Using acceptance and commitment therapy to increase self-compassion: A randomized controlled trial
Open accessAbstract
Self-compassion has been shown to be related to several types of psychopathology, including traumatic stress, and has been shown to improve in response to various kinds of interventions. Current conceptualizations of self-compassion fit well with the psychological flexibility model, which underlies acceptance and commitment therapy (ACT). However, there has been no research on ACT interventions specifically aimed at self-compassion. This randomized trial therefore compared a 6-hour ACT-based workshop targeting self-compassion to a wait-list control. From pretreatment to 2-month follow-up, ACT was significantly superior to the control condition in self-compassion, general psychological distress, and anxiety. Process analyses revealed psychological flexibility to be a significant mediator of changes in self-compassion, general psychological distress, depression, anxiety, and stress. Exploratory moderation analyses revealed the intervention to be of more benefit in terms of depression, anxiety, and stress to those with greater trauma history. © 2014.
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Claims the paper makes
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- Premisecitation
Psychological flexibility, measured by the AAQ-II, correlates with the Self-Compassion Scale at r = .65.
“ACT’s process of change, psychological flexibility, which is measured by the Acceptance and Action Questionnaire-II (AAQ-II; Bond et al., 2011), correlates with the SCS at r = .65”
Quote in the paperSubstantial claim1 of 2 sources checked- cites Neff, unpublished data cited in Neff & Tirch, 2013
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Bond et al., 2011 source
- Findingown data
Psychological flexibility significantly mediated changes in general psychological distress.
“Process analyses revealed psychological flexibility to be a significant mediator of changes in self-compassion, general psychological distress, depression, anxiety, and stress.”
Quote in the paperSubstantial claim- Rests on an assumption: Missing data in the outcome analyses are missing at random.
- Findingown data
From pretreatment to 2-month follow-up, the ACT workshop was significantly more effective than the waitlist control at increasing self-compassion.
“From pretreatment to 2-month follow-up, ACT was significantly superior to the control condition in self-compassion, general psychological distress, and anxiety.”
Quote in the paperSubstantial claim- Rests on an assumption: Missing data in the outcome analyses are missing at random.
- Findingown data
The ACT intervention produced greater improvement in depression among participants with more trauma history.
“Exploratory moderation analyses revealed the intervention to be of more benefit in terms of depression, anxiety, and stress to those with greater trauma history.”
Quote in the paperNot a substantial claim- Rests on an assumption: Missing data in the outcome analyses are missing at random.
- Findingown data
Psychological flexibility significantly mediated changes in self-compassion.
“Process analyses revealed psychological flexibility to be a significant mediator of changes in self-compassion, general psychological distress, depression, anxiety, and stress.”
Quote in the paperSubstantial claim- Rests on an assumption: Missing data in the outcome analyses are missing at random.
- Findingown data
Psychological flexibility significantly mediated changes in anxiety.
“Process analyses revealed psychological flexibility to be a significant mediator of changes in self-compassion, general psychological distress, depression, anxiety, and stress.”
Quote in the paperSubstantial claim- Rests on an assumption: Missing data in the outcome analyses are missing at random.
- Findingown data
Psychological flexibility significantly mediated changes in stress.
“Process analyses revealed psychological flexibility to be a significant mediator of changes in self-compassion, general psychological distress, depression, anxiety, and stress.”
Quote in the paperSubstantial claim- Rests on an assumption: Missing data in the outcome analyses are missing at random.
- Findingown data
From pretreatment to 2-month follow-up, the ACT workshop was significantly more effective than the waitlist control at reducing general psychological distress.
“From pretreatment to 2-month follow-up, ACT was significantly superior to the control condition in self-compassion, general psychological distress, and anxiety.”
Quote in the paperSubstantial claim- Rests on an assumption: Missing data in the outcome analyses are missing at random.
- Findingown data
The ACT intervention produced greater improvement in anxiety among participants with more trauma history.
“Exploratory moderation analyses revealed the intervention to be of more benefit in terms of depression, anxiety, and stress to those with greater trauma history.”
Quote in the paperNot a substantial claim- Rests on an assumption: Missing data in the outcome analyses are missing at random.
- Findingown data
The ACT intervention produced greater improvement in stress among participants with more trauma history.
“Exploratory moderation analyses revealed the intervention to be of more benefit in terms of depression, anxiety, and stress to those with greater trauma history.”
Quote in the paperNot a substantial claim- Rests on an assumption: Missing data in the outcome analyses are missing at random.
- Findingown data
From pretreatment to 2-month follow-up, the ACT workshop was significantly more effective than the waitlist control at reducing anxiety.
“From pretreatment to 2-month follow-up, ACT was significantly superior to the control condition in self-compassion, general psychological distress, and anxiety.”
Quote in the paperSubstantial claim- Rests on an assumption: Missing data in the outcome analyses are missing at random.
- Findingown data
Psychological flexibility significantly mediated changes in depression.
“Process analyses revealed psychological flexibility to be a significant mediator of changes in self-compassion, general psychological distress, depression, anxiety, and stress.”
Quote in the paperSubstantial claim- Rests on an assumption: Missing data in the outcome analyses are missing at random.
- Findingown data
Pre to post changes in psychological flexibility significantly mediated pre to follow-up changes in general psychological distress (GHQ) (bootstrapped point estimate = −1.78, SE = 1.10, 95% CI: −4.74, −.21).
“Pre to post changes in psychological flexibility significantly mediated (p < .05) pre to follow-up changes in general psychological distress as measured by the GHQ (bootstrapped point estimate = −1.78, SE = 1.10, 95% CI: −4.74, −.21).”
Quote in the paperSubstantial claim- Rests on an assumption: Pre-to-post changes in psychological flexibility causally mediate pre-to-follow-up changes in outcomes.
- Rests on an assumption: The AAQ-II validly measures psychological flexibility.
- Findingown data
Among participants scoring moderate or high on the SLESQ-R, ACT produced significantly better DASS-D pre to follow-up change scores than waitlist (conditional effects of −5.11 and −9.04, ps both < .05).
“However, among those scoring moderate (50th percentile) or high (75th percentile), DASS-D pre to follow-up change scores for the ACT treatment group were significantly better than those of the waitlist control (conditional effects of −5.11 and −9.04 respectively, ps both < .05).”
Quote in the paperSubstantial claim- Rests on an assumption: Missing data in the moderation analyses are missing at random.
- Rests on an assumption: The SLESQ-R validly measures trauma history or stressful life events.
- Findingown data
ACT participants showed significantly greater improvement in anxiety from pre to follow-up than waitlist participants, with a medium effect (Estimate = 5.29, SE = 1.92, t(70.47) = 2.76, p = .01, 95% CI: 1.46, 9.11, effect size = .68).
“The pre to follow-up changes were significantly different between the two conditions [Estimate = 5.29, SE = 1.92, t (70.47) = 2.76, p = .01, 95% CI: 1.46, 9.11, effect size = .68, a medium effect].”
Quote in the paperSubstantial claim- Rests on an assumption: The SCS, GHQ, DASS-D, DASS-A, and DASS-S validly measure their target constructs.
- Findingown data
ACT participants showed significantly greater improvement in depression from pre to post than waitlist participants, with a medium effect (Estimate = 5.50, SE = 2.21, t(133.02) = 2.49, p = .01, 95% CI: 1.13, 9.86, effect size = .61).
“Although pre to post changes were significantly different between the two treatment conditions [Estimate = 5.50, SE = 2.21, t (133.02) = 2.49, p = .01, 95% CI: 1.13, 9.86, effect size = .61, a medium effect], the pre to follow-up changes were not significantly different between conditions (p = .15).”
Quote in the paperSubstantial claim- Rests on an assumption: The SCS, GHQ, DASS-D, DASS-A, and DASS-S validly measure their target constructs.
- Findingown data
There was no evidence of moderation by trauma history for the general psychological distress outcome.
“However, there was no evidence of moderation for the general psychological distress outcome.”
Quote in the paperNot a substantial claim - Findingcitation
Stressful life events correlated with psychological flexibility in this study (r = .24, p < .05, 2-tailed).
“Given the significant correlation between stressful life events and psychological flexibility in this study (r = .24, p < .05, 2-tailed; see Yadavaia, 2013), it may be that the workshop was more effective among the more traumatized participants at least partly because they were higher in experiential avoidance.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Yadavaia, 2013
- Findingown data
The SLESQ-R did not significantly moderate the effect of treatment condition on pre to follow-up GHQ change scores (coefficient = −.41, SE = 1.12, 95% CI: −2.64, 1.83).
“The SLESQ-R did not significantly moderate the effect of treatment condition on pre to follow-up GHQ change scores (coefficient of interaction term = −.41, SE = 1.12, 95% CI: −2.64, 1.83).”
Quote in the paperNot a substantial claim- Rests on an assumption: Missing data in the moderation analyses are missing at random.
- Rests on an assumption: The SLESQ-R validly measures trauma history or stressful life events.
- Findingown data
In the SCS data, there was a significant medium time-by-condition interaction (F(2, 102.61) = 10.18, p < .001, effect size = .74).
“An MMRM analysis with a heterogeneous compound symmetry covariance structure best fit the data from the SCS and revealed a significant effect for treatment condition (p < .001) and time (p < .001), and a significant and medium time-by-condition interaction [F(2, 102.61) = 10.18, p < .001, effect size = .74].”
Quote in the paperSubstantial claim- Rests on an assumption: The SCS, GHQ, DASS-D, DASS-A, and DASS-S validly measure their target constructs.
- Findingown data
Among participants scoring moderate or high on the SLESQ-R, ACT produced significantly better DASS-A pre to follow-up change scores than waitlist (conditional effects of −5.09 and −8.40, ps both < .01).
“By contrast, among those scoring moderate or high, DASS-A change scores were significantly better in in the ACT group (conditional effects of −5.09 and −8.40, respectively, ps both <.01).”
