The DOI matches its Crossref record; 93 of the 101 references it cites were found in a registry or an index; 15 of the 54 sources its claims cite were checked for support.
Acceptance and Commitment Therapy as a Treatment for Anxiety and Depression
Open accessAbstract
Acceptance and commitment therapy (ACT) is a modern form of cognitive behavioral therapy based on a distinct philosophy and basic science of cognition. This article reviews the core features of ACT's theoretic model of psychopathology and treatment and its therapeutic approach. It provides a systematic review of randomized controlled trials (RCTs) evaluating ACT for depression and anxiety disorders. Summarizing 36 RCTs, ACT appears to be more efficacious than waitlist conditions and treatment-as-usual, with largely equivalent effects relative to traditional cognitive behavioral therapy. Evidence indicates that ACT treatment outcomes are mediated through increases in psychological flexibility, its theorized process of change. © 2017
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
This review outlines acceptance and commitment therapy’s theoretical foundations and systematically examines randomized trials for anxiety and depression. Across 36 trials, ACT generally outperformed waitlist and treatment-as-usual conditions and was largely comparable to traditional cognitive behavioral therapy, with psychological flexibility often acting as a mediator.
Key findings
- Across 36 randomized controlled trials, ACT was more effective than waitlist and treatment-as-usual for anxiety and depression, and largely equivalent to traditional cognitive behavioral therapy.
- For depression, all 7 waitlist comparisons favored ACT up to 6-month follow-up (Cohen’s d = .32–1.18); 4 of 5 treatment-as-usual comparisons favored ACT up to 18 months (d = .38–1.45); among 5 CT/CBT comparisons, 4 of 5 found equivalent post-treatment effects, with mixed follow-up results.
- Anxiety findings included panic disorder (between-group d = .72 for panic, d = .89 for general functioning; 70% response at post-treatment and 80% at 6-month follow-up), GAD (ABBT vs waitlist d = 1.02; 76% vs 16% no longer meeting GAD criteria at post), and mixed anxiety, social anxiety, OCD, and health anxiety trials showing generally positive outcomes.
- Process analyses in several trials indicated that increases in psychological flexibility mediated ACT outcomes; for depression, 12 of 17 trials examined processes, and formal mediation supported psychological flexibility in three waitlist comparisons and cognitive defusion in one ACT-vs-CT comparison.
Methods
- Narrative/systematic review of published randomized controlled trials of ACT for anxiety disorders and depression, alongside a conceptual review of contextual behavioral science, functional contextualism, relational frame theory, and the psychological flexibility model.
- The abstract reports 36 RCTs total; tables organize trials by anxiety disorder and depression, including comparison conditions such as waitlist, treatment-as-usual, minimal/placebo conditions, and CT/CBT, as well as individual, group, self-help, online, and workshop formats.
- Main analysis is qualitative synthesis of between-group effect sizes, response and recovery rates, quality-of-life outcomes, and mediation/process findings; no pooled meta-analytic effect estimate is reported.
Limitations
- The paper states that many trials have small samples, that research is limited for panic disorder, health anxiety, and specific phobias, and that it remains unclear which clients benefit more from ACT versus traditional CBT or how to match treatments.
- The paper states that ACT’s comparison with CBT for depression is unclear because of the number of trials and small samples, and that follow-up findings are mixed; it also notes inconsistent differential effects on psychological inflexibility relative to CT/CBT.
- Evident from the text: this is a narrative review rather than a meta-analysis, effect sizes are not pooled, included studies vary in protocols, comparators, and outcome measures, and five depression RCTs were excluded because they were not available in English, which may limit generalizability.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
24 No full text of the sources · 21 Own result · 15 Own interpretation · 14 No basis given · 11 Not checked yet · 8 Supported · 4 Partly supported · 3 Sources not found · 1 Supported so far · 1 Not supported · 1 Couldn’t confirm · accuracy not yet measured
At least one cited source doesn’t support this claim or points to a different paper, and none confirmed it — see the verdicts below.
In the paper
“71 and 77% recovered from depression in ACT at 3 month follow up after a one day workshop.68”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Depression RCT Treatment Formats
What the sources say
- Disputedcites [68] Gaudiano, 2015, Acceptance-based behavior therapy for depression with psychosis: results from a pilot feasibility randomized controlled trial, J Psychiatr Pract sourceExperimental — accuracy not yet measured
The Method section (page unavailable) describes a 16-session treatment over four months, not a one-day workshop. The Results report reliable improvement in depressive symptoms for 50% of ADAPT participants at posttreatment, not 71%–77% recovery at three months; the Discussion says the three-month sample was too small for definitive conclusions. (LLM, conf=0.88)
Checked by a reasoning model — may be wrong.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Disputed
Every source the paper cites for this claim was checked and supports it.
In the paper
“This is sometimes referred to as a “decoupling” effect 10 in that ACT alters the context of relating to internal experiences such that they have less influence on behavior (e.g., self-critical thoughts are noticed as just thoughts, while one chooses to engage in social activities).”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Abstract
What the sources say
- Supportedcites [10] Levin, 2015, Decoupling as a mechanism of change in mindfulness and acceptance: a literature review, Behav Modif source
The paper includes ACT among the mindfulness and acceptance therapies it discusses. In Theoretical implications (page unavailable), it says these therapies alter the context in which internal experiences occur so that thoughts noticed as thoughts need not lead to avoidance; its definition of decoupling describes the resulting change in the relation between internal experience and behavior. (LLM, conf=0.91)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Additionally, a web-based intervention for college students with mixed issues also showed that ACT successfully reduced anxiety.23”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Mixed Anxiety
What the sources say
- Supportedcites [23] Levin, 2017, Web-based acceptance and commitment therapy for mental health problems in college students: a randomized controlled trial, Behav Modif source
The Discussion reports that the web-based ACT program improved general and social anxiety relative to a waitlist among college students. The ACT Self-Help Website section describes it as transdiagnostic, addressing a range of problems rather than one disorder. (LLM, conf=0.92)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“in a large well-controlled RCT, 20”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Mixed Anxiety
What the sources say
- Partly supportedcites [20] Arch, 2012, Randomized clinical trial of cognitive behavioral therapy (CBT) versus acceptance and commitment therapy (ACT) for mixed anxiety disorders, J Consult Clin Psychol sourceExperimental — accuracy not yet measured
The Methods (Participants and Design; page unavailable) describe a randomized ACT-versus-CBT trial with 128 treatment starters, and the Discussion (Summary and conclusion; page unavailable) calls ACT a viable treatment for anxiety disorders. The trial enrolled people with anxiety disorders, not a mixed anxiety-and-depression sample; the Discussion (Secondary outcomes) reports reductions in co-occurring mood disorders but does not establish ACT’s utility for depression as a primary condition. (LLM, conf=0.88)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Laboratory-based research has modeled this, demonstrating for example that the tendency to relate to anxiety as bad predicts avoidance behavior 12”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Relational Frame Theory.
What the sources say
- Partly supportedcites [12] Levin, 2017, Examining the role of implicit emotional judgments in social anxiety and experiential avoidance, Journal of Psychopathology and Behavioral Assessment sourceExperimental — accuracy not yet measured
In “Do implicit emotional judgments interact with increases in heart rate?” (page unavailable), an “anxiety is bad” bias predicted shorter speech time—a measure of avoidance—only when heart rate increased during the speech. The “public speaking outcomes” results found no direct association between that bias and speech time or willingness to give another speech. The citing sentence omits this condition and presents the relationship as a general prediction. (LLM, conf=0.87)
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“ACT is now generally considered part of a new generation of CBT approaches focused on process-based treatments.81,82”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Conclusions
What the sources say
- Not checked — no full text of the sourcecites [80] Hofmann, 2008, Acceptance and commitment therapy: new wave or morita therapy?, Clin Psychol Sci Pract source
- Supportedcites [81] Hayes, 2017, The third wave of cognitive behavioral therapy and the rise of process-based care, World Psychiatry source
The paper’s Abstract names acceptance and commitment therapy among the approaches of the third wave of CBT. It also says the third wave is more focused on evidence-based processes linked to procedures, supporting the claim’s process-based characterization. (LLM, conf=0.92)
- Not matchedcites [82] Hayes, 2017
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Every source the paper cites for this claim was checked and supports it.
