A randomized dismantling trial of the open and engaged components of acceptance and commitment therapy in an online intervention for distressed college students
Abstract
This dismantling trial compared the effects of a full online Acceptance and Commitment Therapy (ACT) intervention to the isolated effects of the Open (i.e., acceptance, cognitive defusion) and Engaged (i.e., values, committed action) components of ACT. A sample of 181 distressed college students were randomized to one of four conditions: a 12-session full ACT website (Full), a version targeting the Open components (Open), a version targeting the Engaged components (Engaged), or waitlist. Participants in active conditions were also randomized to receive phone coaching or just email prompts to increase program adherence. All three ACT conditions significantly improved over time relative to the waitlist condition on the primary outcome of mental health symptoms. The Engaged and Full conditions had greater rates of reliable change on the primary outcome relative to waitlist, but not the Open condition. Similarly, only Engaged and Full conditions improved on positive mental health relative to waitlist. The Full condition had greater improvements on a few ACT process measures relative to Engaged and Open conditions, particularly cognitive fusion. Overall, results indicate targeting only the Open components of ACT was somewhat less effective, and that including both the Open and Engaged components led to greater decreases in cognitive fusion.
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The SUS is a gold-standard measure of usability.
“and it was a gold-standard measure of usability (Levin et al., 2020).”
From Online Self-Help Acceptance and Commitment Therapy Module for College Students with Higher Gaming Disorder During COVID-19: A Pilot Study (2023) · cites this paper as Levin et al., 2020
Different components of psychological flexibility do not have equal effects on symptom change in general psychotherapy.
“However, it is noted that different components of psychological flexibility do not have equal effects on symptom change in general psychotherapy (Stockton et al., 2019; Levin et al., 2020).”
From Efficacy and mechanisms of mobile application-delivered Acceptance and Commitment Therapy for posttraumatic stress disorder in China: Study protocol for a randomized controlled trial (2022) · cites this paper as Levin et al., 2020
Dismantling research suggests that the values and committed action components of ACT are especially impactful for broad indicators of functioning, at times performing, along with full-model ACT interventions, for outcomes that include a social well-being component.
“and dismantling research suggests that the values and committed action components of ACT are especially impactful for broad indicators of functioning [65], at times performing, along with full-model ACT interventions, for outcomes that include a social well-being component [66].”
From A Randomized Pilot Study of Acceptance and Commitment Therapy to Improve Social Support for Veterans with PTSD (2022) · cites this paper as [66]
Previous research found comparable effects across therapy components, or greater benefits following the values-based module.
“This is in contrast to previous research, which found comparable effects across therapy components, or greater benefits following the values-based module (Levin et al., 2020; Petersen et al., 2019; Villatte et al., 2016).”
From A randomised trial comparing a brief online delivery of mindfulness-plus-values versus values only for symptoms of depression: Does baseline severity matter? (2020) · cites this paper as Levin et al., 2020
Delivering only the 'open' components was somewhat less effective and including both the 'open' and 'engaged' components created greater decreases in cognitive fusion.
“Delivering only the 'open' components was somewhat less effective and including both the 'open' and 'engaged' components created greater decreases in cognitive fusion.”
From A Feasibility and Pilot Randomised Dismantling Trial of the Efficacy of Self-As-Context During Acceptance and Commitment Therapy. (2021) · cites this paper as Levin et al. (2020)
Levin et al. (2020) reported comparable effects of ACT-Open, ACT-Engage, Full-ACT, and a wait-list condition on reducing distress; the values module and the full programme exceeded the benefits of the acceptance module when considering rates of reliable change.
“Finally, Levin et al., (2020) used a four-armed RCT to compared the effects of ACT-Open, ACT-Engage, Full-ACT, and a wait-list condition on distress (composite of depression, general anxiety, social anxiety, academic distress, and hostility) in college students (n=181), reporting comparable effects of all conditions on reducing distress. The values module and the full programme exceeded the”
From A randomised trial comparing a brief online delivery of mindfulness-plus-values versus values only for symptoms of depression: Does baseline severity matter? (2020) · cites this paper as Levin et al., (2020)
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- Authors
- Levin, M. E., Krafft, J., Hicks, E. T., Pierce, B., & Twohig, M. P.
- Affiliations
- Utah State University (US)
- Corresponding author
- Levin, Michael E.
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2020-03
- Volume
- 126
- Pages
- 103557
- ISSN
- 0005-7967 (ISSN-L)
- OpenAlex
- W3001745999
- Cited by
- 101
- References
- 46
- Citations by year
- 2026: 15 · 2025: 13 · 2024: 17 · 2023: 13 · 2022: 29 · 2021: 11 · 2020: 3
- FWCI
- 5.59
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- Digital Commons - USU (Utah State University) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- acceptance and commitment therapy, online psychological intervention, university students, psychological distress, cognitive fusion, cognitive defusion, values-based action, treatment components, program adherence, psychiatric symptoms, positive mental health
- MeSH terms
- Psychological Distress, Internet-Based Intervention, Adolescent, Adult, Female, Humans, Male, Mental Health, Stress, Psychological, Students, Universities, Young Adult, Acceptance and Commitment Therapy
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