Quote in the paperSubstantial claim- Rests on an assumption: Missing data in the moderation analyses are missing at random.
- Rests on an assumption: The SLESQ-R validly measures trauma history or stressful life events.
- Findingown data
In the GHQ data, there was a significant small time-by-condition interaction (F(2, 106.80) = 3.69, p = .03, effect size = .45).
“An MMRM analysis with a heterogeneous compound symmetry covariance structure best fit the data and revealed a significant effect for treatment condition (p < .001), time (p < .001), and a significant and small time-by-condition interaction [F(2, 106.80) = 3.69, p = .03, effect size = .45].”
Quote in the paperSubstantial claim- Rests on an assumption: The SCS, GHQ, DASS-D, DASS-A, and DASS-S validly measure their target constructs.
- Findingown data
In the DASS-S data, there was no significant time-by-condition interaction (p = .13).
“For the DASS-S, an MMRM analysis with a heterogeneous compound symmetry covariance structure fit the data best and revealed a marginally significant effect for treatment condition (p = .06), a significant effect for time (p = .02), and no significant time-by-condition interaction (p = .13).”
Quote in the paperNot a substantial claim- Rests on an assumption: The SCS, GHQ, DASS-D, DASS-A, and DASS-S validly measure their target constructs.
- Findingown data
The SLESQ-R did not significantly moderate the effect of treatment condition on pre to follow-up SCS change scores (coefficient = .73, SE = .43, 95% CI: −.14, 1.59).
“The SLESQ-R did not significantly moderate the effect of treatment condition on pre to follow-up SCS change scores (coefficient of interaction term = .73, SE = .43, 95% CI: −.14, 1.59).”
Quote in the paperNot a substantial claim- Rests on an assumption: Missing data in the moderation analyses are missing at random.
- Rests on an assumption: The SLESQ-R validly measures trauma history or stressful life events.
- Findingown data
Pre to post changes in AAQ-II significantly mediated pre to follow-up changes in stress (DASS-S) (bootstrapped point estimate = −2.09, SE = 1.52, 95% CI: −7.04, −.09).
“Pre to post changes in AAQ-II significantly mediated (p < .05) pre to follow-up changes in stress as measured by the DASS-S (bootstrapped point estimate = −2.09, SE = 1.52, 95% CI: −7.04, −.09).”
Quote in the paperSubstantial claim- Rests on an assumption: Pre-to-post changes in psychological flexibility causally mediate pre-to-follow-up changes in outcomes.
- Rests on an assumption: The AAQ-II validly measures psychological flexibility.
- Findingown data
Pre to post changes in psychological flexibility (AAQ-II) significantly mediated pre to follow-up changes in self-compassion (SCS) (bootstrapped point estimate = 2.51, SE = .86, 95% CI: .07, 2.01).
“Pre to post changes in psychological flexibility (AAQ-II) significantly mediated (p < .05) pre to follow-up changes in self-compassion as measured by the SCS (bootstrapped point estimate = 2.51, SE = .86, 95% CI: .07, 2.01).”
Quote in the paperSubstantial claim- Rests on an assumption: Pre-to-post changes in psychological flexibility causally mediate pre-to-follow-up changes in outcomes.
- Rests on an assumption: The AAQ-II validly measures psychological flexibility.
- Findingown data
The SLESQ-R significantly moderated the relationship between treatment condition and DASS-A pre to follow-up change scores (coefficient = −2.63, SE = 1.16, 95% CI: −4.94, −.32).
“The SLESQ-R significantly moderated the relationship between treatment condition and DASS-A pre to follow-up change scores (coefficient of interaction term = −2.63, SE = 1.16, 95% CI: −4.94, −.32; see Figure 3).”
Quote in the paperSubstantial claim- Rests on an assumption: Missing data in the moderation analyses are missing at random.
- Rests on an assumption: The SLESQ-R validly measures trauma history or stressful life events.
- Findingown data
Pre to post AAQ-II changes significantly mediated pre to follow-up DASS-A change scores (bootstrapped point estimate = −1.78, SE = 1.27, 95% CI: −6.02, −.26).
“Pre to post AAQ-II changes significantly mediated (p < .05) pre to follow-up DASS-A change scores (bootstrapped point estimate = −1.78, SE = 1.27, 95% CI: −6.02, −.26).”
Quote in the paperSubstantial claim- Rests on an assumption: Pre-to-post changes in psychological flexibility causally mediate pre-to-follow-up changes in outcomes.
- Rests on an assumption: The AAQ-II validly measures psychological flexibility.
- Findingown data
ACT participants showed significantly greater improvement in general psychological distress from pre to follow-up than waitlist participants, with a medium effect (Estimate = 3.52, SE = 1.65, t(108.17) = 2.13, p = .04, 95% CI: .24, 6.80, effect size = .52).
“The pre to follow-up changes were significantly different between the two conditions [Estimate = 3.52, SE = 1.65, t (108.17) = 2.13, p = .04, 95% CI: .24, 6.80, effect size = .52, a medium effect].”
Quote in the paperSubstantial claim- Rests on an assumption: The SCS, GHQ, DASS-D, DASS-A, and DASS-S validly measure their target constructs.
- Findingown data
In the DASS-D data, there was a significant small time-by-condition interaction (F(2, 87.45) = 3.11, p = .0498, effect size = .41).
“An MMRM analysis with a Toeplitz covariance structure best fit the data for the DASS-D and revealed a significant effect for treatment condition (p = .01) and time (p = .03), and a significant and small time-by-condition interaction [F(2, 87.45) = 3.11, p = .0498, effect size = .41].”
Quote in the paperSubstantial claim- Rests on an assumption: The SCS, GHQ, DASS-D, DASS-A, and DASS-S validly measure their target constructs.
- Findingown data
Pre to post changes in psychological flexibility significantly mediated pre to follow-up DASS-D changes (bootstrapped point estimate = −2.89, SE = 1.79; 95% CI: −7.70, −.34).
“Pre to post changes in psychological flexibility significantly mediated (p < .05) pre to follow-up DASS-D changes (bootstrapped point estimate = −2.89, SE = 1.79; 95% CI: −7.70, −.34).”
Quote in the paperSubstantial claim- Rests on an assumption: Pre-to-post changes in psychological flexibility causally mediate pre-to-follow-up changes in outcomes.
- Rests on an assumption: The AAQ-II validly measures psychological flexibility.
- Findingown data
ACT participants showed significantly greater improvement in self-compassion from pre to follow-up than waitlist participants, with a large effect (Estimate = −3.31, SE = .77, t(109.45) = −4.32, p < .001, 95% CI: −4.83, −1.79, effect size = 1.06).
“The pre to follow-up changes were significantly different between the two conditions [Estimate = −3.31, SE = .77, t (109.45) = −4.32, p < .001, 95% CI: −4.83, −1.79, effect size = 1.06, a large effect].”
Quote in the paperSubstantial claim- Rests on an assumption: The SCS, GHQ, DASS-D, DASS-A, and DASS-S validly measure their target constructs.
- Findingown data
The SLESQ-R did not significantly moderate the impact of treatment condition on DASS-S pre to follow-up changes (coefficient = −2.85; SE = 1.51; 95% CI: −5.86, .016; 90% CI: −5.38, −.33).
“The SLESQ-R did not significantly moderate the impact of treatment condition on DASS-S pre to follow-up changes (coefficient of interaction term = −2.85; SE = 1.51; 95% CI: −5.86, .016; 90% CI: −5.38, −.33).”
Quote in the paperNot a substantial claim- Rests on an assumption: Missing data in the moderation analyses are missing at random.
- Rests on an assumption: The SLESQ-R validly measures trauma history or stressful life events.
- Findingown data
Among participants scoring moderate or high on the SLESQ-R, ACT produced significantly better DASS-S pre to follow-up changes than waitlist (conditional effects of −5.16 and −8.75, ps both < .05).
“However, among those scoring moderate or high, DASS-S changes were significantly better for ACT participants (conditional effects of −5.16 and −8.75, respectively, ps both < .05).”
Quote in the paperSubstantial claim- Rests on an assumption: Missing data in the moderation analyses are missing at random.
- Rests on an assumption: The SLESQ-R validly measures trauma history or stressful life events.
- Findingown data
Pre to follow-up changes in depression were not significantly different between ACT and waitlist conditions (p = .15).
“Although pre to post changes were significantly different between the two treatment conditions [Estimate = 5.50, SE = 2.21, t (133.02) = 2.49, p = .01, 95% CI: 1.13, 9.86, effect size = .61, a medium effect], the pre to follow-up changes were not significantly different between conditions (p = .15).”
Quote in the paperNot a substantial claim- Rests on an assumption: The SCS, GHQ, DASS-D, DASS-A, and DASS-S validly measure their target constructs.
- Findingown data
The SLESQ-R was a significant moderator of the impact of treatment condition on DASS-D change from pre to follow-up (coefficient = −3.11, SE = 1.55, 95% CI: −6.20, −.02).
“The SLESQ-R was a significant moderator of the impact of treatment condition on the change in DASS-D scores from pre to follow-up (coefficient of interaction term = −3.11, SE = 1.55, 95% CI: −6.20, −.02).”
Quote in the paperSubstantial claim- Rests on an assumption: Missing data in the moderation analyses are missing at random.
- Rests on an assumption: The SLESQ-R validly measures trauma history or stressful life events.
- Findingown data
The difference between ACT and waitlist in stress change from pre to follow-up was a non-significant trend favoring ACT, with a small effect (Estimate = 4.25, SE = 2.27, t(111.64) = 1.88, p = .06, 95% CI: −.24, 8.75, effect size = .46).
“Evaluation of the difference in the pre to follow-up changes between conditions revealed a non-significant trend towards a small effect in favor of the ACT participants [Estimate = 4.25, SE = 2.27, t (111.64) = 1.88, p = .06, 95% CI: −.24, 8.75, effect size = .46].”