In the paper
“Large effect sizes were also seen for psychological flexibility.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Panic Disorder
What the sources say
- Supportedcites [35] Gloster, 2015, Treating treatment-resistant patients with panic disorder and agoraphobia using psychotherapy: a randomized controlled switching trial, Psychother Psychosom source
The Discussion reports that ACT process measures were consistently in the range of large effects. It identifies improvements in acceptance and defusion, constructs relevant to psychological flexibility. (LLM, conf=0.91)
plainn = 43- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“The Craske et al 44 study was quite large (N=87) and showed that lower psychological flexibility at pre was associated with greater improvement at 12 month follow-up in CBT over ACT;”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Social Anxiety Disorder
What the sources say
- Supportedcites [44] Craske, 2014, Randomized controlled trial of cognitive behavioral therapy and acceptance and commitment therapy for social phobia: outcomes and moderators, J Consult Clin Psychol source
The Abstract (Method) identifies the study as a social-phobia randomized trial with N=87. The Abstract (Results) reports that lower baseline psychological flexibility was associated with greater improvement by 12-month follow-up in CBT compared with ACT. (LLM, conf=0.94)
plaincorrelationaln = 87- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“A study so small (N=11) that randomization could not be used showed equivalent results for group ACT and group CBT.36”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Social Anxiety Disorder
What the sources say
- Partly supportedcites [36] Block, 2000, Acceptance or change: Treating socially anxious college students with ACT or CBGT, Behav Analyst Today sourceExperimental — accuracy not yet measured
The Procedure reports 11 participants across the three conditions and says assignment was semi-random because of scheduling constraints, not because the study was too small. The Results and Discussion report improvement in both active-treatment groups, but say it was premature to judge their differential effectiveness; they do not establish equivalent results. (LLM, conf=0.88)
plainn = 11- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Partly supported
Every source the paper cites for this claim was checked and supports it.
In the paper
“Finally, response rates for the ACT condition were 70% at posttreatment and 80% at 6 month follow-up for panic disorder symptoms.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Panic Disorder
What the sources say
- Supportedcites [35] Gloster, 2015, Treating treatment-resistant patients with panic disorder and agoraphobia using psychotherapy: a randomized controlled switching trial, Psychother Psychosom source
The Response Rates section reports 70% response for panic disorder/agoraphobia symptoms at post-treatment and 80% at six-month follow-up. The paper identifies ACT as the treatment studied. (LLM, conf=0.94)
plainn = 43- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Supported
- It may state two separate claims as one. 36
- Probably not a substantial claim. 12
Every source the paper cites for this claim was checked and supports it.
In the paper
“A full RCT (ACT vs waitlist) was conducted with 43 adults who were nonresponders to previous treatments for panic disorder.35 The between group effect size was d=.72 for panic and d=.89 for general functioning.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Panic Disorder
What the sources say
- Supportedcites [35] Gloster, 2015, Treating treatment-resistant patients with panic disorder and agoraphobia using psychotherapy: a randomized controlled switching trial, Psychother Psychosom source
The Sample Characteristics and Randomization Check section reports 43 patients with panic disorder/agoraphobia, and the Randomization section describes allocation to immediate treatment or a waiting list. The Treatment Efficacy section reports between-group effects of d = 0.72 for panic/agoraphobic symptoms and d = 0.89 for general functioning. The Discussion identifies the participants as treatment-resistant patients who had not responded to first-line treatments. Page numbers are not available in our copy. (LLM, conf=0.94)
plainn = 43- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“ACT has also been evaluated in 6 RCTs in a group format, one of which used a single day workshop format.68”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Depression RCT Treatment Formats
What the sources say
- Could not verifycites [68] Gaudiano, 2015, Acceptance-based behavior therapy for depression with psychosis: results from a pilot feasibility randomized controlled trial, J Psychiatr Pract sourceExperimental — accuracy not yet measured
The Introduction describes this paper’s pilot randomized trial of ADAPT and mentions another ACT-based pilot trial, but it does not count six group-format RCTs. The Methods describe a 16-session protocol, not a single-day workshop. Searches for group trials and a workshop found no passage supporting the cited claim; page numbers were unavailable in our copy. (LLM, conf=0.74)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Could not verify
In the paper
“such as research suggesting that the use of hierarchical frames (that one contains these experiences as part of an observing self) may enhance the impact of ACT exercises focused on practicing psychological flexibility with cognitions.14”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Relational Frame Theory.
What the sources say
- Not checked — no full text of the sourcecites [14] Foody, 2015, An empirical investigation of the role of self, hierarchy, and distinction in a common act exercise, Psychol Rec source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Summarizing across a total of 36 RCTs, ACT appears to be more efficacious than waitlist conditions and treatment-as-usual, with largely equivalent effects relative to traditional cognitive behavioral therapy.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Abstract
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“ACT delivered online also outperformed an active comparison condition of expressive writing at post, though both conditions had equivalent positive effects at depression at follow-up (Pots).”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Depression RCT Treatment Formats
What the sources say
- Not matchedcites Pots
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“Participants receiving an online program actually demonstrated stronger improvements at 6-month follow up on depressive symptoms (g = .76)and life satisfaction (g = .75)relative to face-to-face ACT.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Depression RCT Treatment Formats
What the sources say
- Not checked — no full text of the sourcecites [76] Lappalainen, 2014, ACT Internet-based vs face-to-face? A randomized controlled trial of two ways to deliver Acceptance and Commitment Therapy for depressive symptoms: an 18-month follow-up, Behaviour Research and Therapy source
boosteddirectn = 38- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Results were more mixed at follow up, with one studying finding ACT and CBT were equivalent on depression at 6-month follow up, one study finding CT outperformed ACT on depression at 18-month follow up, and two studies finding ACT outperformed CT on depression at 2-month follow up.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Several RCTs have been conducted comparing ACT to various control conditions
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Two other RCTs compared ACT to minimally active comparison conditions (expressive writing and minimal support group) on depression.Both studies found ACT outperformed comparison conditions on depression at post, but were equivalent at follow up.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Several RCTs have been conducted comparing ACT to various control conditions
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Five RCTs compared ACT to TAU on depression, with 4 out of 5 studies showing ACT improves depression more than TAU up to 18-month follow up.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Several RCTs have been conducted comparing ACT to various control conditions
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“ACT has been adopted internationally, which is demonstrated by the range of countries that have published RCTs on ACT for depression (even when this review was restricted to English-language publications).”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Depression RCT Sample Types
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and relative to placebo conditions (expressive writing d = .43,minimal support group d = .77).”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Depression RCT Processes of Change
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Finally, five RCTs compared ACT to CT or CBT on depression.At post, 4 out of 5 studies found ACT and CT/CBT were equivalent in improving depression, with the remaining study finding ACT led to greater improvements than CT.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Several RCTs have been conducted comparing ACT to various control conditions
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Another RCT 72 found equivalent effects for ACT relative to TAU among individuals with comorbid alcohol and depressive disorders, although it is worth noting that the ACT condition led to less required treatment prior to discharge from the inpatient unit (i.e., greater treatment efficiency).”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Depression RCT Sample Types
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“ACT improved quality of life relative to waitlist in four out of five trials with Cohen's d effect sizes ranging between .39 and 1.03, up to 3-month follow up.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Depression RCT Outcomes with Positive Mental Health and Quality of Life
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“RCTs indicate that ACT leads to greater improvements in depression relative to comparison conditions for depressed individuals with comorbid migraines, 68 with comorbid psychosis, 69 caregivers of family members with dementia, 70 and individuals on long-term sick leave.71”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Depression RCT Sample Types
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Additional open trials have found ACT to produce improvements over time with depression in unique/complex samples including comorbid depression and social anxiety disorder, 73 comorbid depression and obesity, 74 and depressed veterans in the US (Walser et al., 2013).75”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Depression RCT Sample Types
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Among studies reporting rates, ACT response rates ranged from 50% to 58% with depression recovery rates ranging from 24% to 82%.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Depression RCT Treatment Formats
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“These studies similarly found ACT outperforms waitlist and TAU, with equivalent or greater outcomes relative to CT.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Depression RCT Treatment Formats
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Four RCTs evaluated ACT in a self-help format for depression, with three using an online delivery format and one testing a self-help book with email support.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Depression RCT Treatment Formats
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Seven RCTs compared ACT to waitlist conditions on depression, with every study showing that ACT improves depression relative to no treatment up to 6-month follow up.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Several RCTs have been conducted comparing ACT to various control conditions
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, only two of four RCTs found that ACT improved psychological flexibility relative to CT/CBT, with the other two studies finding equal improvements between conditions.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Depression RCT Processes of Change
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Response rates from ACT varied between 25% and 54%, with one study finding that 50% recovered from depression following an ACT self-help program (Lappalainen).”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Depression RCT Treatment Formats
What the sources say
- Not matchedcites Lappalainen
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The work in panic disorder and health anxiety is in its infancy; there has been very little with specific phobias.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Conclusions
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These studies almost exclusively compared ACT to waitlist, finding that ACT produces significant improvements in depression relative to no treatment at post and up to 6-month follow up with effect sizes ranging between Cohen's d of .32 and .98.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Depression RCT Treatment Formats
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“These studies found ACT outperforms waitlist, TAU, and a minimal support group, with largely equivalent effects relative to CT/CBT.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Depression RCT Treatment Formats
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Functional contextualism is a pragmatic world view in that it defines truth with regards to success in achieving stated goals, which in the case of functional contextualism are prediction and influence of behavior.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Abstract
What the sources say
- Not checked — no full text of the sourcecites [8] Hayes, 1988, Finding the philosophical core: a review of Stephen C. Pepper's World Hypotheses: a study in evidence, J Exp Anal Behav source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“RFT focuses on the role of a specific type of behavior, arbitrarily applicable derived relational responding, as a central component of language and cognition.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Relational Frame Theory.
