This ACT for Kids manual was developed by Steven Gordon, Michael Asher, and Michael Selbst

Please note: due to copyright laws, ACBS removed images from the document. Therefore, some of the formatting might be slightly off. 

In this interview (2013), psychologist Dr. Jacqueline Pistorello discusses the latest research on challenges faced by college students, as well as new attempts at supporting them with mindfulness and acceptance interventions. In her recently editted book, Mindfulness and Acceptance for Counseling College Students, Pistorello and others explore how mindfulness and acceptance-based approaches such as acceptance and commitment therapy (ACT), dialectical behavioral therapy (DBT), mindfulness-based cognitive therapy (MBCT), and mindfulness-based stress reduction (MBSR) are being utilized in higher education settings around the world to treat student mental health problems like severe depression, substance abuse, and eating disorders, and/or to help students thrive--both in and out of the classroom.

Q: Are college students more distressed these days?

For adults whose idea of college is this carefree time full of fun and little adult pressures, the current statistics on college mental health may be startling. Suicide is one of the leading causes of death among college students (Suicide Prevention Resource Center, 2004). Over 20% of college students have seriously considered suicide and 8% have attempted it in their lifetime (American College Health Association (ACHA), 2012). Non-suicidal self-injury (NSSI) is also prevalent: 15.3% have engaged in it in their lifetime and 6.8% in the past year (Whitlock et al., 2011). Nearly 50% of college students have a diagnosable psychiatric disorder (Blanco et al., 2008); one in five has suffered from depression and two out of three have experienced overwhelming anxiety in their lifetime (ACHA, 2012). Severe drinking problems are common, with one third engaging in binge drinking (Wechsler & Kowalik, 2005) and 20% experiencing an alcohol use disorder (Blanco et al., 2008); college students are more likely to drink and drive, to engage in binge drinking, and less likely to seek treatment for substance abuse, than their college-aged counterparts in the community.

The question of whether this is an actual increase in pathology is being debated, but the data are compelling. One study examined birth cohort increases in psychopathology among young Americans and demonstrated that American high school and college students reported a gradual increase of symptoms of psychopathology relative to previous generations over the last 70 years, with the current generation of young adults scoring about a standard deviation higher on clinical scales. University counseling center directors overwhelmingly state that the number of college students seeking mental health treatment for serious concerns at counseling centers is increasing. One study showed that the percentage of students presenting with depression, suicidality, and personality disorders doubled within a decade (Benton, Robertson, Tseng, Newton, & Benton, 2003).

Q: Do we need to think differently when treating college students specifically? Aren't college students the same as adolescents or adults, depending on their age?

Traditional college students fall into a special category developmentally. The period between the ages of 18-26 has recently been coined as “emerging adulthood” (Arnett, 2000). This age bracket encompasses the majority of undergraduate students in Universities in the US and even abroad. Researchers have shown that this stage of development is different from adolescence, in that it is characterized by fast transitions into novel and varied social contexts bringing greater freedom and less social control than experienced during adolescence. College students face special pressures as well: a greater proportion live away from home and they are pressed to do well academically; to live up to parents’ expectations; to co-exist with other students, sometimes in very closed quarters; to become more comfortable with those who hail from different socio-cultural-economic backgrounds; to figure out where one stands in terms of sexual orientation, religion, politics, and so on. Thus, what may work with adolescents may not work with this population. Some studies have found, for example, that factors affecting the trajectory of substance abuse among adolescents differ for those in emerging adulthood.

In addition to developmental issues affecting traditionally aged college students, the treatment of students, traditional and non-traditional (students who return to college at an older age), within the context of a campus pose unique challenges. The “therapist” working at a College Counseling Center has a broader role than might typically be expected, balancing mental health and educational issues, balancing the student’s individual needs with campus safety, having to manage confidentiality in the context of parent phone calls, dealing with administrators’ inquiries, and so on.

Understanding how different approaches can be implemented with emerging adults and within a college context, can be very useful to clinicians and researchers alike. 

Q: We understand that you have an edited book coming out on mindfulness and acceptance in counseling college students, by New Harbinger. Why are mindfulness and acceptance important for college students?

That’s a great question. It used to be the case that people could limit their exposure to the amount and kind of information. These days, particularly because of technology, the world moves very fast (e.g., constant texting, Tweeting, rapid video games, multi-tasking) and we are bombarded with a steady stream of information, sometimes gruesome pictures that stay in our minds. We can probably all still picture the planes going into the Twin Towers or more recently, the two blasts during the Boston Marathon bombings. Social networks like Facebook also promote constant comparisons among young adults, and some of their most private matters, sometimes in the context of cyber bullying, may be revealed en masse in ways that cannot be taken back. Unlike those of us who are middle aged now, typical college kids are growing up this way, and we don’t know what effect this will have on their mental health. The research on experiential avoidance is virtually undisputed, suggesting that unless emergent adults learn ways to bring their attention back to this present moment and be able to “carry” difficult emotions, memories, urges, and thoughts, including perhaps constant self-judgments, the repercussions are likely to be dire.

