Web-Based Self-Help for Preventing Mental Health Problems in Universities: Comparing Acceptance and Commitment Training to Mental Health Education.

OBJECTIVE This study sought to test the feasibility of a web-based Acceptance and Commitment Training (ACT) prototype prevention program called ACT on College Life (ACT-CL). METHOD A sample of 234 university students was randomized to either the ACT-CL website or a mental health education (MHE) website. RESULTS Findings indicated a lower level of user engagement and satisfaction ratings with the prototype of ACT-CL than the MHE website. There were no significant differences between conditions on outcome measures at post or follow-up. However, statistical trends suggested the MHE condition actually led to greater remission of severe symptoms than the ACT-CL condition among those with severe symptoms at baseline. There were no differences between conditions on ACT process of change measures. Changes in psychological flexibility were predictive of changes in mental health across conditions, but relations dissipated over time. Furthermore, greater engagement in some components of ACT-CL predicted improvements in psychological flexibility, though not on mental health outcomes. CONCLUSIONS The effects of the ACT-CL program on mental health outcomes and ACT process measures were largely equivalent to those of an education website, although there was a lower level of program engagement with ACT-CL. Findings are discussed in the context of feasibility issues and lessons learned for program revisions.

[1]  Michael E. Levin,et al.  Examining psychological inflexibility as a transdiagnostic process across psychological disorders. , 2014, Journal of contextual behavioral science.

[2]  P. Lovibond,et al.  Manual for the Depression Anxiety Stress Scales. 2 , 1995 .

[3]  S. Hayes,et al.  The effectiveness of acceptance and commitment therapy bibliotherapy for enhancing the psychological health of Japanese college students living abroad. , 2011, Behavior therapy.

[4]  H. Trompetter,et al.  Internet-based guided self-help intervention for chronic pain based on Acceptance and Commitment Therapy: A randomized controlled trial , 2015, Journal of Behavioral Medicine.

[5]  Steven C Hayes,et al.  ScholarWorks @ Georgia State University , 2018 .

[6]  Michael E. Levin,et al.  The impact of treatment components suggested by the psychological flexibility model: a meta-analysis of laboratory-based component studies. , 2012, Behavior therapy.

[7]  Amy R. Murrell,et al.  Measuring Experiential Avoidance in Adults: The Avoidance and Fusion Questionnaire. , 2010 .

[8]  James T. Miller,et al.  An Empirical Evaluation of the System Usability Scale , 2008, Int. J. Hum. Comput. Interact..

[9]  Michael E. Levin,et al.  Feasibility of a Prototype Web-Based Acceptance and Commitment Therapy Prevention Program for College Students , 2014, Journal of American college health : J of ACH.

[10]  B. Comstock,et al.  Pilot randomized controlled trial of web-based acceptance and commitment therapy for smoking cessation. , 2013, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[11]  P. Lachenbruch Statistical Power Analysis for the Behavioral Sciences (2nd ed.) , 1989 .

[12]  Michael E. Levin,et al.  Feasibility of an acceptance and commitment therapy adjunctive web-based program for counseling centers. , 2015, Journal of counseling psychology.

[13]  S. Hayes,et al.  Values are not just goals: Online ACT-based values training adds to goal setting in improving undergraduate college student performance , 2013 .

[14]  Anthony F Jorm Mental health literacy: empowering the community to take action for better mental health. , 2012, The American psychologist.

[15]  M. Olfson,et al.  Mental health of college students and their non-college-attending peers: results from the National Epidemiologic Study on Alcohol and Related Conditions. , 2008, Archives of general psychiatry.

[16]  S. Hayes,et al.  A randomized trial of ACT bibliotherapy on the mental health of K-12 teachers and staff. , 2012, Behaviour research and therapy.

[17]  P. Cuijpers,et al.  Prevention of major depression. , 2010, Annual review of clinical psychology.

[18]  Steven C. Hayes,et al.  Acceptance and Commitment: Implications for Prevention Science , 2008, Prevention Science.

[19]  T. Kashdan,et al.  Motivation for and commitment to social values: The roles of age and gender , 2010 .

[20]  S. Hayes,et al.  Acceptance and Commitment Therapy: The Process and Practice of Mindful Change , 2011 .

[21]  H. Christensen,et al.  Delivering interventions for depression by using the internet: randomised controlled trial , 2004, BMJ : British Medical Journal.

[22]  Francisco J. Ruiz,et al.  A review of Acceptance and Commitment Therapy (ACT) empirical evidence: Correlational, experimental psychopathology, component and outcome studies. , 2010 .

[23]  W. Lambert,et al.  Psychological inflexibility in childhood and adolescence: development and evaluation of the Avoidance and Fusion Questionnaire for Youth. , 2008, Psychological assessment.

[24]  Per Carlbring,et al.  A randomized controlled trial of Internet-delivered cognitive behavior therapy and acceptance and commitment therapy in the treatment of tinnitus. , 2012, Journal of consulting and clinical psychology.

[25]  A. Tolvanen,et al.  ACT Internet-based vs face-to-face? A randomized controlled trial of two ways to deliver Acceptance and Commitment Therapy for depressive symptoms: an 18-month follow-up. , 2014, Behaviour research and therapy.

[26]  E. Bohlmeijer,et al.  Efficacy of an early intervention based on acceptance and commitment therapy for adults with depressive symptomatology: Evaluation in a randomized controlled trial. , 2011, Behaviour research and therapy.

[27]  C. Keyes,et al.  Mental illness and/or mental health? Investigating axioms of the complete state model of health. , 2005, Journal of consulting and clinical psychology.

[28]  K. Fitzpatrick,et al.  Anxiety Sensitivity Amelioration Training (ASAT): a longitudinal primary prevention program targeting cognitive vulnerability. , 2007, Journal of anxiety disorders.

[29]  P. Cuijpers,et al.  Supportive Accountability: A Model for Providing Human Support to Enhance Adherence to eHealth Interventions , 2011, Journal of medical Internet research.

[30]  V. Reyna,et al.  The Glass Is Half Full: Evidence for Efficacy of Alcohol-Wise at One University But Not the Other , 2015, Journal of health communication.

[31]  Gregory T. Smith,et al.  Using Self-Report Assessment Methods to Explore Facets of Mindfulness , 2006, Assessment.

[32]  Jakki O. Bailey,et al.  Internet-based preventive intervention for reducing eating disorder risk: A randomized controlled trial comparing guided with unguided self-help. , 2014, Behaviour research and therapy.

[33]  Julie A Kientz,et al.  Feature-level analysis of a novel smartphone application for smoking cessation , 2015, The American journal of drug and alcohol abuse.

[34]  Harry Budi Santoso,et al.  Measuring the user experience , 2008 .

[35]  E. Bohlmeijer,et al.  Acceptance and commitment therapy as guided self-help for psychological distress and positive mental health: a randomized controlled trial , 2011, Psychological Medicine.