What the sources say
- Not matchedcites [3] Hayes, 2001
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [5] Zettle, 2016 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“However, humans also have the unique capacity to derive relations beyond direct learning history (e.g., learning a nickel is smaller than a dime and a dime is smaller than a quarter, and deriving a quarter is greater than a nickel).”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Relational Frame Theory.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“The unit of analysis in functional contextualism is the organism interacting in and with a context (defined currently and historically).”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Abstract
What the sources say
- Not checked — no full text of the sourcecites [8] Hayes, 1988, Finding the philosophical core: a review of Stephen C. Pepper's World Hypotheses: a study in evidence, J Exp Anal Behav source
- Not checked — no full text of the sourcecites [9] Hayes, 2012, Contextual behavioral science: creating a science more adequate to the challenge of the human condition, J Contextual Behav Sci source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Acceptance and commitment therapy (ACT) 1 is part of a larger research approach called Contextual Behavioral Sciences (CBS).”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Abstract
What the sources say
- Not checked — no full text of the sourcecites [1] Hayes, 2012 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“This last example highlights another key property of relational behavior, which is that they can transform the functions of stimuli.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Relational Frame Theory.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Acceptance and commitment therapy (ACT) is a modern form of cognitive behavioral therapy based on a distinct philosophy (functional contextualism) and basic science of cognition (relational frame theory).”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Abstract
What the sources say
- Not matchedcites [3] Hayes, 2001
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked — no full text of the sourcecites [5] Zettle, 2016 source
- Not checked — no full text of the sourcecites [8] Hayes, 1988, Finding the philosophical core: a review of Stephen C. Pepper's World Hypotheses: a study in evidence, J Exp Anal Behav source
- Not checked — no full text of the sourcecites [9] Hayes, 2012, Contextual behavioral science: creating a science more adequate to the challenge of the human condition, J Contextual Behav Sci source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Not matched
In the paper
“Furthermore, derived relational responding can be applied arbitrarily, meaning social cues (instead of just physical properties of stimuli) can inform us of how to relationally respond to stimuli.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Relational Frame Theory.
What the sources say
- Not matchedcites [11] De Houwer, 2013
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Not matched
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“RFT suggests that the literal context of thoughts might be altered such that these relations do not have the same functions (cognitive defusion).”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Relational Frame Theory.
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“A significant decrease in panic disorder was seen after the first 4 sessions, with additional significant gains found in the following 6 sessions.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Panic Disorder
What the sources say
- Not checked — no full text of the sourcecites [34] Meuret, 2012, Brief acceptance and commitment therapy and exposure for panic disorder: a pilot study, Cogn Behav Pract source
plaindirectn = 11- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Overall, these results indicate that ACT improves quality of life in addition to symptom severity among depressed samples”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Depression RCT Outcomes with Positive Mental Health and Quality of Life
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is less clear how ACT compares to CBT due to the number of trials and tendency for small sample sizes in existing studies, but results suggest it is likely at least equally effective for depression, with some questions raised regarding which treatment may be more effective at follow up.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Several RCTs have been conducted comparing ACT to various control conditions
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Moderation effects for that same trial were also found in that CBT performed better for those with moderate levels of pretreatment anxiety sensitivity, and ACT performed better for those with comorbid disorders.25”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Mixed Anxiety
What the sources say
- Not checked — no full text of the sourcecites [25] Wolitzky-Taylor, 2012, Moderators and non-specific predictors of treatment outcome for anxiety disorders: a comparison of cognitive behavioral therapy to acceptance and commitment therapy, J Consult Clin Psychol source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“these results at least suggest that ACT can be delivered in an online format with similar impact on depression.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Depression RCT Treatment Formats
hedgedn = 38- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Overall, ACT's evidence base for depressive and anxiety disorders continues to grow, indicating this unique, modern CBT is a promising treatment approach warranting dissemination and further study.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Conclusions
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: ACT is a unified treatment protocol.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These include formats that are especially promising for increasing the reach of services in cost effective formats such as one-day workshops, self-help books, and websites.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Depression RCT Treatment Formats
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, there is also a large amount of research indicating ACT is effective for depression, and potentially as effective as traditional CBT.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Conclusions
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Depression was one of the first clinical problems evaluated with ACT 62 and one of the most studied problems since, with 17 RCTs published over the past three decades.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Depressive Disorders
What the sources say
- Not checked yetcites [62] Dabbaghi, 2016, Effectiveness of group training of acceptance and commitment therapy on depression symptoms in soldiers, EBNESINA
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“In the second study, 16 students were assigned to CT or AABT for test anxiety.61 There were surprising results in that those in the AABT condition did markedly better on exams and those in the CT condition did worse.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Health Anxiety and Specific Phobia
What the sources say
- Not checked — no full text of the sourcecites [61] Zettle, 1987, Component and process analysis of cognitive therapy, Psychol Rep source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“In their first work, Roemer and Orsillo 26 tested AABT in an open trial with 16 adults diagnosed with GAD.Results were promising with large effect sizes at post and follow-up with 75% responders at post and 50% at follow-up.”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Generalized Anxiety Disorder
What the sources say
- Not checked — no full text of the sourcecites [26] Roemer, 2007, An open trial of an acceptance-based behavior therapy for generalized anxiety disorder, Behav Ther source
plainn = 16- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper relies on this without support.
Psychological inflexibility is a core concern in mixed anxiety disorders.
“ACT has always been a unified treatment protocol for issues where psychological inflexibility is a core concern.”
The paper relies on this without support.
Most primary outcome measures used in ACT treatment outcome work mix changes to internal events and overt actions.
“However, most primary outcome measures used in treatment outcome work have a mix of changes to internal events and overt actions.”
The paper relies on this without support.
The six processes of change in ACT all work together.
