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The present case details a successful treatment response to 21 sessions of Acceptance and Commitment Therapy (ACT) delivered via teletherapy for mixed anxiety and depressive symptomology during the COVID-19 pandemic. The client ("Natalie"), a 19-year-old, White, cisgender female, presented to a university training clinic reporting primary problematic anxiety consistent with a diagnosis of Generalized Anxiety Disorder. The therapist conceptualized Natalie's anxiety through the ACT psychological flexibility model, wherein Natalie's challenges appeared to be maintained by experiential avoidance and lack of committed action. This case highlights (a) the unique challenges of treating someone with pervasive anxiety amid the uncertain context of the COVID-19 pandemic, (b) repeated assessment of transdiagnostic processes to inform intervention focus, and (c) the process of ACT teletherapy. Symptom, process, and outcome measures taken bi-weekly throughout therapy suggested theoretically consistent and reliable treatment responses. Clinical implications of the case are discussed. [ABSTRACT FROM AUTHOR]

Background: A significant proportion of mental health care professionals (MHCPs) hold stigmatizing attitudes about their patients. When patients perceive and internalize these beliefs, self-stigmatization can increase. Acceptance and Commitment Therapy (ACT) may decrease stigmatizing attitudes by changing the 'us' versus 'them' thinking into continuum beliefs. In the present study MHCPs were given an ACT-based training, aiming to decrease stigmatization, hypothesizing that self-stigmatization of their patients will subsequently decrease. Methods: An RCT with a 2 (pre-test/post-test) x 2 (no training/training) design was conducted. A total of 41 MHCPs participated, 20 were randomized to the experimental and 21 to the control condition respectively. The MHCPs in the experimental condition received an ACT-based training, MHCPs in the control condition received no training. From every MHCP, one of their patients participated in the pre- and post-measurement. As the primary outcome, patients' awareness, agreement, application and hurt-self, was measured using the Self Stigma of Mental Illness Scale - Short Form (SSMIS-SF), before and after the MHCPs' ACT-based training. Results: Significant group x time interaction effects were found for 'application' (internalization of mental illness stereotypes) in patients after the ACT-based training of their MHCP: F (1,39) = 9.33, p < 0.01, ηp2 =.85. On the contrary, no effect was found on the subscales 'awareness', 'agreement' and 'hurt-self'. Conclusion: Preliminary results suggest that a brief ACT training for MHCP might heighten their awareness and contribute to reduction of their stigmatizing attitudes and behavior, leading to less application of self-stigmatizing beliefs in their patients. [ABSTRACT FROM AUTHOR]

Background/Objectives: Compassion Fatigue (CF) is a critical issue among healthcare professionals, exacerbated by exposure to trauma and chronic workplace stress. This pilot study evaluates the effectiveness of a Mindfulness-Oriented Professional Resilience (MOPR) program, a structured intervention designed to mitigate CF and enhance resilience in healthcare professionals. The program integrates mindfulness practices, arousal modulation techniques, and resilience-building strategies over six weekly sessions. Methods: A sample of 73 healthcare workers (mean age 48.6, SD = 9.42) participated in the study, and pre–post data were analyzed using repeated measures ANOVA. Results: Results indicated significant improvements in professional quality of life, with increased Compassion Satisfaction (p < 0.001) and reductions in Burnout (p = 0.003) and Secondary Traumatic Stress (p < 0.001). Mindfulness skills improved significantly across four dimensions—Observing, Describing, Acting with Awareness, and Non-reactivity—with p-values ranging from <0.01 to <0.001. Arousal modulation showed increased Optimal Arousal Zone scores (p < 0.001) and reduced maladaptive stress responses, including Fight/Flight, Freeze, and Feigned Death (p < 0.05). Psychological well-being improvements were observed, particularly in Self-Acceptance (p = 0.014) and Positive Relations (p = 0.041). Conclusions: These findings suggest that the MOPR program is a promising intervention for healthcare professionals, supporting resilience and reducing the psychological burden of caregiving. Future controlled studies should explore its long-term efficacy in diverse clinical settings and in larger samples. [ABSTRACT FROM AUTHOR]

ObjectivesMethodsResultsConclusionClinical implicationsThis study assessed the feasibility and efficacy of “Online Resilience,” a three-lesson online intervention based on third-wave cognitive behavioral therapy (CBT) principles, inspired by acceptance and commitment therapy (ACT), designed for emotionally healthy adults aged 75 and older.A randomized controlled study with 62 participants (mean age = 81) divided into Experimental and Control groups. Outcomes included resilience, well-being, mood, and sleep quality, measured pre-, post-, and at one-month follow-up.The intervention showed feasibility among emotionally healthy older adults with higher baseline resilience and well-being, with attrition rates comparable to similar programs. Resilience improvements were significant post-intervention but diminished by follow-up. Sleep quality improved significantly at follow-up, though control group data was unavailable for comparison. Mood stability was maintained in the intervention group while declining in controls.“Online Resilience” shows promise for promoting resilience, mood stability, and sleep quality in older adults, though limited long-term effects and high attrition warrant program refinements.Brief, self-guided online interventions like this can enhance access to mental health support for older adults, serving as cost-effective preventive tools. However, future programs should address attrition and target individuals with varying baseline psychological resources. [ABSTRACT FROM AUTHOR]

The current case describes the implementation of Acceptance and Commitment Therapy (ACT) and self-compassion interventions with a 37-year-old Queer Hispanic woman "Cynthia" (pseudonym). Cynthia presented to a university training clinic, reporting pervasive difficulties with anxiety, an associated pattern of depressive episodes, and a trauma history. The therapist conceptualized Cynthia's presenting problems through an ACT-based psychological flexibility framework. Functional analysis indicated intolerance of uncertainty, fusion to self-critical thoughts, and experientially avoidant behaviors (e.g., pervasive worry) contributed to Cynthia's anxiety. Values clarification, as well as mindfulness- and acceptance-based interventions, were met with gains in quality-of-life scores and decreases in worry scores as treatment progressed. Additionally, self-compassion interventions were implemented to address pervasive self-criticism and feelings of low self-worth. Across 37 sessions, from pre-to-post treatment, Cynthia's quality of life scores increased by 62.5%, and worry decreased by 52.8%. These results provide support for using ACT and self-compassion interventions for anxiety and co-occurring depression with a Queer, Hispanic woman. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has led to a global health crisis and a significant increase in psychological distress and psychopathological symptoms. We conducted a randomized controlled trial with two online interventions derived from positive psychology (PP) and acceptance and commitment therapy (ACT) in N = 138 “homestayers” during the first lock‐down period in Germany. PP exercises had a positive impact on anxiety scores, which decreased significantly during the intervention, particularly in participants without access to a garden. Direct or indirect social contact, movement/exercise, and exposure to nature were the most frequently reported helpful coping strategies. We conclude that low‐threshold online interventions with a focus on positive aspects of people's lives may be helpful to support mental health during pandemic crises. From a mental health perspective, the results also reinforce the approach of countries that allow their citizens to, for example, still go for walks during periods of contact restrictions, compared to full lock‐down conditions. [ABSTRACT FROM AUTHOR]