Quote in the paperNot a substantial claim- Rests on an assumption: The SCS, GHQ, DASS-D, DASS-A, and DASS-S validly measure their target constructs.
- Findingown data
In the DASS-A data, there was a significant medium time-by-condition interaction (F(2, 67.21) = 7.48, p < .01, effect size = .67).
“For DASS-A scores, an MMRM analysis with an unstructured covariance structure best fit the data and revealed no effect for treatment condition (p = .48), a significant effect for time (p = .04), and a significant and medium time-by-condition interaction [F(2, 67.21) = 7.48, p < .01, effect size = .67].”
Quote in the paperSubstantial claim- Rests on an assumption: The SCS, GHQ, DASS-D, DASS-A, and DASS-S validly measure their target constructs.
- Premisenone given
Before this study, no research had tested an ACT intervention specifically designed to target self-compassion.
“However, there has been no research on ACT interventions specifically aimed at self-compassion.”
- Also stated in: § The Present Study · plain
“no study to date has examined the effectiveness of an ACT protocol targeted at self-compassion”
Quote in the paperSubstantial claim - Also stated in: § The Present Study · plain
- Premisecitation
Self-compassion can increase following various interventions.
“has been shown to improve in response to various kinds of interventions”
- Also stated in: § Abstract · boosted
“Interventions of various lengths and formats, from mindfulness-based stress reduction programs to very brief rationales, have been shown to increase self-compassion”
Quote in the paperSubstantial claim0 of 3 sources checked- cites Neff, 2003a
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Neff, 2012
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Neff & Germer, 2013 source
- Also stated in: § Abstract · boosted
- Premisecitation
Self-compassion is negatively correlated with depression, anxiety, worry, rumination, and PTSD avoidance symptoms.
“self-compassion correlates negatively with depression, anxiety, worry, rumination, and PTSD avoidance symptoms”
Quote in the paperSubstantial claim0 of 3 sources checked - Premisecitation
Self-criticism and low self-compassion contribute to the development of psychological disorders after stressful life events such as trauma.
“self-criticism and low self-compassion play a role in the development of psychological disorders in response to stressful life events, such as exposure to trauma”
Quote in the paperSubstantial claim0 of 3 sources checked - Premisecitation
The psychological flexibility model underlying ACT aligns well with current conceptualizations of self-compassion.
“Current conceptualizations of self-compassion fit well with the psychological flexibility model, which underlies acceptance and commitment therapy (ACT).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Neff & Tirch, 2013
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Hayes et al., 2012 source
- Premisecitation
Self-compassion is associated with multiple forms of psychopathology, including traumatic stress.
“Self-compassion has been shown to be related to several types of psychopathology, including traumatic stress”
Quote in the paperNot a substantial claim0 of 3 sources checked - Premisecitation
Interventions of various lengths and formats increase self-compassion as measured by the Self-Compassion Scale.
“Interventions of various lengths and formats, from mindfulness-based stress reduction programs to very brief rationales, have been shown to increase self-compassion, as measured by Neff’s Self-Compassion Scale”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Neff, 2003a
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Neff, 2012
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Interpretationown data
With limited modification, ACT is a successful treatment for improving self-compassion.
“Taken together, these findings show that the intervention tested here was functionally an ACT-based workshop, and that with limited modification, ACT is a successful treatment for improving self-compassion.”
Quote in the paperSubstantial claim - Interpretationown data
The ACT intervention led to moderate to large reductions in general psychological distress at two months compared to waitlist.
“The ACT intervention also led to moderate to large reductions in general psychological distress at two months, and as compared to the waitlist condition.”
Quote in the paperSubstantial claim - Interpretationown data
The ACT intervention led to large increases in self-compassion compared to waitlist control at post-treatment and two months after the intervention.
“The study showed that the ACT intervention led to large increases in self-compassion as compared to the waitlist control at post-treatment and two months after the intervention.”
Quote in the paperSubstantial claim - Study design and conductreasoning
The non-treatment-seeking sample limits generalizability of the findings to a clinical population.
“In addition, the fact that the sample was not treatment-seeking could limit the generalizability of these findings to a clinical population because, for example, treatment-seeking individuals may be even more distressed than the participants in this study.”
Quote in the paperNot a substantial claim - Interpretationown data
The fact that psychological flexibility was a consistent mediator provides strong evidence that targeting self-compassion with high fidelity to the psychological flexibility model is effective.
“Still, the fact that psychological flexibility was such a consistent mediator in this study provides strong evidence that targeting self-compassion with high fidelity to the psychological flexibility model is effective.”
Quote in the paperSubstantial claim - Study design and conductnone given
The use of a waitlist rather than an active control group does not allow discrimination of placebo or demand effects from treatment effects.
“First, the use of a waitlist rather than active control group does not allow the discrimination of placebo or demand effects from treatment effects.”
Quote in the paperNot a substantial claim - Interpretationown data
Psychological flexibility mediated the effect of the intervention on all outcomes, accounting for 28.1-59.9% of the effects.
“Finally, psychological flexibility mediated the effect of the intervention on all outcomes, accounting for 28.1–59.9% of the effects of the ACT intervention.”
Quote in the paperSubstantial claim - Study design and conductreasoning
The sample of undergraduates in psychology classes limits generalizability because they were younger and higher in intellectual ability, socioeconomic status, and psychological mindedness than the general population.
“Second, the sample used in this study could limit its generalizability. As undergraduates in psychology classes, the participants were younger and higher in intellectual ability, socioeconomic status, and psychological mindedness than the general population.”
Quote in the paperNot a substantial claim - Interpretationcitation
The large effect size on self-compassion (1.06) is comparable to that produced by a much longer self-compassion intervention (effect size = 1.67).
“Particularly notable is the large effect size obtained on the self-compassion outcome (1.06), which is comparable to that produced by a much longer intervention from within the self-compassion tradition (effect size = 1.67, Neff & Germer, 2013).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Neff & Germer, 2013 source
- Interpretationown data
The workshop was more efficacious overall among those who were in greater need of it.
“Still, these findings show that the workshop was more efficacious overall among those who were in greater need of it, an interpretation that comports with other research showing ACT to be more beneficial for those higher in distress and experiential avoidance (e.g., Muto, Hayes, & Jeffcoat, 2011).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Muto, Hayes, & Jeffcoat, 2011 source
- Classified as probably not a substantial claim. 14
- May combine two claims. 16
- The quote only partly states this claim. 1
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationThe AAQ-II correlates very highly with the AAQ-I (r = .97), and the AAQ-I has mediated ACT treatment effects in many outcome studies.
“The AAQ-II correlates very highly with the AAQ-I (r = .97), which has mediated ACT treatment effects in many outcome studies”
Quote in the paperNot a substantial claim1 of 1 sources checked- cites Hayes, Luoma, Bond, Masuda, & Lillis, 2006 source
The Mediational studies section (p. 17) reports that the AAQ mediated ACT outcomes in a worksite study, supporting the mediation part of the claim. But the paper does not report an AAQ-II–AAQ-I correlation of r = .97, and its discussion of AAQ versions (Research on ACT, p. 10) does not identify them as AAQ-I and AAQ-II. (LLM, conf=0.86)
Experimental — accuracy not yet measured
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationA GHQ score of 10 or higher indicates a current DSM-IV Axis I disorder with 78% sensitivity and 60% specificity in this approximate age group.
“a score on the General Health Questionnaire (GHQ; Goldberg, 1972) of 10 or higher, which indicates the presence of a current DSM-IV Axis I disorder with a sensitivity of 78% and a specificity of 60% in this approximate age group”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Baksheev, Robinson, Cosgrave, Baker, & Yung, 2011 source
Classified as probably not a substantial claim. May combine two claims.
PremisecitationACT overlaps considerably with Neff's conceptualization of self-compassion, and relational frame theory may also be relevant to self-compassion.
“Some authors have suggested that acceptance and commitment therapy (ACT; Hayes, Strosahl, & Wilson, 2012) overlaps with Neff’s conceptualization of self-compassion considerably and that Relational Frame Theory (RFT; Hayes, Barnes-Holmes, & Roche, 2001), the basic science of language and cognition behind ACT, may be relevant to self-compassion as well”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Neff & Tirch, 2013
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Hayes, Barnes-Holmes, & Roche, 2001
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Classified as probably not a substantial claim.
Study design and conductown dataParticipants were assigned to the ACT workshop or waitlist condition using a random number generator.
“assigned to either the ACT workshop or waitlist condition via a random number generator”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe Self-Compassion Scale had good internal reliability in the present study (α = .90).
“The SCS has good internal reliability, both in its validation study (α = .92) and in the present study (α = .90).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Neff, 2003a
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
May combine two claims.
PremisecitationAn 8-week mindful self-compassion course improved self-compassion, mindfulness, compassion toward others, life satisfaction, avoidance, depression, anxiety, and stress more than a wait-list control, with gains maintained at 6-month follow-up.
“One study showed that an 8-week mindful self-compassion course based on Neff’s conceptualization improved self-compassion, mindfulness, compassion towards others, life satisfaction, avoidance, depression, anxiety, and stress significantly more than a wait-list control, with all improvements maintained at 6-month follow-up”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Neff & Germer, 2013 source
Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductown dataSeveral covariance assumptions were tested, and the simplest model not significantly different from the unspecified covariance structure was used.
“Several simpler and restrictive covariance assumptions were tested (compound symmetry, compound symmetry heterogeneous, Toeplitz) and the simplest model was used that was not significantly different than the unspecified covariance structure as determined by comparison of nested models through the restricted log-likelihood.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe AAQ-II had good internal consistency in the present study (α = .87).
“The AAQ-II is more internally consistent than the original AAQ (Hayes et al., 2004) with an α = .84 in its validation study and α = .87 in the present study.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Hayes et al., 2004 source
May combine two claims.
Interpretationown dataDifferences between group conditions in outcome and process measures were generally medium to large and always in favor of the ACT intervention.
