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This study examined factors anticipating adolescents' (N=232) adherence and dropout in an online acceptance and commitment therapy (ACT) intervention targeted at promoting well-being during the COVID-19 pandemic. First, results showed that adolescents with high academic achievement and educational expectations were more likely to participate in the induction meeting and start the program. Second, adolescents in the human-supported model fulfilled the adherence criteria more often than adolescents supported by virtual coach only. Finally, though male participants were less likely to participate in the study, participants who started the online program were likely to adhere to it regardless of gender. [ABSTRACT FROM AUTHOR]

Internet-delivered cognitive and behavioral interventions have been shown to be effective in enhancing university students' well-being and reducing symptoms of stress and depression. However, few studies have examined the active components that may contribute to their effectiveness. The present study aimed to explore what kind of online written coach feedback would be useful on participants' outcomes and satisfaction in two Acceptance and Commitment Therapy (ACT) blended interventions. ACT-trained master's level psychology students offered coach support (n = 50; 88% female, Mage = 26 years) to university students, who were randomly assigned to two parallel groups, each offered three face-to-face sessions and an online five-module ACT-based program. One group (iACTa, n = 61) received free-form personalized, individually tailored written feedback, and the other (iACTb, n = 62) received semi-structured written feedback with minimal personalization options. Both groups had gains from participating in the interventions across all measures, including well-being, psychological flexibility, mindfulness skills, and reduction of stress and depression symptoms. However, there were no significant differences between the two groups except for well-being, which favored the iACTb. The iACTa group saw mostly small to large effect sizes (d =.44–0.80) while medium to large effect sizes were observed for the iACTb group (d =.69–0.83). The retention rate was good (iACTa: n = 51, 83.6%; iACTb: n = 54, 87.1%). Semi-structured features almost halved the coaches' written response time for each participant (31 min in iACTa vs. 18 min in iACTb). The results shed light in the very limited research available and suggest that ACT-based,blendedinternetinterventionswithsemi-structured coachfeedback and minimally tailored features can be as effective as interventions with fully personalized feedback in treatment outcomes and participants' satisfaction. • Blended ACT with semi-structured coach feedback is as effective as free-form feedback. • Semi-structured features helped reduce coaches' response time. • University students' well-being, psychological flexibility, and mindfulness increased. • Participants' perceived stress and depression decreased. • Dropout rates were low in both semi-structured and fully personalized feedback intervention groups. [ABSTRACT FROM AUTHOR]

Objective: This study investigated the roles of adherence and usage activity in adolescents' (n = 161) gains during a 5-week web intervention program based on acceptance and commitment therapy (ACT). Method: Program adherence was calculated as adherence percentage in relation to intended usage, whereas completion percentage, usage time, and usage weeks were used as indicators for usage activity. Subjective well-being was measured by self-reported life satisfaction and stress before and after the intervention. Results: First, regression analysis results showed that higher adherence predicted an increase in life satisfaction during intervention. Second, three subgroups of adolescents were identified using K -means cluster analysis in regard to adherence, usage activity and intervention gains: (1) "Adhered, committed users with relatively large intervention gains" (35%), (2) "Less committed users with no intervention gains" (42%), and (3) "Non-committed users with no intervention gains" (23%). The results showed that the highest gains from the Youth Compass intervention program are most likely obtained when the program is used as intended in its design. In addition, time investment and engagement in doing exercises seem as important as filling the minimum adherence criterion. Conclusions: The results support the feasibility of ACT-based web intervention programs in promoting adolescent well-being, although more attention should be paid to motivating adolescents to commit to them and invest enough time in them. [ABSTRACT FROM AUTHOR]

The objective of the present study was to investigate whether an acceptance and commitment therapy (ACT)-based web-intervention (Group 1, CareACT), or a standardized rehabilitation in a rehabilitation center (Group 2) was effective in enhancing the psychological well-being of family caregivers aged 60 and over compared to support provided by voluntary caregiver associations (Group 3). Altogether, 149 family caregivers participated in this quasi-experimental study. Primary outcome measure was depression. Secondary outcomes included anxiety, sense of coherence, quality of life, psychological flexibility, experiential avoidance, and thought suppression. The questionnaires were administered at baseline, and four, and 10 months post-measurement. We investigated differences in the changes between the groups using Mplus modeling techniques. Regarding the main outcome of depression, the results suggest that the CareACT intervention was superior to standardized rehabilitation and to the support given by caregiver associations at four months, both showing a medium-sized difference between the groups. However, the change from four to 10 months post-intervention was not significantly different between these groups (d = 0.32–0.36). Thought suppression showed a significantly different change between the three groups from baseline to four months and to 10 months post-measurement (p =.038). Web-based ACT may have beneficial effects on depressive symptoms and thought suppression in older caregivers. Web-based ACT could be a feasible alternative to institutional rehabilitation and support provided by voluntary caregiver associations. Web-based ACT responds flexibly to the needs of caregivers and provides them an opportunity for learning new skills to promote well-being. [ABSTRACT FROM AUTHOR]

