INTRODUCTION Stress affects many adolescents and is associated with physical and mental health symptoms that can have a negative impact on normative development. However, there are very few evidence-based, specific treatment approaches. The aim of the study was to investigate an eight-session group intervention using components of Acceptance and Commitment Therapy (ACT) enriched with elements of CBT (psychoeducation, problem solving) and art therapy, compared to a waitlist control (WLC) group, regarding its efficacy in reducing stress and associated symptoms. METHODS We conducted a randomized controlled trial in eight cohorts. Eligible participants were 13-18 years old with elevated stress levels. Via block-randomization (n = 70), participants were allocated to receive ACT (n = 38) or WLC (n = 32) and subsequent ACT. We used a multimodal assessment (self-reports, interviews, ecological momentary assessment, physiological markers) before treatment (T1), after the training of the ACT group (T2) and after subsequent training in the WLC group (T3). Primary outcome was perceived stress at T2 assessed with the Perceived Stress Scale. The trial was preregistered at the German Clinical Trials Register (ID: DRKS00012778). RESULTS Results showed significantly lower levels of perceived stress in the ACT group at T2, illustrating superiority of ACT compared to WLC with a medium to large effect size (d = 0.77). Furthermore, the training was effective in the reduction of symptoms of school burnout and physical symptoms associated with stress. CONCLUSION Indicated prevention, especially when based on the principles of ACT and CBT, seems efficient in significantly decreasing stress in adolescents with increased stress.

中文翻译：

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基于接受和承诺疗法原则针对高压力水平青少年的指示性压力预防：一项随机对照试验。


简介 压力影响许多青少年，并与身体和心理健康症状相关，可能对规范发展产生负面影响。然而，基于证据的具体治疗方法很少。该研究的目的是调查采用接受和承诺疗法（ACT）的八个疗程的小组干预，其中富含 CBT（心理教育、问题解决）和艺术疗法的元素，与候补对照（WLC）组相比，它在减轻压力和相关症状方面的功效。方法 我们在八个队列中进行了一项随机对照试验。符合资格的参与者年龄为 13-18 岁，压力水平较高。通过分组随机化 (n = 70)，参与者被分配接受 ACT (n = 38) 或 WLC (n = 32) 以及随后的 ACT。我们在治疗前 (T1)、ACT 组训练后 (T2) 和 WLC 组后续训练后 (T3) 使用多模式评估（自我报告、访谈、生态瞬时评估、生理标记）。主要结果是使用感知压力量表评估 T2 时的感知压力。该试验已在德国临床试验注册处进行预注册（ID：DRKS00012778）。结果 结果显示 ACT 组在 T2 时的感知压力水平显着降低，说明 ACT 相比 WLC 具有中等到大效应大小 (d = 0.77) 的优越性。此外，培训可以有效减少学校倦怠症状和与压力相关的身​​体症状。结论 针对性的预防，尤其是基于 ACT 和 CBT 原则的预防，似乎可以有效地显着减轻压力增加的青少年的压力。