“Psychological flexibility is made up of six processes of change that all work together.”
The paper relies on this without support.
ACT is a unified treatment protocol.
“As ACT is a unified treatment protocol and there is a growing number of trials testing ACT across anxiety and depression issues.”
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?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“So far, PB-CBT proved to be efficacious for alleviating anxiety and depression levels among both the general and chronic pain population, with very good acceptability [38,39,40].”
From A Single-Session Process-Based Cognitive-Behavioral Intervention Combined with Multimodal Rehabilitation Treatment for Chronic Pain Associated with Emotional Disorders (2024) · cites this paper as [38]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Corresponding to the underlying theory, mediation analyses report increasing psychological flexibility as a mediator or process variable of ACT treatment effects, such as increases in quality of life and decreases in symptoms (20–22).”
From Increasing psychological flexibility is associated with positive therapy outcomes following a transdiagnostic ACT treatment (2024) · cites this paper as [22]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“In agreementwithourfindings, theliterature revealed promising outcomes about the use of group ACT to manage mood disorders, regardless of age, gender, ethnicity, and type of disease (40, 41).”
From The Effect of Group Acceptance and Commitment Therapy on the Management of Asthma: A Randomized Clinical Trial (2022) · cites this paper as [40]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“ACT-based interventions have been proven effective with regard to abroad range of health and psychological problems (Kishita et al . 2017; Twohig and Levin 2017; Brown et al . 2016; Lee and Song 2018; Hayes et al . 2006; Bai et al . 2020).”
From Effectiveness of a training programme based on acceptance and commitment therapy aimed at older adults – no moderating role of cognitive functioning (2021) · cites this paper as Twohig and Levin 2017
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“-A review of thirty-six RCTs of anxiety and depression treatments: ACT appears to be more effective than waitlist and treatment as usual with effects relatively equivalent to CBT (Twohig & Levin, 2017).”
From Prolonged grief disorder treatment: An approach to COVID-19 grief (2023) · cites this paper as Twohig & Levin, 2017
Experimental — accuracy not yet measured
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“reductions in anxiety symptoms, depressive symptoms, and stress in both clinical and non-clinical populations”
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 Twohig & Levin, 2017
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“ACT is rooted in functional contextualism and (Hayes et al., 2011) incorporates mindfulness and acceptance-based processes along with commitment and behavior change processes to support adaptive coping with life’s realities (Hayes et al., 2012; Twohig & Levin, 2017).”
From Feasibility and acceptability of a telephone-based ACT intervention for caregivers (TACTICs) of adults with Alzheimer's disease and related dementias (ADRD): a randomized pilot during the COVID-19 pandemic. (2025) · cites this paper as Twohig & Levin, 2017
The cited source says what the claim attributes to it.
In the citing paper
“Empirical evidence for ACT’s transdiagnostic efficacy for conditions including depression, anxiety (Twohig and Levin, 2017), and PTSD (Pohar and Argáez, 2017), has grown exponentially over recent years, with over 1,000 randomized controlled trials published to date (Hayes, 2023).”
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 Twohig and Levin, 2017
The cited source says what the claim attributes to it.
In the citing paper
“There is promising evidence regarding the applicability of ACT to understand and intervene in internalizing disorders (Landy et al., 2015; Twohig & Levin, 2017), including adult (e.g., Caletti et al., 2022) and adolescent SAD (Oyetunde & Ajibola, 2019).”
From Psychological inflexibility explains social anxiety over time: a mediation analyses with a clinical adolescent sample (2024) · cites this paper as Twohig & Levin, 2017
The cited source says what the claim attributes to it.
In the citing paper
“ACT is considered effective in alleviating these symptoms [30].”
From Psychometric Properties of the Japanese Version of the Parental Acceptance and Action Questionnaire in Parents with Infants and Toddlers (2023) · cites this paper as [30]
The cited source says what the claim attributes to it.
In the citing paper
“ACT interventions have been effective in reducing psychopathology and in increasing psychological flexibility (Twohig & Levin, 2017), particularly in adolescents (e.g., Livheim et al., 2015).”
From THE EFFICACY OF A COMPASSION, ACCEPTANCE AND MINDFULNESS-BASED PILOT INTERVENTION FOR ADOLESCENTS’ TEST ANXIETY: A CASE STUDY USING THE ACADEMIC PROGRAM (2023) · cites this paper as Twohig & Levin, 2017
The cited source says what the claim attributes to it.
In the citing paper
“which incorporates both mindfulness and acceptance strategies to promote psychological well-being and is an empirically-supported treatment for depression and anxiety [48].”
From Trajectories of Maternal and Paternal Internalizing Symptoms from Pregnancy to 2 Years Postpartum: Identifying Modifiable Risk and Protective Factors (2024) · cites this paper as [48]
The cited source says what the claim attributes to it.
In the citing paper
“Through randomized controlled studies, there is empirical evidence of ACT on anxiety disorder and depressive disorder [22].”
From Acceptance and Commitment Therapy for Destructive Experiential Avoidance (ACT-DEA): A Feasibility Study (2022) · cites this paper as [22]
The cited source says what the claim attributes to it.
In the citing paper
“ACT has shown small to medium effect sizes on physical and mental health in chronic pain patients [10], as well as in the treatment of anxiety [11,12,13] and depression [12,13,14].”
The cited source says what the claim attributes to it.
In the citing paper
“ACT has a growing evidence base for a range of conditions and populations,20–23 including parenting.24–27”
From Early Parenting Acceptance and Commitment Therapy ‘Early PACT’ for parents of infants with cerebral palsy: a study protocol of a randomised controlled trial (2020) · cites this paper as [21]
The cited source says what the claim attributes to it.
In the citing paper
“These results support the underlying premise of ACT (Hayes, 2019), and are consistent with previous research (Stockton et al., 2019; Twohig and Levin, 2017).”
From Process of change and efficacy of acceptance and commitment therapy (ACT) for anxiety and depression symptoms in adolescents: A meta-analysis of randomized controlled trials. (2025) · cites this paper as Twohig and Levin, 2017
The check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“An 8-week ACT therapy course decreased stress and other psychological health indices in people with IBD in a randomized controlled experiment.”
From The Effect of Acceptance and Commitment Therapy on Psychological Nursing of Acute Cerebral Infarction with Insomnia, Anxiety, and Depression (2022) · cites this paper as [5]
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
In the citing paper
“Evidence suggests that people with chronic pain syndromes are four times more likely to be at risk of developing PTSD and report more functional impact than those without a chronic pain condition.49”
From Psychological interventions for women with persistent pelvic pain: A survey of mental health clinicians (2021) · cites this paper as [49]
Experimental — accuracy not yet measured
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.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Additional information
“Forman et al (2007) | N=101 students seeking service | ACT = CBT for anxiety and |”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Additional information
“Forman et al., 2007 (2012) N = 132 US college students seeking therapy with depression and/or anxiety, Individual ACT vs. CT”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > Social Anxiety Disorder
“Three of these were compared to waitlists, [43][44][45]”
§ Acceptance and commitment therapy as a treatment for anxiety and depression: A review > References
“44. Craske MG, Niles AN, Burklund LJ, et al. Randomized controlled trial of cognitive behavioral therapy and acceptance and commitment therapy for social phobia: outcomes and moderators.”
