Mental health promotion as a new goal in public mental health care: a randomized controlled trial of an intervention enhancing psychological flexibility.
OBJECTIVE
We assessed whether an intervention based on acceptance and commitment therapy (ACT) and mindfulness was successful in promoting positive mental health by enhancing psychological flexibility.


METHODS
Participants were 93 adults with mild to moderate psychological distress. They were randomly assigned to the group intervention (n = 49) or to a waiting-list control group (n = 44). Participants completed measures before and after the intervention as well as 3 months later at follow-up to assess mental health in terms of emotional, psychological, and social well-being (Mental Health Continuum-Short Form) as well as psychological flexibility (i.e., acceptance of present experiences and value-based behavior, Acceptance and Action Questionnaire-II).


RESULTS
Regression analyses showed that compared with the participants on the waiting list, participants in the ACT and mindfulness intervention had greater emotional and psychological well-being after the intervention and also greater psychological flexibility at follow-up. Mediational analyses showed that the enhancement of psychological flexibility during the intervention mediated the effects of the intervention on positive mental health.


CONCLUSIONS
The intervention is effective in improving positive mental health by stimulating skills of acceptance and value-based action.
Fledderus
Martine
M
Department of Psychology and Communication of Health and Risk, University of Twente, Enschede, The Netherlands. m.fledderus@utwente.nl
Bohlmeijer
Ernst T
ET
Smit
Filip
F
Westerhof
Gerben J
GJ
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001521:Behavior Therapy; D005260:Female; D005500:Follow-Up Studies; D006040:Goals; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D011615:Psychotherapy, Group; D011635:Public Health Administration; D013315:Stress, Psychological / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult