Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham, AL, United States.
Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, Gangwon province, Republic of Korea.
J Med Internet Res. 2022 Aug 30;24(8):e39182. doi: 10.2196/39182.
Acceptance and commitment therapy (ACT) is based on a psychological flexibility model that encompasses 6 processes: acceptance, cognitive defusion, self-as-context, being present, values, and committed action.
This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to examine the effects of internet-based ACT (iACT) on process measures.
A comprehensive search was conducted using 4 databases. The quality of the included RCTs was assessed using the Cochrane Collaboration Risk of Bias Tool. A random-effects or fixed-effects model was used. Subgroup analyses for each outcome were conducted according to the type of control group, use of therapist guidance, delivery modes, and use of targeted participants, when applicable.
A total of 34 RCTs met the inclusion criteria. This meta-analysis found that iACT had a medium effect on psychological flexibility and small effects on mindfulness, valued living, and cognitive defusion at the immediate posttest. In addition, iACT had a small effect on psychological flexibility at follow-up. The overall risk of bias across studies was unclear.
Relatively few studies have compared the effects of iACT with active control groups and measured the effects on mindfulness, valued living, and cognitive defusion. These findings support the processes of change in iACT, which mental health practitioners can use to support the use of iACT.
接纳与承诺疗法（ACT）基于心理灵活性模型，该模型包含 6 个过程：接纳、认知解离、自我作为背景、活在当下、价值观和承诺行动。
本系统评价和随机对照试验（RCT）的荟萃分析旨在考察基于互联网的接受与承诺疗法（iACT）对过程测量的影响。
使用 4 个数据库进行全面检索。使用 Cochrane 协作风险偏倚工具评估纳入 RCT 的质量。根据对照组的类型、治疗师指导的使用、交付模式和目标参与者的使用情况（如适用），对每种结局进行随机效应或固定效应模型分析。
共有 34 项 RCT 符合纳入标准。本荟萃分析发现，iACT 在即时后测时对心理灵活性有中等影响，对正念、有价值的生活和认知解离有小的影响。此外，iACT 在随访时对心理灵活性有小的影响。总体而言，研究的偏倚风险尚不清楚。
相对较少的研究比较了 iACT 与积极对照组的效果，并测量了对正念、有价值的生活和认知解离的影响。这些发现支持 iACT 的变化过程，心理健康从业者可以利用这些过程来支持 iACT 的使用。