Introduction: The present study was conducted with the aim of investigating the effectiveness of acceptance and commitment therapy (ACT) on psychological capital, weight and fat mass of obese women. Method: This study is a semi -experimental, involving a pre -test and post -test design with a control group. The research population comprised all overweight and obese women living in Yazd in 2021. According to the inclusion criteria, 30 people were selected and randomly replaced in two experimental and control groups (15 people in each group). The research instruments included a demographic information questionnaire, the psychological capital questionnaire, and the ACT treatment protocol. Following the pre -test, subjects in the control group underwent ACT treatment training sessions as the independent variable. The intervention consisted of nine group therapy sessions, each lasting 1.5 hours. Analysis of covariance (ANCOVA) was used to analyze the data. Results: At the beginning of the research, the average weight in the experimental group was 73.85 kg and in the control group was 74.01 kg. The findings of the research showed that the treatment based on ACT was able to play an effective role in increasing the psychological capital of overweight and obese women in Yazd city (p=0/001). This treatment was also effective in reducing the fat mass and weight of the participants (p=0/001). Conclusion: According to the results of the present study, it seems that ACT can play an effective role in solving the problems of overweight women and increase their psychological capital and reduce their weight and fat mass . [ABSTRACT FROM AUTHOR]

BackgroundA significant proportion of mental health care professionals (MHCPs) hold stigmatizing attitudes about their patients. When patients perceive and internalize these beliefs, self-stigmatization can increase. Acceptance and Commitment Therapy (ACT) may decrease stigmatizing attitudes by changing the ‘us’ versus ‘them’ thinking into continuum beliefs. In the present study MHCPs were given an ACT-based training, aiming to decrease stigmatization, hypothesizing that self-stigmatization of their patients will subsequently decrease.MethodsAn RCT with a 2 (pre-test/post-test) x 2 (no training/training) design was conducted. A total of 41 MHCPs participated, 20 were randomized to the experimental and 21 to the control condition respectively. The MHCPs in the experimental condition received an ACT-based training, MHCPs in the control condition received no training. From every MHCP, one of their patients participated in the pre- and post-measurement. As the primary outcome, patients’ awareness, agreement, application and hurt-self, was measured using the Self Stigma of Mental Illness Scale - Short Form (SSMIS-SF), before and after the MHCPs’ ACT-based training.ResultsSignificant group x time interaction effects were found for ‘application’ (internalization of mental illness stereotypes) in patients after the ACT-based training of their MHCP: F (1,39) = 9.33, p < 0.01, ηp2 = .85. On the contrary, no effect was found on the subscales ‘awareness’, ‘agreement’ and ‘hurt-self’.ConclusionPreliminary results suggest that a brief ACT training for MHCP might heighten their awareness and contribute to reduction of their stigmatizing attitudes and behavior, leading to less application of self-stigmatizing beliefs in their patients.

Statistics anxiety is a significant problem for students' learning experience in the psychological sciences. This article explores a novel teaching methodological approach during the global pandemic to improve students' performance by reducing their statistics anxiety. The subject design and teaching methodological approach were developed based on twenty years of experience taking into consideration the student feedback, while its implementation was aligned with the 5-E's Victorian Teaching and Learning pedagogical Model (VTLM). Moreover, to reduce the statistics anxiety, two sections were embedded in the Learning Management System of the subject: (1) an interactive web-based mindfulness intervention and (2) a head-start 'Ready, Set, Go' information pack. The implementation of these approaches resulted in a better understanding of statistical concepts and utilization of the SPSS software by the majority of the students (80% pass-rate). Consequently, a 6% increase in pass rates and an average of 32% increase in satisfaction scores for each item in the university central survey were observed. While the uniqueness of the first year of COVID-period makes comparisons difficult, it is matched by the urgency of the need for effective interventions to support student success. [ABSTRACT FROM AUTHOR]

Objective: Acceptance and Commitment Therapy (ACT) is an evidence-based psychological intervention that has gained increasing attention in recent years. While extensively studied for its effectiveness in adult populations, there has been growing interest in exploring the application of ACT in children and adolescents psychotherapy. This umbrella review aims to provide an overview of the current literature on the use and efficacy of ACT in children and adolescents, as well as to highlight potential considerations and future directions for research. Method: A comprehensive search was done in scientific databases, including Scopus, PubMed, and Web of Sciences, using keywords related to ACT, children, adolescents, and psychotherapy. Relevant articles were included, with a focus on systematic reviews and meta-analysis. Results: Our findings indicate consistent effectiveness for ACT and related interventions across various delivery formats, including in-person, group, and internet-based approaches, in reducing symptoms of internalizing and externalizing problems, as well as improving overall quality of life among children and adolescents. However, two articles comparing ACT with traditional cognitive behavioral therapy did not demonstrate superiority. Additionally, when comparing internetbased and in-person delivery modes, the included studies did not show significant differences between the two types. Conclusion: ACT shows promise as an effective therapeutic approach in children and adolescents psychotherapy. However, more research is warranted to establish its specific techniques and adaptations for different age groups and presenting problems. Additionally, future research should explore the feasibility and effectiveness of delivering ACT in varied settings. [ABSTRACT FROM AUTHOR]

Social anxiety disorder (SAD) often develops during teenager years, and it is important to conceptualize developmentally appropriate interventions. Exposure therapy framed from a perspective of acceptance and commitment therapy (ACT) shows promise for decreasing pathology and increasing wellbeing. This case illustrates the process through which exposure therapy was integrated with ACT to elicit meaningful outcomes in a case of SAD with a 16-year-old female. Treatment outcomes assessed included engagement in values-based activities as well as assessments of depression, anxiety, experiential avoidance, and context-specific wellness. Intervention focused on learning ACT principles through relatable metaphors and experiential exercises and practicing them with values-guided social exposures. This integration resulted in increased engagement of socially meaningful experiences and associated changes in treatment outcomes. Implications, guidelines, and recommendations are presented, including the need for skill-focused treatments, identifying deficits in psychological flexibility, and maintaining a compassionate yet growth-oriented course of treatment. [ABSTRACT FROM AUTHOR]

