Acceptance and commitment therapy for the treatment of stress among social workers: A randomized controlled trial
Abstract
Chronic stress increases the risk of health problems and absenteeism, with negative consequences for individuals, organizations and society. The aim of the present study was to examine the effect of a brief stress management intervention based on the principles of Acceptance and Commitment Therapy (ACT) on stress and general mental health for Swedish social workers (n = 106) in a randomized, controlled trial. Participants were stratified according to stress level at baseline in order to examine whether initial stress level moderated the effect of the intervention. Two thirds of the participants had high stress levels at baseline (Perceived Stress Scale; score of ≥ 25). The results showed that the intervention significantly decreased levels of stress and burnout, and increased general mental health compared to a waiting list control. No statistically significant effects were, however, found for those with low levels of stress at baseline. Among participants with high stress, a substantial proportion (42%) reached criteria for clinically significant change. We concluded that the intervention successfully decreased stress and symptoms of burnout, and increased general mental health. Evidence is, thus, provided supporting ACT as brief, stress management intervention for social workers.
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The study aimed to receive consent from up to 140 participants, anticipating approximately a 26% attrition rate.
“However, based on the average drop-out rate reported in previous ACT interventions for HCPs [12, 24, 29], we aimed to receive consent from up to 140 participants, anticipating approximately a 26% attrition rate.”
From A workplace Acceptance and Commitment Therapy (ACT) intervention for improving healthcare staff psychological distress: A randomised controlled trial (2022) · cites this paper as [24]
The estimated sample size necessary to detect a small to medium effect size at an alpha rate of 0.05 (two-tailed) was 104 participants.
“Based on previous RCT studies of ACT interventions in HCPs [24, 29], we estimated a small to medium effect size (f = 0.22). The estimated sample size necessary to detect a small to medium effect size at an alpha rate of 0.05 (two-tailed) using the G* Power 3 programme [37], was 104 participants.”
From A workplace Acceptance and Commitment Therapy (ACT) intervention for improving healthcare staff psychological distress: A randomised controlled trial (2022) · cites this paper as [24]
This finding is consistent with the positive findings of ACT interventions for distress observed in a number of RCT studies in workplace contexts.
“This finding is consistent with the positive findings of ACT interventions for distress observed in a number of RCT studies in workplace contexts [12, 15, 24, 29, 66, 67].”
From A workplace Acceptance and Commitment Therapy (ACT) intervention for improving healthcare staff psychological distress: A randomised controlled trial (2022) · cites this paper as [24]
Including a case formulation at the beginning of therapy helps understand the functional impact of the presenting complaint of the client.
“Include a case formulation at the beginning of therapy to understand the functional impact of the presenting complaint of the client (Brinkborg, Michanek, Hesser, & Berglund, 2011; Finnes et al., 2019; Folke et al., 2012; Kohtala et al., 2017; Macías et al., 2019).”
From Developing a brief acceptance and commitment therapy model for industrial psychologists (2022) · cites this paper as Brinkborg, Michanek, Hesser, & Berglund, 2011
ACT appears to be applicable for the adjustment process post-TBI.
“and appears to be applicable for this adjustment process post-TBI.”
From Can acceptance and commitment therapy facilitate psychological adjustment after a severe traumatic brain injury? A pilot randomized controlled trial. (2020) · cites this paper as Brinkborg, Michanek, Hesser, & Berglund, 2011
ACT has successfully reduced chronic stress in a non-TBI population.
“As a transdiagnostic approach, ACT has successfully reduced chronic stress in a non TBI population (Brinkborg, Michanek, Hesser, & Berglund, 2011)”
From Can acceptance and commitment therapy facilitate psychological adjustment after a severe traumatic brain injury? A pilot randomized controlled trial. (2020) · cites this paper as Brinkborg, Michanek, Hesser, & Berglund, 2011
Mindfulness-based cognitive therapy has shown promising results in reducing suicidal ideation.
“Mindfulness-based cognitive therapy has also shown promising results in reducing suicidal ideation [8].”
From The effectiveness of a suicide prevention app for indigenous Australian youths: study protocol for a randomized controlled trial. (2013) · cites this paper as [8]
Participants were eligible if they had an elevated score of 17 or more on the Perceived Stress Scale, which assured a moderate or greater stress level.
“eligible for inclusion if they had an elevated score of 17 or more on the Perceived Stress Scale (PSS; Cohen, Kamarck, & Mermelstein, 1983). This value was chosen as it marks the mean of a normative adult population (Cohen & Janicki-Deverts, 2012) and has been used in several other studies (e.g., Brinkborg et al., 2011). This cut-off value assured that participants had a moderate or greater stress”
From The link between stress, well-being, and psychological flexibility during an Acceptance and Commitment Therapy self-help intervention (2018) · cites this paper as Brinkborg et al., 2011
Earlier research in the treatment of stress among social workers found that changes in PF during an intervention were linked with decreases in stress during the intervention.
“These findings are in line with earlier research in the treatment of stress among social workers (Brinkborg et al., 2011), which found that changes in PF during an intervention were linked with decreases in stress during the intervention.”
From The link between stress, well-being, and psychological flexibility during an Acceptance and Commitment Therapy self-help intervention (2018) · cites this paper as Brinkborg et al., 2011
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- Authors
- Brinkborg, H., Michanek, J., Hesser, H., & Berglund, G.
- Affiliations
- Stockholm University (SE)
- Linköping University (SE)
- Corresponding author
- Berglund, Gunilla
- ORCID
- Hesser, Hugo
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2011-06
- Volume
- 49
- Issue
- 6-7
- Pages
- 389-398
- ISSN
- 0005-7967 (ISSN-L)
- OpenAlex
- W2027168418
- Cited by
- 235
- References
- 46
- Citations by year
- 2026: 8 · 2025: 8 · 2024: 19 · 2023: 16 · 2022: 20 · 2021: 32 · 2020: 18 · 2019: 24 · 2018: 16 · 2017: 10 · 2016: 14 · 2015: 14 · 2014: 15 · 2013: 12 · 2012: 5
- FWCI
- 11.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Social Psychology › Stress and Burnout Research
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- acceptance and commitment therapy, occupational stress, social workers, burnout, stress management interventions, general mental health, perceived stress, brief psychological intervention
- MeSH terms
- Adult, Burnout, Professional, Female, Humans, Male, Mental Health, Middle Aged, Personal Satisfaction, Psychotherapy, Social Support, Social Work, Stress, Psychological, Treatment Outcome
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