Effects of acceptance and commitment therapy on process measures of family caregivers: A systematic review and meta-analysis.
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According to recent systematic reviews regarding ACT for family caregivers of people with chronic conditions, only one study considered grief as an outcome measure.
“According to recent systematic reviews regarding ACT for family caregivers of people with chronic conditions (Han et al., 2020, 2021), only one study (Davis et al., 2020) considered grief as an outcome measure.”
From The feasibility and preliminary effects of a pilot randomized controlled trial: Videoconferencing acceptance and commitment therapy in distressed family caregivers of people with dementia. (2023) · cites this paper as Han et al., 2020
Recent meta-analysis studies in family caregivers of people with chronic conditions found small effects of ACT on anxiety and quality of life at posttest and small to medium effects of ACT on psychological flexibility at posttest and follow-ups compared to control groups.
“Also, the findings are supported by recent meta-analysis studies in family caregivers of people with chronic conditions, which found small effects of ACT on anxiety and QoL at posttest and small to medium effects of ACT on psychological flexibility at posttest and follow-ups compared to control groups (Han et al., 2020, 2021).”
From The feasibility and preliminary effects of a pilot randomized controlled trial: Videoconferencing acceptance and commitment therapy in distressed family caregivers of people with dementia. (2023) · cites this paper as Han et al., 2020
ACT targets psychological inflexibility (eg, experiential avoidance and lack of value clarity) to promote psychological well-being.
“targets psychological inflexibility (eg, experiential avoidance and lack of value clarity) to promote psychological well-being.22”
From Acceptance and Commitment Therapy Among Informal Caregivers of People With Chronic Health Conditions: A Systematic Review and Meta-Analysis (2023) · cites this paper as [22]
Acceptance and commitment therapy (ACT) has consistently demonstrated robust efficacy in addressing psychological distress.
“Acceptance and commitment therapy (ACT), an evolving cognitive behavioral intervention that has consistently demonstrated robust efficacy in addressing psychological distress,21,22,23 targets psychological inflexibility”
From Acceptance and Commitment Therapy Among Informal Caregivers of People With Chronic Health Conditions: A Systematic Review and Meta-Analysis (2023) · cites this paper as [22]
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Acceptance and Commitment Therapy Processes and Mediation: Challenges and How to Address Them
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“On the other hand, greater psychological flexibility and low EA in parents has been linked to compassionate interactions (Han et al., 2020; Wong et al., 2016), adaptive parenting practices, and lower levels of youth internalizing and externalizing problems (Brassell et al.”
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“…and ACT process measures were not statistically significant possibly due to the small sample size, these measures still showed improvements at posttest, supported by the previous ACT studies for family caregivers showing improvements in these outcomes (Han et al., 2020; Losada et al., 2015).”
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“…by recent meta-analysis studies in family caregivers of people with chronic conditions, which found small effects of ACT on anxiety and QoL at posttest and small to medium effects of ACT on psychological flexibility at posttest and follow-ups compared to control groups (Han et al., 2020, 2021).”
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“…studies that involved ACT (ie, not iACT in particular) found similar findings to this meta-analysis study that included a medium effect of ACT on psychological flexibility in family caregivers [6] and a small effect of self-help ACT on psychological flexibility in adult populations [58].”
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“The aforementioned studies, although promising [21], showed a high dropout rate [20], or the intervention did not prove highly effective [30].”
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“For parents of children with chronic conditions, increased psychological flexibility may manifest in accepting difficult thoughts and emotions that may arise in caregiving situations and increasing time for personally meaningful activities in accordance with personal values (Han et al., 2020).”
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“Dementia caregivers have also responded to ACT delivered with a therapist (Han et al., 2020; Kishita et al., 2020), and online.”
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“Two recent systematic reviews of ACT programs have also demonstrated small to moderate effects on depression, anxiety, stress and quality of life in care partners of various populations (Gloster et al., 2020; Han et al., 2021b).”
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“Finding ways to maintain valued roles and goals in light of losses (e.g., having short calls frequently rather than planning a family holiday to get connected with other family members) may be particularly important for this population (Han et al., 2020).”
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“Behavioral strategies based on Acceptance and Commitment Therapy (ACT), including acceptance, cognitive defusion, and goal setting, may provide significant psychological relief for care-givers (65).”
Cognitive fusion and treatment response to depression in caregivers of relatives with dementia
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“A systematic review and meta-analysis of the efficacy of ACT interventions for family caregivers across 24 studies found significant reductions in psychological distress and significant improvements in QoL (Han et al., 2020).”