Purpose: The primary objective of this study is to compare the effectiveness of Spiritual Therapy and Acceptance and Commitment Therapy (ACT) on illnessrelated worries in patients with fibromyalgia syndrome. Methodology: The research method employed is quasi-experimental (pre-test, post-test with a control group). The research tools include spiritual therapy and acceptance and commitment therapy packages, as well as the Illness Worry Questionnaire, which consists of 23 items. The content validity for the entire scale was 0.95. The statistical population included patients diagnosed with fibromyalgia (referred to the clinic in Tehran in 2024). A total of 36 participants were selected through purposive sampling and were randomly assigned to two experimental groups (12 in the Spiritual Therapy group and 12 in the Acceptance and Commitment Therapy group) and one control group (12 participants). For hypothesis testing, analysis of covariance (ANCOVA) was used, and SPSS version 23 software was employed. Findings: The research findings, based on the pairwise comparison of post-test mean scores of worry, among the ACT group, the Spiritual Therapy group, and the control group, indicate that the significance level for all groups is (sig<0.05). Therefore, the difference between the mean scores is statistically significant, and the research hypothesis is accepted with 95% confidence. Conclusion: Given that the effect size (?²>0.36) is significant, both Acceptance and Commitment Therapy (ACT) and Spiritual Therapy have a strong impact on reducing illness-related worries in patients with fibromyalgia syndrome. Furthermore, Spiritual Therapy is more effective in reducing worries than Acceptance and Commitment Therapy. [ABSTRACT FROM AUTHOR]

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Abstract Background Chronic pain is a leading cause of disability and negatively impacts biological/physical, psychological, and social aspects of life resulting in significant pain interference or disability. This project was part of a longitudinal mixed-methods implementation evaluation of the TelePain-Empower Veterans Program (EVP), a non-pharmacological chronic pain intervention. The purpose of this quality management project was to examine electronic patient-reported outcome measures (ePROs) including primary pain-related (intensity, interference, catastrophizing, kinesiophobia) and secondary outcomes (physical, psychological, acceptance, social) to determine TelePain-EVP effectiveness. Secondary purpose was to examine dosing effects to better understand potential dose relationships between EVP use and ePROs. Methods Standardized ePRO measures were examined at week 1 (baseline), week 10 (post-EVP), and week 26 (follow-up). Qualtrics, a cloud-based platform was used to collect ePRO data at each time point. Veterans that completed at-least one survey at any specified time point were categorized as responders (n = 221). Linear-mixed models (LMMs) were fit to assess changes for each primary and secondary ePRO. Results Participants ranged from 24 to 81 years old; veterans were typically male (65.16%), black or African American (76.47%), married or partnered (41.63%), attended at-least some college or vocational school (67.87%), and reported low back as their primary pain location (29.41%). There was a significant decrease in pain catastrophizing from baseline to post-TelePain-EVP (p

Background and Objectives: Social anxiety is one of the most common disorders in adolescents. The present study was conducted with the aim of determining the effectiveness of acceptance and commitment therapy (ACT) on behavioral brain systems, selfefficacy, and rumination of adolescent girls with social anxiety disorder. Materials and Methods: This was a quasi-experimental study with a pre-test and post-test design with experimental and control groups. The statistical population included girls aged 12 to 18 years with social anxiety in Tehran City in academic year 2023. Using convenience sampling 30 people were selected and randomly assigned into experimental (n=15) and control (n=15) groups. The experimental group participated in ACT for 8 sessions twice a week for 90 minutes, but the control group received no training. In this research, Nolen and Hoeksma's Rumination Questionnaire, Scherer et al.'s Self-efficacy Questionnaire, and Carver and Whait's Brain-Behavioral Systems Questionnaire were used for pre-test and post-test evaluation. The collected data were analyzed using multivariate analysis of covariance (MANCOVA). Results: The results indicated that ACT had a significant effect on the reduction of rumination (Eta=0.49, F=26.91, p<0.001), and improvement of self-efficacy (Eta=0.61, F=43.56, p<0.001) and brain behavioral system (Eta=0.32, F=12.71, p<0.001) in adolescent girls of Tehran City. Conclusion: It seems that treatment based on ACT had a good effect on rumination, self-efficacy, and brain-behavioral systems of teenage girls suffering from social anxiety. It is recommended to use ACT method in counseling centers to improve the health of adolescents with social anxiety disorder. [ABSTRACT FROM AUTHOR]

To examine the reliability and validity of the Chinese version of the Multidimensional Psychological Flexibility Inventory (C-MPFI) in college students and other groups. A total of 2794 participants were included in the study, including college students (Sample A: N = 1405), middle school students (Sample B: N = 438), epidemic prevention and control volunteers (Sample C: N = 496), and private enterprise employees (Sample D: N = 455). Sample A was asked to complete C-MPFI and the validity questionnaires at the same time. Other sample groups were only required to complete C-MPFI. After 3 weeks, 355 college students filled in the same questionnaires to assess the test-retest reliability. The exploratory factor analysis showed that the C-MPFI consisted of six factors, with a total of 30 items. The confirmatory factor analysis showed that the six-factor structure fit was acceptable (χ2 = 1629.64, df = 398, CFI = 0.90, TLI = 0.89, RMSEA = 0.070, SRMR = 0.078). C-MPFI and its dimensions are significantly positively correlated with positive indicators of mental health (life satisfaction), significantly negatively correlated with negative emotions (depression, anxiety, stress), and significantly negatively correlated with empirical avoidance and cognitive fusion. C-MPFI and its dimensions demonstrated good internal consistency and test-retest reliability in different samples. The C-MPFI scores were comparable across groups, according to the results of the measurement invariance tests, the configural invariance, metric invariance, scalar invariance, and strict invariance of the 6-factor model. It suggested that the C-MPFI has good reliability and validity. [ABSTRACT FROM AUTHOR]

