Strosahl, Hayes, Bergan, & Romano, 1998

Health care reform and managed care have produced a growing emphasis on identifying models of psychotherapy that are both clinically effective and can be readily introduced through field based training. This report summarizes the results of the Acceptance and Commitment Therapy Training Project, conducted at Group Health Cooperative of Puget Sound. Seventeen masters level therapists and one psychologist (those not receiving training=10; receiving training=8) participated in a one year training package consisting of a didactic workshop, an intensive clinical training, and monthly supervision groups. Prior to training, both therapist groups participated in a clinical effectiveness study of therapy involving baseline and five month follow-up assessment of 59 psychotherapy clients. Following the training, both therapist groups again completed the same outcomes assessment with 67 psychotherapy clients. Results indicated that, prior to treatment, there were no significant differences in self rated coping or problem severity, but therapists who were to receive training produced significantly poorer psychological acceptance ratings in their clients. After training, clients of ACT trained therapists reported significantly better coping than the clients of untrained therapists, referred clients significantly less for medication evaluations, and were more likely to have completed treatment in the five months following initiation of treatment. Trained and untrained therapists no longer differed in post treatment acceptance ratings. A structural equation model indicated that ACT training accounted for differential coping outcomes and lead to improved client's self ratings of psychological acceptance. Implications for research on clinical effectiveness and technology transfer of behavior therapy are discussed.