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Symposia

Technology/Digital Health

Advancing Digital ACT Interventions: Evidence-Based Strategies for Expanding Access to Care

1 - (SYM 52) Evaluating Digital Acceptance & Commitment Therapy as a Transdiagnostic Mental Health Resource for Adults with Chronic Health Conditions

Friday, November 21, 2025
3:06 PM - 3:27 PM CST
Location: Bolden 6, Level 2
Keywords: Technology / Mobile Health, ACT (Acceptance & Commitment Therapy), Randomized Controlled Trial
Recommended Readings: Ong, C. W., Lee, E. B., Levin, M. E., & Twohig, M. P. (2022). Online process-based training for perfectionism: A randomized trial. Behaviour Research and Therapy, 156, 104152.,   Arch, J. J., Mitchell, J. L., Schmiege, S. J., Levin, M. E., Genung, S. R., Nealis, M. S., Fink, R. M., Bright, E. E., Andorsky, D. J., & Kutner, J. S. (2022). A randomized controlled trial of a multi-modal palliative care intervention to promote advance care planning and psychological well-being among adults with advanced cancer: study protocol. BMC palliative care, 21(1), 198. https://doi.org/10.1186/s12904-022-01087-z,   Bowers, E. M., Capel, L. K., Woolley, M. G., Barnes, A., Twohig, M. P., & Levin, M. E. (2024). Efficacy and feasibility of web-based ACT-Enhanced behavioral treatment for skin picking in adults: A randomized waitlist-controlled trial. Journal of Obsessive-Compulsive and Related Disorders, 43, 100909.,   Donahue, M. L., & Levin, M. E. (2024). Pilot evaluation of a prototype online acceptance and commitment therapy program for adults living with a chronic health condition. International Journal of Mental Health, 53(4), 397–419. https://doi.org/10.1080/00207411.2024.2321432,   Klimczak, K. S., San Miguel, G. G., Mukasa, M. N., Twohig, M. P., & Levin, M. E. (2023). A systematic review and meta-analysis of self-guided online acceptance and commitment therapy as a transdiagnostic self-help intervention. Cognitive behaviour therapy, 52(3), 269–294. https://doi.org/10.1080/16506073.2023.2178498
Abstract Body

Individuals living with chronic health conditions (CHCs) experience significant challenges that can impair quality of life and mental health (Mondor et al., 2016). Psychological inflexibility (rigid patterns of behavior overly governed by thoughts, feelings, and other inner experiences) is one transdiagnostic process that contributes to impaired quality of life among individuals with CHCs (Fang & Ding, 2022). Acceptance and Commitment Therapy (ACT) has been found efficacious for improving psychological inflexibility and quality of life when applied to specific CHCs (Konstantinou et al., 2023). A transdiagnostic digital version of ACT for CHCs could provide wide access to a mental health resource for individuals with CHCs, including rarer conditions that otherwise might not have such resources available.

 

This pre-registered trial (NCT06179264) evaluated a novel digital ACT program designed to improve quality of life among adults with CHCs. A sample of 100 adults with CHCs were recruited online throughout the US, with phone screening to ensure valid participants. Participants were randomized to a 6-session digital ACT program or waitlist condition. Self-report assessments were completed at baseline, post-intervention (week 6), and follow up (week 10).

 

Indicators of feasibility included recruiting 100 participants with a wide range of CHCs (61 unique CHCs) in only 3 months, and participants completing 4 of 6 ACT modules on average (median = 5.5, SD = 2.4). Significant time by condition interactions with multilevel models indicated participants in ACT improved more than waitlist at follow up on quality of life (β = .38, p = .01), functional impairment (β = .33, p = .01), and psychological inflexibility (β = .29, p = .03). Baseline distress moderated effects on distress, such that ACT improved distress more than waitlist among those with higher initial distress (β = -0.62, p < .001). Pre- to post-intervention improvements in psychological inflexibility mediated treatment effects on pre- to follow up quality of life (β = 2.60, 95% CI [0.32, 5.97]), but not other outcomes. Participants who completed more ACT modules improved more at follow up on psychological inflexibility (β = 3.27, p < .01) and distress (β = 3.38, p = .048), but not for other outcomes. Results will be discussed in terms of the importance of using digital interventions to reach adults with a wide range of CHCs who would benefit from mental health resources as well as how adherence and psychological inflexibility are important processes in understanding who benefit from these resources.