Background: Chronic pain is a leading cause of disability and negatively impacts biological/physical, psychological, and social aspects of life resulting in significant pain interference or disability. This project was part of a longitudinal mixed-methods implementation evaluation of the TelePain-Empower Veterans Program (EVP), a non-pharmacological chronic pain intervention. The purpose of this quality management project was to examine electronic patient-reported outcome measures (ePROs) including primary pain-related (intensity, interference, catastrophizing, kinesiophobia) and secondary outcomes (physical, psychological, acceptance, social) to determine TelePain-EVP effectiveness. Secondary purpose was to examine dosing effects to better understand potential dose relationships between EVP use and ePROs. Methods: Standardized ePRO measures were examined at week 1 (baseline), week 10 (post-EVP), and week 26 (follow-up). Qualtrics, a cloud-based platform was used to collect ePRO data at each time point. Veterans that completed at-least one survey at any specified time point were categorized as responders (n = 221). Linear-mixed models (LMMs) were fit to assess changes for each primary and secondary ePRO. Results: Participants ranged from 24 to 81 years old; veterans were typically male (65.16%), black or African American (76.47%), married or partnered (41.63%), attended at-least some college or vocational school (67.87%), and reported low back as their primary pain location (29.41%). There was a significant decrease in pain catastrophizing from baseline to post-TelePain-EVP (p <.001). However, pain catastrophizing improvement from baseline was not present at week 26 (p =.116). Pain interference also decreased from baseline to post-treatment (p =.05), but this improvement did not exceed the adjusted significance threshold. Additional pre-post improvements were also observed for certain secondary ePROs: psychological (anxiety, depression), acceptance (activities engagement). Only the activities engagement effect remained 26 weeks from baseline. Mixed results were observed for EVP dose across primary and secondary outcomes. Conclusions: Evidence from this evaluation indicate that TelePain-EVP has positive outcomes for certain pain (catastrophizing), psychological (anxiety, depression), and acceptance (activities engagement) for veterans with chronic pain. More TelePain related studies and enterprise-wide evaluations are needed along with comparative and cost effectiveness methods to determine patient benefits and the economic value gained of treatment options such as TelePain-EVP. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is the most common disease and the second cause of death in women, which has many physical and psychological complications, and anxiety is one of them. Today, with the advancement of psychology, there are various ways to reduce stress and anxiety, especially for diseases such as cancer. Among these methods is treatment based on acceptance and commitment. Aims: The purpose of this research was to evaluate the effectiveness of acceptance and commitment therapy (ACT) on disease perception, self-care behaviors and treatment adherence in female patients with breast cancer. Methods: The current research design is a quasi-experimental pre-test-post-test type with a control group and follow-up. The statistical population of the research includes all female patients with breast cancer aged 25 to 45 who were referred to the oncology department of Imam Hossein Hospital in the second half of 2018, 40 of whom were selected through purposive sampling along with screening and based on Cohen's table, using The effect size and power of the test was selected as sample people, these people were replaced in two experimental and control groups using a random method. The experimental group underwent Acceptance and Commitment Therapy (ACT). In order to collect research data, a long-form disease perception questionnaire, a Madanlo treatment adherence questionnaire, and a self-care ability questionnaire were used. Results: The results of analysis of variance with repeated measurements showed that acceptance and commitment-based treatment (ACT) was effective on the perception, adherence to treatment, and self-care ability of female breast cancer patients, and this effect was stable in the follow-up phase. Conclusion: According to the findings of this research, it can be said that acceptance and commitment therapy (ACT) as an effective intervention can be effective on the perception, adherence to treatment, and self-care ability of female patients with breast cancer. Therefore, the use of psychological services in parallel with the process of treating people with breast cancer is necessary for faster treatment.

Introduction: Neurotic perfectionism has a variety of psychological consequences that should be considered in psychotherapy applications. Aim: The present study aimed to examine the effectiveness of acceptance and commitment therapy (ACT) on neurotic perfectionism and internalized self-criticism in neurotic perfectionist girls. Method: This study was conducted using a single-case quasi-experimental design with, concurrent multiple baseline. The research population consisted of neurotic perfectionist girls visiting counseling centers in Ahvaz in 2022. The participants were a sample of 5 girls selected using purposive sampling with a minimum cut-off score of 145 in the Neurotic Perfectionism Questionnaire (NPQ). The acceptance and commitment therapy (ACT) (Twohig & et al, 2021) was implemented in eleven 90-minute sessions. The participants completed the Neurotic Perfectionism Questionnaire (1994), and the Levels of Self-Criticism Scale (2004). The data were collected in three baseline, intervention, and three-month follow-up phases and analyzed using reliable change index (RCI), recovery percentage, and visual inspection. Results: The analysis of the recovery percentage showed the participants’ neurotic perfectionism 17.67 and internalized self-criticism 19.73 improved in the intervention phase and their neurotic perfectionism 36.25 and internalized self-criticism 49.90 increased in the follow-up phase. Moreover, the reliability change index of both variables in the post-treatment and follow-up phases was significant (P=0.05). Conclusion: Considering the effectiveness of acceptance and commitment therapy in reducing neurotic perfectionism and internalized self-criticism by increasing psychological flexibility, this therapy can be used as an intervention method in neurotic perfectionist girls.

The present study was conducted to investigate the efficacy of ACT (Acceptance and Commitment Therapy) on the perceived stress and enhancing a sense of coherence among individuals diagnosed with ulcerative colitis. A quasi-experimental design comprising a pre-test, post-test, control group, and a two-month follow-up period was utilized for the study. The statistical cohort comprised all patients diagnosed with ulcerative colitis who were referred to the Digestion and Liver Research Center during the autumn and winter of 2019-20, under the supervision of Alzahra Hospital. A total of 25 patients who were diagnosed with ulcerative colitis were chosen using a purposive sampling method and assigned at random to either the experimental or control group. Over the course of two months, the experimental group participated in ten ACT sessions, each lasting seventy-five minutes. The applied questionnaires utilized in this study comprised the Perceived Stress Scale (PSS) and Sense of Coherence Questionnaire (SCQ). The data obtained from the study were subjected to analysis using mixed ANOVA via SPSS-23. Patients with ulcerative colitis (p

Non-Suicidal Self-Injury (NSSI) behavior is carried out as an effort to avoid thought, feeling, somatic sensation or other internal experiences that are uncomfortable or troublesome. The intervention carried out using Acceptance and Commitment Therapy (ACT) to increase psychological flexibility targeted at avoiding experiences or tendencies to avoid unwanted thoughts or emotions. This research aims to provide NSSI behavioral intervention which is carried out using the Acceptance and Commitment Therapy (ACT) as an effort to change positive behavior through a process of acceptance, attention and behavior change. The population in this research is students of SMAN 1 Bogor and the sample was taken using purposive sampling technique with the characteristics of conducting NSSI for 1 year, so three people are selected as samples who have met the criteria. This research is designed using single subject research with the ABA model and analyzed using inferential statistics. By using the Difficulties in Emotion Regulation (DERS) instrument, the results obtained in the baseline phase (A1) are an average score of 99.6; intervention phase (B) obtained an average score of 80.9; and at baseline (A2) an average score of 63.8 is obtained. This means that there is a decrease in the graph of NSSI behavior at each intervention session using ACT. This research provides information that using (ACT) can reduce NSSI behavior in students.

