State of the ACT Evidence

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This page will be updated approximately once every six months.
Date of late update: April, 2015.

ACT is committed to a high standard of empirical evaluation. This includes not just controlled assessment and evaluations of outcomes but also the specification and evaluation of the putative processes of change. Furthermore, we also seek to understand the links between these processes of change and basic functional behavioral principles, including those drawn from RFT.

One web page is unable to collect together the growing evidence for all of the above areas at one time point or to keep it up to date going forward. More modestly, the three sections below aim to provide information on:

1. Organizations that describe ACT, or areas of ACT, as evidence based
2. Links to peer reviewed assessments of the ACT evidence base
3. Snapshots of the ACT RCT evidence base

1. Organizations that describe ACT, or areas of ACT, as evidence based:

A number of different organizations, external to ACBS, have stated that ACT is empirically supported in certain areas or as a whole according to their standards. These include:

i. American Psychological Association, Society of Clinical Psychology (Div. 12), Research Supported Psychological Treatments:

Chronic Pain - Strong Research Support
Depression - Modest Research Support
Mixed anxiety - Modest Research Support
Obsessive-Compulsive Disorder - Modest Research Support
Psychosis - Modest Research Support
For more information on what the "modest" and "strong" labels mean, click here

ii. SAMHSA's National Registry of Evidence-based Programs and Practices, ACT, last review July 2010.

2. Links to peer reviewed assessments of the ACT evidence base:

Below is a list of meta-analyses, systematic or narrative reviews of the ACT evidence base, or large sections of it. They are presented in reverse chronological order, by year of publication:

A-Tjak, J. G., Davis, M. L., Morina, N., Powers, M. B., Smits, J. A., & Emmelkamp P. M., (2015) A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems.  Psychotherapy and Psychosomatics, 84(30), 30-36.
DOI: 10.1159/000365764
Full Text: Available at DOI 

Ost, L. G. (2014). The efficacy of Acceptance and Commitment Therapy: an updated systematic review and meta-analysis. Behaviour Research and Therapy, 61, 105-121.
DOI: 10.1016/j.brat.2014.07.018
Full Text: Available at DOI

Smout, M.F., Hayes, L., Atkins, P.W.B., Klausen, J., & Duguid, J.E. (2012). The empirically supported status of acceptance and commitment therapy: An update. Clinical Psychologist, 16, 97-109.
DOI: 10.1111/j.1742-9552.2012.00051.x
Full Text: ACBS Website

Ruiz, F. J. (2010). A review of Acceptance and Commitment Therapy (ACT) empirical evidence: Correlational, experimental psychopathology, component and outcome studies. International Journal of Psychology and Psychological Therapy, 10, 125-162.
DOI: No DOI
Full Text: ACBS Website

Powers, M.B., Vörding, M. & Emmelkamp, P.M.G. (2009). Acceptance and commitment therapy: A meta-analytic review. Psychotherapy and Psychosomatics, 8, 73-80.
DOI: 10.1159/000190790
Full Text: ACBS Website

Gaudiano, B. A. (2009). Öst's (2008) Methodological Comparison of Clinical Trials of Acceptance and Commitment Therapy versus Cognitive Behavior Therapy: Matching Apples with Oranges? Behaviour Research and Therapy, 47, 1066-1070.
DOI: 10.1016/j.brat.2009.07.020
Full Text: ACBS Website

Öst, L. (2008). Efficacy of the third wave of behavioral therapies: A systematic review and meta-analysis. Behaviour Research and Therapy, 46(3), 296-321.
DOI: 10.1016/j.brat.2007.12.005
Full Text: ACBS Website

Hayes, S. C., Luoma, J., Bond, F., Masuda, A., & Lillis, J. (2006). Acceptance and Commitment Therapy: Model, processes, and outcomes. Behaviour Research and Therapy, 44(1), 1-25.
DOI: 10.1016/j.brat.2005.06.006
Full Text: ACBS Website

3. Snapshots of the ACT RCT evidence base:

As of August 2014, there are 102 randomized controlled trials (RCTs) of ACT published. Details of each of these studies, along with links to the original research articles, can be found here. Below, we provide a snapshot of this ACT RCT evidence-base, summarizing clinical areas in order of the number of published RCTs. It is, of course, acknowledged that evidence from RCTs is only one part of evidence-based practice.

 

Area: Number of studies: RCT page study number(s):
Pain 16 9, 14, 20, 24, 31, 37, 39, 52, 55, 65, 68, 73, 74, 75, 92, 96
Depression 13 1, 2, 26, 41, 43, 47, 49, 66, 67, 69, 78, 89, 93
Stress 11 3, 34, 35, 46, 61, 62, 63, 64, 79, 83, 85
Anxiety 8 5,19, 22, 45, 48, 59, 86, 95
Various 7 17, 32, 33, 40, 51, 90, 100
Weight Loss 6 25, 27, 44, 70, 72, 87
Substance Abuse 5 6, 29, 53, 58, 84
Smoking 5 8, 42, 71, 101, 102
Cancer 4 15, 57, 81, 91
Eating Disorders 4 30, 56, 60, 76
Social Anxiety 4 77, 80, 82, 99
Psychosis 3 4, 13, 36
Epilepsy 2 11, 23
Borderline Personality Disorder 2 12, 54
Diabetes 2 24, 81
Tinnitus 2 38, 50
Parenting 2 97, 98
Stigma 2 7, 16
Trichotillomania 1 10
OCD 1 28
Prevention 1 88