Acceptance and commitment therapy and subjective wellbeing: A systematic review and meta-analyses of randomised controlled trials in adults

Background

In comparison to a more restricted focus on symptom-specific outcomes, clinical trials of psychological interventions are increasingly focusing on transdiagnostic outcomes such as subjective wellbeing (SWB). SWB has been broadly defined as a person's cognitive and affective evaluations of his or her life. Such evaluations may include appraisals of emotions and mood, satisfaction with life, and relationships with others. Acceptance and Commitment Therapy (ACT) has been shown to offer promise for improving SWB.

Objective

The current review aimed to address an important gap in the literature by synthesising and critically appraising the research findings of randomised controlled trials (RCTs) of face-to-face and guided ACT interventions that assessed SWB.

Method

Four electronic databases (Medline, PsycINFO, Scopus and Web of Science) were searched for relevant literature from inception. Searches identified 921 records. Eleven studies which met full inclusion criteria were identified via database and reference lists searches. Risk of bias was evaluated using the Cochrane Risk of Bias Tool (RoB).

Results/Conclusions

Overall, 1406 participants were recruited to the included studies; of which 27% (n = 369 participants) were male. A wide variety of mental and physical health issues were included. The results of the risk of bias assessment highlighted the variable quality of the included studies. Methodological issues highlighted in the current review related to allocation concealment, handling of incomplete data, and small sample sizes. Five different measure of SWBs were utilised in the included studies, of which the most commonly utilised measure was the MHC-SF (Keyes, 2002). The results of meta-analyses revealed that SWB post-treatment scores (across different SWB measures) were significantly higher for ACT intervention groups in comparison to control groups, in all but one study. The majority of these studies revealed moderate effect sizes in favour of ACT. Findings indicate that ACT interventions show evidence of enhancing SWB in clinical and non-clinical populations. However, further RCTs that consistently use the same standardised measure(s) of SWB are necessary to facilitate further meta-analysis of the research.

To find the full text version of this article and others (as well as download a full text .pdf.), ACBS members can visit the ScienceDirect homepage here.