Abstract This paper describes an interdisciplinary integration of the concept of environmental identity into cognitive behavioural approaches to facilitate psychotherapy interventions for climate distress. Environmental identity encompasses one's sense of self in relation to the natural world and other species, and is an important sub-identity analogous to gender, sexual and other forms of self and social identity recognized in psychotherapy. We provide a background on the construct of environmental identity as developed in social and environmental psychology and share culturally responsive methods for mental health practitioners and the public to evoke and explore their own environmental identity. We then discuss steps to create environmental identity-based therapy interventions using cognitive and behavioural approaches for climate distress. We highlight the potential for acceptance and commitment therapy to foster mindfulness and values-based action, dialectical behaviour therapy to support emotional regulation, and radically open dialectical behaviour therapy to mitigate perfectionism and over-controlled coping styles. We also describe a composite case study of environmental identity-based cognitive behavioural therapy for an LGBTQ+ client. Key learning aims (1) The paper presents new opportunities and techniques for adapting cognitive behavioural interventions in a climate conscious manner, with insights and observations from the authors based on clinical practice, which informs research into psychotherapy best practices in the context of environmental and climate issues. (2) Readers will become familiar with the empirical basis of environmental identity drawn from theory and research in social and environmental psychology; how environmental experiences and values intersect with other forms of personal and social identity addressed in mental health practice; and culturally responsive ways to elicit environmental identity on the part of practitioners and those they serve. (3) Readers are guided through examples of environmental identity-based cognitive and behavioural interventions including (1) promoting values-based action using acceptance and commitment therapy, (2) addressing emotional dysregulation using dialectical behaviour therapy, and (3) modifying over-controlled or perfectionistic coping styles using radically open dialectical behaviour therapy. (4) A composite case study provides an example of environmental identity-based cognitive behavioural therapy for a 20-year-old LGBTQ+ person experiencing climate distress. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effects of acceptance and commitment-based psychoeducation program on prospective psychological counselors' some personal (psychological flexibility and self-compassion) and professional (empathy and effective counselor characteristics) qualifications. The research was designed as a pretest-posttest control group quasi-experimental study with follow-up measurements. The study group consisted of 32 prospective psychological counselors drawn from department of guidance and psychological counseling. They were assigned to the experimental and control groups (16 by 16). While the experimental group was given an acceptance and commitment-based psychoeducation program consisting of 10 sessions, no intervention was performed for the participants in the control group. Pretest, posttest, first follow-up (3 months), and second follow-up (9 months) measurements of the experimental and control groups were taken. A two-way analysis of variance in repeated measurements test was used via the IBM SPSS software package. The results revealed that the program was not only significantly effective in increasing the psychological flexibility and self-compassion levels of prospective psychological counselors but also resulted in a permanent effect. It was found that the intervention program did not lead to a significant change in the empathy levels and effective counselor characteristics of the prospective psychological counselors. [ABSTRACT FROM AUTHOR]

Objective: Many persons with fibromyalgia (FM) use online peer support groups (OPSGs) to address unmet emotional or psychological needs. Some OPSG members have suggested that participation in an OPSG is a viable substitute for professional psychological services, however, no published research exploring this claim was identified. Methods: Discussion content collected from three Facebook FM OPSGs was thematically analyzed to explore whether the content posted in FM OPSGs emulated content consistent with the psychological flexibility model underlying Acceptance and Commitment Therapy (ACT) – an evidence-based psychotherapy for chronic pain conditions. Results: The content posted in OPSGs did not emulate and often contradicted the core psychological flexibility processes or skills emphasized in ACT programs. Conclusion: Participation in an FM OPSG should be approached cautiously. Content from the FM OPSGs should not be considered a substitute for professionally delivered ACT, although participation may provide emotional support to help individuals move towards readiness for active psychotherapy. Innovation: This research represents a novel application of the psychological flexibility model underlying ACT to assess the potential therapeutic value of a peer support community. Additionally, it is the first to clarify that content in FM OPSGs is not aligned with psychological flexibility processes.

Background: Breast cancer is the most common disease and the second cause of death in women, which has many physical and psychological complications, and anxiety is one of them. Today, with the advancement of psychology, there are various ways to reduce stress and anxiety, especially for diseases such as cancer. Among these methods is treatment based on acceptance and commitment. Aims: The purpose of this research was to evaluate the effectiveness of acceptance and commitment therapy (ACT) on disease perception, self-care behaviors and treatment adherence in female patients with breast cancer . Methods: The current research design is a quasi -experimental pre -test -post -test type with a control group and follow -up. The statistical population of the research includes all female patients with breast cancer aged 25 to 45 who were referred to the oncology department of Imam Hossein Hospital in the second half of 2018, 40 of whom were selected through purposive sampling along with screening and based on Cohen's table, using The effect size and power of the test was selected as sample people, these people were replaced in two experimental and control groups using a random method. The experimental group underwent Acceptance and Commitment Therapy (ACT). In order to collect research data, a long -form disease perception questionnaire, a Madanlo treatment adherence questionnaire, and a self-care ability questionnaire were used. Results: The results of analysis of variance with repeated measurements showed that acceptance and commitment -based treatment (ACT) was effective on the perception, adherence to treatment, and self-care ability of female breast cancer patients, and this effect was stable in the follow -up phase. Conclusion: According to the findings of this research, it can be said that acceptance and commitment therapy (ACT) as an effective intervention can be effective on the perception, adherence to treatment, and self-care ability of female patients with breast cancer. Therefore, the use of psychological services in parallel with the process of treating people with breast cancer is necessary for faster treatment. [ABSTRACT FROM AUTHOR]

This service evaluation examined the feasibility and service user reported experience of a brief psychological intervention for adults with Non-Epileptic Attack Disorder (NEAD). 15 participants attended an individual six-session Acceptance and Commitment therapy (ACT)-informed intervention comprising of psychoeducation and grounding techniques. Participant experience of the intervention was assessed using outcome measures and an online focus group which indicated their satisfaction. Participants fed back that longer therapy intervention; education of other health professionals (having reported previous negative experiences); and group/family support sessions would enhance future care. [ABSTRACT FROM AUTHOR]

