Acceptance-based interventions in the treatment of PTSD: Group and individual pilot data using Acceptance and Commitment Therapy

Wharton, Emily; Edwards, Katharine Sears; Juhasz, Katherine; Walser, Robyn D.

doi:10.1016/j.jcbs.2019.09.006

Cited by 60Mindfulness and Compassion InterventionsPosttraumatic Stress Disorder ResearchPsychotherapy Techniques and Applications

Acceptance-based interventions in the treatment of PTSD: Group and individual pilot data using Acceptance and Commitment Therapy

Wharton, Emily, Edwards, Katharine Sears, Juhasz, Katherine, Walser, Robyn D.·2019·Journal of Contextual Behavioral Science

DOI 10.1016/j.jcbs.2019.09.006

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Participants in both Wharton et al. pilot studies showed significant decreases in PTSD symptoms at posttreatment with medium to large effect sizes.
“Participants in both studies showed significant decreases in PTSD symptoms at posttreatment with medium to large effect sizes.”
From Group-Based Acceptance and Commitment Therapy for PTSD in a HMO Psychiatry Clinic: An Open Trial (2024) · cites this paper as Wharton et al., 2019
Wharton et al. (2019) assessed the effectiveness of 12 sessions of individual ACT and 12 sessions of group ACT in two pilot studies of male veterans.
“Wharton et al. (2019) assessed the effectiveness of 12 sessions of individual ACT and 12 sessions of group ACT in two pilot studies of male veterans.”
From Group-Based Acceptance and Commitment Therapy for PTSD in a HMO Psychiatry Clinic: An Open Trial (2024) · cites this paper as Wharton et al., 2019
The efficacy of acceptance and commitment therapy has been confirmed in studies on substance use disorder, post-traumatic stress disorder, and comorbid psychiatric disorders.
“The efficacy of ACT has also been confirmed in studies on substance use disorder [23], post-traumatic stress disorder [24], and comorbid psychiatric disorders that are considered significant challenges for clinicians and practitioners [25].”
From Acceptance and Commitment Therapy for Destructive Experiential Avoidance (ACT-DEA): A Feasibility Study (2022) · cites this paper as [24]
ACT has shown preliminary evidence in improving PTSD symptoms.
“ACT has also shown preliminary evidence in improving interpersonal difficulties [34,35,36] and PTSD symptoms [37,38,39,40].”
From A Randomized Pilot Study of Acceptance and Commitment Therapy to Improve Social Support for Veterans with PTSD (2022) · cites this paper as [39]
A pilot study of 12-session ACT group and individual interventions showed a significant improvement in PTSD symptoms in both the ACT group (n=10) and individual interventions (n=9).
“A pilot study of 12-session ACT group and individual interventions showed a significant improvement in PTSD symptoms in both the ACT group (n = 10) and individual interventions (n = 9) [39].”
From A Randomized Pilot Study of Acceptance and Commitment Therapy to Improve Social Support for Veterans with PTSD (2022) · cites this paper as [39]

