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Exploring the Improvement of Processes And Mediators Including The Effect of Person-Level Variables Post-Acceptance and Commitment Therapy
Embregts, L. (2025) Exploring the Improvement of Processes And Mediators Including The Effect of Person-Level Variables Post-Acceptance and Commitment Therapy.
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| Abstract: | This systematic literature review aimed to clarify how Acceptance and Commitment Therapy (ACT) works and for whom it is most effective. Guided by process-based therapy frameworks, the review synthesized evidence from randomized controlled trials (RCTs) to (1) identify which psychological processes are targeted by ACT, (2) determine which of these processes mediate treatment outcomes, and (3) examine whether person-level variables moderate ACT's effects. Consistent processes targeted by ACT were psychological flexibility, cognitive defusion, acceptance, and mindfulness, all appeared as a mediator in symptom reduction and functioning improvement. However, other core ACT processes (e.g., values, committed action, self-as-context) were under-investigated, leaving important theoretical assumptions untested. Notably, ACT did not consistently outperform cognitive or behavioral therapies on these process measures, raising concerns about treatment specificity and the role of shared therapeutic mechanisms. In terms of moderation, a limited number of baseline characteristics including higher fusion, depressive symptoms, and diagnostic status predicted greater process changes, though these did not reliably translate into superior clinical outcomes. These findings underscore both the empirical promise and current limitations of ACT research. To fully realize the potential of personalized, process-based therapy, future work should prioritize neglected ACT components, employ dismantling designs to test treatment specificity, and further investigate individual differences to support the development of more personalized, mechanism-informed interventions. |
| Item Type: | Essay (Master) |
| Faculty: | BMS: Behavioural, Management and Social Sciences |
| Subject: | 77 psychology |
| Programme: | Psychology MSc (66604) |
| Link to this item: | https://purl.utwente.nl/essays/107642 |
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