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Supplemental material, sj-docx-5-pmj-10.1177_02692163221099610 for Acceptance and commitment therapy for patient fatigue interference and caregiver burden in advanced gastrointestinal cancer: Results of a pilot randomized trial by Catherine E Mosher, Ekin Secinti, Wei Wu, Deborah A Kashy, Kurt Kroenke, Jonathan B Bricker, Paul R Helft, Anita A Turk, Patrick J Loehrer, Amikar Sehdev, Ahmad A Al-Hader, Victoria L Champion and Shelley A Johns in Palliative Medicine

Supplemental material, sj-docx-4-pmj-10.1177_02692163221099610 for Acceptance and commitment therapy for patient fatigue interference and caregiver burden in advanced gastrointestinal cancer: Results of a pilot randomized trial by Catherine E Mosher, Ekin Secinti, Wei Wu, Deborah A Kashy, Kurt Kroenke, Jonathan B Bricker, Paul R Helft, Anita A Turk, Patrick J Loehrer, Amikar Sehdev, Ahmad A Al-Hader, Victoria L Champion and Shelley A Johns in Palliative Medicine

Supplemental material, sj-docx-1-pmj-10.1177_02692163221099610 for Acceptance and commitment therapy for patient fatigue interference and caregiver burden in advanced gastrointestinal cancer: Results of a pilot randomized trial by Catherine E Mosher, Ekin Secinti, Wei Wu, Deborah A Kashy, Kurt Kroenke, Jonathan B Bricker, Paul R Helft, Anita A Turk, Patrick J Loehrer, Amikar Sehdev, Ahmad A Al-Hader, Victoria L Champion and Shelley A Johns in Palliative Medicine

Supplemental material, sj-docx-1-pmj-10.1177_02692163221099610 for Acceptance and commitment therapy for patient fatigue interference and caregiver burden in advanced gastrointestinal cancer: Results of a pilot randomized trial by Catherine E Mosher, Ekin Secinti, Wei Wu, Deborah A Kashy, Kurt Kroenke, Jonathan B Bricker, Paul R Helft, Anita A Turk, Patrick J Loehrer, Amikar Sehdev, Ahmad A Al-Hader, Victoria L Champion and Shelley A Johns in Palliative Medicine

Supplemental material, sj-docx-3-pmj-10.1177_02692163221099610 for Acceptance and commitment therapy for patient fatigue interference and caregiver burden in advanced gastrointestinal cancer: Results of a pilot randomized trial by Catherine E Mosher, Ekin Secinti, Wei Wu, Deborah A Kashy, Kurt Kroenke, Jonathan B Bricker, Paul R Helft, Anita A Turk, Patrick J Loehrer, Amikar Sehdev, Ahmad A Al-Hader, Victoria L Champion and Shelley A Johns in Palliative Medicine

Supplemental material, sj-docx-5-pmj-10.1177_02692163221099610 for Acceptance and commitment therapy for patient fatigue interference and caregiver burden in advanced gastrointestinal cancer: Results of a pilot randomized trial by Catherine E Mosher, Ekin Secinti, Wei Wu, Deborah A Kashy, Kurt Kroenke, Jonathan B Bricker, Paul R Helft, Anita A Turk, Patrick J Loehrer, Amikar Sehdev, Ahmad A Al-Hader, Victoria L Champion and Shelley A Johns in Palliative Medicine

Supplemental material, sj-docx-4-pmj-10.1177_02692163221099610 for Acceptance and commitment therapy for patient fatigue interference and caregiver burden in advanced gastrointestinal cancer: Results of a pilot randomized trial by Catherine E Mosher, Ekin Secinti, Wei Wu, Deborah A Kashy, Kurt Kroenke, Jonathan B Bricker, Paul R Helft, Anita A Turk, Patrick J Loehrer, Amikar Sehdev, Ahmad A Al-Hader, Victoria L Champion and Shelley A Johns in Palliative Medicine

Supplemental material, sj-docx-3-pmj-10.1177_02692163221099610 for Acceptance and commitment therapy for patient fatigue interference and caregiver burden in advanced gastrointestinal cancer: Results of a pilot randomized trial by Catherine E Mosher, Ekin Secinti, Wei Wu, Deborah A Kashy, Kurt Kroenke, Jonathan B Bricker, Paul R Helft, Anita A Turk, Patrick J Loehrer, Amikar Sehdev, Ahmad A Al-Hader, Victoria L Champion and Shelley A Johns in Palliative Medicine

Supplemental material, sj-docx-2-pmj-10.1177_02692163221099610 for Acceptance and commitment therapy for patient fatigue interference and caregiver burden in advanced gastrointestinal cancer: Results of a pilot randomized trial by Catherine E Mosher, Ekin Secinti, Wei Wu, Deborah A Kashy, Kurt Kroenke, Jonathan B Bricker, Paul R Helft, Anita A Turk, Patrick J Loehrer, Amikar Sehdev, Ahmad A Al-Hader, Victoria L Champion and Shelley A Johns in Palliative Medicine

Supplemental material, sj-docx-6-pmj-10.1177_02692163221099610 for Acceptance and commitment therapy for patient fatigue interference and caregiver burden in advanced gastrointestinal cancer: Results of a pilot randomized trial by Catherine E Mosher, Ekin Secinti, Wei Wu, Deborah A Kashy, Kurt Kroenke, Jonathan B Bricker, Paul R Helft, Anita A Turk, Patrick J Loehrer, Amikar Sehdev, Ahmad A Al-Hader, Victoria L Champion and Shelley A Johns in Palliative Medicine

