Tailoring Acceptance and Commitment Therapy Skill Coaching in the Moment Through Smartphones: Results from a Randomized Controlled Trial
There is growing evidence for the efficacy of acceptance and commitment therapy (ACT) interventions delivered through smartphones, but research has not yet focused on how to optimize such interventions. One benefit of mobile interventions is the ability to adapt content based on in-the-moment variables. The current randomized controlled trial evaluated whether an ACT app that tailored skill coaching based on in-the-moment ecological momentary assessments (EMAs) would be more efficacious than the same app where skill coaching was random or an EMA-only condition. A sample of 69 adults interested in using a self-help app were randomized to one of three app conditions and used the app for the following 4 weeks. Results indicated equivalently high user satisfaction with the tailored versus random apps. Participants used the EMA-only app the most and the tailored app the least, but overall adherence was adequate. Participants in the tailored app improved significantly more on psychological distress and positive mental health relative to the random app and EMA-only conditions. However, no differences were found between the random app and EMA-only conditions on outcomes. Between-group differences over time were also found on psychological inflexibility, but this appeared to be primarily due to a lower rate of improvement in the random app condition relative to both tailored and EMA-only. Overall, these results suggest that tailoring ACT skill coaching based on in-the-moment variables leads to greater efficacy.
KeywordsmHealth Psychological inflexibility Mindfulness Micro-interventions Just-in-time adaptive interventions
MEL was the principal investigator including designing and overseeing the conduct of the study, conducting data analyses, and writing the manuscript. JH assisted with the design of the study, was the primary research coordinator for day-to-day operation of the study, and assisted in preparing the manuscript. RAC was a co-investigator who assisted in designing the study, conducting data analyses, and preparing the manuscript.
Compliance with Ethical Standards
Conflict of Interest
Dr. Levin is a research associate with Contextual Change LLC, a company that focuses on developing commercial online programs to address college student mental health. Mr. Jack Haeger and Dr. Rick Cruz declare that they have no conflicts 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. The study was approved by the Utah State University Institutional Review Board.
Informed consent was obtained from all individual participants included in the study.
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