“Differences between group conditions in outcome and process measures were generally medium to large and always in favor of the ACT intervention.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe DASS-21 depression, anxiety, and stress subscales had acceptable to good internal consistency at pretreatment in the present study (αs = .86, .76, and .84, respectively).
“Internal consistency has previously been shown to be good (α for each scale > .87; Antony, Bieling, Cox, Enns, & Swinson, 1998), and was acceptable to good at pretreatment in the present study (αs for depression, anxiety, and stress = .86, .76, and .84, respectively).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Antony, Bieling, Cox, Enns, & Swinson, 1998 source
May combine two claims. The quote only partly states this claim.
Study design and conductown dataInter-rater reliability for the adherence instrument was acceptable: raters never differed by more than 1 point and agreed precisely 76% of the time.
“The raters’ responses were never more than 1 point apart, and they agreed precisely 76% of the time.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataThe workshop had a greater effect on self-compassion, depression, anxiety, and stress among those endorsing more types of stressful life events, including a history of trauma.
“Exploratory analyses and visual inspection suggested that the workshop had a greater effect on self-compassion, depression, anxiety, and stress among those endorsing more types of stressful life events, including a history of trauma.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataThe General Health Questionnaire had good internal consistency at pretreatment in the present study (α = .87).
“Internal consistency is good in college-aged individuals (Cronbach’s α = .84; Winefield, Goldney, Winefield, & Tiggemann, 1989) and was good at pretreatment in the current study (α = .87).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Winefield, Goldney, Winefield, & Tiggemann, 1989 source
May combine two claims.
Interpretationown dataThe brief ACT intervention was efficacious to improve self-compassion and symptoms of psychopathology, and these improvements were mediated by the hypothesized process of change.
“Overall, these outcomes are consistent with our theoretical rationale, suggesting that this brief intervention was efficacious to improve self-compassion and symptoms of psychopathology, and that these improvements were mediated by the hypothesized process of change.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataBefore formal statistical analyses, distributional assumptions were examined, including skewness, kurtosis, outliers, and homogeneity of variance.
“Before conducting formal statistical analyses, underlying distributional assumptions were examined, particularly skewness, kurtosis, outliers, and homogeneity of variance.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationAdherence to the ACT protocol was rated by trained clinical psychology graduate students using an adapted manual that assessed coverage of the six ACT flexibility processes and the absence of ACT-inconsistent approaches.
“Clinical psychology graduate students with a minimum of 1 year of practicum training in ACT rated each workshop using an adherence manual adapted from Plumb & Vilardaga (2010) that assessed coverage of the 6 ACT flexibility processes and the absence of ACT-inconsistent approaches”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Plumb & Vilardaga (2010) source
May combine two claims.
Interpretationown dataDepression symptoms were significantly reduced in the ACT group after the intervention and at two months follow-up.
“Symptoms of depression were significantly reduced in the ACT group after the intervention and at two months follow up.”
Quote in the paperSubstantial claimMay combine two claims.
Study design and conductown dataA mixed model repeated measures analysis was used because modeling time categorically provided better fit than hierarchical linear modeling, and MMRM retains intent-to-treat advantages by using all available data and accounting for missingness.
“Although hierarchical linear modeling (HLM) was explored as a method of data analysis, in virtually all cases modeling time categorically rather than as a linear covariate provided a better fit as determined by a comparison of nested models using restricted log-likelihoods, and thus a mixed model repeated measures (MMRM) analysis was used.”
- Also stated in: § Outcomes · hedged
“MMRM is a mixed regression model that retains most of the advantages of HLM for an intent-to-treat analysis (Raudenbush & Bryk, 2002) in using all available data from all subjects and taking into account the obtained outcome and missingness, thus reducing the problem of missing data.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Raudenbush & Bryk, 2002
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Rests on an assumption: Missing data in the outcome analyses are missing at random.
- Also stated in: § Outcomes · hedged
May combine two claims.
Interpretationown dataFor stress, the ACT intervention led to moderate reductions over time, but between-group differences only reached a trend, possibly due to insufficient power to detect small effects.
“For the last outcome, stress, the ACT intervention led to moderate reductions over time, but between group differences only reached a trend, which could be due to insufficient power to detect small effects.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningBecause the AAQ-II measures several facets of psychological flexibility and the intervention targeted several ACT processes, it is difficult to know which components of the intervention impacted which processes.
“However, because the AAQ-II measures several facets of psychological flexibility, and because the intervention targeted several of the 6 ACT processes, it is difficult to know which components of the intervention impacted which processes and were most beneficial.”
Quote in the paperNot a substantial claimMay combine two claims.
Interpretationown dataAnxiety symptoms improved in the ACT condition at each measurement occasion, and these improvements were superior to waitlist.
“Conversely, symptoms of anxiety improved in the ACT condition at each measurement occasion—improvements which were superior as compared to the waitlist condition.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductown dataOnly the Anxiety subscale failed distributional criteria, and it met criteria after two follow-up outliers were removed.
“Only the Anxiety subscale of the DASS failed to meet criteria, but did so after 2 outliers were removed from follow-up.”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductown dataOverall adherence scores for the three workshops were high (4.59, 4.69, and 4.86; M = 4.71, SD = .14), indicating the intervention was delivered skillfully and in depth.
“Overall adherence scores for the 3 workshops were high in all cases (4.59, 4.69, and 4.86; M = 4.71, SD = .14), indicating that the intervention was delivered skillfully and in depth.”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductown dataThere was no baseline difference between conditions on any screening measure or demographic variable except age, where ACT participants were significantly younger (p = .04) but the means differed by less than 1 year.
“There was no difference on any screening measure or demographic variable (gender, racial/ethnic background, sexual orientation, or grade point average) between the two conditions, except that that ACT participants were significantly younger than waitlist control participants (p = .04), although the means differed by less than 1 year.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductown dataThe unblocked randomization procedure did not ensure equivalent group sizes, resulting in a smaller ACT group (n = 34) than waitlist group (n = 44).
“The ACT group was smaller (n = 34) than the waitlist group (n = 44) because of the unblocked randomization procedure, which could not ensure equivalence of group size.”
Quote in the paperNot a substantial claim
The paper relies on this without support.
Missing data in the outcome analyses are missing at random.
“MMRM is a mixed regression model that retains most of the advantages of HLM for an intent-to-treat analysis (Raudenbush & Bryk, 2002) in using all available data from all subjects and taking into account the obtained outcome and missingness, thus reducing the problem of missing data.”
The paper relies on this without support.
Pre-to-post changes in psychological flexibility causally mediate pre-to-follow-up changes in outcomes.
“Pre to follow-up changes in the outcome variable were entered as outcomes, and pre to post changes in the process variable (AAQ-II) were entered as mediators.”
The paper relies on this without support.
Missing data in the moderation analyses are missing at random.
“Using bootstrapping, 30 imputed datasets were generated, and missing data were imputed based on values for all other variables in the dataset.”
The paper relies on this without support.
The AAQ-II validly measures psychological flexibility.
“The functional role of psychological flexibility (AAQ-II) in producing effects on the outcome measures was examined by mediation analysis.”
The paper relies on this without support.
The SLESQ-R validly measures trauma history or stressful life events.
“To evaluate whether the workshop was differentially effective for individuals according to trauma history, the SLESQ-R (taken at pretreatment) was evaluated as a moderator of the effect of treatment condition on outcomes.”
The paper relies on this without support.
The SCS, GHQ, DASS-D, DASS-A, and DASS-S validly measure their target constructs.
“An MMRM analysis with a heterogeneous compound symmetry covariance structure best fit the data from the SCS and revealed a significant effect for treatment condition (p < .001) and time (p < .001), and a significant and medium time-by-condition interaction [F(2, 102.61) = 10.18, p < .001, effect size = .74].”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Defusion and self-as-context show particularly strong links to reductions in rigid, self-critical, and shame-based thinking and to the development of more compassionate self-perspectives.
“These processes predict subsequent improvements in mental health, with defusion—conceptually analogous to decentering in the mindfulness literature—and self-as-context showing particularly strong links to reductions in rigid, self-critical, and shame-based thinking, as well as to the development of more compassionate self-perspectives (89).”
From The therapeutic role of self-transcendence in moral injury recovery: theory, mechanisms, and clinical implications (2026) · cites this paper as [89]
The Present Study section describes defusion and self-as-context as central to self-compassion, and the Method > Intervention section says the workshop targeted self-criticism and self-conceptualizations. But Future Directions and Clinical Implications says the study could not determine which individual ACT processes were most beneficial; it does not establish particularly strong links for these two processes or a reduction in shame-based thinking. Page numbers are unavailable in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredPrior literature found that ACT helps one detach from thoughts and emotions and be more self-compassionate.
“These findings are also consistent with what prior literature found as benefits of ACT, helping one to detach oneself from thoughts and emotions and to be more self-compassionate [46].”
From ClearMind Workshop: An ACT-based Intervention Tailored for Academic Procrastination among Computing Students (2024) · cites this paper as [46]
The Discussion reports that the ACT intervention increased self-compassion. The paper also describes defusion from self-critical thoughts, but The Present Study says to embrace painful thoughts and feelings rather than avoid them; it does not establish detachment from emotions as a benefit. (LLM, conf=0.84)
Experimental — accuracy not yet measuredAcceptance and Commitment Therapy promotes self-compassion.
“research suggests that ACT does promote self-compassion [16]”
From Self-compassion in Acceptance and Commitment Therapy for chronic pain: A pilot study (2022) · cites this paper as [16]
Researchers have found that, when compared to a wait-list control condition, ACT resulted in greater increases in self-compassion.
“Researchers have found that, when compared to a wait-list control condition, ACT resulted in greater increases in self-compassion (Yadavaia et al., 2014).”
