Acceptance and Commitment Therapy (ACT) for Adolescents: Outcomes of a Large-Sample, School-Based, Cluster-Randomized Controlled Trial
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The purpose of this study was to examine the efficacy of an abbreviated, classroom-based, teacher-taught Acceptance and Commitment Therapy (ACT) program as an intervention to improve mental health in adolescents. In a group-randomized controlled trial, students (N = 586, age 14–21) were nested within 34 classes, which were in turn nested within 14 schools. Individual classes were randomly assigned to either a four-session ACT program or a usual-curriculum control condition. Students were assessed using questionnaires at pre- and post-treatment, and a 12-month follow-up. Questionnaires assessed quality of life, internalizing and externalizing problems, thought and attention problems, and psychological inflexibility. Hierarchical linear modeling showed no significant improvements on any of the outcome measures compared with the control group. No substantive effect sizes for ACT across time were observed. These findings failed to support ACT in the format that was used in this current study, which was as an abbreviated, classroom-based, teacher-taught program to improve mental health for all students. We had a large sample and many outcome variables, but failed to find any statistically significant effects or substantive effect sizes. In this study, ACT was delivered by teachers as opposed to mental health professionals, so it is possible that professionally trained therapists are needed for ACT to be efficacious.
KeywordsAcceptance and commitment therapy ACT School-based prevention Adolescence Mental health
We sincerely thank CGG Vlaams-Brabant Oost, Preventiedienst Stad Leuven, CGG Waas en Dender, Preventiedienst Stad Sint-Niklaas, and the schools, teachers, and students who participated in this project.
Compliance with Ethical Standards
This study was co-funded by the foundation “Go for Happiness” and the Province of Flemish Brabant.
Conflict of Interest
Authors Francis Pascal-Claes and Maarten Bockstaele were involved in the adaptation of the ACT intervention program to a Flemish school context. Authors Filip Raes, James W. Griffith, Romina Hellemans, and Katleen Van der Gucht declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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