Flourishing in people with depressive symptomatology increases with acceptance and commitment therapy. Post-hoc analyses of a randomized controlled trial

Bohlmeijer, Ernst T.; Lamers, Sanne M.A.; Fledderus, Martine

doi:10.1016/j.brat.2014.12.014

Cited by 81Mindfulness and Compassion InterventionsPsychological Well-being and Life SatisfactionAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Flourishing in people with depressive symptomatology increases with acceptance and commitment therapy. Post-hoc analyses of a randomized controlled trial

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Bohlmeijer, Ernst T., Lamers, Sanne M.A., Fledderus, Martine·2015·Behaviour Research and Therapy

DOI 10.1016/j.brat.2014.12.014

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Abstract

Mental health is more than the absence of mental illness. Rather, both well-being (positive mental health) and mental illness are actually two related continua, with higher levels of well-being defined as "flourishing." This two-continua model and existing studies about the impact of flourishing on psychopathology underscore the need for interventions that enhance flourishing and well-being. Acceptance and Commitment Therapy (ACT) is a model of cognitive behavioral therapy that aims not only to reduce psychopathology but also to promote flourishing as well. This is the first study to evaluate the impact of ACT on flourishing. A post-analysis was conducted on an earlier randomized controlled trial of a sample of adults with depressive symptomatology who participated in a guided self-help ACT intervention. This post-analysis showed a 5%-28% increase of flourishing by the participants. In addition, the effects on flourishing were maintained at the three-month follow-up. When compared to participants in a control group, the flourishing of the ACT-trained participants increased from 5% to about 14% after nine weeks. In addition to levels of positive mental health at baseline, an increase of psychological flexibility during the intervention was a significant predictor of flourishing at the three-month follow-up.

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The interaction effect found in this study is in line with the fact that stimulating people toward value-based and engaged living is an explicit goal of ACT, whereas traditional CBT is primarily focused on alleviating psychopathology.
“The interaction effect found in this study is in line with the fact that stimulating people toward value-based and engaged living is an explicit goal of ACT, whereas traditional CBT is primarily focused on alleviating psychopathology [24-26].”
From Blended Acceptance and Commitment Therapy Versus Face-to-face Cognitive Behavioral Therapy for Older Adults With Anxiety Symptoms in Primary Care: Pragmatic Single-blind Cluster Randomized Trial. (2021) · cites this paper as [24]
The Introduction (page unavailable) explicitly says that promoting valued or engaged living is a primary focus of ACT. It does not establish the claimed contrast with traditional CBT; the paper instead mentions a cognitive-behavioral intervention designed to increase psychological well-being. The citing study’s interaction effect is its own finding, not a result attributed to this source. (LLM, conf=0.86)
Experimental — accuracy not yet measured
ACT explicitly incorporates many elements from both dimensions of mental health.
“More so than for its effectiveness, we included ACT in this study as ACT is explicitly aligned with many elements of both mental health dimensions.”
From Both positive mental health and psychopathology should be monitored in psychotherapy: Confirmation for the dual-factor model in acceptance and commitment therapy (2017) · cites this paper as Bohlmeijer et al., 2015
The MHC-SF has been found to have adequate reliability and validity in past research and to be sensitive to detecting the effects of ACT.
“The MHC-SF has been found to have adequate reliability and validity in past research (Keyes, 2005) and to be sensitive to detecting the effects of ACT (Bohlmeijer, Lamers & Fledderus, 2015).”
From Web-Based Acceptance and Commitment Therapy for Mental Health Problems in College Students: A Randomized Controlled Trial (2017) · cites this paper as Bohlmeijer, Lamers & Fledderus, 2015
A previous study has shown that ACT can increase flourishing, a measure including both hedonic and eudemonic well-being.
“A previous study has shown that ACT can increase flourishing, a measure including both hedonic and eudemonic well-being (Bohlmeijer, Lamers, & Fledderus, 2015).”
From Blended care in the treatment of subthreshold symptoms of depression and psychosis in emerging adults: A randomised controlled trial of Acceptance and Commitment Therapy in Daily-Life (ACT-DL) (2020) · cites this paper as Bohlmeijer, Lamers, & Fledderus, 2015
ACT aligns with a concept of mental health that includes positive mental health, not only the absence of disease and illness.
“It has been recognized as a treatment that explicitly aligns with the understanding of mental health as not only the absence of disease and illness but also the presence of the so-called positive mental health [24-26].”
From Blended Acceptance and Commitment Therapy Versus Face-to-face Cognitive Behavioral Therapy for Older Adults With Anxiety Symptoms in Primary Care: Pragmatic Single-blind Cluster Randomized Trial. (2021) · cites this paper as [24]

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Authors: Bohlmeijer, E. T., Lamers, S. M. A., & Fledderus, M.
Affiliations: University of Twente (NL)
Corresponding author: Bohlmeijer, Ernst T.
ORCID: Bohlmeijer, Ernst T.
Venue: Behaviour Research and Therapy
Publisher: Elsevier BV
Published: 2015-02
Volume: 65
Pages: 101-106
ISSN: 0005-7967 (ISSN-L)
DOI: 10.1016/j.brat.2014.12.014
OpenAlex: W2020260049
Semantic Scholar: 44b6c32532e1b1faf1c8468bbbd5fa0293b96c52
Cited by: 81
References: 53
Citations by year: 2026: 5 · 2025: 5 · 2024: 2 · 2023: 7 · 2022: 8 · 2021: 17 · 2020: 7 · 2019: 7 · 2018: 4 · 2017: 11 · 2016: 6 · 2015: 2
FWCI: 7.47
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Behaviour Research and Therapy (publishedVersion)
PubMed (publishedVersion)
University of Twente Research Information (publishedVersion, other-oa)
University of Twente Research Information (submittedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: eudaimonia, acceptance and commitment therapy, depressive symptoms, positive mental health, psychological flexibility, well-being
MeSH terms: Adolescent, Adult, Aged, Depression, Female, Humans, Male, Mental Health, Middle Aged, Treatment Outcome, Young Adult, Acceptance and Commitment Therapy

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Flourishing in people with depressive symptomatology increases with acceptance and commitment therapy. Post-hoc analyses of a randomized controlled trial

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