acceptance and commitment group therapy (ACT-G) for health anxiety: a randomized controlled trial. A randomized controlled trial of Internet-delivered cognitive behavior therapy and acceptance and commitment therapy in the treatment of tinnitus.
UNLABELLED Support staff working with individuals with intellectual disability ( ID ) and challenging behaviour experience high levels of work-related stress . Preliminary theoretical and experimental research has highlighted the potential suitability of acceptance and mindfulness approaches for addressing support staff stress . This study examines the effectiveness of an acceptance and mindfulness-based stress management workshop on the levels of psychological distress and well-being of support staff working with individuals with ID and challenging behaviour . Support staff ( n=120 ) were r and omly assigned to a  workshop intervention condition ( n=66 ) or to a waiting list control condition  ( n=54 ) . Measurements were completed at three time points ( pre- , post and 6 week follow-up ) for : psychological distress , well-being , perceived work stressors , thought suppression , and emotional avoidance/psychological inflexibility . MAIN FINDINGS The intervention led to significantly greater reductions in distress in the intervention group than in the control group . This was largely maintained at 6 week follow-up . This effect was more pronounced amongst a sub sample that had shown higher levels of psychological distress at baseline . Thought suppression was found to reduce significantly in the intervention group between post intervention and follow-up , although no significant change was found in well-being or experiential avoidance/psychological inflexibility . Overall , results demonstrated support for the effectiveness of an acceptance and mindfulness-based intervention in reducing distress The present study examined the impact of a brief version of an acceptance-based treatment ( acceptance and commitment therapy ; ACT ) that teaches patients to accept unavoidable private events ; to identify and focus on actions directed toward valued goals ; and to defuse from odd cognition , just noticing thoughts rather than treating them as either true or false . Eighty inpatient participants with positive psychotic symptoms were r and omly assigned to treatment as usual ( TAU ) or to 4 sessions of ACT plus TAU . ACT participants showed significantly higher symptom reporting and lower symptom believability and a rate of rehospitalization half that of TAU participants over a 4-month follow-up period . The same basic pattern of results was seen with all participant subgroups except delusional participants who denied symptoms Acceptance and commitment therapy ( ACT ) interventions for persons with chronic pain have recently received empirical support . ACT focuses on reducing the disabling influences of pain through targeting ineffective control strategies and teaches people to stay in contact with unpleasant emotions , sensations , and thoughts . The aim of the present study was to investigate the effect of a guided internet-delivered ACT intervention for persons with chronic pain . A total of 76 patients with chronic pain were included in the study and r and omized to either treatment for 7 weeks or to a control group that participated in a moderated online discussion forum . Intent-to-treat analyses showed significant increases regarding activity engagement and pain willingness . Measurements were provided with the primary outcome variable Chronic Pain Acceptance Question naire which was in favour of the treatment group . Reductions were found on other measures of pain-related distress , anxiety and depressive symptoms . A six month follow-up showed maintenance of improvements . We conclude that an acceptance based internet-delivered treatment can be effective for persons with chronic pain OBJECTIVE We conducted a pilot r and omized trial of telephone-delivered acceptance and commitment therapy ( ACT ) versus cognitive behavioral therapy ( CBT ) for smoking cessation . METHOD Participants were 121 uninsured South Carolina State Quitline callers who were adult smokers ( at least 10 cigarettes/day ) and who wanted to quit within the next 30 days . Participants were r and omized to 5 sessions of either ACT or CBT telephone counseling and were offered 2 weeks of nicotine replacement therapy ( NRT ) . RESULTS ACT participants completed more calls than CBT participants ( M = 3.25 in ACT vs. 2.23 in CBT ; p = .001 ) . Regarding satisfaction , 100 % of ACT participants reported their treatment was useful for quitting smoking ( vs. 87 % for CBT ; p = .03 ) , and 97 % of ACT