Skip to main content
SpringerLink
Log in

Acceptance and Commitment Training (ACT) as a Positive Psychological Intervention: A Systematic Review and Initial Meta-analysis Regarding ACT’s Role in Well-Being Promotion Among University Students

  • Review Article
  • Published:
Journal of Happiness Studies Aims and scope Submit manuscript

Abstract

This paper (a) makes the argument for conceiving Acceptance and Commitment Training (ACT), when applied to the enhancement of well-being, as a positive psychological intervention, and (b) supports this view by reviewing evidence for ACT’s impact on university student well-being. Searches of the literature identified five randomized experiments that measured improvements in university student well-being as a function of ACT interventions relative to control conditions. A meta-analysis revealed a significant, small pooled effect size on well-being (d = 0.29), providing initial evidence of ACT’s role as a positive psychological intervention among university students. Strengths and limitations of the extant literature are discussed, as are implications of, and future directions for, this area of study. It is concluded that research, theory, and application within well-being scholarship may be facilitated by recognizing ACT’s application to the enhancement of well-being.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Notes

  1. Levin et al. (2016a), among others, have argued that the word ‘training’ is more applicable than ‘therapy’ when acceptance and commitment interventions are applied to non-clinical samples; given the current focus on ACT as a positive psychological intervention applied to university students, we adopt this convention herein.

References

  • American College Health Association. (2016). National college health assessment II: Canadian Reference group executive summary. Hanover, MD: American College Health Association.

    Google Scholar 

  • A-Tjak, J. G., Davis, M. L., Morina, N., Poers, M. B., Smiths, 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, 30–36.

    Article  Google Scholar 

  • Bolier, L., Haverman, M., Westerhof, G. J., Ripder, H., Smit, F., & Bohlmeijer, E. (2013). Positive psychology interventions: A meta-analysis of randomized controlled studies. BMC Public Health, 13, 119. https://doi.org/10.1186/1471-2458-13-119.

    Article  Google Scholar 

  • Bradburn, N. M. (1969). The structure of psychological well-being. Chicago, IL: Aldine.

    Google Scholar 

  • Bruffaerts, R., Mortier, P., Kiekens, G., Auerbach, R. P., Cuijpers, P., Demyttenaere, K., et al. (2018). Mental health problems in college freshmen: Prevalence and academic functioning. Journal of Affective Disorders, 225, 97–103.

    Article  Google Scholar 

  • Burckhardt, R., Manicavasagar, V., Batterham, P., & Hadzi-Pavlovic, D. (2016). A randomized controlled trial of strong minds: A school-based mental health program combining acceptance and commitment therapy and positive psychology. Journal of School Psychology, 57, 41–52.

    Article  Google Scholar 

  • Ciarrochi, J., Atkins, P. W. B., Hayes, L. L., Sahdra, B. K., & Parker, P. (2016). Contextual positive psychology: Policy recommendations for implementing positive psychology into schools. Frontiers in Psychology, 7, 1561. https://doi.org/10.3389/psyg.2016.01561.

    Article  Google Scholar 

  • Ciarrochi, J., Kashdan, T. B., & Harris, R. (2013). The foundations of flourishing. In T. B. Kashdan & J. Ciarrochi (Eds.), Mindfulness, acceptance, and positive psychology: The seven foundations of well-being (pp. 1–29). Oakland, CA: Context Press.

    Google Scholar 

  • Cohen, J. (1988). Statistical power analysis for the behavioral sciences. New York: Routledge Academic.

    Google Scholar 

  • Danitz, S. B., & Orsillo, S. M. (2014). The mindful way through the semester: An investigation of the effectiveness of an acceptance-based behavioral therapy program on psychologica wellness in first-year students. Behavior Modification, 38, 549–566.

    Article  Google Scholar 

  • Deval, C., Bernard-Curie, S., & Monestes, J.-L. (2017). Effects of an acceptance and commitment therapy intervention on leaders’ and managers’ psychological flexibility. Journal de Therapie Comportementale et Cognitive, 27, 34–42.

    Article  Google Scholar 

  • Feeney, T. K., & Hayes, S. C. (2016). Acceptance and commitment therapy: A contextual view of “positive” and “negative” as applied to positive clinical psychology. In A. M. Wood & J. Johnson (Eds.), The Wiley handbook of positive clinical psychology (pp. 445–459). Chichester: Wiley.

    Chapter  Google Scholar 

  • Fledderus, M., Bohlmeijer, E. T., Smit, F., & Westerhof, G. J. (2010). Mental health promotion as a new goal in public mental health care: A randomized controlled trial of an intervention enhancing psychological flexibility. American Journal of Public Health, 100, 2372–2378.

    Article  Google Scholar 

  • Frogeli, E., Djordjevic, A., Rudman, A., Livheim, F., & Gustavsson, P. (2016). A randomized controlled pilot trial of acceptance and commitment training (ACT) for preventing stress-related ill health among future nurses. Anxiety Stress and Coping, 29, 202–218.