The impact of the COVID-19 pandemic on mental health crisis may have a long-lasting effect amidst people who went through loss of lives, self-quarantine, social distancing, job loss, the threat of illness, psychosocial and economic crisis. The dramatic increase of mental health difficulties makes psychotherapeutic assistance a vital need. Recent literature states that Acceptance Commitment Therapy is one of the effective methods to moderate psychological distress resulting from the uncertainties of a pandemic. In this study, we aim to identify literature on the effectiveness of ACT in treating anxiety, depression, and stress during the COVID-19 pandemic, and by doing so observe its effectiveness and potential use in pandemic like situations that may arise in the future. The narrative review method is adopted in the study. By focusing on acceptance, mindfulness, and values-based action, Acceptance and Commitment Therapy (ACT) efficiently alleviates anxiety, depression, and stress that are associated to the COVID-19 pandemic. Small sample sizes, inconsistent evidence quality, a shortage of knowledge of long-term impacts, and a lack of attention to the therapeutic process are some of the study gaps, though. Future research should examine ACT protocols, provide manuals tailored to the pandemic, and look into technology-assisted psychotherapy like cyberpsychotherapy. [ABSTRACT FROM AUTHOR]

Introduction: Neurotic perfectionism has a variety of psychological consequences that should be considered in psychotherapy applications. Aim: The present study aimed to examine the effectiveness of acceptance and commitment therapy (ACT) on neurotic perfectionism and internalized self-criticism in neurotic perfectionist girls. Method: This study was conducted using a single-case quasi-experimental design with, concurrent multiple baseline. The research population consisted of neurotic perfectionist girls visiting counseling centers in Ahvaz in 2022. The participants were a sample of 5 girls selected using purposive sampling with a minimum cut-off score of 145 in the Neurotic Perfectionism Questionnaire (NPQ). The acceptance and commitment therapy (ACT) (Twohig & et al, 2021) was implemented in eleven 90-minute sessions. The participants completed the Neurotic Perfectionism Questionnaire (1994), and the Levels of Self-Criticism Scale (2004). The data were collected in three baseline, intervention, and three-month follow-up phases and analyzed using reliable change index (RCI), recovery percentage, and visual inspection. Results: The analysis of the recovery percentage showed the participants’ neurotic perfectionism 17.67 and internalized self-criticism 19.73 improved in the intervention phase and their neurotic perfectionism 36.25 and internalized self-criticism 49.90 increased in the follow-up phase. Moreover, the reliability change index of both variables in the post-treatment and follow-up phases was significant (P=0.05). Conclusion: Considering the effectiveness of acceptance and commitment therapy in reducing neurotic perfectionism and internalized self-criticism by increasing psychological flexibility, this therapy can be used as an intervention method in neurotic perfectionist girls. [ABSTRACT FROM AUTHOR]

Abstract Background Chronic pain is a highly prevalent health condition among veterans. Traditional pharmacological interventions present unique challenges for chronic pain management including prescription opioid addiction and overdose. In alignment with the 2016 Comprehensive Addiction and Recovery Act and VA’s Stepped Care Model to meet veterans’ pain management needs, the Offices of Rural Health and Pain Management, Opioid Safety, and Prescription Drug Monitoring Program (PMOP) funded an enterprise-wide initiative to implement a Step 3 integrated tele-pain program: Empower Veterans Program (EVP). EVP provides veterans with chronic pain self-care skills using a whole health driven approach to pain management. Objectives The Comprehensive Addiction and Recovery Act prompted the strategic approach to offer non-pharmacological options to meet veterans’ pain management needs. EVP, a 10-week interdisciplinary group medical appointment, leverages Acceptance and Commitment Therapy, Mindful Movement, and Whole Health to provide veterans with chronic pain self-care skills. This evaluation was conducted to describe participant characteristics, graduation, and satisfaction rates; and assess pre-post patient-reported outcomes (PRO) associated with EVP participation. Methods A sample of 639 veterans enrolled in EVP between May, 2015 and December, 2017 provided data to conduct descriptive analyses to assess participant demographics, graduation, and satisfaction rates. PRO data were analyzed using a within-participants pre-post design, and linear mixed-effects models were used to examine pre-post changes in PRO. Results Of 639 participants, 444 (69.48%) graduated EVP. Participant median program satisfaction rating was 8.41 (Interquartile Range: 8.20–9.20). Results indicate pre-post EVP improvements (Bonferroni-adjusted p

The purpose of this paper is to investigate the efficacy of Acceptance and Commitment Therapy (ACT) on the life quality and resilience of those recuperated from Covid-19. The research method was quasi-experimental with pre-test, post-test, control group and three-month follow-up period design. The statistical population of the study included those recuperated from Covid-19 with the record of hospitalization in the city of Bandar Abbas in the winter of 2020. Twenty-seven recovered people from Covid-19 were selected via the snowball method and randomly 13 of them were accommodated into experimental (7 males and 6 females) and 14 of them were accommodated into control groups (6 males and 8 females). The experimental group received ACT during two-and-a-half months (in 10 sessions). The applied questionnaires in this study included resilience questionnaire and life quality scale. The data from the study were analyzed through mixed ANOVA via SPSS-23 statistical software. The results showed that ACT has been effective on the life quality (F=38.75; Eta=0.61; P

This paper describes an approach to sexual therapy for sexual dysfunctions and sexual relationship dysfunctions that was inspired first by the „Third Power of Psychology“, the Humanistic Psychology and Psychotherapy (HPT) and secondly by the „Third Wave of Psychotherapy“, here Acceptance and Commitment Therapy (ACT). Accordingly, the therapy focuses on the acceptance of problems and the concession that something is not right, instead of attempting to eliminate or correct dysfunction. Acceptance and Commitment Sexual Therapy (Akzeptanz- und Zugeständnis-Sexualtherapie, AZST) is based on the assumption that sexual dysfunctions and sexual relationship dysfunctions can be resolved once the pressure to correct (or „fix“) a dysfunction is eliminated. The approach draws on the broader understanding of sexual health derived from the principles of Ivan Bloch, in which socio-cultural norms, ideals and expectations relating to sexual activity form the background for the evaluation of sexual health. It is assumed that, on the macro level, sexual dysfunctions are not individual psychological symptoms but rather expressions of social normative sexual expectations which are internalized by the individual as potentially pathological. Specifically, that sexual interactions must result in „successful“ penis-vaginal penetration and rate as „bad sex“ when this goal is not achieved. Clinical observations show that sexual dysfunctions, on the micro level, are largely penetration dysfunctions which occur with internalized pressure to achieve penis-vaginal penetration. Acceptance and Commitment Sexual Therapy supports the couple in their recognition of socialy normative pathogenic sexual expectations, and in their refocusing on the communication function of sexuality. The paper gives a schematic overview of the principles and processes of Acceptance and Commitment Sexual Therapy. [ABSTRACT FROM AUTHOR]