participants would recommend their treatment to a friend ( vs. 83 % for CBT ; p = .06 ) . On the primary outcome of intent-to-treat 30-day point prevalence abstinence at 6 months postr and omization , the quit rates were 31 % in ACT versus 22 % in CBT ( odds ratio [ OR ] = 1.5 , 95 % confidence interval [ CI ] = 0.7 - 3.4 ) . Among participants depressed at baseline ( n = 47 ) , the quit rates were 33 % in ACT versus 13 % in CBT ( OR = 1.2 , 95 % CI = 1.0 - 1.6 ) . Consistent with ACT 's theory , among participants scoring low on acceptance of cravings at baseline ( n = 57 ) , the quit rates were 37 % in ACT versus 10 % in CBT ( OR = 5.3 , 95 % CI = 1.3 - 22.0 ) . CONCLUSIONS ACT is feasible to deliver by phone , is highly acceptable to quitline callers , and shows highly promising quit rates compared with st and ard CBT quitline counseling . As results were limited by the pilot design ( e.g. , small sample ) , a full-scale efficacy trial is now needed OBJECTIVE The aim of this study was to design a trial that could evaluate the effect of acceptance and commitment therapy as a group-intervention for multiple sclerosis patients with psychological distress .  DESIGN R and omized controlled trial with assessment at pretreatment , end of treatment , and at 3-month follow-up . SUBJECTS Multiple sclerosis out patients with elevated symptoms of anxiety and /or depression ( n = 21 ) . METHODS Patients were r and omly assigned to acceptance and commitment therapy or relaxation training . Both treatments consisted of 5 sessions over 15 weeks containing didactic sessions , group discussion s , and exercises . Outcome was assessed by self-rated symptoms of anxiety , depression , and a measure of acceptance . RESULTS At 3-month follow-up , the relaxation training group had a significant decline in anxiety symptoms whereas the acceptance and commitment therapy group showed a maintained improvement in rated acceptance at follow-up . CONCLUSION The results reflect the different emphases of the therapies . Acceptance and commitment therapy is aim ed at living an active , valued life and increasing acceptance , while relaxation training focuses directly on coping strategies to h and le emotional symptoms . The results are preliminary , but supportive of further study of brief group interventions for reducing psychological distress in patients with multiple sclerosis BACKGROUND The Internet provides us with tools ( user metrics or para data ) to evaluate how users interact with online interventions . Analysis of these para data can lead to design improvements . OBJECTIVE The objective was to explore the qualities of online participant engagement  in an online intervention . We analyzed the para data in a r and omized controlled trial of alternative versions of an online intervention design ed to promote consumption of fruit and vegetables . METHODS Volunteers were r and omized to 1 of 3 study arms involving several online sessions . We created 2 indirect measures of breadth and depth to measure different dimensions and dynamics of program engagement based on factor analysis of para data measures of Web pages visited and time spent online with the intervention material s. Multiple regression was used to assess influence of engagement on retention and change in dietary intake . RESULTS Baseline surveys were completed by 2513 enrolled participants . Of these , 86.3 % ( n = 2168 ) completed the follow-up surveys at 3 months , 79.6 % ( n = 2027 ) at 6 months , and 79.4 % ( n = 1995 ) at 12 months . The 2 tailored intervention arms exhibited significantly more engagement than the untailored arm ( P < .01 ) . Breadth and depth measures of engagement were significantly associated with completion of follow-up surveys ( odds ratios [ OR ] = 4.11 and 2.12 , respectively , both P values < .001 ) . The breadth measure of engagement was also significantly positively associated with a key study outcome , the mean increase in fruit and vegetable consumption ( P < .001 ) . CONCLUSIONS By exploring participants ' exposures to online interventions , para data are valuable in explaining the effects of tailoring in increasing participant engagement in the intervention . Controlling for intervention arm , greater engagement is also associated with retention of participants and positive change in a key outcome of the intervention , dietary change . This paper demonstrates the utility of para data capture and analysis for evaluating online health interventions . TRIAL REGISTRATION NCT00169312 ; http:// clinical trials.gov/ct2/show/NCT00169312 ( Archived by WebCite at http://www.webcitation.org/5u8sSr0Ty ) OBJECTIVE Recent studies support the efficacy of Acceptance and Commitment Therapy ( ACT ) with people with chronic pain . In addition , Selective Optimization with Compensation strategies ( SOC ) can help the elderly with chronic pain to accept their chronic condition and increase functional autonomy . Our aim was to analyze the efficacy of an ACT treatment program combined with training in SOC strategies for elderly people with chronic pain living in nursing homes . METHODS 101 participants ( mean age = 82.26 ; SD = 10.00 ; 78.6 % female ) were r and omized to the  intervention  condition ( ACT-SOC ) or to a minimal support group ( MS ) . Complete data are available for 53 participants  ( ACT-SOC : n = 27 ; MS : n = 26 ) . Assessment s of functional performance , pain intensity , pain acceptance , SOC strategies , emotional well being and catastrophizing beliefs were done preintervention and postintervention . RESULTS Significant time by intervention changes ( P = 0.05 ) were found in acceptance , pain related anxiety , compensation strategies , and pain interference in walking ability . Simple effects changes were found in acceptance ( P = 0.01 ) , selection strategies ( P = 0.05 ) , catastrophizing beliefs ( P = 0.03 ) , depressive symptoms ( P = 0.05 ) , pain anxiety ( P = 0.01 ) and pain interference in mood and walking ability ( P = 0.03 ) in the ACT-SOC group . No significant changes were found in the MS group . CONCLUSIONS These results suggest that an ACT intervention combined with training in SOC strategies could help older people with pain to improve their emotional well being and their functional capability BACKGROUND Depression is a highly prevalent disorder , causing a large burden of disease and substantial economic costs . Web-based self-help interventions seem promising in promoting mental health . AIMS To compare the efficacy of a guided web-based intervention based on acceptance and commitment therapy ( ACT ) with an active control ( expressive writing ) and a waiting-list control condition ( Netherl and s Trial Register NTR1296 ) . METHOD Adults with depressive symptoms from the general population were r and omised to ACT ( n = 82 ) , expressive writing  ( n = 67 ) or waiting-list control  ( n = 87 ) . The main outcome was reduction in depressive symptoms assessed with the Center for Epidemiological Studies - Depression scale . RESULTS Significant reductions in depressive symptoms were found following the ACT intervention , compared with the control group ( Cohen 's d = 0.56 ) and the expressive writing intervention ( d = 0.36 ) . The effects were sustained at 6-month and 12-month follow-up . CONCLUSIONS Acceptance and commitment therapy as a web-based public mental health intervention for adults with depressive symptoms can be effective and applicable Background Work-related stress is a significant problem for both people and organizations . It may lead to mental illnesses such as anxiety and depression , result ing in increased work absences and disabilities . Scalable interventions to prevent and manage harmful stress can be delivered with the help of technology tools to support self-observations and skills training . Objective The aim of this study was to assess the feasibility of the P4Well intervention in treatment of stress-related psychological problems .  P4Well is a novel intervention which combines modern psychotherapy ( the cognitive behavioral therapy and the acceptance and commitment therapy ) with personal health technologies to deliver the intervention via multiple channels , includinggroup meetings , Internet/Web portal , mobile phone applications , and personal monitoring devices . Methods This pilot study design was a small-scale r and omized controlled trial that compared the P4Well intervention with a waiting list control group . In addition to personal health technologies for self- assessment , the intervention consisted of 3 psychologist-assisted group meetings .  Self-assessed psychological measures through question naires were collected offline pre- and post-intervention , and 6 months after the intervention for the intervention group . Acceptance and usage of technology tools were measured with user experience question naires and usage logs . Results A total of 24 subjects were r and omized : 11 participants were followed up in the intervention group ( 1 was lost to follow-up ) and 12 participants did not receive any intervention ( control group ) . Depressive and psychological symptoms decreased and self-rated health and working ability increased . All participants reported they had benefited from the intervention . All technology tools had active users and 10/11 participants used at least 