    Article  Google Scholar 

  • Glass, G. V., McGaw, B., & Smith, M. L. (1981). Meta-analyses in social research. Newbury Park: Sage.

    Google Scholar 

  • Gregoire, S., Lachance, L., Bouffard, T., & Dionne, F. (2018). The use of acceptance and commitment therapy to promote mental health and school engagement in university students: A multisite randomized controlled trial. Behavior Therapy, 49, 360–372.

    Article  Google Scholar 

  • Gruman, J. A., Lumley, M. N., & Gonzalez-Morales, M. G. (2018). Incorporating balance: Challenges and opportunities for positive psychology. Canadian Psychology, 59, 54–64.

    Article  Google Scholar 

  • Hacker, T., Stone, P., & MacBeth, A. (2016). Acceptance and commitment therapy—Do we know enough? Cumulative and sequential meta-analyses of randomized controlled trials. Journal of Affective Disorders, 190, 551–565.

    Article  Google Scholar 

  • Hayes, S. C. (2004). Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behavior Therapy, 35, 639–665.

    Article  Google Scholar 

  • Hayes, S. C. (2013). The genuine conversation. In T. B. Kashdan & J. Ciarrochi (Eds.), Mindfulness, acceptance, and positive psychology: The seven foundations of well-being (pp. 303–319). Oakland, CA: Context Press.

    Chapter  Google Scholar 

  • Hayes, S. C., Luoma, J., Bond, F., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes, and outcomes. Behaviour Research and Therapy, 4, 1–25.

    Article  Google Scholar 

  • Hayes, S. C., Pistorello, J., & Levin, M. E. (2012). Acceptance and commitment therapy as a unified model of behavior change. The Counseling Psychologist, 40, 976–1002.

    Article  Google Scholar 

  • Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and commitment therapy: An experiential approach to behavior change. New York: The Guilford Press.

    Google Scholar 

  • Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003). Measuring inconsistency in meta-analyses. British Medical Journal, 327, 557–560.

    Article  Google Scholar 

  • Howell, A. J. (2009). Flourishing: Achievement-related correlates of students’ well-being. Journal of Positive Psychology, 4, 1–13.

    Article  Google Scholar 

  • Johnson, J., & Wood, A. M. (2017). Integrating positive and clinical psychology: Viewing human functioning as continua from positive to negative can benefit clinical assessment, interventions and understandings of resilience. Cognitive Therapy and Research, 41, 335–349.

    Article  Google Scholar 

  • Kashdan, T. B., & Rottenberg, J. (2010). Psychological flexibility as a fundamental aspect of health. Clinical Psychology Review, 30, 865–878.

    Article  Google Scholar 

  • Keyes, C. L. M. (2005). Mental illness and/or mental health? Investigating axioms of the complete state model of health. Journal of Consulting and Clinical Psychology, 73, 539–548.

    Article  Google Scholar 

  • Keyes, C. L. M., & Annas, J. (2009). Feeling good and functioning well: Distinctive concepts in ancient philosophy and contemporary science. Journal of Positive Psychology, 4, 197–201.

    Article  Google Scholar 

  • Lakens, D. (2013). Calculating and reporting effect sizes to facilitate cumulative science: A practical primer for t-tests and ANOVAs. Frontiers in Psychology, 4(863), 1–12.

    Google Scholar 

  • Levin, M. E., Haeger, J. A., Pierce, B. G., & Twohig, M. P. (2017). Web-based acceptance and commitment therapy for mental health problems in college students: A randomized controlled trial. Behavior Modification, 41, 141–162.

    Article  Google Scholar 

  • Levin, M. E., Hayes, S. C., Pistorello, J., & Seeley, J. R. (2016a). Web-based self-help for preventing mental health problems in universities: Comparing acceptance and commitment training to mental health education. Journal of Clinical Psychology, 72, 207–225.

    Article  Google Scholar 

  • Levin, M. E., Lillis, J., & Biglan, A. (2016b). The potential of community-wide strategies for promoting psychological flexibility. In R. D. Zettle, S. C. Hayes, D. Barnes-Holmes, & A. Biglan (Eds.), The Wiley handbook of contextual behavioral science (pp. 483–495). Chichester: Wiley.

    Google Scholar 

  • Lomas, T., & Ivtzan, I. (2016). Second wave positive psychology: Exploring the positive–negative dialectics of wellbeing. Journal of Happiness Studies, 17, 1753–1758.

    Article  Google Scholar 

  • Massé, R., Poulin, C., Dassa, C., Lambert, J., Bélair, S., & Battaglini, A. (1998). The structure of mental health: Higher order confirmatory factor analyses of psychological distress and well-being measures. Social Indicators Research, 45, 475–504.

    Article  Google Scholar 

  • Mazzucchelli, T. G., Kane, R. T., & Rees, C. S. (2010). Behavioral activation intervention for well-being: A meta-analysis. Journal of Positive Psychology, 5, 105–121.

    Article  Google Scholar 

  • Mennin, D. S., Ellard, K. K., Fresco, D. M., & Gross, J. J. (2013). Emphasizing commonalities across cognitive-behavioral therapies. Behavior Therapy, 44, 234–248.