A randomised multiple-baseline single case experimental design (SCED) was used to examine feasibility, acceptability, and preliminary effectiveness of an online Acceptance and Commitment Therapy (ACT) intervention for adults with Type 1 diabetes (T1D). Consenting participants reporting diabetes-specific distress (n = 25) were randomised to baseline length (1–3 weeks) before completing a six-week online ACT intervention, followed by one-month follow-up (FU). The primary outcome assessed generic and diabetes-specific well-being, measured at pre, post, and FU using the Well-Being Questionnaire. Secondary outcomes were: diabetes-dependent quality of life (Audit of Diabetes-Dependent Quality of Life at pre, post, FU); mood and anxiety measured daily using visual analogue scales (VAS); diabetes self-management (daily self-management activities VAS, and pre, post, FU measurements using the Diabetes Self-Management Questionnaire); glycaemic control (information from continuous glucose monitoring devices and daily self-monitoring of blood glucose); and psychological flexibility (Multidimensional Psychological Flexibility Inventory at pre, post, FU). Nine participants completed all phases of the study, rating the intervention as highly acceptable. Most participants showed clinically significant improvements in generic well-being (n = 5) and diabetes-specific well-being (n = 7) at follow-up. Diabetes-dependent QoL reliably improved at follow-up for three participants. Improvements in mood (n = 7) and anxiety (n = 6) were observed across phase comparisons. Most participants reported a significant increase in physical activity (n = 5) across phases. A positive trend of increased time in blood glucose range from baseline to intervention was observed for four participants. Psychological flexibility significantly increased from baseline to follow-up for seven participants. Interpretation of the findings was considered in the context of limitations including high rates of attrition (55%). • A web-based ACT intervention for adults with type 1 diabetes was evaluated using SCED. • Web-based ACT was an acceptable approach for adults with type 1 diabetes. • Preliminary effectiveness was found for mood, anxiety and physical activity. • Web-based ACT enhanced psychological flexibility and diabetes-specific well-being. • Future research is warranted with a larger sample and extended follow-up. [ABSTRACT FROM AUTHOR]

Cardiovascular diseases (CVDs) remain a public health problem. Patients with CVDs face difficulties adhering to self-care recommendations and experience psychological symptoms and impaired quality of life (QOL). The benefits of acceptance and commitment therapy (ACT) have been demonstrated in these health outcomes but have yet to be for CVD patients. The purpose of this study was to review the evidence to determine the effects of ACT on such health outcomes in CVD patients using narrative and quantitative approaches. Experimental studies using ACT interventions in adult patients with CVDs on QOL, self-care, and psychological symptoms were identified. Studies published in English and Chinese in ten major databases with no time limits until November 2022 were considered. The risk of bias was evaluated using the assessment tool of the Effective Public Health Practice Project (EPHPP) and the Psychotherapy Outcome Study Methodology Rating Form (POMRF). Meta-analyses were performed on clinically homogeneous comparisons where possible. A total of 17 experimental studies with 1,312 participants were included. Despite the heterogeneity of the studies, the findings showed that ACT interventions tend to improve QOL and self-care in CVD patients. The pooled results also indicated that the effects of ACT interventions on anxiety as measured by the Generalized Anxiety Disorder (GAD-7) Scale significantly outperformed those of comparator groups (combined MD −1.54, 95% CI −2.14 to −0.95) at post-treatment for CVD patients, as well as on depression as measured using the Patient Health Questionnaire (PHQ-9) (combined MD −2.46, 95% CI −3.61 to −1.31). ACT appears to be effective at improving health outcomes in patients with CVD. Due to the high heterogeneity of the reviewed studies and the lack of transparent reporting on the form and intensity of ACT interventions for patients with CVD, only a small number of studies were included in the current meta-analysis, which may partially threaten the reliability and reproducibility of the findings. Recommendations and future research directions are provided to optimize future research on ACT interventions for patients with CVD. • Patients with cardiovascular diseases find self-management challenging. • Acceptance and commitment therapy appears to be effective in improving outcomes. • More randomized controlled trials are needed for cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Background: Acceptance and Commitment Therapy interventions are increasing in use in neurological populations. There is a lack of information on the measures available. Purpose: To identify and classify the measures used in Acceptance and Commitment Therapy research studies with adults with acquired neurological conditions. Methods: PRISMA-ScR guided scoping review. MEDLINE, PsycInfo and CINAHL databases searched (up to date 29/06/2022) with forward and backward searching. All study types included. Extraction of Acceptance and Commitment Therapy process-of-change and health-related outcome measures. Outcomes coded using the Core Outcome Measures in Effectiveness Trials (COMET) taxonomy. Results: Three hundred and thirty three papers found on searching. Fifty four studies included and 136 measurement tools extracted. Conditions included multiple sclerosis, traumatic brain injury and stroke. Thirty-eight studies measured processes of change, with 32 measures extracted. The process measure most often used was the Acceptance and Action Questionnaire (n = 21 studies). One hundred and four health-related outcome measures extracted. Measures exploring quality of life, health status, anxiety and depression occurred most frequently, and were used in all included neurological conditions. COMET domains most frequently coded were emotional functioning/well-being (n = 50), physical functioning (n = 32), role functioning (n = 22) and psychiatric (n = 22). Conclusions: This study provides a resource to support future identification of candidate measures. This could aid development of a Core Outcome Set to support both research and clinical practice. Further research to identify the most appropriate and relevant targets and tools for use in these populations should include expert consensus, patient, carer and public involvement and psychometric examination of measures. [ABSTRACT FROM AUTHOR]