Citations
Cites
Relational frame theory: a post-Skinnerian account of human language and cognition
Barnes‐Holmes, Y., Hayes, S. C., Barnes‐Holmes, D., & Roche, B. T. (2001) · Choice Reviews Online · doi:10.5860/choice.39-2482 · Cited by 1,975
Hayes, S. C., Levin, M. E., Plumb-Vilardaga, J., Villatte, J. L., & Pistorello, J. (2013) · Behavior Therapy · doi:10.1016/j.beth.2009.08.002 · Cited by 1,120 · cited 1×
“Clarifying philosophical assumptions is critical for ensuring the coherence and effectiveness of a program of research(6), as well as understanding differences between therapeutic approaches.(7) ACT as a part of CBS adopts the core assumptions of”
BackgroundSelf-citationForman, E. M., Herbert, J. D., Moitra, E., Yeomans, P. D., & Geller, P. A. (2007) · Behavior Modification · doi:10.1177/0145445507302202 · Cited by 687 · cited 3×
“PF mediated ACT vs. WL treatment effects but not ACT vs. EW (Pots et al., 2016b) CT/CBT Comparison Conditions Forman et al., 2007 (2012) N = 132 US college students seeking therapy with depression and/or anxiety, Individual ACT vs. CT CT = ACT at post on depression, CT > ACT at 18 month FU (f = .21) with 82% recovered…”
BackgroundMethodThe third wave of cognitive behavioral therapy and the rise of process-based care
Hayes, S. C., & Hofmann, S. G. (2017) · World Psychiatry · doi:10.1002/wps.20442 · Cited by 613
Roemer, L., Orsillo, S. M., & Salters-Pedneault, K. (2008) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0012720 · Cited by 554
(2010) · Redalyc (Universidad Autónoma del Estado de México) · Cited by 542
Levin, M. E., Hildebrandt, M. J., Lillis, J., & Hayes, S. C. (2012) · Behavior Therapy · doi:10.1016/j.beth.2012.05.003 · Cited by 471
Self-citationArch, J. J., Eifert, G. H., Davies, C., Vilardaga, J. C. P., Rose, R. D., & Craske, M. G. (2012) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0028310 · Cited by 443
Twohig, M. P., Hayes, S. C., Plumb, J. C., Pruitt, L. D., Collins, A. B., Hazlett-Stevens, H., & Woidneck, M. R. (2010) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0020508 · Cited by 434 · cited 3×
“Yadegari et al. (2014) N=16, 18-20 YO; ACT vs WL ACT > WL; SPAI: ACT 134 pre, 57 post; WL 148 pre 149 post Craske et al. (2014) N=87; ACT vs CBT vs WL, Assessments at pre, post, 6 mo, and 12 mo ACT = CBT, both > WL; response rates post 52% CBT, 41% ACT, 6 mo FU 57% CBT 53% ACT, 12 mo FU 40% CBT, 41% ACT Obsessive-Comp…”
BackgroundInfluentialSelf-citationHayes, S. C., Barnes-Holmes, D., & Wilson, K. G. (2012) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2012.09.004 · Cited by 409 · cited 1×
“functional contextualism, which are generally consistent with common assumptions in behavior analysis.(8,9) Functional contextualism is a pragmatic world view in that it defines truth with regards to success in achieving stated goals, which in the case of functional contextualism are prediction and influence of behavi…”
Background
Research works printed but not linked: 2
- Baghooli, 2014, Effectiveness of acceptance and commitment therapy in reduction of severity symptoms of patients with obsessive–compulsive disorder, Adv Environ Biol, 8, 2519
- Vakili, 2014, The comparison of acceptance and commitment therapy with selective serotonin reuptake inhibitors in the treatment of obsessive-compulsive disorder, Zahedan Journal of Research in Medical Sciences, 16, 10
Cited by
Sorted by citations
Jungmann, S. M., & Witthöft, M. (2020) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2020.102239 · Cited by 635
Davis, A. K., Barrett, F. S., & Griffiths, R. R. (2020) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2019.11.004 · Cited by 375
Major depressive disorder: Validated treatments and future challenges
Karrouri, R., Hammani, Z., Benjelloun, R., & Otheman, Y. (2021) · World Journal of Clinical Cases · doi:10.12998/wjcc.v9.i31.9350 · Cited by 232
Akbari, M., Seydavi, M., Hosseini, Z. S., Krafft, J., & Levin, M. E. (2022) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2022.03.007 · Cited by 155
Self-citationAcceptance and Commitment Therapy in group format for anxiety and depression. A systematic review.
Coto-Lesmes, R., Fernández-Rodríguez, C., & González-Fernández, S. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2019.11.154 · Cited by 141
Schaumberg, K., Reilly, E. E., Gorrell, S., Levinson, C. A., Farrell, N. R., Brown, T. A., Smith, K. M., Schaefer, L. M., Essayli, J. H., Haynos, A. F., et al. (2021) · Clinical Psychology Review · doi:10.1016/j.cpr.2020.101952 · Cited by 121
Asikainen, H., Salmela‐Aro, K., Parpala, A., & Katajavuori, N. (2019) · Learning and Individual Differences · doi:10.1016/j.lindif.2019.101781 · Cited by 119
Johannsen, M., Nissen, E. R., Lundorff, M., & O'Toole, M. S. (2022) · Clinical Psychology Review · doi:10.1016/j.cpr.2022.102156 · Cited by 116
Levin, M. E., Krafft, J., Hicks, E. T., Pierce, B., & Twohig, M. P. (2020) · Behaviour Research and Therapy · doi:10.1016/j.brat.2020.103557 · Cited by 101
Self-citationMathew, A., Doorenbos, A. Z., Jang, M. K., & Hershberger, P. E. (2021) · Journal of Cancer Survivorship · doi:10.1007/s11764-020-00938-z · Cited by 91
Macri, J. A., & Rogge, R. D. (2024) · Clinical Psychology Review · doi:10.1016/j.cpr.2024.102432 · Cited by 89
Wojnarowska, A., Kobylinska, D., & Lewczuk, K. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.00242 · Cited by 82
Tassone, F., Protic, D. D., Allen, E. G., Archibald, A. D., Baud, A., Brown, T. W., Budimirovic, D. B., Cohen, J., Dufour, B. D., Eiges, R., et al. (2023) · Cells · doi:10.3390/cells12182330 · Cited by 78
Davis, A. K., Xin, Y., Sepeda, N. D., Garcia-Romeu, A., & Williams, M. T. (2021) · Chronic Stress · doi:10.1177/24705470211035607 · Cited by 67
“Because prior research showed that acute psychedelic effects (mystical type, insight, and challenging) are associated with reductions in trauma symptoms in this population,(21) that psychedelic effects are associated with changes in psychological flexibility,(30) and that increases in psychological flexibility are ass…”
BackgroundComorbidity of opioid-related and anxiety-related symptoms and disorders
Langdon, K. J., Dove, K., & Ramsey, S. (2019) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2018.12.020 · Cited by 53
“Acceptance and Commitment Therapy and Cognitive-Behavioral Therapy have demonstrated efficacy in the treatment of chronic pain [53, 54] anxiety disorders [55, 56], and substance use disorders [57, 58].”
BackgroundWharton, E., Edwards, K. S., Juhasz, K., & Walser, R. D. (2019) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2019.09.006 · Cited by 60
Shabani, M. J., Mohsenabadi, H., Omidi, A., Lee, E. B., Twohig, M. P., Ahmadvand, A., & Zanjani, Z. (2019) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2019.04.003 · Cited by 56
“Data in this area consists of two preliminary studies utilizing multiple baselines designs with children and adolescents with OCD (Armstrong, Morrison, & Twohig, 2013; Barney, Field, Morrison, & Twohig, 2017).”
BackgroundSelf-citationThe Impact of Psychological Flexibility on Psychological Well-Being in Adults With Obesity
Usubini, A. G., Varallo, G., Granese, V., Cattivelli, R., Consoli, S., Bastoni, I., Volpi, C., Castelnuovo, G., & Molinari, E. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.636933 · Cited by 52
“, 2018) including anxiety and depressive symptomatology (Twohig and Levin, 2017) as well as chronic pain (Vowles and McCracken, 2008) and stress (Cristina et al.”
