title: Acceptance and commitment therapy as a web-based intervention for depressive symptoms: randomised controlled trial.
abstract: BACKGROUND
  Depression is a highly prevalent disorder, causing a large burden of disease and substantial economic costs. Web-based self-help interventions seem promising in promoting mental health.
  
  
  OBJECTIVE
  To compare the efficacy of a guided web-based intervention based on acceptance and commitment therapy (ACT) with an active control (expressive writing) and a waiting-list control condition (Netherlands Trial Register NTR1296).
  
  
  METHODS
  Adults with depressive symptoms from the general population were randomised to ACT (n = 82), expressive writing (n = 67) or waiting-list control (n = 87). The main outcome was reduction in depressive symptoms assessed with the Center for Epidemiological Studies - Depression scale.
  
  
  RESULTS
  Significant reductions in depressive symptoms were found following the ACT intervention, compared with the control group (Cohen's d = 0.56) and the expressive writing intervention (d = 0.36). The effects were sustained at 6-month and 12-month follow-up.
  
  
  CONCLUSIONS
  Acceptance and commitment therapy as a web-based public mental health intervention for adults with depressive symptoms can be effective and applicable.
authors.affiliation: Wendy T. M. Pots, MSc, DClinPsych, University of Twente, Department of Psychology, Health and Technology, Enschede, and Dimence, Community Mental Health Centre, Almelo; Martine Fledderus, PhD, University of Twente, Department of Psychology, Health and Technology, Enschede; Peter A. M. Meulenbeek, PhD, DClinPsych, University of Twente, Department of Psychology, Health and Technology, Enschede, and Community Mental Health Centre, Warnsveld; Peter M. ten Klooster, PhD, Karlein M. G. Schreurs, PhD, Ernst T. Bohlmeijer, PhD, University of Twente, Department of Psychology, Health and Technology, Enschede, The Netherlands w.t.m.pots@utwente.nl.
authors.forename: Wendy T M
authors.initials: WT
authors.lastname: Pots
authors.affiliation: Wendy T. M. Pots, MSc, DClinPsych, University of Twente, Department of Psychology, Health and Technology, Enschede, and Dimence, Community Mental Health Centre, Almelo; Martine Fledderus, PhD, University of Twente, Department of Psychology, Health and Technology, Enschede; Peter A. M. Meulenbeek, PhD, DClinPsych, University of Twente, Department of Psychology, Health and Technology, Enschede, and Community Mental Health Centre, Warnsveld; Peter M. ten Klooster, PhD, Karlein M. G. Schreurs, PhD, Ernst T. Bohlmeijer, PhD, University of Twente, Department of Psychology, Health and Technology, Enschede, The Netherlands.
authors.forename: Martine
authors.initials: M
authors.lastname: Fledderus
authors.affiliation: Wendy T. M. Pots, MSc, DClinPsych, University of Twente, Department of Psychology, Health and Technology, Enschede, and Dimence, Community Mental Health Centre, Almelo; Martine Fledderus, PhD, University of Twente, Department of Psychology, Health and Technology, Enschede; Peter A. M. Meulenbeek, PhD, DClinPsych, University of Twente, Department of Psychology, Health and Technology, Enschede, and Community Mental Health Centre, Warnsveld; Peter M. ten Klooster, PhD, Karlein M. G. Schreurs, PhD, Ernst T. Bohlmeijer, PhD, University of Twente, Department of Psychology, Health and Technology, Enschede, The Netherlands.
authors.forename: Peter A M
authors.initials: PA
authors.lastname: Meulenbeek
authors.affiliation: Wendy T. M. Pots, MSc, DClinPsych, University of Twente, Department of Psychology, Health and Technology, Enschede, and Dimence, Community Mental Health Centre, Almelo; Martine Fledderus, PhD, University of Twente, Department of Psychology, Health and Technology, Enschede; Peter A. M. Meulenbeek, PhD, DClinPsych, University of Twente, Department of Psychology, Health and Technology, Enschede, and Community Mental Health Centre, Warnsveld; Peter M. ten Klooster, PhD, Karlein M. G. Schreurs, PhD, Ernst T. Bohlmeijer, PhD, University of Twente, Department of Psychology, Health and Technology, Enschede, The Netherlands.
authors.forename: Peter M
authors.initials: PM
authors.lastname: ten Klooster
authors.affiliation: Wendy T. M. Pots, MSc, DClinPsych, University of Twente, Department of Psychology, Health and Technology, Enschede, and Dimence, Community Mental Health Centre, Almelo; Martine Fledderus, PhD, University of Twente, Department of Psychology, Health and Technology, Enschede; Peter A. M. Meulenbeek, PhD, DClinPsych, University of Twente, Department of Psychology, Health and Technology, Enschede, and Community Mental Health Centre, Warnsveld; Peter M. ten Klooster, PhD, Karlein M. G. Schreurs, PhD, Ernst T. Bohlmeijer, PhD, University of Twente, Department of Psychology, Health and Technology, Enschede, The Netherlands.
authors.forename: Karlein M G
authors.initials: KM
authors.lastname: Schreurs
authors.affiliation: Wendy T. M. Pots, MSc, DClinPsych, University of Twente, Department of Psychology, Health and Technology, Enschede, and Dimence, Community Mental Health Centre, Almelo; Martine Fledderus, PhD, University of Twente, Department of Psychology, Health and Technology, Enschede; Peter A. M. Meulenbeek, PhD, DClinPsych, University of Twente, Department of Psychology, Health and Technology, Enschede, and Community Mental Health Centre, Warnsveld; Peter M. ten Klooster, PhD, Karlein M. G. Schreurs, PhD, