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Acceptance and Commitment Training (ACT) as a Positive Psychological Intervention: A Systematic Review and Initial Meta-analysis Regarding ACT’s Role in Well-Being Promotion Among University Students

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Journal of Happiness Studies
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Andrew J. Howell
Andrew J. Howell
Andrew J. Howell
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Holli-Anne Passmore at Concordia University of Edmonton
Holli-Anne Passmore
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This paper (a) makes the argument for conceiving Acceptance and Commitment Training (ACT), when applied to the enhancement of well-being, as a positive psychological intervention, and (b) supports this view by reviewing evidence for ACT’s impact on university student well-being. Searches of the literature identified five randomized experiments that measured improvements in university student well-being as a function of ACT interventions relative to control conditions. A meta-analysis revealed a significant, small pooled effect size on well-being (d = 0.29), providing initial evidence of ACT’s role as a positive psychological intervention among university students. Strengths and limitations of the extant literature are discussed, as are implications of, and future directions for, this area of study. It is concluded that research, theory, and application within well-being scholarship may be facilitated by recognizing ACT’s application to the enhancement of well-being.
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Vol.:(0123456789)
Journal of Happiness Studies (2019) 20:1995–2010
https://doi.org/10.1007/s10902-018-0027-7
1 3
REVIEW ARTICLE
Acceptance andCommitment Training (ACT) asaPositive
Psychological Intervention: ASystematic Review andInitial
Meta‑analysis Regarding ACT’s Role inWell‑Being Promotion
Among University Students
AndrewJ.Howell1· Holli‑AnnePassmore2
Published online: 5 September 2018
© Springer Nature B.V. 2018
Abstract
This paper (a) makes the argument for conceiving Acceptance and Commitment Training
(ACT), when applied to the enhancement of well-being, as a positive psychological inter-
vention, and (b) supports this view by reviewing evidence for ACT’s impact on university
student well-being. Searches of the literature identified five randomized experiments that
measured improvements in university student well-being as a function of ACT interven-
tions relative to control conditions. A meta-analysis revealed a significant, small pooled
effect size on well-being (d = 0.29), providing initial evidence of ACT’s role as a positive
psychological intervention among university students. Strengths and limitations of the
extant literature are discussed, as are implications of, and future directions for, this area of
study. It is concluded that research, theory, and application within well-being scholarship
may be facilitated by recognizing ACT’s application to the enhancement of well-being.
Keywords Acceptance and commitment training· Well-being· Positive psychology·
University students
1 Introduction
The last two decades have witnessed the significant and independent advancement of both
positive psychological interventions and Acceptance and Commitment Training (ACT).1
Meta-analyses support the impact of positive psychological interventions (such as gratitude
expression and visualizing one’s best possible self) on well-being and related outcomes
* Andrew J. Howell
howella@macewan.ca
1 MacEwan University, Edmonton, Canada
2 University ofBritish Columbia, Kelowna, Canada
1 Levin etal. (2016a), among others, have argued that the word ‘training’ is more applicable than ‘therapy’
when acceptance and commitment interventions are applied to non-clinical samples; given the current focus
on ACT as a positive psychological intervention applied to university students, we adopt this convention
herein.
Content courtesy of Springer Nature, terms of use apply. Rights reserved.
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Acceptance and Commitment Therapy
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  • Apr 2016
This chapter examines a clinical approach that has been shown to be useful not only for addressing human suffering but also for promoting human growth; it is also based on a set of philosophical assumptions and theoretical principles that help one's think about the context in which positive psychology is pursued. Inside this dialectic the authors hope acceptance and commitment therapy (ACT) can contribute to the maturation and development of positive clinical psychology. Behavior therapy is based on a functional and monistic scientific approach that has contributed considerably to one understanding of human action. Cognitive defusion and mindfulness techniques attempt to alter the undesirable functions of thoughts and other private events. The chapter discusses the importance of psychological flexibility. A growing body of research suggests that people can address negative thoughts and feelings in a non-avoidant and mindful fashion, which empowers a behavioral focus on meaning and purpose.
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Both positive mental health and psychopathology should be monitored in psychotherapy: Confirmation for the dual-factor model in acceptance and commitment therapy
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  • Jan 2017
The dual-factor model of mental health suggests that enhancing positive mental health and alleviating psychopathology do not automatically go hand-in-hand. This study investigates the relationship between the effectiveness on depression/anxiety symptoms and positive mental health of Acceptance and Commitment Therapy (ACT). It draws on RCT data (n = 250) of a self-help ACT. Patients’ depression/anxiety symptoms and positive mental health were completed at baseline, at post-intervention after nine weeks, and at follow-up after five months. Percentage of unique variance of depression/anxiety symptoms explained by positive mental health (and vice versa), and the degree of classificatory agreement between improvements in positive mental health and depression/anxiety, were examined using regression analysis and Reliable Change Index (RCI). Positive mental health, i.e. baseline and change, explained 15% and 12% of the variance in follow-up depression and anxiety symptoms, beyond the 7% and 9% that was explained by baseline levels of depression and anxiety. Depression and anxiety symptoms, i.e., baseline and change, explained 10% and 9% of the variance in follow-up positive mental health, on top of the 35% that was explained by baseline levels of positive mental health. Cross-classification of the Reliable Changes showed that 64% of the participants that improved during the ACT-intervention, improved on either depression symptoms or positive mental health, and 72% of the participants improved on either anxiety symptoms or positive mental health. The findings support the dual-factor model and suggest that it is important to systematically implement measures of both psychopathology and positive mental health in mental health care and therapy evaluations.
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Effects of an acceptance and commitment therapy intervention on leaders’ and managers’ psychological flexibility
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  • Nov 2016
Psychological flexibility, the ability to persist or change behavior even in the presence of challenging psychological events, was found as a central determinant of mental health and performance at work. Several studies showed that Acceptance and Commitment Therapy (ACT) interventions improve psychological flexibility, wellbeing and performance, and lead to lower levels of stress, depression, and burnout. To date, studies about the effects of such interventions were conducted with distressed employees, manual/technical or service workers. The aim of the present study is to evaluate the impact of an ACT intervention on psychological flexibility and wellbeing at work with leaders and senior managers, as specific populations who have to develop behavioral skills due to their positions. The evolution of psychological flexibility at work and various indicators of wellbeing in a group of 57 “high-functioning” participants receiving three 4-hours ACT sessions was compared to a control group receiving no intervention. Results of ANCOVAs showed that the ACT intervention resulted in a significant improvement in psychological flexibility at work with a moderate effect size compared to the control group, but no evolution in wellbeing in these high status participants.
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