Investigating the acceptability of a culturally adapted acceptance and commitment therapy group for UK Vietnamese communities: A practice-based feasibility study
Abstract
Acceptance and Commitment Therapy (ACT) is an empirically supported psychotherapy that offers promise for the mental health of minoritised ethnic populations. Given the diversity of those presenting to inner-city services and barriers to accessing appropriate mental healthcare, we sought to develop a culturally syntonic ACT intervention for UK Vietnamese refugee communities in a practice-based partnership project between a National Health Service and local third-sector service in East London. The aim was to explore the feasibility, acceptability and impact of the adapted intervention to inform culturally inclusive clinical practice and future research. We outline key aspects of Vietnamese belief systems and culture, and consider how these might influence the optimisation of group-based ACT. We then present a mixed-method evaluation of the seven-session adapted ACT group for 11 participants (9 male and 5 female, aged between 44 and 73 years). Individual-level change analyses indicated clinically significant improvements in psychological flexibility for the minority of participants and a mixed pattern for impact on well-being. A thematic analysis and descriptive approach examined acceptability, feasibility and narratives of impact. Participants reported positive feedback on group experience, relevance and usefulness, and emergent themes indicate that the group facilitated key acceptance, commitment and behaviour-change processes, promoted social connections and increased engagement in meaningful life activities in relation to new perspectives and values-based action. Limitations are outlined, but overall, findings suggest preliminary support for the potential beneficial effect of the adapted ACT group as a feasible, culturally acceptable therapeutic approach for UK Vietnamese communities that is worthy of further investigation.
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Participants find culturally adapted ACT enjoyable and acceptable.
“Studies have also demonstrated that participants find culturally adapted ACT enjoyable and acceptable [58,61,62].”
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Byrne, A., Mustafa, S., & Miah, I. Q. (2017) · Psychoanalytic Psychotherapy · doi:10.1080/02668734.2017.1322131 · Cited by 10 · see citing works
Jensen, E., Carr, R., Degnan, A., Berry, K., & Edge, D. (2021) · British Journal of Clinical Psychology · doi:10.1111/bjc.12273 · Cited by 9 · see citing works
Acceptance and Commitment Therapy and Zen Buddhism
Fung, K. P.-L., & Wong, J. P. (2017) · Mindfulness in behavioral health · doi:10.1007/978-3-319-54595-0_21 · Cited by 8 · see citing works
Perry, A., Gardener, C., Dove, J., Eiger, Y., & Loewenthal, K. M. (2018) · International Journal of Social Psychiatry · doi:10.1177/0020764018756935 · Cited by 7 · see citing works
Self-citationAddressing ethnic inequalities in the pathways to care for psychosis
Kirkbride, J. B. (2018) · BMC Medicine · doi:10.1186/s12916-018-1236-y · Cited by 7 · see citing works
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“Speci fi cally, as a mindfulness-based intervention, it may be that those who attended to their internal distress were more aware of it and therefore rated it more highly (Fung et al., 2020; Katz et al., 2019).”
The psychometric properties of the Vietnamese Version of the Five Facet Mindfulness Questionnaire
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“AAQ-II has demonstrated good internal consistency, test – retest reliability and validity in community samples (Bond et al., 2011), with the psychometric properties also validated in clinical and non-clinical samples in diverse countries (Nguyen et al., 2022; Zhang et al., 2014).”
Guidance for psychologists on working with community organisations
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Acceptance and Commitment Therapy and Asian Thought
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Working with Spirituality in Refugee Care
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Validation of a Vietnamese Mental Health Recovery Scale for Vietnamese refugees
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Self-citationWorking across boundaries in services for children, young people and families
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Wang, D., Lin, B., Zhang, S., Xu, W., & Liu, X. (2024) · Journal of Medical Internet Research · doi:10.2196/50664 · Cited by 8 · see citing works
“Studies have also demonstrated that participants find culturally adapted ACT enjoyable and acceptable [58,61,62].”
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Anderson, J. (2025) · Mental Health Science · doi:10.1002/mhs2.70024 · Cited by 2 · see citing works
Bhui, K. S., Basu, D., Nagpal, S., Mutiso, V., Pillai, R. S., Hadfield, K., Lauwrens, Z., & Ndetei, D. M. (2024) · Cambridge Prisms Global Mental Health · doi:10.1017/gmh.2024.87 · Cited by 4 · see citing works
“In so doing, we drew on traditions of thematic analysis of qualitative data in process evaluations (Moore et al., 2015; Limbani et al., 2019; Perry et al., 2024), although quantitative and qualitative data from multiple sources can be used (Bowden et al., 2020).”
BackgroundSelf-citationGul, M., Kanwal, A., & Aqeel, M. (2025) · Mental Health and Social Inclusion · doi:10.1108/mhsi-05-2025-0147
Hall, C. D. X., Bao, A., Sabuncu, B. C., Wang, L., Luu, M. N., Mills, J. C., Trang, K., Millender, E., Lane, B. L., Cheung, D. H., et al. (2025) · AIDS Care · doi:10.1080/09540121.2025.2578652
- Authors
- Perry, A., Gardener, C., Shieh, J., Hồ, Q. T., Doan, A., & Bhui, K.
- Affiliations
- East London NHS Foundation Trust (GB)
- University College London (GB)
- Vietnamese Mental Health Service
- Independent Psychotherapist
- Corresponding author
- Perry, Aradhana
- Venue
- Transcultural Psychiatry
- Publisher
- SAGE Publications
- Published
- 2024-03-26
- Volume
- 61
- Issue
- 4
- Pages
- 626-651
- ISSN
- 1363-4615 (ISSN-L)
- 1461-7471
- OpenAlex
- W4393194946
- Cited by
- 7
- References
- 117
- Citations by year
- 2025: 5 · 2024: 2
- FWCI
- 3.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Transcultural Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- City and Hackney Clinical Commissioning Group Psychological Therapies and Wellbeing Alliance
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Social Sciences › Sociology and Political Science › Cultural Competency in Health Care
- Keywords
- acceptance and commitment therapy, cultural adaptation, Vietnamese refugees, group therapy, acceptability, feasibility, psychological flexibility, well-being, ethnic minority mental health, cultural beliefs, behavior change, values-based action, social connectedness
- MeSH terms
- Southeast Asian People, Adult, Aged, Feasibility Studies, Female, United Kingdom, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Psychotherapy, Group, Refugees, Vietnam, Acceptance and Commitment Therapy, Culturally Competent Care
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