Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Nov;54(6):971-988.
doi: 10.1016/j.beth.2022.07.005. Epub 2022 Jul 16.

Acceptance and Commitment Therapy Processes and Mediation: Challenges and How to Address Them

Joanna J Arch  1 , Joel N Fishbein  2 , Lauren B Finkelstein  2 , Jason B Luoma  3
Affiliations

Acceptance and Commitment Therapy Processes and Mediation: Challenges and How to Address Them

Joanna J Arch et al. Behav Ther. 2023 Nov.

Abstract

Acceptance and commitment therapy (ACT) emphasizes a focus on theory-driven processes and mediating variables, a laudable approach. The implementation of this approach would be advanced by addressing five challenges, including (a) distinguishing ACT processes in measurement contexts, (b) developing and rigorously validating measures of ACT processes, (c) the wide use of psychometrically weaker ACT process measures and the more limited use of stronger measures in earlier work, (d) the inconsistency of past evidence that ACT processes are sensitive or specific to ACT or mediate ACT outcomes specifically, and (e) improving statistical power and transparency. Drawing on the existing literature, we characterize and provide evidence for each of these challenges. We then offer detailed recommendations for how to address each challenge in ongoing and future work. Given ACT's core focus on theorized processes, improving the measurement and evaluation of these processes would significantly advance the field's understanding of ACT.

Keywords: acceptance and commitment therapy; assessment; measurement; mediation; replication.

PubMed Disclaimer

Conflict of interest statement

The authors declare no other conflicts of interest.

References

    1. Abernethy AP, Aziz NM, Basch E, Bull J, Cleeland CS, Currow DC, Fairclough D, Hanson L, Hauser J, Ko D, Lloyd L, Morrison RS, Otis-Green S, Pantilat S, Portenoy RK, Ritchie C, Rocker G, Wheeler JL, Zafar SY, & Kutner JS (2010). A strategy to advance the evidence base in palliative medicine: Formation of a palliative care research cooperative group. Journal of Palliative Medicine, 13(12), 1407–1413. - PMC - PubMed
    1. Allen MT (2021). An exploration of the relationships of experiential avoidance (as measured by the AAQ-II and MEAQ) with negative affect, perceived stress, and avoidant coping styles. PeerJ, 9, e11033. - PMC - PubMed
    1. Arch JJ, & Craske MG (2008). Acceptance and commitment therapy and cognitive behavioral therapy for anxiety disorders: Different treatments, similar mechanisms?. Clinical Psychology: Science and Practice 15(4), 263–279.
    1. Arch JJ, Wolitzky-Taylor KB, Eifert GH, & Craske MG (2012). Longitudinal treatment mediation of traditional cognitive behavioral therapy and acceptance and commitment therapy for anxiety disorders. Behaviour Research and Therapy, 50(7–8), 469–478. - PubMed
    1. Barney JL, Lillis J, Haynos AF, Forman E, & Juarascio AS (2019). Assessing the valuing process in acceptance and commitment therapy: Experts’ review of the current status and recommendations for future measure development. Journal of Contextual Behavioral Science, 12, 225–233. - PMC - PubMed

LinkOut - more resources