BackgroundSchrammen, E., Roesmann, K., Rosenbaum, D., Redlich, R., Harenbrock, J., Dannlowski, U., & Leehr, E. J. (2022) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2022.104895 · Cited by 54
Liu, F., Zhang, Z., Liu, S., & Feng, Z. (2022) · PLoS ONE · doi:10.1371/journal.pone.0279621 · Cited by 59
Krafft, J., Potts, S., Schoendorff, B., & Levin, M. E. (2019) · Behavior Modification · doi:10.1177/0145445517748561 · Cited by 45
Self-citationHall, A. E., Nguyen, N. H., Cascavita, C. T., Shariati, K., Patel, A. K., Chen, W., Kang, Y., Ren, X., Tseng, C.-H., Hidalgo, M. A., et al. (2025) · Annals of Surgery · doi:10.1097/sla.0000000000006677 · Cited by 52
Østergaard, T., Lundgren, T., Zettle, R. D., Landrø, N. I., & Haaland, V. Ø. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.00528 · Cited by 45
The Frail Depressed Patient: A Narrative Review on Treatment Challenges
Aprahamian, I., Borges, M. K., Hanssen, D. J. C., Jeuring, H. W., & Voshaar, R. C. O. (2022) · Clinical Interventions in Aging · doi:10.2147/cia.s328432 · Cited by 45
Luck, T., & Luck-Sikorski, C. (2020) · Das Gesundheitswesen · doi:10.1080/13548506.2020.1859558 · Cited by 37
“…(Körner et al., 2015; PLOS ONE Staff, 2015), modern cognitive behavioral approaches like Acceptance and Commitment Therapy (ACT; Hayes et al., 2006; Twohig & Levin, 2017) as well as newly introduced specific integrative emotion-focused approaches for the therapy of shame and guilt (Lammers, 2016)…”
BackgroundNiu, Y., Sheng, S., Chen, Y., Ding, J., Li, H., Shi, S., Wu, J., & Ye, D. (2022) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2021.106225 · Cited by 40
Fernández-Rodríguez, C., Coto-Lesmes, R., Martínez-Loredo, V., González-Fernández, S., & Cuesta, M. (2023) · Behavior Modification · doi:10.1177/01454455221083309 · Cited by 35
“Results are similar regarding ACT (Coto-Lesmes et al., 2020b; Dindo et al., 2017; González-Fernández & Fernández-Rodríguez, 2019; Twohig & Levin, 2017), and also in the case of UP (Cassiello-Robbins et al., 2020; Sakiris & Berle, 2019).”
MethodHartmann, A. S., Cordes, M., Hirschfeld, G. H. F., & Vocks, S. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2018.12.132 · Cited by 39
Presciutti, A., Siry-Bove, B., Newman, M. M., Elmer, J., Grigsby, J., Masters, K., Shaffer, J., Vranceanu, A.-M., & Perman, S. (2022) · Journal of the American Heart Association : Cardiovascular and Cerebrovascular Disease · doi:10.1161/jaha.121.025713 · Cited by 32
“29,30 Future, individual-level interventions could target these factors in both survivors ofcardiac arrest and their informal caregivers (if applicable).”
Haeger, J. A., Davis, C. H., & Levin, M. E. (2022) · Journal of American College Health · doi:10.1080/07448481.2020.1763366 · Cited by 33
Self-citationGrazzi, L., Andrasik, F., Rizzoli, P., Bernstein, C., Sansone, E., & Raggi, A. (2021) · Headache The Journal of Head and Face Pain · doi:10.1111/head.14139 · Cited by 34
Jin, X., Wong, C. L., Li, H., Chen, J., Chong, Y. Y., & Bai, Y. (2021) · Journal of Advanced Nursing · doi:10.1111/jan.14798 · Cited by 32
Byrne, G., & Ní Ghráda, Á. (2019) · Aggression and Violent Behavior · doi:10.1016/j.avb.2019.01.001 · Cited by 32
Philip, J., & Cherian, V. (2020) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2020.100603 · Cited by 31
School-Based Acceptance and Commitment Therapy for Adolescents With Anxiety: A Pilot Trial
Petersen, J. M., Davis, C. H., Renshaw, T. L., Levin, M. E., & Twohig, M. P. (2023) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2022.02.021 · Cited by 31
Self-citationLevin, M. E., Krafft, J., & Twohig, M. P. (2020) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2020.05.001 · Cited by 28
Self-citationAssociation between burnout and stigma in physicians
Favre, S., Bajwa, N. M., Dao, M. D., Audétat, M., NENDAZ, M. R., Perron, N. J., Perneger, T., & Richard-Lepouriel, H. (2023) · PLoS ONE · doi:10.1371/journal.pone.0283556 · Cited by 36
“Among people suffering from depression, the combination of the increased potential for aversive experiences, a tendency for experiential avoidance, and rigid patterns of behavior under the control of cognitions that are insensitive to the current context are grouped under the term “psychological inflexibility” process…”
BackgroundPsychological Flexibility and Depression in Advanced CKD and Dialysis
Iida, H., Fujimoto, S., Wakita, T., Yanagi, M., Suzuki, T., Koitabashi, K., Yazawa, M., Kawarazaki, H., Ishibashi, Y., Shibagaki, Y., et al. (2020) · Kidney Medicine · doi:10.1016/j.xkme.2020.07.004 · Cited by 26
Han, J., Zhang, L., Liu, Y., Zhang, C., Zhang, Y., Tang, R., & Bi, L. (2022) · Journal of Nursing Management · doi:10.1111/jonm.13696 · Cited by 25
“Compared with alternative methods, the ACT had supporting findings on the effectiveness on patients’ problems, such as depression, anxiety, chronic pain and cancer adaptation (Du et al., 2021; Mathew et al., 2021; Twohig & Levin, 2017).”
MethodBeygi, Z., Tighband Jangali, R., Derakhshan, N., Alidadi, M., Javanbakhsh, F., & Mahboobizadeh, M. (2023) · Iranian Journal of Psychiatry · doi:10.18502/ijps.v18i2.12373 · Cited by 28
“suggests that clinical improvement is rooted in improved psychological flexibility (18).”
BackgroundLu, Y., Li, Y., Huang, Y., Zhang, X., Wang, J., Wu, L., & Cao, F. (2023) · Journal of Medical Internet Research · doi:10.2196/51549 · Cited by 24
Morgan, T. A., Dalrymple, K., D’Avanzato, C., Zimage, S., Balling, C., Ward, M., & Zimmerman, M. (2021) · Behavior Therapy · doi:10.1016/j.beth.2020.08.004 · Cited by 24
Mirzaeidoostan, Z., Zargar, Y., & Zandi Payam, A. (2019) · Iranian Journal of Psychiatry and Clinical Psychology · doi:10.32598/ijpcp.25.1.2 · Cited by 25
Salvati, M., & Chiorri, C. (2021) · Journal of Homosexuality · doi:10.1080/00918369.2021.1990686 · Cited by 24
“…Schmidt, & Walach, 2004), the Mindfulness Based Cognitive Therapy (MBCT, Chiesa & Serretti, 2011), the Acceptance and Commitment Therapy (ACT, Twohig & Levin, 2017), the Compassion Focused Therapy (CFT, Leaviss & Uttley, 2015), or the Dialectical and Behavior Therapy (DBT, Valentine,…”
BackgroundBut parents need help! Pathways to caregiver mental health care in pediatric hospital settings
Salley, C. G., Axelrad, M. E., Fischer, E. A., & Steuer, K. B. (2022) · Palliative & Supportive Care · doi:10.1017/s1478951522001353 · Cited by 24
“…depression, anxiety, and chronic stress can respond well to treatment with evidenced-based interventions such as Cognitive Behavioral Therapy (Trauer et al. 2015; van Dis et al. 2020), Acceptance and Commitment Therapy (Twohig and Levin 2017), and Mindfulness strategies (Goldberg et al. 2018).”
BackgroundLevin, M. E., Navarro, C., Cruz, R. A., & Haeger, J. (2019) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2018.1503706 · Cited by 21
“There is a large body of research indicating that these ACT components can impact mental health (Levin et al., 2012) and that reducing these pathological processes with ACT mediates treatment effects for problems including depression and anxiety disorders (Twohig & Levin 2017).”