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Zhao, C., Zhao, Z., Levin, M. E., Lai, L., Shi, C., Hu, J., Chen, W., & Ren, Z. (2023) · Behaviour Research and Therapy · doi:10.1016/j.brat.2023.104440 · Cited by 22 · see citing works
The Process of Learning Mindfulness and Acceptance through the Use of a Mobile App Based on Acceptance and Commitment Therapy: A Grounded Theory Analysis
Reyes, A. T. (2022) · Issues in Mental Health Nursing · doi:10.1080/01612840.2021.1953652 · Cited by 21 · see citing works
Acceptance and Commitment Therapy for Destructive Experiential Avoidance (ACT-DEA): A Feasibility Study
Na, E., Lee, K., Jeon, B.-H., Jo, C., Kwak, U.-H., Jeon, Y., Yang, K., Lee, E. J., & Jeong, J. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192416434 · Cited by 21 · see citing works
“The efficacy of ACT has also been confirmed in studies on substance use disorder [23], post-traumatic stress disorder [24], and comorbid psychiatric disorders that are considered significant challenges for clinicians and practitioners [25].”
Background
Exploring the relationships between resilience, mindfulness, and experiential avoidance after the use of a mindfulness‐ and acceptance‐based mobile app for posttraumatic stress disorder
Reyes, A. T., Song, H., Bhatta, T. R., & Kearney, C. A. (2021) · Perspectives In Psychiatric Care · doi:10.1111/ppc.12848 · Cited by 19 · see citing works
Effects of acceptance and commitment therapy on cognitive function: A systematic review
Liu, H., Liu, N., Chong, S. T., Koh, E. B. Y., & Badayai, A. R. A. (2023) · Heliyon · doi:10.1016/j.heliyon.2023.e14057 · Cited by 17 · see citing works
Acceptance and commitment therapy for co-occurring gambling disorder and posttraumatic stress disorder in veterans: a narrative review
Hitch, C., Leightley, D., Murphy, D., Trompeter, N., & Dymond, S. (2023) · European Journal of Psychotraumatology · doi:10.1080/20008066.2023.2178203 · Cited by 15 · see citing works
Acceptance and commitment therapy for demoralization syndrome and cancer-related trauma: A randomized clinical trial study
Sarizadeh, M. S., Rahimian Boogar, I., Talepasand, S., & Gharemanfard, F. (2021) · International Journal of Cancer Management · doi:10.5812/ijcm.114637 · Cited by 15 · see citing works
Prediction of PTSD related to COVID-19 in emergency staff based on the components of self-compassion and perceived social support
Shahsavarinia, K., Amiri, P., Mousavi, Z., Gilani, N., Saadati, M., & Soleimanpour, H. (2022) · BMC Psychiatry · doi:10.1186/s12888-022-04017-8 · Cited by 14 · see citing works
Comparing the Effectiveness of Acceptance and Commitment Therapy and Well-being Therapy on Life Expectancy and Psychological Health in Elderly Nonclinical Depressed Patients
Golestanifar, S., & DashtBozorgi, Z. (2021) · Journal of Rafsanjan University of Medical Sciences · doi:10.52547/jrums.20.3.297 · Cited by 13 · see citing works
Efficacy and mechanisms of mobile application-delivered Acceptance and Commitment Therapy for posttraumatic stress disorder in China: Study protocol for a randomized controlled trial
Zhao, Z., Zhao, C., Ren, Z., Shi, C., & Lai, L. (2022) · Internet Interventions · doi:10.1016/j.invent.2022.100585 · Cited by 10 · see citing works
“This approach has been increasingly used in PTSD intervention and has shown some uniqueness in theoretical conceptualization and practical strategies (Wharton et al., 2019).”
Method
Acceptance and commitment therapy (ACT) among U.S. veterans: A systematic review
Donahue, M. L., Fruge, J. E., Andresen, F. J., & Twohig, M. P. (2024) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2024.100731 · Cited by 10 · see citing works
Focusing on the self in context as an emotion regulatory strategy: an evaluation of the “self-as-context” component of ACT compared to cognitive reappraisal in managing stress
Godbee, M., & Kangas, M. (2022) · Anxiety, Stress, & Coping · doi:10.1080/10615806.2021.1985472 · Cited by 10 · see citing works
Automatic thoughts: Understanding the precursors of self-concealment within the psychological flexibility framework
Sease, T. B., Perkins, D. R., Sandoz, E. K., & Sudduth, H. (2021) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2021.09.008 · Cited by 11 · see citing works
Effectiveness of Acceptance and Commitment Therapy in Depression and Anxiety in People with Substance Use Disorder
Hashemi, Z., Eyni, S., & Ebadi, M. (2022) · Iranian Journal of Psychiatry and Behavioral Sciences · doi:10.5812/ijpbs.110135 · Cited by 11 · see citing works
Group acceptance and commitment therapy for adolescent anxiety: A systematic review and meta-analysis
Burley, J., & McAloon, J. (2024) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2023.11.003 · Cited by 13 · see citing works
Outcomes of Acceptance and Commitment Therapy for depression and predictors of treatment response in Veterans Health Administration patients
Grau, P. P., Sripada, R. K., Ganoczy, D. A., Weinstein, J. H., & Pfeiffer, P. N. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.12.025 · Cited by 13 · see citing works
Testing the Effectiveness of a Mindfulness- and Acceptance-Based Smartphone App for Nurses Traumatized by the COVID-19 Pandemic: A Pilot Study
Reyes, A. T., Fudolig, M. A., Manoj Sharma, M., & Evangelista, L. S. (2024) · Issues in Mental Health Nursing · doi:10.1080/01612840.2024.2385571 · Cited by 7 · see citing works
A Systematic and Meta-Analytical Review of Acceptance and Commitment Therapy for PTSD
Rehman, S., Ghazali, S. R., & Elklit, A. (2025) · Journal of Loss and Trauma · doi:10.1080/15325024.2025.2565354 · Cited by 9 · see citing works