Supplemental material, sj-docx-6-pmj-10.1177_02692163221099610 for Acceptance and commitment therapy for patient fatigue interference and caregiver burden in advanced gastrointestinal cancer: Results of a pilot randomized trial by Catherine E Mosher, Ekin Secinti, Wei Wu, Deborah A Kashy, Kurt Kroenke, Jonathan B Bricker, Paul R Helft, Anita A Turk, Patrick J Loehrer, Amikar Sehdev, Ahmad A Al-Hader, Victoria L Champion and Shelley A Johns in Palliative Medicine

Supplemental material, sj-docx-2-pmj-10.1177_02692163221099610 for Acceptance and commitment therapy for patient fatigue interference and caregiver burden in advanced gastrointestinal cancer: Results of a pilot randomized trial by Catherine E Mosher, Ekin Secinti, Wei Wu, Deborah A Kashy, Kurt Kroenke, Jonathan B Bricker, Paul R Helft, Anita A Turk, Patrick J Loehrer, Amikar Sehdev, Ahmad A Al-Hader, Victoria L Champion and Shelley A Johns in Palliative Medicine

Background: Web-based cessation programs are now common for intervening with smokers. However, it remains unclear how acceptable or effective these interventions are among people with affective disorders and symptoms (ADS; eg, depression and anxiety). Research examining this is extremely limited, with mixed results on cessation rates. Additional large studies are needed to more fully understand whether Web-based interventions are similarly used and equally effective among people with and without affective disorder symptomology. If not, more targeted Web-based interventions may be required. Objective: The goal of the research was to compare Web-based treatment acceptability (defined by satisfaction and use) and 12-month cessation outcomes between smokers with and without ADS. Methods: Participants (N=2512) were adult smokers enrolled in a randomized, comparative effectiveness trial of two Web-based smoking interventions designed for the general population of smokers. At baseline, participants reported demographic and smoking characteristics and completed measures assessing ADS. Participants were then classified into subgroups based on their self-reported ADS—either into a no ADS group or into six nonmutually exclusive subgroups: depression, posttraumatic stress disorder (PTSD), panic disorder (PD), generalized anxiety disorder (GAD), social anxiety disorder (SAD), and more than one ADS. Surveys at 12 months postrandomization included subjective ratings of treatment acceptability and self-reported smoking cessation. Treatment use (ie, number of log-ins and total duration of exposure) was assessed via automated records. Results: Relative to the no ADS group, all six ADS subgroups reported significantly greater satisfaction with their assigned Web treatment program, but they spent less time logged in than those with no ADS. For number of log-ins, a treatment arm by ADS group interaction was observed across all ADS subgroups except GAD, suggesting that relative to the no ADS group, they logged in less to one website but not the other. At the 12-month follow-up, abstinence rates in the no ADS group (153/520, 29.42%) were significantly higher than for participants who screened positive for depression (306/1267, 24.15%; P=.03), PTSD (294/1215, 24.19%; P=.03), PD (229/1003, 23.83%; P=.009), and two or more ADS (323/1332, 24.25%; P=.03). Post hoc analyses suggest the lower quit rates may be associated with differences in baseline nicotine dependence and levels of commitment to resist smoking in difficult situations. Website use did not explain the differential abstinence rates. Conclusions: Despite reporting higher levels of treatment satisfaction, most smokers with ADS used their assigned intervention less often and had lower quit rates than smokers with no ADS at treatment onset. The results support the need for developing more targeted interventions for smokers with ADS. Trial registration: Clinical Trials.gov NCT01812278; https://clinicaltrials.gov/ct2/show/NCT01812278 (Archived by WebCite at http://www.webcitation.org/78L9cNdG4)

Öst's (2014) systematic review and meta-analysis of Acceptance and Commitment Therapy (ACT) has received wide attention. On the basis of his review, Öst argued that ACT research was not increasing in its quality and that, in contradiction to the views of Division 12 of the American Psychological Association (APA), ACT is “not yet well-established for any disorder” (2014, p. 105). We conducted a careful examination of the methods, approach, and data used in the meta-analysis. Based in part on examinations by the authors of the studies involved, which were then independently checked, 91 factual or interpretive errors were documented, touching upon 80% of the studies reviewed. Comparisons of Öst's quality ratings with independent teams rating the same studies with the same scale suggest that Ost's ratings were unreliable. In all of these areas (factual errors; interpretive errors; quality ratings) mistakes and differences were not random: Ost's data were dominantly more negative toward ACT. The seriousness, range, and distribution of errors, and a wider pattern of misinterpreting the purpose of studies and ignoring positive results, suggest that Öst's review should be set aside in future considerations of the evidence base for ACT. We argue that future published reviews and meta-analyses should rely upon diverse groups of scholars rather than a single individual; that resulting raw data should be made available for inspection and independent analysis; that well-crafted committees rather than individuals should design, apply and interpret quality criteria; that the intent of transdiagnostic studies need to be more seriously considered as the field shifts away from a purely syndromal approach; and that data that demonstrate theoretically consistent mediating processes should be given greater weight in evaluating specific interventions. Finally, in order to examine substantive progress since Öst's review, recent outcome and process evidence was briefly examined. Refereed/Peer-reviewed