From Feasibility and preliminary outcomes of compassion-focused acceptance and commitment therapy delivered via telehealth in a community behavioral health clinic (2025) · cites this paper as Yadavaia et al., 2014
The findings on ACT's effect on self-compassion are consistent with the results of Khamoshi Ghalenoi & Mansouri (17) and Yadavaia et al. (32).
“These findings are consistent with the results of Khamoshi Ghalenoi & Mansouri (17) and Yadavaia et al. (32).”
From Effects of the Acceptance and Commitment Therapy on Resiliency, Self-Compassion, and Corona Disease Anxiety on Medical Staff Involved in COVID-19 Pandemic (2023) · cites this paper as Yadavaia et al. (32)
ACT has shown treatment benefits for anxiety symptoms.
“anxiety symptoms (Forman et al., 2007; Niles et al., 2014; Yadavaia et al., 2014)”
From Examining domains of psychological flexibility and inflexibility as treatment mechanisms in acceptance and commitment therapy: A comprehensive systematic and meta-analytic review (2024) · cites this paper as Yadavaia et al., 2014
Statistics recomputed
Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.
- ConsistentF(2, 102.61) = 10.18reported p < .001 · recomputed p < .001
“F(2, 102.61) = 10.18, p < .001”
- Consistentt(109.56) = 3.08reported p < .01 · recomputed p = .003
“t (109.56) = 3.08, p < .01”
- Consistentt(109.37) = 8.21reported p < .001 · recomputed p < .001
“t (109.37) = 8.21, p < .001”
- Consistentt(109.45) = -4.32reported p < .001 · recomputed p < .001
“t (109.45) = −4.32, p < .001”
- ConsistentF(2, 106.8) = 3.69reported p = .03 · recomputed p = .028
“F(2, 106.80) = 3.69, p = .03”
- Consistentt(108.29) = -3.34reported p < .01 · recomputed p = .001
“t (108.29) = −3.34, p < .01”
- Consistentt(108.08) = -5.56reported p < .001 · recomputed p < .001
“t (108.08) = −5.56, p < .001”
- Consistentt(108.17) = 2.13reported p = .04 · recomputed p = .035
“t (108.17) = 2.13, p = .04”
- ConsistentF(2, 87.45) = 3.11reported p = .0498 · recomputed p = .050
“F(2, 87.45) = 3.11, p = .0498”
- Consistentt(63.18) = -2.73reported p = .01 · recomputed p = .008
“t (63.18) = −2.73, p = .01”
- Consistentt(133.02) = 2.49reported p = .01 · recomputed p = .014
“t (133.02) = 2.49, p = .01”
- ConsistentF(2, 67.21) = 7.48reported p < .01 · recomputed p = .001
“F(2, 67.21) = 7.48, p < .01”
- Consistentt(71.37) = -3.48reported p < .01 · recomputed p < .001
“t (71.37) = −3.48, p < .01”
- Consistentt(70.47) = 2.76reported p = .01 · recomputed p = .007
“t (70.47) = 2.76, p = .01”
- Consistentt(111.53) = -3.02reported p < .01 · recomputed p = .003
“t (111.53) = −3.02, p < .01”
- Consistentt(111.64) = 1.88reported p = .06 · recomputed p = .063
“t (111.64) = 1.88, p = .06”
- Consistentt(63) = 3.72reported p < .01 · recomputed p < .001
“t(63) = 3.72, p < .01”
- Consistentt(63) = 3.03reported p < .01 · recomputed p = .004
“t(63) = 3.03, p < .01”
- Consistentt(63) = -2.01reported p = .049 · recomputed p = .049
“t(63) = −2.01, p = .049”
- Consistentt(63) = -1.14reported p = .26 · recomputed p = .259
“t(63) = −1.14, p = .26”
- Consistentt(63) = -1.79reported p = .08 · recomputed p = .078
“t(63) = −1.79, p = .08”
- Consistentt(63) = -0.8reported p = .43 · recomputed p = .427
“t(63) = −.80, p = .43”
- Consistentt(63) = -2.4reported p = .02 · recomputed p = .019
“t(63) = −2.40, p = .02”
- Consistentt(63) = -1.59reported p = .12 · recomputed p = .117
“t(63) = −1.59, p = .12”
- Consistentt(63) = -1.86reported p = .07 · recomputed p = .068
“t(63) = −1.86, p = .07”
- Consistentt(63) = -1.09reported p = .28 · recomputed p = .280
“t(63) = −1.09, p = .28”
- ConsistentF(1, 64) = 6.18reported p = .02 · recomputed p = .016
“F(1,64) = 6.18, p = .02”
- ConsistentF(1, 64) = 7.55reported p < .01 · recomputed p = .008
“F(1,64) = 7.55, p < .01”
- ConsistentF(1, 64) = 5.41reported p = .02 · recomputed p = .023
“F(1, 64) = 5.41, p = .02”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Self-compassion estimate falls outside its reported confidence interval
MajorThe reported mediation estimate is 2.51, but the upper limit of its reported 95% confidence interval is 2.01. The point estimate therefore lies outside the interval presented alongside it, suggesting that at least one value was reported incorrectly.
“bootstrapped point estimate = 2.51, SE = .86”
“95% CI: .07, 2.01”
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“The protocol for the 6-hour workshop was based on the manual used by Lillis, Hayes, and Bunting (2009) but was adapted significantly to focus on self-compassion (see Yadavaia, 2013 for the complete protocol).”
MethodSelf-citationWhat Does the Acceptance and Action Questionnaire (AAQ-II) Really Measure?
Wolgast, M. (2014) · Behavior Therapy · doi:10.1016/j.beth.2014.07.002 · Cited by 421 · see citing works
Fletcher, L. B., & Hayes, S. C. (2005) · Journal of Rational-Emotive & Cognitive-Behavior Therapy · doi:10.1007/s10942-005-0017-7 · Cited by 378 · cited 1× · see citing works
“Third, Neff's self-compassion conceptualization and ACT both emphasize mindfulness, which from an ACT perspective consists of defusion, acceptance, contact with the present moment, and self-as-context (Fletcher & Hayes, 2005).”
MethodSelf-citationMindfulness, Acceptance, and Positive Psychology: The Seven Foundations of Well-Being
Kashdan, T. B., & Ciarrochi, J. (2013) · Cited by 272 · see citing works
Self‐compassion and PTSD symptom severity
Thompson, B. L., & Waltz, J. (2008) · Journal of Traumatic Stress · doi:10.1002/jts.20374 · Cited by 245 · see citing works
Assessing Psychological Flexibility: What Does It Add Above and Beyond Existing Constructs?
Gloster, A. T., Klotsche, J., Chaker, S., Hummel, K. V., & Hoyer, J. (2011) · Psychological Assessment · doi:10.1037/a0024135 · Cited by 206 · see citing works
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Muto, T., Hayes, S. C., & Jeffcoat, T. (2011) · Behavior Therapy · doi:10.1016/j.beth.2010.08.009 · Cited by 144 · see citing works
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Baksheev, G. N., Robinson, J., Cosgrave, E. M., Baker, K., & Yung, A. R. (2011) · Psychiatry Research · doi:10.1016/j.psychres.2010.10.010 · Cited by 111 · see citing works
The General Health Questionnaire: Reliability and validity for Australian youth
Winefield, H. R., Goldney, R. D., Winefield, A. H., & Tiggemann, M. (1989) · Australian & New Zealand Journal of Psychiatry · doi:10.3109/00048678909062592 · Cited by 110 · see citing works
Methods for Addressing Missing Data in Psychiatric and Developmental Research
Croy, C. D., & Novins, D. K. (2005) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/01.chi.0000181044.06337.6f · Cited by 109 · see citing works
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Evaluating the Cultural Validity of the Stressful Life Events Screening Questionnaire
Green, B. L., Chung, J. Y., Daroowalla, A., Kaltman, S. I., & DeBenedictis, C. N. (2006) · Violence Against Women · doi:10.1177/1077801206294534 · Cited by 80 · see citing works
Assessing treatment integrity in acceptance and commitment therapy: strategies and suggestions
Plumb, J. C., & Vilardaga, R. (2010) · International Journal of Behavioral Consultation and Therapy · doi:10.1037/h0100912 · Cited by 75 · cited 1× · see citing works
“…psychology graduate students with a minimum of 1 year of practicum training in ACT rated each workshop using an adherence manual adapted from Plumb and Vilardaga (2010) that assessed coverage of the 6 ACT flexibility processes and the absence of ACT-inconsistent approaches, e.g. cognitive…”
MethodSelf-citationA Review of the Validity of the General Health Questionnaire in Adolescent Populations
Tait, R., Hulse, G., & Robertson, S. (2002) · Australian and New Zealand journal of psychiatry (Print) · doi:10.1046/j.1440-1614.2002.01028.x · Cited by 70 · see citing works
Brown, F. J., & Hooper, S. (2009) · Journal of Intellectual Disabilities · doi:10.1177/1744629509346173 · Cited by 64 · see citing works
Vilardaga, R., Hayes, S. C., Atkins, D. C., Bresee, C., & Kambiz, A. (2013) · Behaviour Research and Therapy · doi:10.1016/j.brat.2013.04.003 · Cited by 49 · see citing works
Self-citationSharhabani-Arzy, R., Amir, M., & Swisa, A. (2005) · Personality and Individual Differences · doi:10.1016/j.paid.2004.08.006 · Cited by 42 · see citing works
Vilardaga, R., Bricker, J. B., & McDonell, M. G. (2014) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2014.03.003 · Cited by 37 · see citing works
Self-citationSylvester, M. (2011) · Cited by 12 · see citing works
Precourt, G. (2009) · Journal of Advertising Research · doi:10.2501/s0021849909090126 · Cited by 7 · see citing works
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Self-citation
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Self-compassion interventions and psychosocial outcomes: a meta-analysis of RCTs
Ferrari, M., Hunt, C., Harrysunker, A., Abbott, M. J., Beath, A. P., & Einstein, D. A. (2019) · Mindfulness · doi:10.1007/s12671-019-01134-6 · Cited by 740 · see citing works
“Other therapeutic interventions, such as CBT or ACT, which investigated the effects of alternative approaches on self-compassion as an outcome, were excluded (e.g., Yadavaia et al. 2014).”
