Acceptance and commitment training focused on repetitive negative thinking for clinical psychology trainees: A randomized controlled trial

Abstract

This par­al­lel ran­dom­ized con­trolled trial eval­u­ated the ef­fect of Ac­cep­tance and Com­mit­ment Train­ing (ACT) fo­cused on dis­rupt­ing repet­i­tive neg­a­tive think­ing (RNT) ver­sus a wait­list con­trol (WLC) in clin­i­cal psy­chol­ogy trainees. Ninety-four un­der­grad­u­ate, clin­i­cal psy­chol­ogy trainees of a Colom­bian uni­ver­sity were in­vited to par­tic­i­pate in the study. Eighty-five trainees agreed to par­tic­i­pate and were al­lo­cated by means of sim­ple ran­dom­iza­tion to a group, 6-ses­sion RNT-fo­cused ACT in­ter­ven­tion or the WLC. The ACT train­ing was based on an on­line pro­gram for emo­tional dis­or­ders. The pri­mary out­comes were mea­sures of emo­tional symp­toms and val­ued liv­ing, whereas process mea­sures were RNT-re­lated mea­sures. All par­tic­i­pants com­pleted the study. At post­treat­ment, re­peated mea­sures ANOVA showed that the train­ing was ef­fi­ca­cious in re­duc­ing emo­tional symp­toms (d = 0.75), de­pres­sion (d = 0.79), the fre­quency of be­hav­iors ob­struct­ing val­ued liv­ing (d = 0.51), RNT fo­cused on clin­i­cal prac­tice (d = 0.89), and gen­eral RNT (d = 0.62). Larger ef­fect sizes were ob­tained by par­tic­i­pants show­ing high lev­els of emo­tional symp­toms (d = 0.75–2.52), with 73.33% of par­tic­i­pants ob­tain­ing a re­li­able change in emo­tional symp­toms, and 66.67% a clin­i­cally sig­nif­i­cant change ver­sus 7.14% for both in­di­ca­tors in the WLC con­di­tion. The train­ing ef­fects were lon­gi­tu­di­nally me­di­ated by the re­duc­tion of RNT fo­cused on clin­i­cal prac­tice at two-thirds of the pro­gram. An easy-to-im­ple­ment RNT-fo­cused ACT train­ing is ef­fec­tive in re­duc­ing emo­tional symp­toms and pro­mot­ing val­ued liv­ing in clin­i­cal psy­chol­ogy trainees.