Acceptance and commitment therapy in daily life training: a feasibility study of an mHealth intervention
Open accessAbstract
BACKGROUND: With the development of mHealth, it is possible to treat patients in their natural environment. Mobile technology helps to bridge the gap between the therapist's office and the "real world." The ACT in Daily Life training (ACT-DL) was designed as an add-on intervention to help patients practice with acceptance and commitment therapy in their daily lives. The ACT-DL consists of two main components: daily monitoring using experience sampling and ACT training in daily life. OBJECTIVES: To assess the acceptability and feasibility of the ACT-DL in a general outpatient population. A secondary objective was to conduct a preliminary examination of the effectiveness of the ACT-DL. METHODS: An observational comparative study was conducted. The experimental group consisted of 49 patients who volunteered for ACT-DL, and the control group consisted of 112 patients who did not volunteer. As part of an inpatient treatment program, both groups received a 6-week ACT training. Participants went home to continue their treatment on an outpatient basis, during which time the experimental group received the 4-week add-on ACT-DL. Acceptability and feasibility of the ACT-DL was assessed weekly by telephone survey. Effectiveness of the ACT-DL was evaluated with several self-report questionnaires ( Flexibility Index Test (FIT-60): psychological flexibility, Brief Symptom Inventory: symptoms, Utrechtse Coping List: coping, and Quality of life visual analog scale (QoL-VAS): quality of life). RESULTS: More than three-quarters of the participants (76%) completed the full 4-week training. User evaluations showed that ACT-DL stimulated the use of ACT in daily life: participants practiced over an hour a week (mean 78.8 minutes, standard deviation 54.4), doing 10.4 exercises (standard deviation 6.0) on average. Both ACT exercises and metaphors were experienced as useful components of the training (rated 5 out of 7). Repeated measures ANCOVA did not show significant effects of the ACT-DL on psychological flexibility (P=.88), symptoms (P=.39), avoidant coping (P=.28), or quality of life (P=.15). CONCLUSIONS: This is the first study that uses experience sampling to foster awareness in daily life in combination with acceptance and commitment therapy to foster skill building. Adherence to the ACT-DL was high for an intensive mHealth intervention. ACT-DL appears to be an acceptable and feasible mHealth intervention, suitable for a broad range of mental health problems. However, short-term effectiveness could not be demonstrated. Additional clinical trials are needed to examine both short-term and long-term effects.
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Experiential sampling has been used with acceptance and commitment therapy not only for assessment, but also for intervention, as a means of fostering awareness in the daily life of mental health inpatients.
“Additionally, ES has been used with ACT not only for assessment, but also for intervention, as a means of fostering awareness in the daily life of mental health inpatients (Batink et al., 2016).”
From Online ACT intervention for fibromyalgia: An exploratory study of feasibility and preliminary effectiveness with smartphone-delivered experiential sampling assessment (2022) · cites this paper as Batink et al., 2016
High degrees of program satisfaction were reported by participants in these studies.
“High degrees of program satisfaction were reported by participants in these studies”
From Blended care in the treatment of subthreshold symptoms of depression and psychosis in emerging adults: A randomised controlled trial of Acceptance and Commitment Therapy in Daily-Life (ACT-DL) (2020) · cites this paper as Batink et al., 2016
The ACT-DL protocol was fine-tuned based on a feasibility study in a clinical population.
“The protocol of this intervention was fine-tuned based on a feasibility study in a clinical population (Batink et al., 2016)”
From Blended care in the treatment of subthreshold symptoms of depression and psychosis in emerging adults: A randomised controlled trial of Acceptance and Commitment Therapy in Daily-Life (ACT-DL) (2020) · cites this paper as Batink et al., 2016
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- Authors
- Batink, T., Bakker, J., Vaessen, T., Kasanova, Z., Collip, D., van Os, J., Wichers, M., Germeys, I., & Peeters, F.
- Affiliations
- Maastricht University Medical Centre (NL)
- University Medical Center Groningen (NL)
- Corresponding author
- Batink, Tim
- ORCID
- Venue
- JMIR mhealth and uhealth
- Publisher
- JMIR Publications Inc.
- Published
- 2016-09-15
- Volume
- 4
- Issue
- 3
- Pages
- e103
- ISSN
- 2291-5222 (ISSN-L)
- PMC
- PMC5070582
- OpenAlex
- W2520812783
- Cited by
- 48
- References
- 30
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 3 · 2023: 4 · 2022: 5 · 2021: 4 · 2020: 7 · 2019: 5 · 2018: 7 · 2017: 4
- FWCI
- 7.14
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JMIR mhealth and uhealth (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion, cc-by)
- Lirias (submittedVersion, other-oa)
- Research Publications (Maastricht University) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Journal of Medical Internet Research (cc-by)
- Funders
- FP7 Ideas: European Research Council (309767)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Keywords
- acceptance and commitment therapy, mobile health intervention, ecological momentary assessment, psychological flexibility, adjunctive therapy, outpatient care, feasibility and acceptability, coping, quality of life, mental health
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