1 tool actively . Physiological measurements with personal feedback were considered the most useful intervention component . Conclusions Our results confirm the feasibility of the intervention and suggest that it had positive effects on psychological symptoms , self-rated health , and self-rated working ability . The intervention seemed to have a positive impact on certain aspects of burnout and job strain , such as cynicism and over-commitment . Future studies need to investigate the effectiveness , benefits , and possible problems of psychological interventions which incorporate new technologies . Trial Registration The Finnish Funding Agency for Technology and Innovation ( TEKES ) , Project number Low-intensity interventions for people suffering from depressive symptoms are highly desirable . The aim of the present study was to investigate the outcomes of a web-based acceptance and commitment therapy (ACT)–based intervention without face-to-face contact for people suffering from depressive symptoms . Participants ( N = 39 ) with depressive symptoms were r and omly assigned to an Internet-delivered acceptance and commitment therapy ( iACT ) intervention or a waiting list control condition ( WLC ) . Participants were evaluated with st and ardized self-reporting measures ( Beck Depression Inventory [ BDI-II ] , Symptom Checklist–90 [ SCL-90 ] , Acceptance and Action Question naire [ AAQ-2 ] , Five Facet Mindfulness Question naire [ FFMQ ] , Automatic Thoughts Question naire [ ATQ ] , and White Bear Suppression Inventory [ WBSI ] ) at pre- and post-measurement . Long-term effects in the iACT group were examined using a 12-month follow-up . The iACT program comprised home assignments , online feedback given by master’s-level students of psychology over a 7-week intervention period , and automated email-based reminders . Significant effects were observed in favor of the iACT group on depression symptomatology ( between effect sizes [ ESs ] at post-treatment , iACT/WLC , g = .83 ) , psychological and physiological symptoms ( g = .60 ) , psychological flexibility ( g = .67 ) , mindfulness skills ( g = .53 ) , and frequency of automatic thoughts ( g = .57 ) as well as thought suppression ( g = .53 ) . The treatment effects in the iACT group were maintained over the 12-month follow-up period ( within-iACT ES : BDI-II , g = 1.33 ; SCL-90 , g = 1.04 ; ATQF/B [ Frequency/Believability ] , FFMQ , WBSI , AAQ-II , g = .74 - 1.08 ) . The iACT participants stated that they would be happy to recommend the same intervention to others with depressive symptoms . We conclude that an ACT-based guided Internet-delivered treatment with minimal contact can be effective for people with depressive symptoms Depression presents a serious condition for the individual and a major challenge to health care and society . Internet-based cognitive behavior therapy ( ICBT ) is a treatment option supported in several trials , but there is as yet a lack of effective studies of ICBT in “ real world ” primary care setting s. We examined whether ICBT differed from treatment-as-usual ( TAU ) in reducing depressive symptoms after 3 months . TAU comprised of visits to general practitioner , registered nurse , antidepressant drugs , waiting list for , or psychotherapy , or combinations of these alternatives . Patients , aged ≥ 18 years , who tentatively met criteria for mild to moderate depression at 16 primary care centers in the south-western region of Sweden were recruited and then assessed in a diagnostic interview . A total of 90 patients were r and omized to either TAU or ICBT . The ICBT treatment included interactive elements online , a workbook , a CD with mindfulness and acceptance exercises , and minimal therapist contact . The treatment period lasted for 12 weeks after which both groups were assessed . The main outcome measure was Beck Depression Inventory-II ( BDI-II ) . Additional measures were Montgomery Åsberg Depression Rating Scale – self rating version ( MADRS-S ) and Beck Anxiety Inventory ( BAI ) . The analyses revealed no significant difference between the two groups at post treatment , neither on BDI-II , MADRS-S , nor BAI . Twenty patients ( 56 % ) in the ICBT treatment completed all seven modules . Our findings suggest that ICBT may be successfully delivered in primary care and that the effectiveness , after 3 months , is at par with TAU OBJECTIVE This study sought to test the feasibility of a web-based Acceptance and Commitment Training ( ACT ) prototype prevention program called ACT on College Life ( ACT-CL ) . METHOD A sample of 234 university students was r and omized to either the  ACT-CL website or a mental health