BackgroundCompassion interventions: The programmes, the evidence, and implications for research and practice
Kirby, J. N. (2017) · Psychology and Psychotherapy: Theory, Research and Practice · doi:10.1111/papt.12104 · Cited by 427 · see citing works
Arslan, G., Yıldırım, M., Tanhan, A., Buluş, M., & Allen, K.-A. (2021) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-020-00337-6 · Cited by 355 · see citing works
Effectiveness of Self-Compassion Related Therapies: a Systematic Review and Meta-analysis
Wilson, A. C., Mackintosh, K., Power, K., & Chan, S. W. Y. (2019) · Mindfulness · doi:10.1007/s12671-018-1037-6 · Cited by 301 · see citing works
Psychological flexibility: What we know, what we do not know, and what we think we know
Doorley, J. D., Goodman, F. R., Kelso, K. C., & Kashdan, T. B. (2020) · Social and Personality Psychology Compass · doi:10.1111/spc3.12566 · Cited by 264 · see citing works
Self-Compassion and Psychological Well-being
Neff, K., & Germer, C. (2017) · Oxford Handbooks Online · doi:10.1093/oxfordhb/9780190464684.013.27 · Cited by 215 · see citing works
The role of psychological factors in oncology nurses' burnout and compassion fatigue symptoms
Duarte, J., & Pinto‐Gouveia, J. (2017) · European Journal of Oncology Nursing · doi:10.1016/j.ejon.2017.04.002 · Cited by 192 · see citing works
“flexibility (Yadavaia et al., 2014), which broadly refers to an individual’s ability to fully embrace and connect with the experiences in the present moment, without avoidance, and to change or persist in behaviors that are in line with identified values (Hayes et al.”
Linardon, J. (2020) · Behavior Therapy · doi:10.1016/j.beth.2019.10.002 · Cited by 133 · see citing works
Hacker, T., Stone, P., & MacBeth, A. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.10.053 · Cited by 130 · see citing works
“Secondary aims were to investigate the efficacy of ACT when compared against active treatments and when anxiety or depression were predetermined target outcomes.”
BackgroundInfluentialLee, E., Govind, T., Ramsey, M., Wu, T. C., Daly, R., Liu, J., Tu, X. M., Paulus, M. P., Thomas, M. L., & Jeste, D. V. (2021) · Translational Psychiatry · doi:10.1038/s41398-021-01491-8 · Cited by 134 · see citing works
Han, A., & Kim, T. H. (2023) · Mindfulness · doi:10.1007/s12671-023-02148-x · Cited by 119 · see citing works
“Two studies directly targeted individuals with low levels of self-compassion (Arimitsu, 2016; Yadavaia et al., 2014), and two studies directly targeted adults with high levels of self-criticism (Krieger et al.”
BackgroundMethodNewcomb, M. E., Macapagal, K. R., Feinstein, B. A., Bettin, E., Swann, G., & Whitton, S. W. (2017) · AIDS and Behavior · doi:10.1007/s10461-017-1674-0 · Cited by 102 · see citing works
“Other techniques rooted in acceptance, such as acknowledging one’s internal reactions to a problem and identifying that negative situations may not be able to change, have been effective in decreasing sexual minority stress [50].”
Duarte, J., & Pinto-Gouveia, J. (2017) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2017.03.002 · Cited by 98 · see citing works
Lee, E. E., Bangen, K. J., Avanzino, J. A., Hou, B., Ramsey, M., Eglit, G., Liu, J., Tu, X. M., Paulus, M., & Jeste, D. V. (2020) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2020.0821 · Cited by 85 · see citing works
Macri, J. A., & Rogge, R. D. (2024) · Clinical Psychology Review · doi:10.1016/j.cpr.2024.102432 · Cited by 89 · see citing works
Uğur, E., Kaya, Ç., & Tanhan, A. (2021) · Current Psychology · doi:10.1007/s12144-020-01074-8 · Cited by 81 · see citing works
“Psychological flexibility is a mediator of changes in self-compassion, anxiety, depression, stress and general psychological distress (Yadavaia et al. 2014), positively related to the psychologically resilient outcomes (Galatzer-Levy et al.”
BackgroundViskovich, S., & Pakenham, K. I. (2018) · Journal of Clinical Psychology · doi:10.1002/jclp.22656 · Cited by 77 · see citing works
Feasibility and acceptability of a brief online self-compassion intervention for mothers of infants
Mitchell, A. E., Whittingham, K., Steindl, S., & Kirby, J. (2018) · Archives of Women's Mental Health · doi:10.1007/s00737-018-0829-y · Cited by 77 · see citing works
Khoramnia, S., Bavafa, A., Jaberghaderi, N., Parvizifard, A., Foroughi, A., Ahmadi, M., & Amiri, S. (2020) · Trends in Psychiatry and Psychotherapy · doi:10.1590/2237-6089-2019-0003 · Cited by 65 · see citing works
The role of mindfulness and compassion in enhancing nurturing family environments.
Kirby, J. N. (2016) · Clinical Psychology Science and Practice · doi:10.1111/cpsp.12149 · Cited by 61 · see citing works
Landi, G., Pakenham, K. I., Crocetti, E., Grandi, S., & Tossani, E. (2021) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2021.05.004 · Cited by 51 · see citing works
Meyer, E. C., Szabo, Y. Z., Frankfurt, S. B., Kimbrel, N. A., DeBeer, B. B., & Morissette, S. B. (2019) · Behaviour Research and Therapy · doi:10.1016/j.brat.2019.01.002 · Cited by 52 · see citing works
Mindfulness, selfcompassion, and depressive symptoms in chronic pain: the role of pain acceptance
Carvalho, S. A., Gillanders, D., Palmeira, L., Pinto‐Gouveia, J., & Castilho, P. (2018) · Journal of Clinical Psychology · doi:10.1002/jclp.22689 · Cited by 49 · see citing works
Waters, C. S., Annear, B., Flockhart, G., Jones, I., Simmonds, J. R., Smith, S., Traylor, C., & Williams, J. F. (2020) · British Journal of Clinical Psychology · doi:10.1111/bjc.12261 · Cited by 51 · see citing works
“…and psychological flexibility have been emphasized (Dahl, Plumb, Stewart, & Lundgren, 2009; Neff & Tirch, 2013), and compassion-focused strategies have been incorporated into ACT interventions (Neff & Tirch, 2013; Tirch, Schoendorff, & Silberstein, 2014; Yadavaia, Hayes, & Vilardaga, 2014).”
Peltz, J. S., Rogge, R. D., Bodenlos, J. S., Kingery, J. N., & Pigeon, W. R. (2020) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2019.12.003 · Cited by 47 · see citing works
Hayes, S. C., & King, G. A. (2024) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2024.100809 · Cited by 76 · see citing works
Self-citationOng, C. W., Barney, J. L., Barrett, T. S., Lee, E. B., Levin, M. E., & Twohig, M. P. (2019) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2019.06.005 · Cited by 40 · see citing works
Meyer, E. C., Frankfurt, S. B., Kimbrel, N. A., DeBeer, B. B., Gulliver, S. B., & Morrisette, S. B. (2018) · Journal of Clinical Psychology · doi:10.1002/jclp.22596 · Cited by 40 · see citing works
“A recent randomized control trial of ACT compared to a waitlist control found that participants in the intervention had significant improvements in self-compassion, general psychological distress, anxiety, and depression from pretreatment to follow-up, and that increases in psychological flexibility mediated these cha…”
BackgroundStjernswärd, S., & Hansson, L. I. (2016) · Mindfulness · doi:10.1007/s12671-016-0653-2 · Cited by 38 · see citing works
“Mindfulness and compassion can help tame the inner critic (Stjernswärd and Hansson 2016b), reduce guilt and stress, and improve interpersonal relationships (Hofmann et al. 2010; Jazaieri et al. 2014; Stjernswärd and Hansson 2016b; Yadavaia et al. 2014).”
BackgroundMechanisms of the acceptance and commitment therapy: A meta-analytic structural equation model
REN, Z., ZHAO, C., BIAN, C., ZHU, W., JIANG, G., & ZHU, Z. (2019) · Acta Psychologica Sinica · doi:10.3724/sp.j.1041.2019.00662 · Cited by 36 · see citing works
“…= 16)使用推荐的 Bootstrap 法进行中介检验(Preacher & Hayes, 2008), 个别研 究仍使用传统的回归逐步检验法(Kemani, Hesser, Olsson, Lekander, & Wicksell, 2016)。当然, 也有些研究采用更为复杂的中介检验方法 , 比如多水平 (HLM)中介模型 (Rost, Wilson, Buchanan, Hildebrandt, & Mutch, 2012; Zarling, Lawrence, & Marchman, 2015)和结构方程模型 (Eilenberg, Hoffmann,…”
Psychological flexibility, self-compassion and daily functioning in chronic pain
Davey, A., Chilcot, J., Driscoll, E., & McCracken, L. M. (2020) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2020.06.005 · Cited by 38 · see citing works
Kirby, J. N., & Gilbert, P. (2019) · Mindfulness · doi:10.1007/s12671-018-1088-8 · Cited by 34 · see citing works
Han, A., Yuen, H. K., Jenkins, J., & Yun Lee, H. (2022) · Clinical Gerontologist · doi:10.1080/07317115.2021.1908475 · Cited by 33 · see citing works
Kornfield, R., Stamatis, C. A., Bhattacharjee, A., Pang, B., Nguyen, T., Williams, J. J., Kumar, H., Popowski, S., Beltzer, M., Karr, C. J., et al. (2023) · Internet Interventions · doi:10.1016/j.invent.2023.100667 · Cited by 33 · see citing works
“Third, willingness, which also stems from ACT, supports approaching a full range of human experiences without selectively avoiding unpleasant ones.”