    Article  Google Scholar 

  • Mothersill, K. (2016). Enhancing positivity in cognitive behavioural therapy. Canadian Psychology, 57, 1–7.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Pawelski, J. O. (2016). Defining the ‘positive’ in positive psychology: Part II. A normative analysis. Journal of Positive Psychology, 11, 357–365.

    Article  Google Scholar 

  • Peter, T., Roberts, L. W., & Dengate, J. (2011). Flourishing in life: An empirical test of the dual continua model of mental health and mental illness among Canadian university students. The International Journal of Mental Health Promotion, 13, 13–22.

    Article  Google Scholar 

  • Quoidbach, J., Mikolajczak, M., & Gross, J. J. (2015). Positive interventions: An emotion regulation perspective. Psychological Bulletin, 141, 655–693.

    Article  Google Scholar 

  • Räsänen, P., Lappalainen, P., Muotka, J., Tolvanen, A., & Lappalainen, R. (2016). An online guided ACT intervention for enhancing the psychological wellbeing of university students: A randomized controlled clinical trial. Behaviour Research and Therapy, 78, 30–42.

    Article  Google Scholar 

  • Rusk, R. D., & Waters, L. E. (2013). Tracing the size, reach, impact, and breadth of positive psychology. Journal of Positive Psychology, 8, 207–221.

    Article  Google Scholar 

  • Schueller, S. M., Kashdan, T. B., & Parks, A. C. (2014). Synthesizing positive psychological interventions: Suggestions for conducting and interpreting meta-analyses. International Journal of Wellbeing, 4, 91–98.

    Article  Google Scholar 

  • Seligman, M. E. P., & Csikszentmihalyi, M. (2000). Positive psychology: An introduction. American Psychologist, 55, 5–14.

    Article  Google Scholar 

  • Seligman, M. E. P., & Peterson, C. (2003). Positive clinical psychology. In L. G. Aspinwall & U. M. Staudinger (Eds.), A psychology of human strengths: Fundamental questions and future directions for a positive psychology (pp. 305–317). Washington, DC: American Psychological Association.

    Chapter  Google Scholar 

  • Sin, N. L., & Lyubomirsky, S. (2009). Enhancing well-being and alleviating depressive symptoms with positive psychological interventions: A practice-friendly meta-analysis. Journal of Clinical Psychology, 65, 467–487.

    Article  Google Scholar 

  • Takami Lageborn, C., Ljung, R., Vaez, M., & Dahlin, M. (2017). Ongoing university studies and the risk of suicide: A register-based nationwide cohort study of 5 million young and middle-aged individuals in Sweden, 1993–2011. British Medical Journal Open, 7, e014264.

    Google Scholar 

  • Trompetter, H. R., Lamers, S. M. A., Westerhof, G. J., Fledderus, M., & Bohlmeijer, E. T. (2017). Both positive mental health and psychopathology should be monitored in psychotherapy: Confirmation for the dual-factor model in acceptance and commitment therapy. Behaviour Research and Therapy, 91, 58–63.

    Article  Google Scholar 

  • Wang, S., Zhou, Y., Yu, S., Ran, L.-W., Liu, X.-P., & Chen, Y.-F. (2017). Acceptance and commitment therapy and cognitive–behavioral therapy as treatments for academic procrastination: A randomized controlled group session. Research on Social Work Practice, 27, 48–58.

    Article  Google Scholar 

  • Weiss, L. A., Westerhof, G. J., & Bohlmeijer, E. T. (2016). Can we increase psychological well-being? The effects of interventions on psychological well-being: A meta-analysis of randomized controlled trials. PLoS ONE, 11, e0158092.

    Article  Google Scholar 

  • Werner, K., & Gross, J. J. (2009). Emotion regulation and psychopathology. In A. M. Kring & D. M. Sloan (Eds.), Emotion regulation and psychopathology: A transdiagnostic approach to etiology and treatment (pp. 13–37). New York: Guilford Press.

    Google Scholar 

  • Wong, P. (2012). Positive Psychology 2.0: Towards a balanced interactive model of the good life. Canadian Psychology, 52, 69–81.

    Article  Google Scholar 

  • Wood, A. M., & Tarrier, N. (2010). Positive clinical psychology: A new vision and strategy for integrated research and practice. Clinical Psychology Review, 30, 819–829.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. MacEwan University, Edmonton, Canada

    Andrew J. Howell

  2. University of British Columbia, Kelowna, Canada

    Holli-Anne Passmore

Authors
  1. Andrew J. Howell
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Holli-Anne Passmore
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Andrew J. Howell.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Howell, A.J., Passmore, HA. Acceptance and Commitment Training (ACT) as a Positive Psychological Intervention: A Systematic Review and Initial Meta-analysis Regarding ACT’s Role in Well-Being Promotion Among University Students. J Happiness Stud 20, 1995–2010 (2019). https://doi.org/10.1007/s10902-018-0027-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10902-018-0027-7

Keywords

Search

Navigation