By Steven C. Hayes
ACT RCTs have hit 600 trials!
That's right. 600.
If you spend a little time looking at this amazing body of work several things jump out at you. ACT Randomized Controlled Trials webpage
First, the increased rate of RCT production is jaw dropping. It took 28 years for ACT to reach 100 Randomized Controlled Trials but there were 103 trials in 2020 alone -- a new RCT every few days. It is already notably faster in 2021.
Second, the topics cover nearly every area of human functioning in mental, behavioral, and social health. Many trials are being conducted outside of traditional DSM syndromes, and trials focused on exercise, physical health conditions, relationships, prejudice, social conditions, and performance are expanding rapidly.
Third, the peaks of the ACT research program are now very high indeed as defined by the size, funding, and complexity of the trials, the prestige of the outlets, and the impact of the research worldwide. ACT trials are now being published in journals like JAMA Internal Medicine, or Lancet Global Health. The results of trials are being promulgated by the World Health Organization. Single trials with hundreds of participants are common and even trials with thousands of participants are now an occasional reality.
Fourth, the ACT research program is global. Trials are now coming from all parts of the world, and a large number now originate within the Middle East or Asia. Iran, Korea, China, and Thailand are now regular contributors. The non-English speaking world is more and more center to research on ACT. The core psychological flexibility model is holding up fairly well across cultures; cultural adaptations (e.g., integration with local religious traditions) are also now more common.
Fifth, it is now common for RCTs to emphasize processes of change, not merely outcomes, and empirical support for the underlying psychological flexibility model is a common finding.
Sixth, ACT is having consistent success across a wide range of delivery methods. Online, telephone, or app-based ACT interventions are now common and results are typically quite positive, as are group methods, peer support, self-help books, and other delivery vehicles.
Randomized Controlled Trials are just one facet of the ACT / RFT / CBS research program. However, still today, Randomized Controlled Trials are key to agencies, governments, policy makers, and funders so they are quite important to the ACBS community and to the people we serve. These trials are why ACT is now being recognized by official agency and country guidelines around the world, such as the National Institute for Health and Care Excellence (NICE) guidelines in the UK or the World Health Organization guidelines on the management of chronic pain in children, and with the growth of research that will only increase. That recognition allows practitioners to argue for ACT-based continuing education programs, for researchers to argue for grant funding, or for program developers to be given the green light to develop ACT programs in agencies.
The 600 Randomized Controlled Trial milestone represents the culmination of more than 30 years of ACT research from this community. Chris Berghoff and the ACBS Communications Committee maintain the list of RCTs on the ACT Randomized Controlled Trials webpage and countless hours have been spent finding, cataloging, formatting, and posting the flow of ACT research world wide. It is a great resource with information about each study's trial area, trial conditions, sample size, and link to the full text of the study. If you had a randomized controlled trial published in a journal and it is not listed on the webpage, please email the citation to missing.studies @ gmail.com.
It is easy to search for studies in particular problem areas -- after you land on the webpage just put search terms in your web browser (not the search box inside the website). The terms will then be highlighted.
If you want to stay up on this wing of ACT research I recommend you check the ACT Randomized Controlled Trials webpage on a regular basis. A link that is easy to remember is bit.ly/ACTRCTs (capitalization matters). New RCTs are added to the list monthly!
Congratulations to all the wonderful researchers whose work is contained in this awesome list. It is up to the entire community both to continue to progress and to use this body of work for the good of others.