Group-Based Acceptance and Commitment Therapy for PTSD in a HMO Psychiatry Clinic: An Open Trial
Loftus, S. T., Wetzler, K., Paquette, K., Christopherson, C. D., Skolnik, M. C., & Nelson, R. S. (2024) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-024-09628-8 · Cited by 4 · see citing works
“Wharton et al. (2019) assessed the effectiveness of 12 sessions of individual ACT and 12 sessions of group ACT in two pilot studies of male veterans.”
ACT-Informed Treatment of Co-morbid Psychiatric Disorders in the Postpartum Period: A Case Report
Grove, L., Roche, A. I., Doyle, R., Stowe, Z. N., & Thomas, E. B. K. (2023) · Clinical Case Studies · doi:10.1177/15346501221091273 · Cited by 4 · see citing works
The Role of Acceptance and Commitment Therapy in Improving Social Functioning Among Psychiatric Patients: A Systematic Review
Latella, D., Marafioti, G., Formica, C., Calderone, A., Fauci, E. L., Foti, A., Calabrò, R. S., & Filippello, G. (2025) · Healthcare · doi:10.3390/healthcare13131587 · Cited by 6 · see citing works
The effectiveness of Acceptance and Commitment Therapy on parental stress in parents of special children: a meta-analysis
Guo, Y., He, H., & Lan, J. (2025) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-025-00944-y · Cited by 4 · see citing works
Psychological inflexibility as a moderator of the relationship between adverse childhood experiences and negative automatic thoughts
Sease, T. B., John, D. A., Perkins, D. R., & Sandoz, E. K. (2023) · Journal of Family Trauma Child Custody & Child Development · doi:10.1080/26904586.2023.2189203 · Cited by 4 · see citing works
Coach-Assisted eHealth With Group or Individual Support for Employees With Obesity: Randomized Controlled Trial on Weight, Body Composition, and Health Metrics
Männistö, S. A., Pietiläinen, K. H., Muotka, J. S., Suojanen, L.-U., Lappalainen, R. I., & Korpela, R. (2025) · Journal of Medical Internet Research · doi:10.2196/60436 · Cited by 3 · see citing works
Data‐informed selection of evidence‐based treatments for posttraumatic stress disorder and co‐occurring symptoms
Torres, V. A., Coe, E., Jackson, J. E., Leonard, K., Rostockyj, J. A., Swensen, K., Meyer, E. C., Gulliver, S. B., & Jones, S. (2025) · Journal of Traumatic Stress · doi:10.1002/jts.23133 · Cited by 3 · see citing works
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Boiko, D. I., Shkodina, A. D., Uddin, M. E., Rahman, M. H., & Kader, M. A. (2025) · Sleep Medicine · doi:10.1016/j.sleep.2025.106803 · Cited by 3 · see citing works
The Effect of Cognitive Fusion on Change in PTSD and Depression Symptom Severity in Veterans Engaged in Group Psychotherapy
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Racial Differences in Trauma Outcomes After a Mindfulness App Intervention in Frontline Nurses: A Secondary Data Analysis
Reyes, A. T., Fudolig, M. A., Brock, A., Sharma, M., & Evangelista, L. S. (2025) · Issues in Mental Health Nursing · doi:10.1080/01612840.2025.2556448 · Cited by 2 · see citing works
Smartphone app-delivered Acceptance and Commitment Therapy (ACT) for post-traumatic stress disorder and gambling harm in veterans: A pilot feasibility study
Williams, J. M., Heath, C., Leightley, D., Murphy, D., & Dymond, S. (2025) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2025.100956 · Cited by 2 · see citing works
Randomized Controlled Trial of Acceptance and Commitment Therapy for Posttraumatic Stress Disorder Symptoms in Afghan Adolescent Girls
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Factors associated with receipt of minimally adequate psychotherapy for PTSD at the Veterans Health Administration
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Addressing Attrition from Psychotherapy for PTSD in the U.S. Department of Veterans Affairs
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Mindful Nonreactivity Moderates the Relationship between Posttraumatic Stress Disorder and Depression
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Additional file 1 of Prediction of PTSD related to COVID-19 in emergency staff based on the components of self-compassion and perceived social support
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Effectiveness of Acceptance and Commitment Therapy as a Treatment for Posttraumatic Stress Disorder and Moral Injury
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Authors: Wharton, E., Edwards, K. S., Juhasz, K., & Walser, R. D.
Affiliations: National Center for Post Traumatic Stress Disorder (US)
Stanford Medicine (US)
Corresponding author: Wharton, Emily
ORCID: Edwards, Katharine Sears
Juhasz, Katherine
Walser, Robyn D.
Venue: Journal of Contextual Behavioral Science
Publisher: Elsevier BV
Published: 2019-10
Volume: 14
Pages: 55-64
ISSN: 2212-1447 (ISSN-L)
DOI: 10.1016/j.jcbs.2019.09.006
OpenAlex: W2977699184
Cited by: 60
References: 85
Citations by year: 2026: 6 · 2025: 13 · 2024: 9 · 2023: 13 · 2022: 10 · 2021: 9
FWCI: 5.55
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Journal of Contextual Behavioral Science (publishedVersion)
Funders: Department of Veterans Affairs
Veterans Health Administration, Office of Research and Development
Topics: Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords: post-traumatic stress disorder, acceptance and commitment therapy, acceptance-based interventions, veterans, group therapy, individual psychotherapy, experiential avoidance, thought suppression, mindfulness, psychological flexibility

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