The present study examined if an Acceptance and Commitment Therapy (ACT)–based online intervention for parents had indirect effects on their children's quality of life mediated by changes in parental well-being, psychological flexibility and mindfulness skills. Participants were 74 adults, who either received an ACT-based guided online intervention or were allocated to the wait list control group, and their children (n = 66) who had type 1 diabetes or functional disabilities. Structural equation modeling (SEM) and a bias-corrected bootstrap approach were applied to examine the indirect effects of the treatment on children's quality of life through changes in parents' well-being and psychological processes involving psychological flexibility, cognitive defusion, and mindfulness skills. Children's quality of life was assessed both by self-reports and parents' evaluations. Significant indirect effects on children's quality of life were found through improvements in parental well-being and mindfulness skills. The intervention had significant indirect effects on parents' evaluations of their children's quality of life concerning family and other social relationships, as well as on physical well-being. In regard to children's self-reported quality of life, the intervention had significant indirect effects on self-esteem, family relations, emotional well-being, and functioning at school/kindergarten. The results indicate that it is beneficial for children's quality of life to improve parents' ability to describe their experiences, being non-reactive to one's inner experiences and acting with awareness as well as cognitive defusion. Highlights: Parents of children with chronic conditions can benefit from an ACT web intervention leading also to increased quality of life in children. Children quality of life improved though improvements in parental wellbeing and mindfulness skills. Improving parents' ability to describe their experiences, being non-reactive to one's inner experiences and acting with awareness it is beneficial for children's quality of life. [ABSTRACT FROM AUTHOR]

A novel eight-week program based on Acceptance and Commitment Therapy (ACT) principles was created to alleviate burnout-related ill - being and to enhance well - being. This randomized controlled trial investigated the effectiveness of the program and explored whether changes in psychological flexibility mediated the results of the intervention. The program consisted of structured weekly face-to-face group meetings and daily practices provided via a website. Employees from varying professional backgrounds with burnout (mean age = 47 years, 79% female), who all received usual treatment, 1 were randomized into control (TAU, n = 80, receiving no other support) and ACT + TAU intervention (n = 88, receiving additional ACT support) groups. The ACT + TAU group outperformed the TAU group in all 14 scales used, indicating that burnout - related ill-being at work (between-group Cohen's d = 0.36–0.76) and psychological symptoms (d = 0.27–0.61) decreased and general well - being (d = 0.14–0.38) and psychological flexibility skills (d = 0.29–0.64) increased during the intervention. These gains were maintained during the one-year follow-up period. The changes in the psychological flexibility -factor mediated almost completely the changes in the outcome factors of burnout, well-being, and psychological symptoms. The study suggests that psychological flexibility skills can be crucial elements in job-related burnout interventions and that combined group and web-based interventions may offer an efficient treatment method. • A novel eight–week program based on ACT was created to alleviate burnout. • The intervention was a combined face–to–face group and web-based program. • The intervention group outperformed the control group in all 14 scales used. • The intervention had significant, broad, and long–lasting effects on burnout. • Changes in psychological flexibility mediated the intervention's results. [ABSTRACT FROM AUTHOR]

Acceptance and commitment therapy programs have rarely been used as preventive tools for alleviating stress and enhancing coping skills among adolescents. This randomized controlled trial examined the efficacy of a novel Finnish web- and mobile-delivered five-week intervention program called Youth COMPASS among a general sample of ninth-grade adolescents (n= 249, 49% females). The intervention group showed a small but significant decrease in overall stress (between-group Cohen's d = 0.22) and an increase in academic buoyancy (d= 0.27). Academic skills did not influence the intervention gains, but the intervention gains were largest among high-stressed participants. The results suggest that the acceptance and commitment based Youth COMPASS program may be well suited for promoting adolescents' well-being in the school context. [ABSTRACT FROM AUTHOR]

Mindfulness skills, psychological flexibility and psychological symptoms were compared among 58 physically less active and 50 physically active adults who were recruited and classified based on their self-reported physical activity. Additionally, this study evaluated the association of objectively measured physical activity with psychological variables. Methods Participants completed questionnaires evaluating their mindfulness skills and psychological flexibility as well as their psychological and depressive symptoms. Physical activity was assessed objectively using an accelerometer for seven consecutive days. Results Based on the self-reported physical activity levels physically active individuals had better mindfulness skills and less psychological and depressive symptoms compared to physically less active adults. A consistent correlation was observed between objectively measured physical activity and psychological well-being. Conclusions This study support the view that physically active adults had better psychological well-being compared to physically less active adults. These results also suggest that a physically active lifestyle is related to better mindfulness skills and having less psychological and depressive symptoms. [ABSTRACT FROM AUTHOR]