Mindfulness and acceptance-based approaches have something to offer emerging adults that might very well not only be unique but utterly necessary given the current socio-cultural context.

Q: So, tell us a little about your book. What is it? What mindfulness approaches are discussed in it?

This is an edited “how to” book. It provides illustration of how different mindfulness and acceptance-based approaches are being utilized with college students. A thorough review of specific mindfulness based approaches with college students at this point would be premature. Although this is a burgeoning field, and more and more studies are being conducted every month, the empirical evidence specifically with college students is building. The book emphasizes ACT, it also provides exposure to how DBT, MBSR, MBCT, and Ellen Langer’s mindful learning can be applied with college students and/or campus settings. This book is primarily geared towards practitioners or researchers working with college students or young adults. However, the book may be useful for anyone trying to implement ACT or other mindfulness based approaches outside the more typical therapy setting. The chapters are diverse and some of the initiatives go outside the box and may be helpful to individuals who are entertaining applying ACT or mindfulness based approaches in different settings.

This is a practical guide. The chapters are written by extremely knowledgeable authors who are not just theoreticians but are "in the trenches" and know how to explain what works best in a very practical, step-by-step way. The book also includes an extensive online Appendix where protocols, Power Point presentations, and modifiable Word documents (e.g., group flyers) developed by chapter authors can be accessed; this can be a huge time saver. 

Q: What new research is included that will be of interest to the ACT community?

We do have some hot off the press research findings mentioned in this book, hailing from across the globe (Australia, Italy, England, and the United States), that will be of interest to the ACT community in general. For example, one of the chapters summarizes findings from a study comparing ACT and MBCT. Although there were almost no differences in outcome, the authors discuss which individuals may benefit more from each approach. Another chapter described ACT podcasts that were created for college students, and summarizes findings regarding the utility of ACT podcasts, relative to CBT podcasts; this study found that students listening to the ACT podcasts reported greater academic engagement (e.g., less reading/texting during classes). Another chapter described a transdiagnostic ACT group showing promising findings; although we often laud ACT for being a transdiagnostic approach, most published ACT research so far has focused on one specific diagnostic categories (e.g., depression, psychosis), whereas this open trial study included a range of anxiety and mood problems. Other chapters describing ACT have gone beyond the therapy room, such as applying ACT in various classroom settings (including infusing ACT into an Abnormal Psychology class or creating ACT seminars), towards the training of college student peer mentors, and via an online values intervention. The latter study showed that adding values training to an online goal-setting procedure led to statistically significant improvements in grades. The range of new approaches and methods is impressive and readers will have a lot of new ideas about how to best serve college students.
 

ACBS has an ACT in Education Special Interest Group (SIG) that members can join. Read more about the ACT in Education SIG and its mission here. The ACT in Education SIG has a SIG resources webpage available to ACBS members.

Below are members' discussions of ACT applications in specific settings and populations.

• Connect - Wellbeing from the Word Go (for Elementary/Primary School)
• Blind Spots: Why Students Fail and the Science That Can Save Them (2020) book by Kimberly Nix Berens
• Two-for-one Teaching: Connecting Instruction to Student Values; Integrate Social-emotional Learning into Academic Instruction (2019) book by Lauren Porosoff and Jonathan Weinstein
• Using ACT and RFT in the Classroom
• Finding the Door to the CBS House: How a Teacher Discovered ACT and Now Uses CBS in Her Classroom (ACBS Newsletter, October 2017)
• EMPOWER Your Students: Tools to Inspire a Meaningful School Experience, Grades 6-12 (Increase Motivation and Engagement in the Classroom) (2017) by Lauren Porosoff and Jonathan Weinstein
• Seven Session Protocol for Anti-bullying in Schools
• The Story of Little Sapling. by Dennis Embry and Leslie Rogers. This story is for children over age 6.
• Blog Post about ACT in Schools Research (2016)
• Blog Post about First Spanish Book on ACT Applied to Education (2014)