Self-citationMunawar, K., Choudhry, F. R., Lee, S. H., Siau, C. S., Kadri, N. B. M., & Binti Sulong, R. M. (2021) · Heliyon · doi:10.1016/j.heliyon.2021.e07842 · Cited by 22
“In this regard, experimental studies have demonstrated usefulness of ACT for anxiety and depressive disorders (Bai et al., 2020; Bond and Bunce, 2000; Forman et al., 2007; Kelson et al., 2019; Lappalainen et al., 2007; Twohig and Levin, 2017; Zettle and Hayes, 1986), physical health issues (Gonz alez-Fern andez and Fe…”
BackgroundOguz, G., Celikbas, Z., Batmaz, S., Cagli, S., & Sungur, M. Z. (2019) · International Journal of Cognitive Therapy · doi:10.1007/s41811-019-00047-5 · Cited by 23
Zimmerman, M., D’Avanzato, C., & King, B. T. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.12.015 · Cited by 24
“ACT is a third wave behavioral therapy treatment that has been demonstrated to be of benefit for patients with depression (Coto-Lesmes et al., 2020; Twohig and Levin, 2017; Washburn et al., 2021).”
Rutschmann, R., Romanczuk-Seiferth, N., Gloster, A., & Richter, C. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1403718 · Cited by 21
“Corresponding to the underlying theory, mediation analyses report increasing psychological fl exibility as a mediator or process variable of ACT treatment effects, such as increases in quality of life and decreases in symptoms (20 – 22).”
Easdale-Cheele, T., Parlatini, V., Cortese, S., & Bellato, A. (2024) · Brain Sciences · doi:10.3390/brainsci14050453 · Cited by 29
“It has been proven effective for people with disorders where inflexibility plays a crucial role, such as anxiety disorders and depression [69].”
BackgroundBaker, L. D., Stroman, J. C., Kalantar, E. A., Bock, R. C., & Berghoff, C. R. (2021) · Journal of Traumatic Stress · doi:10.1002/jts.22677 · Cited by 21
Ruiz, F. J., Suárez‐Falcón, J. C., Segura‐Vargas, M. A., & Gil‐Luciano, B. (2022) · Journal of Clinical Psychology · doi:10.1002/jclp.23212 · Cited by 22
Measuring psychological inflexibility in adult and child hearing loss
Ong, C. W., Whicker, J. J., Muñoz, K. F., & Twohig, M. P. (2019) · International Journal of Audiology · doi:10.1080/14992027.2019.1630759 · Cited by 22
Self-citationNa, 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
“Through randomized controlled studies, there is empirical evidence of ACT on anxiety disorder and depressive disorder [22].”
BackgroundBertele, S., Heitland, I., Fraccarollo, D., Stapel, B., Bauersachs, J. K., Westhoff‐Bleck, M., & Kahl, K. G. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.1002143 · Cited by 23
Addiction and Mindfulness; Pornography Addiction and Mindfulness-Based Therapy ACT
Fraumeni‐McBride, J. (2019) · Sexual Addiction & Compulsivity The Journal of Treatment and Prevention · doi:10.1080/10720162.2019.1576560 · Cited by 27
“…is sufficient theoretical framework available to apply addiction identifiers to problematic pornography use (Kor et al., 2014), which further has implications to the benefits of using ACT in treating perceived problematic or addictive pornography use (Hayes et al., 2011; Twohig & Levin, 2017).”
BackgroundMethodInfluentialWhittingham, K., Sheffield, J., Mak, C., Dickinson, C., & Boyd, R. N. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-037033 · Cited by 20
Lee, S. W., Choi, M., & Lee, S. J. (2022) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2022.11.009 · Cited by 22
Brooks, T., Sharp, R., Evans, S., Baranoff, J., & Esterman, A. (2021) · Journal of Multidisciplinary Healthcare · doi:10.2147/jmdh.s313109 · Cited by 23
Edwards, D. J. (2024) · Frontiers in Computational Neuroscience · doi:10.3389/fncom.2024.1395901 · Cited by 24
“This is because, from a middle-level functional contextual perspective, ACT (Hayes et al., 1999, 2006, 2011; Harris, 2006; Twohig and Levin, 2017; Bai et al., 2020) emphasizes contextually defined values identification, orientation, and alignment and therefore maybe again one useful avenue to…”
BackgroundKrafft, J., Ong, C. W., Twohig, M. P., & Levin, M. E. (2019) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2018.08.003 · Cited by 18
Self-citationThe buffering effect of attentional control on the relationship between cognitive fusion and anxiety
Thomas, K. N., & Bardeen, J. R. (2020) · Behaviour Research and Therapy · doi:10.1016/j.brat.2020.103653 · Cited by 19
“…component of larger treatment packages (e.g., Acceptance and Commitment Therapy [ACT]) positively impacts treatment outcomes for individuals with mood and anxiety disorders (Arch, Wolitzky-Taylor, Eifert, & Craske, 2012; Barrera, Szafranski, Ratcliff, Garnaat, & Norton, 2016; Twohig & Levin, 2017).”
BackgroundSun, Y., Ji, M., Zhang, X., Chen, J., Wang, Y., & Wang, Z. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.06.017 · Cited by 19
López-Pinar, C., Lara-Merín, L., & Macías, J. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.09.076 · Cited by 34
ACT in the workplace: A meta-analytic examination of randomized controlled trials
Unruh, I., Neubert, M., Wilhelm, M., & Euteneuer, F. (2022) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2022.09.003 · Cited by 17
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 25
“Despite the limitations, previous studies have shown the positive effects of ACT interventions on pain, depression, sleep, and anxiety [48,94].”
ResultOng, C. W., Krafft, J., Panoussi, F., Petersen, J. M., Levin, M. E., & Twohig, M. P. (2021) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2021.02.001 · Cited by 16
Gao, C., Xiao, X., Zhang, L., Xu, H., Wang, M., & Wang, H. (2022) · International Journal of Nursing Sciences · doi:10.1016/j.ijnss.2022.05.001 · Cited by 15
“Acceptance and cognitive defusion are the core processes of acceptance and commitment therapy [19].”
BackgroundMa, J., Ji, L., & Lu, G. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1050227 · Cited by 16
“ACT has gained more and more empirical support in treating depression (Twohig and Levin, 2017; A-Tjak et al., 2018).”
BackgroundAs'hab, P. P., Keliat, B. A., & Wardani, I. Y. (2022) · Journal of Public Health Research · doi:10.4081/jphr.2021.2737 · Cited by 16
An examination of the role of psychological inflexibility in hoarding using multiple mediator models
Ong, C. W., Krafft, J., Levin, M. E., & Twohig, M. P. (2018) · Journal of Cognitive Psychotherapy · doi:10.1891/0889-8391.32.2.97 · Cited by 15
“…is the primary treatment target of acceptance and commitment therapy (ACT; Hayes, Strosahl, & Wilson, 1999) and research has consistently found that reductions in psychological inflexibility mediate ACT treatment effects (Twohig & Levin, 2017), supporting the importance of this mechanism of change.”
Self-citationWang, X., Chen, J., Liu, Y.-E., & Wu, Y. (2022) · Computational and Mathematical Methods in Medicine · doi:10.1155/2022/8538656 · Cited by 16
Krafft, J., Klimczak, K. S., & Levin, M. E. (2022) · Cognitive Therapy and Research · doi:10.1007/s10608-021-10242-4 · Cited by 14
“…the literature on cognitive restructuring has focused on altering affect, while the literature on cognitive defusion has focused on encouraging valued living (Arch & Craske, 2008), although effects of interventions incorporating these processes are often similar (Twohig & Levin, 2017).”
Self-citationZou, J., Wu, S., Yuan, X., Hu, Z., Tang, J., & Hu, M. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.720518 · Cited by 13
Figueiredo, D. V., Alves, F., & Vagos, P. (2024) · Current Psychology · doi:10.1007/s12144-023-04650-w · Cited by 13
“There is promising evidence regarding the applicability of ACT to understand and intervene in internalizing disorders (Landy et al., 2015; Twohig & Levin, 2017), including adult (e.g., Caletti et al., 2022) and adolescent SAD (Oyetunde & Ajibola, 2019).”