Background: Chronic pain is a highly prevalent health condition among veterans. Traditional pharmacological interventions present unique challenges for chronic pain management including prescription opioid addiction and overdose. In alignment with the 2016 Comprehensive Addiction and Recovery Act and VA's Stepped Care Model to meet veterans' pain management needs, the Offices of Rural Health and Pain Management, Opioid Safety, and Prescription Drug Monitoring Program (PMOP) funded an enterprise-wide initiative to implement a Step 3 integrated tele-pain program: Empower Veterans Program (EVP). EVP provides veterans with chronic pain self-care skills using a whole health driven approach to pain management. Objectives: The Comprehensive Addiction and Recovery Act prompted the strategic approach to offer non-pharmacological options to meet veterans' pain management needs. EVP, a 10-week interdisciplinary group medical appointment, leverages Acceptance and Commitment Therapy, Mindful Movement, and Whole Health to provide veterans with chronic pain self-care skills. This evaluation was conducted to describe participant characteristics, graduation, and satisfaction rates; and assess pre-post patient-reported outcomes (PRO) associated with EVP participation. Methods: A sample of 639 veterans enrolled in EVP between May, 2015 and December, 2017 provided data to conduct descriptive analyses to assess participant demographics, graduation, and satisfaction rates. PRO data were analyzed using a within-participants pre-post design, and linear mixed-effects models were used to examine pre-post changes in PRO. Results: Of 639 participants, 444 (69.48%) graduated EVP. Participant median program satisfaction rating was 8.41 (Interquartile Range: 8.20–9.20). Results indicate pre-post EVP improvements (Bonferroni-adjusted p <.003) in the three primary pain outcomes (intensity, interference, catastrophizing), and 12 of 17 secondary outcomes, including physical, psychological, health-related quality of life (HRQoL), acceptance, and mindfulness measures. Discussion: Data suggest that EVP has significant positive outcomes in pain, psychological, physical, HRQoL, acceptance, and mindfulness measures for veterans with chronic pain through non-pharmacological means. Future evaluations of intervention dosing effect and long-term effectiveness of the program is needed. [ABSTRACT FROM AUTHOR]

HIV disproportionately affects young Black men who have sex with men (YBMSM) in the Southern United States. Pre-exposure prophylaxis (PrEP) is an efficacious, biomedical approach to prevent HIV. While Mississippi (MS) has among the highest rates of new HIV infections, it also ranks among the top three states for unmet PrEP need. Thus, increasing engagement in PrEP care for YBMSM in MS is imperative. A potential method to improve psychological flexibility and promote PrEP uptake, explored by this study, is the incorporation of Acceptance and Commitment Therapy (ACT) into PrEP interventions. ACT is an evidence-based intervention used to treat a wide range of mental and physical illnesses. Twenty PrEP-eligible YBMSM and ten clinic staff working with YBMSM in MS were surveyed and interviewed between October 2021 and April 2022. The brief survey covered PrEP structural barriers, PrEP stigma, and psychological flexibility. Interview topics included internal experiences related to PrEP, existing health behaviors, PrEP related personal values, and relevant constructs from the Adaptome Model of Intervention Adaptation (service setting, target audience, mode of delivery, and cultural adaptations). Qualitative data were coded based on ACT and the Adaptome model, organized using NVivo, then thematically analyzed. Patients identified side effects, costs, and taking a daily prescription as top barriers to taking PrEP. Staff reported the top barrier to PrEP for clients was concern others would believe they were living with HIV. Levels of psychological flexibility and inflexibility varied widely among participants. The resulting thematic categories derived from the interviews included 1) thoughts, emotions, associations, memories, and sensations (TEAMS) related to PrEP and HIV, 2) general health behaviors (existing coping techniques, views on medication, HIV/PrEP approach and avoidance), 3) values related to PrEP use (relationship values, health values, intimacy values, longevity values), and 4) Adaptome Model adaptations. These results informed the development of a new intervention, ACTPrEP. Interview data organized by the Adaptome Model of Intervention Adaptation determined appropriate ACT-informed intervention components, content, intervention adaptations, and implementation strategies. Interventions informed by ACT that help YBMSM endure short-term discomfort related to PrEP by relating it to their values and long-term health goals are promising for increasing individuals' willingness to initiate and maintain PrEP care. • HIV disproportionately affects young Black men who have sex with men (YBMSM). Pre-exposure prophylaxis (PrEP) prevents HIV. • 20 PrEP-eligible YBMSM and 10 clinic staff in Mississippi were surveyed and interviewed between October 2021 and April 2022. • Thematic categories: thoughts, emotions, associations, memories, and sensations, health behaviors, values, and adaptations. • Interventions informed by ACT can help YBMSM endure short-term discomfort and increase willingness to initiate PrEP. [ABSTRACT FROM AUTHOR]

Mental health difficulties often start in childhood and the number of young people experiencing mental health difficulties is rising, particularly since the Covid-19 pandemic. School-based programmes have been identified as an effective way to provide support for young people and present an opportunity to offer universal programmes, which can increase equity of access, facilitate resilience and reduce stigma. Whilst there is an emerging evidence of the benefits of preventive mental health programmes delivered in schools, there is a need for more robust evidence and methodological rigour in the development and descriptions of these programmes. Acceptance and Commitment Therapy (ACT) is one approach that may be appropriate as a framework for preventing and reducing mental health difficulties in schools. This paper describes the content development of a UK-based universal school programme using ACT: the In-school Training in Emotional Resilience (InTER-ACT) programme. It describes the steps taken across the stages of content development, from planning the programme, delivering the programme in a school, receiving feedback and integrating the subsequent revisions. The final version of the programme, including summaries of session content, is provided. Consistent with an ACT ethos, the personal values of the researchers, and the influence of these on the programme are discussed, providing a novel integration of methodical detail and authentic, reflective practice. This article provides a transparent and detailed overview of the iterative processes involved in developing the content of an evidence-based pastoral care programme in a way that is systematic, rigorous and responsive to teacher and pupil feedback. [ABSTRACT FROM AUTHOR]

Depression and anxiety are common problems in patients with cancer which may interfere with the daily activities of these patients. Acceptance and Commitment Therapy (ACT) is a type of third-wave behavioral that increases psychological flexibility in relation to personal events. The aim of this study was to investigate the effect of ACT on the psychological distress of patients with cancer. In this study, a systematic review was conducted by searching the PubMed, Embase, Science Direct, Cochrane, CINHAL, Google Scholar, Scopus, SID, Mag Iran databases with no lower time limit and until May 2020. A total of 15 studies entered the final review with the total sample size of 965 of which 470, and 495 were in the ACT, and the comparison groups respectively. The results of the study showed that ACT in all studies reduced the mean score of anxiety and depression after treatment, as well as during follow-up. This reduction was significant in most studies. The present systematic review study showed that ACT can be used as an appropriate intervention in improving the psychological state of patients with cancer. In most studies that measured the effect size, the effect of the intervention on anxiety and depression was observed. [ABSTRACT FROM AUTHOR]