BackgroundInfluentialBeyond acceptance and commitment therapy: Process-based therapy
Ong, C. W., Levin, M. E., & Twohig, M. P. (2020) · The Psychological Record · doi:10.1007/s40732-020-00397-z · Cited by 32 · see citing works
Trindade, I. A., Ferreira, C., & Pinto-Gouveia, J. (2020) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2019.12.005 · Cited by 31 · see citing works
The utility of the Valuing Questionnaire in Chronic Pain
Carvalho, S. A., Palmeira, L., Pinto-Gouveia, J., Gillanders, D., & Castilho, P. (2018) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2018.06.002 · Cited by 30 · see citing works
Chaotic-Enmeshment and Anxiety: The Mediating Role of Psychological Flexibility and Self-Compassion
Berryhill, M. B., Hayes, A., & Lloyd, K. (2018) · Contemporary Family Therapy · doi:10.1007/s10591-018-9461-2 · Cited by 30 · see citing works
“Theoretically, there are parallels between self-compassion and the ACT processes used to increase psychological flexibility (Yadavaia et al. 2014).”
BackgroundHsu, T., Adamowicz, J. L., & Thomas, E. B. K. (2023) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2023.10.006 · Cited by 31 · see citing works
Chen, G., He, J., Cai, Z., & Fan, X. (2020) · Children and Youth Services Review · doi:10.1016/j.childyouth.2020.105698 · Cited by 28 · see citing works
Interrupting internalized racial oppression: A community based ACT intervention
Banks, K. H., Goswami, S., Goodwin, D., Petty, J., Bell, V., & Musa, I. (2021) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2021.02.006 · Cited by 30 · see citing works
Hill, M. L., Schaefer, L. W., Spencer, S. D., & Masuda, A. (2020) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2020.04.006 · Cited by 26 · see citing works
Hazzard, V. M., Yoon, C. Y., Emery, R. L., Mason, S. M., Crosby, R. D., Wonderlich, S. A., & Neumark‐Sztainer, D. (2021) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2021.105307 · Cited by 26 · see citing works
Kocovski, N. L., Fleming, J. E., Blackie, R. A., MacKenzie, M. B., & Rose, A. L. (2019) · Behavior Therapy · doi:10.1016/j.beth.2018.10.007 · Cited by 25 · see citing works
Stjernswärd, S., & Hansson, L. I. (2018) · Internet Interventions · doi:10.1016/j.invent.2018.03.004 · Cited by 25 · see citing works
“Increased self-compassion can also improve interpersonal relationships (Hofmann et al., 2011; Jazaieri et al., 2014; Yadavaia et al., 2014).”
BackgroundSelf-Compassion Mediates the Perfectionism and Depression Link on Chinese Undergraduates
Wei, S., Li, L., Shi, J., Liang, H., & Yang, X. (2021) · Annals of Palliative Medicine · doi:10.21037/apm-20-1582 · Cited by 24 · see citing works
“The acceptance and commitment therapy (ACT) has been proved effective in strengthening individual’s self-compassion, especially for patients with psychological distress, depression, and anxiety (68).”
BackgroundKılıç, A., Hudson, J. L., Scott, W., McCracken, L. M., & Hughes, L. D. (2022) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2022.110728 · Cited by 27 · see citing works
Self-compassion in Acceptance and Commitment Therapy for chronic pain: A pilot study
Carvalho, S. A., Gillanders, D., Forte, T., Trindade, I. A., Pinto-Gouveia, J., Lapa, T., Valentim, A., Santos, E., Paciência, J., Guiomar, R., et al. (2022) · Scandinavian Journal of Pain · doi:10.1515/sjpain-2021-0214 · Cited by 21 · see citing works
Böge, K., Pollex, F., Bergmann, N., Hahne, I., Zierhut, M. M., Mavituna, S., Thomas, N., & Hahn, E. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.959467 · Cited by 20 · see citing works
Galvin, J., Howes, A., McCarthy, B., & Richards, G. (2020) · Autism · doi:10.1177/1362361320966853 · Cited by 20 · see citing works
“, 2016), acceptance and commitment therapy (Yadavaia et al., 2014), affect training (Hildebrandt et al.”
BackgroundTrindade, I. A., Pereira, J., Galhardo, A., Ferreira, N. B., Lucena-Santos, P., Carvalho, S. A., Oliveira, S., Skvarc, D., Rocha, B. S., Portela, F., et al. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.699367 · Cited by 20 · see citing works
Adie, T., Steindl, S. R., Kirby, J. N., Kane, R. T., & Mazzucchelli, T. G. (2021) · Mindfulness · doi:10.1007/s12671-021-01637-1 · Cited by 20 · see citing works
Adonis, M. N., Loucaides, M., Sullman, M. J. M., & Lajunen, T. J. (2025) · Scientific Reports · doi:10.1038/s41598-025-91819-x · Cited by 23 · see citing works
“The significant moderating role of self-compassion underscores its importance in trauma recovery interventions 58 .”
Fung, K. P.-L., Liu, J. J. W., Sin, R., Shakya, Y. B., Guruge, S., Bender, A., & Wong, J. P. (2020) · Community Mental Health Journal · doi:10.1007/s10597-020-00723-3 · Cited by 20 · see citing works
Misra, A., Bryan, A., S. Faber, N., Printz Pereira, D., Faber, S., T. Williams, M., & D. Skinta, M. (2023) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2023.05.008 · Cited by 21 · see citing works
Determination of specific life changes on psychological distress during the COVID-19 pandemic
Kabasawa, K., Tanaka, J., Komata, T., Matsui, K., Nakamura, K., Ito, Y., & Narita, I. (2021) · PLoS ONE · doi:10.1371/journal.pone.0256481 · Cited by 20 · see citing works
“These respondents might have psychological flexibility, which is a process of acceptance and commitment therapy that consists of defusion, acceptance, present moment awareness, self-as-context committed action, and values [37].”
BackgroundJemima, R., Strelan, P., & Proeve, M. J. (2021) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2021.08.001 · Cited by 20 · see citing works
Forkus, S. R., Breines, J. G., & Weiss, N. H. (2019) · Psychological Trauma · doi:10.1037/tra0000481 · Cited by 18 · see citing works
The lived experience of parenting a child with sensory sensitivity and picky eating
Cunliffe, L., Coulthard, H., & Williamson, I. R. (2022) · Maternal and Child Nutrition · doi:10.1111/mcn.13330 · Cited by 16 · see citing works
“Research supporting this concept has found being kind to the self and open/ flexible, holds greater benefits for those under psychological trauma, depression, and difficult living environments Yadavaia et al. (2014).”
BackgroundDuarte, J., & Pinto‐Gouveia, J. (2016) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2016.12.002 · Cited by 17 · see citing works
Morcillo-Muñoz, Y., Castellano, M. H. J., Exposito, F. J. D., Sánchez-Guarnido, A. J., Alcantara, M. G., & Baena-Parejo, M. I. (2021) · Clinics and Practice · doi:10.3390/clinpract11030072 · Cited by 16 · see citing works
“ACT aims to promote committed action guided by values and help individuals take personal responsibility for pain control [8,9].”
BackgroundMcCallum, M., Ho, A. S., May, C. N., Behr, H., Mitchell, E. S., & Michealides, A. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182413358 · Cited by 15 · see citing works
Mallik, D., Kaplan, J., Somohano, V. C., Bergman, A. L., & Bowen, S. W. (2021) · Substance Use & Misuse · doi:10.1080/10826084.2021.1899220 · Cited by 15 · see citing works
“Mindfulness and PF share emphasis of an open, non-judgmental perspective regarding internal distress (Meyer et al., 2018; Yadavaia et al., 2014).”
BackgroundCooper, D. D. J., Popovic, G. C., & Grisham, J. R. (2023) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2023.100799 · Cited by 14 · see citing works
Pyszkowska, A., & Wrona, K. (2021) · PeerJ · doi:10.7717/peerj.11198 · Cited by 12 · see citing works
Relational Behavior and ACT: A Dynamic Relationship
Belisle, J., & Dixon, M. R. (2021) · Behavior Analysis in Practice · doi:10.1007/s40617-021-00599-z · Cited by 14 · see citing works
“for (i.e., self-compassion; Luoma & Platt, 2015; Yadavaia et al., 2014), with a potential shift in relational functions.”
BackgroundLuo, X., Che, X., & Lei, Y. (2023) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2023.10.004 · Cited by 12 · see citing works
Self-Compassion in Psychotherapy: Clinical Integration, Evidence Base, and Mechanisms of Change
Germer, C. K. (2023) · Mindfulness in behavioral health · doi:10.1007/978-3-031-22348-8_22 · Cited by 13 · see citing works
Marta‐Simões, J., & Ferreira, C. (2018) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2018.11.004 · Cited by 12 · see citing works
Wong, M. Y. C., Fung, H. W., Wong, J. Y. H., & Lam, S. K. K. (2025) · Scientific Reports · doi:10.1038/s41598-025-95821-1 · Cited by 21 · see citing works
“To further investigate the effect of self-criticism, the connection between self-compassion, acceptance, and action, which also highlights psychological flexibility and emotional well-being, should be discussed 21 .”
Anderson, M., McCracken, L. M., & Scott, W. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1322723 · Cited by 12 · see citing works
“Given their overlap, ACT-based interventions that aim to improve psychological flexibility may also improve self-compassion (Yadavaia et al., 2014).”