Geda, Y. E., Krell‐Roesch, J., Fisseha, Y., Tefera, A., Beyero, T., Rosenbaum, D., Szabo, T. G., Araya, M., & Hayes, S. C. (2021) · Frontiers in Public Health · doi:10.3389/fpubh.2021.732800 · Cited by 21
Jiao, C.-Y., Song, X., Shao, W.-Y., Feng, L.-P., & Jiao, D. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.1015331 · Cited by 13
“Consequently, psychological treatment, such as Acceptance and Commitment Therapy, can reduce anxiety and depression by improving psychological flexibility (Twohig and Levin, 2017).”
BackgroundDesign of a dual randomized trial in a type 2 hybrid effectiveness—implementation study
Stevens, J., Mills, S. D., Millett, M.-L. E., Lin, F., & Leeman, J. (2023) · Implementation Science · doi:10.1186/s13012-023-01317-9 · Cited by 13
“Below we walk the reader through the DRCT design using constructed examples that evaluate acceptance and commitment therapy (ACT) [22] as the active intervention program (Pa).”
MethodBanovic, I., Montreuil, L., Derrey-Bunel, M., Scrima, F., Savoye, G., Beaugerie, L., & Gay, M. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.00703 · Cited by 15
Gaupp, R., Walter, M., Bader, K., Benoy, C., & Lang, U. E. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00861 · Cited by 15
“It uses a transdiagnostic framework and is successful in the treatment of anxiety and depression (17), pain (18), addiction (19), obsessive compulsive disorder (20), irritable bowel syndrome (21), diabetes, epilepsy (22), and cancer (23).”
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
Kaplan, D. M., Hamann, H. A., Price, S. N., Williamson, T. J., Ver Hoeve, E. S., McConnell, M. H., Duchschere, J. E., Garland, L. L., & Ostroff, J. S. (2023) · Journal of Psychosocial Oncology · doi:10.1080/07347332.2022.2033377 · Cited by 13
Gharashi, K., Moheb, N., & Abdi, R. (2019) · Auditory and Vestibular Research · doi:10.18502/avr.v28i2.866 · Cited by 13
“Furthermore, Twohig and Levin studied ACT efficiency in different psychological fields and improvement of psychological flexibility and stated its superiority over other traditional methods [23].”
BackgroundJo, D., Yang, Y., & Yang, E. (2024) · Cognitive Therapy and Research · doi:10.1007/s10608-024-10534-5 · Cited by 12
“Recently, the PF model (e.g., Acceptance and Commit - ment Therapy, ACT) has gained attention in academic and clinical settings to address mental health concerns, such as depression and anxiety (Twohig & Levin, 2017).”
Davis, C. H., Twohig, M. P., & Levin, M. E. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.12.097 · Cited by 15
Self-citationWang, D., Lin, B., Xiong, F., Deng, Y., & Zhang, L. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.08.125 · Cited by 14
Østergaard, T., Lundgren, T., Rosendahl, I. K., Zettle, R. D., Jonassen, R., Harmer, C. J., Stiles, T. C., Landrø, N. I., & Haaland, V. Ø. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.01995 · Cited by 11
Gaudiano, B. A., Davis, C. H., Miller, I. W., & Uebelacker, L. A. (2020) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2436 · Cited by 12
“ACT has shown effectiveness in treating depression across a number of studies (Twohig & Levin, 2017), including when adapted for internet-based self-help interventions (Brown, Glendenning, Hoon, & John, 2016).”
Ebrahimi, A., Nasre Esfahan, E., Akuchekian, S., Izadi, R., Shaneh, E., & Mahaki, B. (2022) · Journal of Research in Medical Sciences · doi:10.4103/jrms.jrms_449_21 · Cited by 9
“mediated through increases in psychological flexibility and health behavior.[14] A possible explanation for the”
BackgroundResultAcceptance 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
Self-citationHühne, V., Chacur, C., de Oliveira, M. V. S., Fortes, P. P., de Menezes, G. M. B., & Fontenelle, L. F. (2023) · Expert Review of Neurotherapeutics · doi:10.1080/14737175.2023.2265066 · Cited by 10
“Despite CBT being an established psychotherapeutic approach for the management of OCD [95] and MDD, alternative therapeutic techniques, particularly contextual therapies, have also demonstrated efficacy in RCTs [114,115].”
BackgroundApolinário-Hagen, J., Drüge, M., Hennemann, S., & Breil, B. (2021) · Advances in experimental medicine and biology · doi:10.1007/978-981-33-6044-0_17 · Cited by 10
Samawi, F. S., Alremawi, S. A. A., & Arabiyat, A. A. H. (2021) · International Journal of Instruction · doi:10.29333/iji.2022.15113a · Cited by 10
“Twohig & Levin (2017) also mentioned that future professional anxiety leads to a decline in the student's personal and academic motivation and leaves him prey to tension and psychological pressure, resulting in many psychological and organic disorders, the increase in negative and irrational…”
BackgroundTonn, P., Seule, L., Degani, Y., Herzinger, S., Klein, A., & Schulze, N. (2022) · JMIR Formative Research · doi:10.2196/37061 · Cited by 10
“Recent developments in in linguistic and psychological research in relational frame theory have been acceptance-based treatments, such as acceptance and commitment therapy [22,23].”
BackgroundDevelopment of the Transdiagnostic Skills Scale (T2S)
Vancappel, A., Raysseguier, C., Bouyer, C., Jansen, E., Mangolini, A., Brunault, P., Barbe, P.-G., Réveillère, C., & El‐Hage, W. (2022) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2022.2082522 · Cited by 10
“, 2021), emotional acceptance [70] and assertiveness [71,72].”
BackgroundHashemi, Z., Eyni, S., & Ebadi, M. (2022) · Iranian Journal of Psychiatry and Behavioral Sciences · doi:10.5812/ijpbs.110135 · Cited by 11
University of Coimbra, P., PIRES, C. P., HOFMANN, S. G., Philipps-University Marburg, G., PUTWAIN, D. W., Liverpool John Moores University, U., DO CÉU SALVADOR, M., & University of Coimbra, P. (2023) · Journal of Evidence-Based Psychotherapies · doi:10.24193/jebp.2023.1.3 · Cited by 9
Bürkle, J. J., Schmidt, S., & Fendel, J. C. (2025) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2025.102977 · Cited by 10
Primdahl, J., Bremander, A., Hendricks, O., Østergaard, M., Latocha, K. M., Andersen, L., Jensen, K. V., & Esbensen, B. A. (2024) · BMC Health Services Research · doi:10.1186/s12913-023-10463-1 · Cited by 9
Metadata
- Authors
- Twohig, M. P., & Levin, M. E.
- Affiliations
- Utah State University (US)
- Corresponding author
- Twohig, Michael P.
- Venue
- Psychiatric Clinics of North America
- Publisher
- Elsevier BV
- Published
- 2017-12
- Volume
- 40
- Issue
- 4
- Pages
- 751-770
- ISSN
- 0193-953X (ISSN-L)
- OpenAlex
- W2725508837
- Cited by
- 268
- References
- 101
- Citations by year
- 2026: 28 · 2025: 33 · 2024: 37 · 2023: 33 · 2022: 42 · 2021: 39 · 2020: 27 · 2019: 20 · 2018: 8 · 2017: 1
- FWCI
- 2.34
- Type
- journal article
- Language
- en
- Open access
- Locations
- Psychiatric Clinics of North America (publishedVersion)
- PubMed (publishedVersion)
- Digital Commons - USU (Utah State University) (submittedVersion)
- 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 › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- acceptance and commitment therapy, anxiety disorders, depression, psychological flexibility, cognitive behavioral therapy, change processes, treatment efficacy, psychopathology models
- MeSH terms
- Anxiety Disorders, Depressive Disorder, Humans, Acceptance and Commitment Therapy
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-09-30, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-09-30 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