Hi all.
I am attaching a Word file that provides information about ACT and/or ACT-related work with youth. There are some quick to review charts and lists, manuscript summaries, and references, as well as contact information for individuals working with "kiddos" or parents, teachers, etc. There is some admitted overlap and also some non-repetition between those things - so, for example, some (but not all) of the stuff listed in charts is listed in summaries and some citations are in summaries but not the reference list, etc. I ask that you just read it all carefully and overlook the imperfections. One of my students (Andrew Scherbarth) and I spent a good deal of time and have worked quite hard to get it looking as good as is does. A lot of information is there. We have excluded work that is only basic in nature. Therefore, it does not address RFT, stimulus equivalence studies, or the like UNLESS there was a clear clinical application in the title or abstract of the article, chapter, etc. I think that would be a great addition to the RFT section of this website (hint, hint). We are doing some of that in my lab now and may get around to posting it later, but if someone else could do it sooner... We did include in-press, in-review, in-preparation, ongoing, and even upcoming studies that I know of in addition to the published stuff. We included people doing clinical work without research components, but not in much detail. I did my best to include everything and mention everybody that I know has done or is doing this work. Please, please, forgive me if I forgot anything/anyone. If I wrongly included you, or you don't want to be included, I apologize. Please, let us all know. Also, if I did not know about you/your work and it should be included, please, take an active role in speaking and stepping up. We need more ACT stuff with these groups! What I hope is that people interested in clinical or research work with youth and related populations will "make themselves known" by adding their contact information and interests to this list. Ideally, new communication will be fostered and known contacts will be stregthened in efforts to advance this work. I provided some suggestions at WorldCon2 about where I think we need to go. If you take up those topics or others with youth, please let us all know!
Thanks and take care,
Amy Murrell (2006)

Therapist guides

• Challenging Perfectionism: An Integrative Approach for Supporting Young People Using ACT, CBT and DBT (2020) by Dawn Starley
• Acceptance and Commitment Therapy: The Clinician's Guide for Supporting Parents (2019) by Koa Whittingham and Lisa Coyne 
• Parenting a Troubled Teen: Manage Conflict and Deal with Intense Emotions Using Acceptance and Commitment Therapy (2017) by Patricia E. Zurita Ona PsyD
• EMPOWER Your Students: Tools to Inspire a Meaningful School Experience (2017) book by Lauren Porosoff and Jonathan Weinstein
• Acceptance & Mindfulness Treatments for Children & Adolescents: A Practitioner’s Guide
• ACT for Adolescents: Treating Teens and Adolescents in Individual and Group Therapy
• Mindfulness and Acceptance for Counseling College Students: Theory and Practical Applications for Intervention, Prevention, and Outreach (The Context Press Mindfulness and Acceptance Practical Series)
• Teen Anxiety: A CBT and ACT Activity Resource Book for Helping Anxious Adolescents
• The Thriving Adolescent: Using Acceptance and Commitment Therapy and Positive Psychology to Help Teens Manage Emotions, Achieve Goals, and Build Connection

Client books

• Acceptance and Mindfulness Toolbox for Children and Adolescents: 75+ Worksheets & Activities for Trauma, Anxiety, Depression, Anger & More
• The ACT Workbook for Teens with OCD
• Becoming Mum
• Dark Agents, Book One: Violet and the Trial of Trauma
• EMPOWER Your Students: Tools to Inspire a Meaningful School Experience, Grades 6-12
• Get Out of Your Mind and Into Your Life for Teens: A Guide to Living an Extraordinary Life
• The Gifted Kids Workbook: Mindfulness Skills to Help Children Reduce Stress, Balance Emotions, and Build Confidence
• The Joy of Parenting: An Acceptance and Commitment Therapy Guide to Effective Parenting in the Early Years
• The Mental Health and Wellbeing Workout for Teens: Skills and Exercises from ACT and CBT for Healthy Thinking
• The Mindfulness and Acceptance Workbook for Teen Anxiety: Activities to Help You Overcome Fears and Worries Using
• Acceptance and Commitment Therapy (Instant Help Book for Teens)
• Nuna and the Fog
• Parenting a Troubled Teen: Manage Conflict and Deal with Intense Emotions Using Acceptance and Commitment Therapy
• Parenting Your Anxious Child with Mindfulness and Acceptance: A Powerful New Approach to Overcoming Fear, Panic, and Worry Using Acceptance and Commitment Therapy
• Stuff That Sucks: Accepting What You Can’t Change and Committing to What You Can

(This webpage was updated on August 16, 2020)

The following ACT consistent parenting tips are from Louise Shepherd and written with the general public in mind. Please feel free to share this with clients or friends, family etc.

Mindful Motherhood: 9 Tips for Living in the Moment

How to Ride the Emotional Roller Coaster of Motherhood

Treatment Protocol and Manuals

• At-Risk Adolescents


• ACT for outpatient adolescent substance treatment


• ACT For Kids: Living a Valued Life


• ACT for Parents of Developmentally Disabled Children Manual


• Experiential Adolescent Group Program


• Mindtrain- ACT treatment manual for therapists working with anxious children


• Young Children