Background Obesity and stress are among the most common lifestyle-related health problems. Most of the current disease prevention and management models are not satisfactorily cost-effective and hardly reach those who need them the most. Therefore, novel evidence-based controlled interventions are necessary to evaluate models for prevention and treatment based on selfmanagement. This randomized controlled trial examines the effectiveness, applicability, and acceptability of different lifestyle interventions with individuals having symptoms of metabolic syndrome and psychological distress. The offered interventions are based on cognitive behavioral approaches, and are designed for enhancing general well-being and supporting personalized lifestyle changes. Methods 339 obese individuals reporting stress symptoms were recruited and randomized to either (1) a minimal contact web-guided Cognitive Behavioral Therapy-based (CBT) intervention including an approach of health assessment and coaching methods, (2) a mobile-guided intervention comprising of mindfulness, acceptance and value-based exercises, (3) a face-toface group intervention using mindfulness, acceptance and value-based approach, or (4) a control group. The participants were measured three times during the study (pre = week 0, post = week 10, and follow-up = week 36). Psychological well-being, lifestyles and habits, eating behaviors, and user experiences were measured using online surveys. Laboratory measurements for physical well-being and general health were performed including e.g. liver function, thyroid glands, kidney function, blood lipids and glucose levels and body composition analysis. In addition, a 3-day ambulatory heart rate and 7-day movement data were collected for analyzing stress, recovery, physical activity, and sleep patterns. Food intake data were collected with a 48 -hour diet recall interview via telephone. Differences in the effects of the interventions would be examined using multiple-group modeling techniques, and effect-size calculations. Discussion This study will provide additional knowledge about the effects of three low intensity interventions for improving general well-being among individuals with obesity and stress symptoms. The study will show effects of two technology guided self-help interventions as well as effect of an acceptance and value-based brief group intervention. Those who might benefit from the aforesaid interventions will increase knowledge base to better understand what mechanisms facilitate effects of the interventions. Trial registration Current Clinical Trials NCT01738256, Registered 17 August, 2012 [ABSTRACT FROM AUTHOR]

This study investigated whether beneficial intervention effects on burnout and mindfulness skills diffuse and facilitate the long-term development of different levels of subjective well-being: experiential (perceived stress), eudaimonic (psychological and social well-being), and evaluative (life satisfaction). Participants were Finnish employees with notable burnout (n = 105, 80% women). The study utilized individual profiles of burnout and mindfulness skills identified in a previous study (Kinnunen, Puolakanaho, Tolvanen, Mäkikangas, & Lappalainen, 2019). The profiles were based on levels and changes in burnout and mindfulness skills during an 8-week intervention and 4-month follow-up. In the present study, the same profiles were compared using a χ2 test for changes in the different levels of subjective well-being over 12 months. Although most profiles showed benefits in experiential subjective well-being, achieving a significant increase in eudaimonic or evaluative levels at the 12-month study period required a considerable decrease in burnout and increase in mindfulness skills during the preceding 6 months. Those who initially benefited the most from the intervention, that is, showed a decrease in burnout and increase in mindfulness skills, also showed the most favorable development in all 3 levels of subjective well-being during the 12-month study period. The differences in well-being between those who initially benefited from the intervention and those who did not seemed unlikely to diminish over time. It is thus important to monitor intervention effects on each level of subjective well-being to identify participants who are likely to need additional support to achieve long-term changes in well-being in all levels. [ABSTRACT FROM AUTHOR]

Stress, anxiety and depression are relatively common problems among university students. This study examined whether an online psychological intervention aiming at enhancing the wellbeing of university students could be an effective and practical alternative for meeting the needs of a university population. University students ( N = 68; 85% female; 19–32 years old) were randomly assigned to either a guided seven-week online Acceptance and Commitment Therapy (iACT) intervention or a waiting list control condition (WLC). A between-groups pre–post (iACT vs WLC) design with 12-month follow-up for the iACT participants was conducted. The intervention participants were offered two face-to-face meetings, completed online exercises during a five-week period, and received personal weekly written feedback via the website from their randomly assigned, trained student coaches. Waitlist participants were offered the intervention program soon after the post measurements. Results in this small efficacy trial showed that the iACT participants had significantly higher gains in wellbeing (between group, d = 0.46), life satisfaction ( d = 0.65), and mindfulness skills ( d = 0.49). In addition, iACT participants' self-reported stress ( d = 0.54) and symptoms of depression ( d = 0.69) were significantly reduced compared to the participants in the control group. These benefits were maintained over a 12-month follow-up period (within iACT group, d = 0.65–0.69, for primary measures). The results suggest that an online-based, coach-guided ACT program with blended face-to-face and online sessions could be an effective and well-accepted alternative for enhancing the wellbeing of university students. [ABSTRACT FROM AUTHOR]