ABSTRACT

Online Acceptance and Commitment Therapy (ACT) interventions use websites and smartphone apps to deliver ACT exercises and skills. The present meta-analysis provides a comprehensive review of online ACT self-help interventions, characterizing the programs that have been studied (e.g. platform, length, content) and analyzing their efficacy. A transdiagnostic approach was taken, including studies that addressed a range of targeted problems and populations. Multi-level meta-analyses were used to nest multiple measures of a single construct within their respective studies. A total of 53 randomized controlled trials were included (n = 10,730). Online ACT produced significantly greater outcomes than waitlist controls at post-treatment for anxiety, depression, quality of life, psychological flexibility, and all assessed outcomes (i.e. omnibus effect), which were generally maintained at follow-up. However, only psychological flexibility and all assessed outcomes at post-treatment were found to be significantly greater for online ACT when compared to active controls, with no significant follow-up effects. Overall, these results further clarify that ACT can be effectively delivered in an online format to target a wide range of mental health concerns, although it is less clear if and when online ACT is more efficacious than other online interventions.

摘要

在线接受和承诺疗法 (ACT) 干预使用网站和智能手机应用程序来提供 ACT 练习和技能。本荟萃分析对在线 ACT 自助干预措施进行了全面审查，描述了所研究项目的特征（例如平台、长度、内容）并分析了它们的功效。采取了跨诊断方法，包括针对一系列目标问题和人群的研究。多级荟萃分析用于在各自的研究中嵌套单个结构的多个测量值。共纳入 53 项随机对照试验（n = 10,730）。在焦虑、抑郁、生活质量、心理灵活性和所有评估结果（即综合效应）方面，在线 ACT 在治疗后产生的结果明显优于等候名单控制，这些结果通常在随访时得到维持。然而，与主动控制相比，在线 ACT 仅发现治疗后的心理灵活性和所有评估结果显着更高，没有显着的后续影响。总体而言，这些结果进一步阐明，ACT 可以以在线形式有效地提供，以针对广泛的心理健康问题，尽管尚不清楚在线 ACT 是否以及何时比其他在线干预更有效。