education ( MHE ) website . RESULTS Findings indicated a lower level of user engagement and satisfaction ratings with the prototype of ACT-CL than the MHE website . There were no significant differences between conditions on outcome measures at post or follow-up . However , statistical trends suggested the MHE condition actually led to greater remission of severe symptoms than the ACT-CL condition among those with severe symptoms at baseline . There were no differences between conditions on ACT process of change measures . Changes in psychological flexibility were predictive of changes in mental health across conditions , but relations dissipated over time . Furthermore , greater engagement in some components of ACT-CL predicted improvements in psychological flexibility , though not on mental health outcomes . CONCLUSIONS The effects of the ACT-CL program on mental health outcomes and ACT process measures were largely equivalent to those of an education website , although there was a lower level of program engagement with ACT-CL . Findings are discussed in the context of feasibility issues and lessons learned for program revisions In this comparative intervention study , 107 working individuals with above average levels of distress  were r and omly assigned to one of three conditions : acceptance and commitment therapy ( ACT ; n = 37 ) ; stress inoculation training ( SIT ; n = 37 ) ; or a waitlist control group ( n = 33 ) . The interventions were delivered to small groups in the workplace via two half-day training sessions . ACT and SIT were found to be equally effective in reducing psychological distress across a three month assessment period . Mediation analysis indicated that the beneficial impact of ACT on mental health result ed from an increase in psychological flexibility rather than from a change in dysfunctional cognitive content . Contrary to hypothesis , a reduction in dysfunctional cognitions did not mediate change in the SIT condition . Results suggest that the worksite may offer a useful , yet underutilised , arena for testing cognitive-behavioural theories of change Abstract Objective : This study examined the feasibility of a prototype Web-based acceptance and commitment therapy ( ACT ) program for preventing mental health problems among college students . Participants : Undergraduate first-year students ( N = 76 ) participated between May and November 2011 . Methods : Participants were r and omized to ACT or a waitlist , with assessment s conducted at baseline , posttherapy , and 3-week follow-up . Waitlist participants accessed the program after the second assessment . Results : Program usability/usage data indicated high program acceptability . Significant improvements were found for ACT knowledge , education values , and depression with ACT relative to waitlist . Subgroup analyses indicated that ACT decreased depression and anxiety relative to waitlist among students with at least minimal distress . Within the ACT condition , significant improvements were observed from baseline to 3-week follow-up on all outcome and process measures . Conclusions : Results provide preliminary support for the feasibility of a Web-based ACT prevention program The aim of the present study was to investigate two interventions based on Acceptance and Commitment Therapy ( ACT ) for depressive symptoms : A face-to-face treatment ( ACT group ) was compared to a guided self-help treatment delivered via the Internet consisting of two assessment sessions ( pre and post ) and an ACT-based Internet program ( iACT ) .  Out patients experiencing at least mild depressive symptoms were r and omized to either approach . The iACT treatment group received access to an ACT-based Internet program and supportive web-based contact over a period of 6 weeks . The face-to-face group received ACT-based treatment once a week over the same period of time . In both groups , the results showed a significant effect on depression symptomatology , and general wellbeing after treatment and at the 18-month follow-up . However , the data indicated that the iACT group changed differently regarding depressive symptoms and wellbeing as compared to the face-to face ACT group . Results showed large pre-treatment to 18-month follow-up within-group effect sizes for all symptom measures in the iACT treatment group ( 1.59 - 2.08 ) , and for most outcome measures in the face-to-face ACT group ( 1.12 - 1.37 ) . This non-inferiority study provides evidence that guided Internet-delivered ACT intervention can be as effective as ACT-based face-to-face treatment for out patients reporting depressive symptoms , and it may offer some advantages over