Zhou, X., Zou, N., Shi, C., Chen, S., & Shi, J. (2026) · Aging & Mental Health · doi:10.1080/13607863.2025.2573071 · Cited by 1 · see citing works
“Although Han et al. reported the effectiveness of ACT on process measures and caregiving burden in informal caregivers (Han et al. 2020; Han et al., 2021), no focus was given to informal caregivers of PwD who face unique stressors.”
Self-citationUnderstanding Acceptance and Commitment Therapy for Youth
Petersen, J. M. (2025) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2025.02.012 · Cited by 1 · see citing works
Lim, R. G., Mohamad, F. S., & Voon, S. P. (2025) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2025.100920 · Cited by 1 · see citing works
Thapar, S., Quesada, D., & Knaüper, B. (2025) · JMIR Formative Research · doi:10.2196/69532 · Cited by 2 · see citing works
“ACT has been extensively studied in >1000 randomized trials [14,15] that have been summarized in several meta-analyses [16,17] and a review of 20 meta-analyses [2], demonstrating medium-to-large effect sizes across a broad range of mental health conditions.”
Özer, D. (2026) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/jpm.70130 · Cited by 1 · see citing works
“…stronger effects compared to those implemented in later stages, as they may support the strengthening of family processes, enhance adaptive coping within the family system and contribute positively to the illness trajectory of individuals with psychosis (Han et al. 2020; Özer and Dişsiz 2024).”
A Pilot Acceptance and Commitment Intervention for Parents of Children With RASopathies
Little, P., Ghriwati, N. A., Siegel, A., Toledo‐Tamula, M. A., Curlee, M. S., Baker, M., Rogge, R. D., Yohe, M. E., Gross, A. M., & Martin, S. C. (2024) · Clinical Practice in Pediatric Psychology · doi:10.1037/cpp0000551 · Cited by 1 · see citing works
“Han et al. (2020) summarized the results of ACT interventions for parents in a systematic review and meta-analysis.”
Han, A., & Kim, T. H. (2022) · doi:10.2196/preprints.39182
Self-citationSaviri, M. R., Chehri, A., Hosseini, S. S., & Amiri, H. (2022) · doi:10.61838/kman.aftj.3.2.16
Rodríguez, L. M., Brito, M. L., de, E. L. H. M., Hernández-Lugo, M. D. L. C., & Castillo, E. F. (2025) · Región Científica · doi:10.58763/rc2025363
Acceptance and Commitment Therapy: Current State of the Literature and Future Directions
Simsion, D. D., Caruana, E., & Morris, E. M. J. (2025) · Springer eBooks · doi:10.1007/978-3-032-00353-9_7
Resilience Amidst Ambiguity: Considerations for Family Members Affected by Alcohol Use Disorders
Navarro, G. H., & Fickling, M. J. (2025) · Alcoholism Treatment Quarterly · doi:10.1080/07347324.2025.2601679
“They found that ACT interventions enhanced family members’ psychological flexibility and physical health, while decreasing stress reactions; however, AFMs experiencing psychological ambiguous loss due to AUD were not included in this study (Han et al., 2020).”
Chong, Y. Y., Chan, J. K. F., Yau, P. T., Li, T. M. H., Fung, K. P., & Chien, W. T. (2026) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2026.105525
Couchman, A., Katangwe‐Chigamba, T., Howe, D., Flanagan, E. C., Farquhar, M. C., Gould, R. L., McCracken, L. M., Clegg, I., Anyiam-Osigwe, A., Ashford, P., et al. (2026) · Aging & Mental Health · doi:10.1080/13607863.2026.2698708
Simsion, D. D., Jermey, A., & Morris, E. M. J. (2026) · Clinical Psychologist · doi:10.1080/13284207.2026.2713441
- Authors
- Han, A., Yuen, H. K., Lee, H. Y., & Zhou, X.
- Affiliations
- University of Alabama at Birmingham (US)
- University of Alabama (US)
- Corresponding author
- Han, Areum
- Venue
- Journal of Contextual Behavioral Science
- Publisher
- Elsevier BV
- Published
- 2020-10
- Volume
- 18
- Pages
- 201-213
- ISSN
- 2212-1447 (ISSN-L)
- OpenAlex
- W3092523048
- Cited by
- 39
- References
- 74
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 5 · 2023: 9 · 2022: 8 · 2021: 3
- FWCI
- 0.39
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Contextual Behavioral Science (publishedVersion)
- Funders
- ACT
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Health Professions › Pharmacy › Nursing care and research
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- acceptance and commitment therapy, family caregivers, psychological flexibility, acceptance, cognitive defusion, self-as-context, cognitive fusion, valued living, mindfulness, committed action, process indicators
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