BackgroundCarvalho, S. A., Trindade, I. A., Duarte, J., Menezes, P. J., Patrão, B., Nogueira, M. R., Guiomar, R. N. R. M., Lapa, T. A. S. C., Pinto‐Gouveia, J., & Castilho, P. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.630766 · Cited by 11 · see citing works
“Recently, some studies suggested that ACT interventions also promote self-compassion (Yadavaia et al., 2014; Luoma and Platt, 2015), a non-judgmental and mindful approach to one’s pain and suffering (Neff, 2003), which presents known links with pain regulation systems, such as heart-rate variability…”
BackgroundSchick, M. R., Nalven, T., Crawford, M. C., & Spillane, N. S. (2021) · Translational Issues in Psychological Science · doi:10.1037/tps0000300 · Cited by 11 · see citing works
Fattahi, A., Mazini, F., Jaberghaderi, N., Rajabi, F., Derakhshani, M., & Laki, M. (2023) · Trends in Psychiatry and Psychotherapy · doi:10.47626/2237-6089-2023-0685 · Cited by 10 · see citing works
Berman, B. M., & Kurlancheek, K. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.758356 · Cited by 10 · see citing works
Self-Esteem and Suicidal Thoughts and Behaviors: A Meta-Analytic Review
Buecker, S., Doll, J., Diaz, S. A., Haehner, P., Berg, F., Kaurin, A., & Teismann, T. (2025) · Clinical psychological science : a journal of the Association for Psychological Science · doi:10.1177/21677026241308163 · Cited by 11 · see citing works
“…acceptance-and-commitment therapy, which includes enhancing self-compassion and self-kindness and may help improving in psychological flexibility (Yadavaia et al., 2014), can be fruitful in protecting against the negative effects of low self-esteem (Marshall et al., 2015) and shield against STBs…”
Rebuttal of Atkins et al. (2017) critique of the Öst (2014) meta-analysis of ACT
Öst, L. (2017) · Behaviour Research and Therapy · doi:10.1016/j.brat.2017.08.008 · Cited by 9 · see citing works
Kabul ve Kararlılık Terapisi Odaklı Deneysel Araştırmalar: Sistematik Bir Gözden Geçirme
Dursun, A., & AKKAYA, M. (2022) · Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry · doi:10.18863/pgy.1014526 · Cited by 9 · see citing works
Ravanbakhsh, L., Ebrahimi, M. I., Haddadi, A., & Yazdi-Ravandi, S. (2023) · Iranian Journal of Psychiatry and Behavioral Sciences · doi:10.5812/ijpbs-136845 · Cited by 8 · see citing works
“Due to its perspective, acceptance and commitment treatment increases self-compassion by limiting emotional thoughts, especially negative ones, which regulate mood and reduce anxiety (32).”
BackgroundSelf-Compassion and Social Anxiety: A Scoping Review
Slivjak, E. T., Majid, F. A., Wrigley, J., Russell, S., Zielony, L., & Arch, J. J. (2024) · Mindfulness · doi:10.1007/s12671-024-02450-2 · Cited by 9 · see citing works
“Although contextual behavioral therapy modalities such as ACT have been shown to increase self-compassion (Khoramnia et al., 2020; Ong et al., 2019; Yadavaia et al., 2014), self-compassion is not typically the primary intervention target in these interventions; most content does not specifically…”
Langroudi, K. F., & Skinta, M. D. (2019) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x19000096 · Cited by 8 · see citing works
“Furthermore, the elements of self-compassion highlighted by Neff (2009) – mindfulness, common humanity, and self-kindness – can be evoked within ACT ’ s emphasis on acceptance, defusion, and perspective-taking in the present moment (Yadavaia et al. , 2014).”
BackgroundKian, A. A., Rostami, B., Moosavi, S. E., Maghbooli, M., & Fakoor, E. (2020) · Iranian Journal of Psychiatry and Clinical Psychology · doi:10.32598/ijpcp.26.2.2817.1 · Cited by 9 · see citing works
Self-compassion: conceptualization, research, and interventions (Brief review)
Foroughi, A., Khanjani, S., Rafiee, S., & Taheri, A. A. (2020) · Shenakht Journal of Psychology and Psychiatry · doi:10.29252/shenakht.6.6.77 · Cited by 8 · see citing works
Viator, T. L., Levy, J. J., & Murphy, B. A. (2024) · Music & Science · doi:10.1177/20592043241268665 · Cited by 8 · see citing works
“Further, targeting psychological fl exibility may also help musicians practice self-compassion in the face of professional setbacks, which are common in the music performance industry (Pecen et al., 2018; Yadavaia et al., 2014).”
Oliveira, S., Cunha, M. I. V. A., Rosado, A. F. B., Matos‐Pina, I., & Ferreira, C. (2025) · Mindfulness · doi:10.1007/s12671-025-02521-y · Cited by 7 · see citing works
“In fact, the conjugation of self-compassion, ACT, and mindfulness-based approaches has been a study theme during the last decade since these interventions are compatible and complementary (e.g. Baltzell et al., 2019; Neff & Tirch, 2013; Yadavaia et al., 2014).”
Ditton, E., Knott, B., Hodyl, N. A., Horton, G. L., Walker, F. R., & Nilsson, M. (2022) · JMIR Research Protocols · doi:10.2196/32992 · Cited by 8 · see citing works
Gunawan, F. Y., & Oriza, I. I. D. (2022) · ANIMA Indonesian Psychological Journal · doi:10.24123/aipj.v37i1.3033 · Cited by 13 · see citing works
Han, A., Wilroy, J. D., Jenkins, J., & Yuen, H. K. (2023) · Disability and Rehabilitation · doi:10.1080/09638288.2022.2038283 · Cited by 6 · see citing works
Kılıç, A., Hudson, J., Scott, W., McCracken, L. M., Hackett, R. A., & Hughes, L. D. (2023) · Internet Interventions · doi:10.1016/j.invent.2023.100658 · Cited by 6 · see citing works
“For example, being directed to reappraise ‘maladaptive ’ cognitions through CBT can be viewed as another source of criticism directed to oneself, further fostering the vicious cycle of criticism (Yadavaia et al., 2014).”
BackgroundO'Boyle-Finnegan, Ú., Graham, C. D., Doherty, N., & Adair, P. (2022) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2022.05.002 · Cited by 5 · see citing works
Posttraumatic stress among trauma-exposed Hispanic/Latinx adults: relations to mental health
Mayorga, N. A., Shepherd, J. M., Matoska, C. T., Kabel, K. E., Vujanovic, A. A., Viana, A. G., & Zvolensky, M. J. (2023) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2023.2176783 · Cited by 6 · see citing works
The Role of Psychologists and Psychological Approaches in Cancer Care
Zacharia, M., & Karekla, M. (2022) · Springer eBooks · doi:10.1007/978-3-030-84702-9_19 · Cited by 6 · see citing works
Hulbert-Williams, N., Norwood, S. F., Gillanders, D. T., Finucane, A., Spiller, J. A., Strachan, J., Millington, S., & Swash, B. (2019) · Pilot and Feasibility Studies · doi:10.1186/s40814-019-0488-4 · Cited by 7 · see citing works
Chen, H., Abdelrasheed, N. S. G., Mecheser, A. E., Tayyib, N. A., Ramaiah, P., Prasad, K., Estrada-Araoz, E. G., Alkhayyat, S., Ramadan, M. F., & Abdollahi, A. (2023) · Research Square · doi:10.21203/rs.3.rs-2925992/v1 · Cited by 6 · see citing works
Büyüköksüz, E. (2025) · BMC Psychology · doi:10.1186/s40359-025-03023-1 · Cited by 7 · see citing works
“The components of the ACT framework on psychological well-being are discussed in scholarly literature, particularly with the concept of self-compassion [34, 35].”
Transdiagnostic Approach to Anxiety Disorders: Common Factors and Integrative Interventions
Türk, F., Dalkılınç, G., Açıkgöz, S., Kara, B. C., Guven, S. N., Kul, A., & Hamamcı, Z. (2026) · Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry · doi:10.18863/pgy.1841690 · Cited by 5 · see citing works
Ghari Saadati, L., Ghorban Shiroudi, S., & Khalatbari, J. (2022) · Avicenna Journal of Nursing and Midwifery Care · doi:10.32592/ajnmc.30.1.30 · Cited by 5 · see citing works
Değerli, F. İ., & Odacı, H. (2023) · Current Psychology · doi:10.1007/s12144-023-04274-0 · Cited by 7 · see citing works
“There are some studies in the literature on the relationship between ACT and self-compassion (Bar-nard & Curry, 2011; Neff & Tirch, 2013; Ong et al., 2019; Yadavaia et al., 2014).”
Kleiman, K., Marks, D. R., Block-Lerner, J., Tirch, D., Brady, V., Foote, B., & Silberstein-Tirch, L. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1509396 · Cited by 4 · see citing works
The Efficacy of Acceptance and Commitment Therapy for Transitional-Age Youth: A Meta-analysis
Keulen, J., Deković, M., Oud, M., A-Tjak, J. G. L., & Bodden, D. H. M. (2025) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-025-00543-5 · Cited by 4 · see citing works
- Authors
- Yadavaia, J. E., Hayes, S. C., & Vilardaga, R.
- Affiliations
- University of Nevada, Reno (US)
- University of Washington (US)
- Corresponding author
- Yadavaia, James E.
- Venue
- Journal of Contextual Behavioral Science
- Publisher
- Elsevier BV
- Published
- 2014-10
- Volume
- 3
- Issue
- 4
- Pages
- 248-257
- ISSN
- 2212-1447 (ISSN-L)
- PMC
- PMC4260406
- OpenAlex
- W2141219537
- Cited by
- 188
- References
- 69
- Citations by year
- 2026: 20 · 2025: 27 · 2024: 18 · 2023: 21 · 2022: 18 · 2021: 26 · 2020: 21 · 2019: 14 · 2018: 11 · 2017: 7 · 2016: 4 · 2015: 1
- FWCI
- 4.73
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Contextual Behavioral Science (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (K99DA037276)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
- Keywords
- acceptance and commitment therapy, self-compassion, psychological flexibility, psychological distress, anxiety, depression, stress, trauma history, workshop intervention, mediation, moderation
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