a face-to-face intervention Acceptance-based psychological interventions can potentially minimize the burden of chronic pain . This r and omized controlled trial evaluated an internet-delivered , guided self-help intervention based on Acceptance and Commitment Therapy ( ACT ) . A total of 238 chronic pain sufferers from the general population were r and omly allocated to either ACT ( n = 82 ) , an internet-based control condition Expressive Writing ( n = 79 ) or a waiting list condition ( n = 77 ) . Participants completed measures at baseline , posttreatment ( 3 months ) and at a 3-month follow-up . At follow-up , ACT participants had improved in pain interference in daily life ( primary outcome ) compared to participants in Expressive Writing ( Cohen ’s d = .47 ) , but not compared to waiting list participants ( p value = .11 ) . Those who adhered to the ACT-intervention ( 48 % ) did improve significantly compared to waiting list participants ( d = .49 ) . ACT- participants also showed superior improvement on depression , pain intensity , psychological inflexibility and pain catastrophizing ( d : .28–.60 ) . Significant clinical improvement was present . Especially , 28 % of ACT- participants showed general clinical ly relevant improvement in pain interference , as well as in pain intensity and depression ( vs. Expressive Writing and waiting list 5 % ) . Given these findings , internet-based ACT programs may be a promising treatment modality for chronic pain BACKGROUND Cognitive-behavioural therapy ( CBT ) brings about significant clinical improvement in anxiety and depression , but therapists are in short supply . We report the first phase of a r and omized controlled trial of an interactive multimedia program of cognitive-behavioural techniques , Beating the Blues ( BtB ) , in the treatment of patients in general practice with anxiety , depression or mixed anxiety/depression . METHOD One hundred and sixty-seven adults suffering from anxiety and /or depression and not receiving any form of psychological treatment or counselling were r and omly allocated to receive , with or without medication , BtB or treatment as usual ( TAU ) . Measures were taken on five occasions : prior to treatment , 2 months later , and at 1 , 3 and 6 months follow-up using the Beck Depression Inventory , Beck Anxiety Inventory and Work and Social Adjustment Scale . RESULTS Patients who received BtB showed significantly greater improvement in depression and anxiety compared to TAU by the end of treatment ( 2 months ) and to 6 months follow-up . Symptom reduction was paralleled by improvement in work and social adjustment . There were no interactions of BtB with concomitant pharmacotherapy or duration of illness , but evidence , on the Beck Anxiety Inventory only , of interaction with primary care practice . Importantly , there was no interaction between the effects of BtB and baseline severity of depression , from which we conclude that the effects of the computer program are independent of starting level of depression . CONCLUSIONS These results demonstrate that computerized interactive multimedia cognitive-behavioural techniques under minimal clinical supervision can bring about improvements in depression and anxiety , as well as in work and social adjustment , with and without pharmacotherapy and in patients with pre-treatment illness of duration s greater or less than 6 months . Thus , our results indicate that wider dissemination of cognitive-behavioural techniques is possible for patients suffering from anxiety and /or depression Eating disorders are among the most challenging disorders to treat , with even state-of-the-art cognitive-behavioral treatments achieving only modest success . One possible reason for the high rate of treatment failure for eating disorders is that existing treatments do not attend sufficiently to critical aspects of the disorder such as high experiential avoidance , poor experiential awareness , and lack of motivation . These variables are explicit targets of Acceptance and Commitment Therapy ( ACT ) . The current study examined the efficacy of an ACT-based group treatment for eating disorders by examining whether the addition of ACT groups to treatment-as-usual ( TAU ) at a residential treatment facility for eating disorders would improve treatment outcomes .  TAU patients received an intensive residential treatment , while  ACT patients received these services but additionally attended , depending on diagnosis , either ACT for anorexia nervosa groups or ACT for bulimia nervosa groups . Although individuals in both treatment conditions demonstrated large decreases in eating pathology , there were trends toward larger decreases among those receiving ACT . ACT patients also showed lower rates of rehospitalization during the 6 months after discharge . Overall , results suggest that ACT is a viable treatment option for individuals with eating pathology  and further outcome research is warranted OBJECTIVE Web-based smoking cessation interventions have high reach , but low effectiveness . To address this problem , we conducted a pilot r and omized controlled trial of the first web-based acceptance and commitment therapy ( ACT ) intervention for smoking cessation . The aims were to determine design feasibility , user receptivity , effect on 30-day point prevalence quit rate at 3 months post-r and omization , and mediation by ACT theory-based processes of acceptance . METHODS Adult participants were recruited nationally into the double-blind r and omized controlled pilot trial ( N = 222 ) , which compared web-based ACT for smoking cessation ( WebQuit.org ) with the National Cancer Institute 's Smokefree.gov-the U.S. national st and ard for web-based smoking cessation interventions . RESULTS We recruited 222 participants in 10 weeks . Participants spent significantly longer on the ACT WebQuit.org site per login ( 18.98 vs. 10.72 min ; p = .001 ) and were more satisfied with the site ( 74 % vs. 42 % ; p = .002 ) . Using available follow-up data , more than double the fraction of participants in the ACT WebQuit.org arm had quit smoking at the 3-month follow-up ( 23 % vs. 10 % ; OR = 3.05 ; 95 % CI = 1.01 - 9.32 ; p = .050 ) . Eighty percent of this effect was mediated by ACT theory-based increases in total acceptance of physical , cognitive , and emotional cues to smoke ( p < .001 ) . CONCLUSIONS The trial design was feasible . Compared with Smokefree.gov , ACT had higher user receptivity and short-term cessation , and strong evidence of theory-based mechanisms of change . While results were promising , they were limited by the pilot design ( e.g. , limited follow-up ) , and thus a full-scale efficacy trial is now being conducted BACKGROUND Internet-based cognitive behavior therapy for depression has been tested in several trials but there are no internet studies on behavioral activation ( BA ) , and no studies on BA over the internet including components of acceptance and commitment therapy ( ACT ) . The aim of this study was to develop and test the effects of internet-delivered BA combined with ACT against a waiting list control condition as a first test of the effects of treatment . METHODS Selection took place with a computerized screening interview and a subsequent semi-structured telephone interview . A total of 80 individuals from the general public were r and omized to one of two conditions . The treatment lasted for 8 weeks after which both groups were assessed . We also included a 3 month follow-up . The treatment included interactive elements online and a CD-ROM for mindfulness and acceptance exercises . In addition , written support and feedback was given by a therapist every week . RESULTS Results at posttreatment showed a large between group effect size on the Beck Depression inventory II d=0.98 ( 95%CI=0.51 - 1.44 ) . In the treated group 25 % ( 10/40 ) reached remission defined as a BDI score ≤ 10 vs. 5 % ( 2/40 ) in the control group . Results on secondary measures were smaller . While few dropped out from the study ( N=2 ) at posttreatment , the average number of completed modules was M=5.1 out of the seven modules . LIMITATIONS The study only included a waiting-list comparison and it is not possible to determine which treatment components were the most effective . CONCLUSIONS We conclude that there is initial evidence that BA with components of ACT can be effective in reducing symptoms of depression Objective : Smokers with depressive symptoms have more difficulty quitting smoking than the general population of smokers . The present study examines a web-based treatment using acceptance and commitment therapy ( ACT ) for smokers with depressive symptoms . The study aim ed to determine participant receptivity to the intervention and its effects on smoking cessation , acceptance of internal cues , and depressive symptoms . Methods : Smokers who had positive screening results for depressive symptoms at baseline ( n = 94 ) were selected from a r and omized controlled trial ( N = 222 ) comparing web-based ACT for smoking cessation ( WebQuit.org ) with Smokefree.gov .  Forty-five participants ( 48 % ) completed the three-month follow-up . Results : Compared to Smokefree.gov , WebQuit participants spent significantly more time on site ( p = .001 ) and had higher acceptance of physical cravings ( p = .033 ) . While not significant , WebQuit participants were more engaged and satisfied with their program and were more accepting of internal cues overall . There was preliminary evidence that WebQuit participants had higher quit rates ( 20 % versus 12 % ) and lower depressive symptoms at follow-up ( 45 % versus 56 % ) than those in Smokefree.gov . Conclusions : This was the first study of web-based ACT for smoking cessation among smokers with depressive symptoms , with promising evidence of receptivity , efficacy , impact on a theory-based change process , and possible secondary effects on depression . A fully powered trial of the ACT WebQuit.org intervention specifically for depressed smokers is needed . This was part of a clinical trial registered as NCT#01166334 at www . clinical trials.gov BACKGROUND Severe health anxiety is frequent and costly , yet rarely diagnosed or treated . Earlier treatment studies show problems with recruitment , dropout and recovery . In the current study , the authors aim ed to test the effect of acceptance and commitment group therapy ( ACT-G ) compared to waitlist in patients with severe health anxiety . METHOD During March 2010 to April 2012 , 126 consecutively referred patients meeting research criteria for severe health anxiety were block-r and omized ( 1:1 ) to ACT-G or a 10 months ' waitlist ( Clinical trials.gov , no. NCT01158430 ) . Patients allocated to ACT-G were treated in seven groups of nine patients between December 2010 and October 2012 and received nine weekly 3-h group sessions and a booster session consisting of ACT techniques . The primary outcome was decided a priori as the mean change in self-reported illness worry on the Whiteley-7 Index ( WI ) from baseline to 10 months ' follow-up . Secondary outcomes were improvement in emotional distress and health-related quality of life at 10 months ' follow-up . RESULTS Intention-to-treat analysis showed a statistically significant mean difference of 20.5 points [ 95 % confidence interval ( CI ) 11.7 - 29.4 , p < 0.001 ] on the WI between the groups at 10 months , and the between-group effect sizes were large ( Cohen 's d = 0.89 , 95 % CI 0.50 - 1.29 ) . The number needed to treat was 2.4 ( 95 % CI 1.4 - 3.4 , p < 0.001 ) . Diagnosis and treatment were well accepted by the patients . CONCLUSIONS ACT-G seems feasible , acceptable and effective in treating severe health anxiety OBJECTIVE Our aim in this r and omized controlled trial was to investigate the effects on global tinnitus severity of 2 Internet-delivered psychological treatments , acceptance and commitment therapy ( ACT ) and cognitive behavior therapy ( CBT ) , in guided self-help format . METHOD Ninety-nine participants ( mean age = 48.5 years ; 43 % female ) who were significantly distressed by tinnitus were recruited from the community . Participants were r and omly assigned to CBT ( n = 32 ) , ACT ( n = 35 ) , or a control condition ( monitored Internet discussion forum ; n = 32 ) , and they were assessed with st and ardized self-report measures ( Tinnitus H and icap Inventory ; Hospital Anxiety and Depression Scale ; Quality of Life Inventory ; Perceived Stress Scale ; Tinnitus Acceptance Question naire ) at pre- , posttreatment ( 8 weeks ) , and 1-year follow-up . RESULTS Mixed-effects linear regression analysis of all r and omized participants showed significant effects on the primary outcome ( Tinnitus H and icap Inventory ) for CBT and for ACT compared with control at posttreatment ( 95 % CI [ -17.03 , -2.94 ] , d = 0.70 , and 95 % CI [ -16.29 , -2.53 ] , d = 0.68 , respectively ) . Within-group effects were substantial from pretreatment through 1-year-follow-up for both treatments ( 95 % CI [ -44.65 , -20.45 ] , d = 1.34 ) , with no significant difference between treatments ( 95 % CI [ -14.87 , 11.21 ] , d = 0.16 ) . CONCLUSIONS Acceptance-based procedures may be a viable alternative to traditional CBT techniques in the management of tinnitus . The Internet can improve access to psychological interventions for tinnitus
Background The need for effective interventions to improve mental health and emotional well-being at a population level are gaining prominence both in the United Kingdom and globally .
Advances in technology and widespread adoption of Internet capable devices have facilitated rapid development of Web-delivered psychological therapies .
Interventions design ed to manage a range of affective disorders by applying diverse therapeutic approaches are widely available .
Objective The main aim of this review was to evaluate the evidence base of acceptance and commitment therapy ( ACT ) in a Web-based delivery format .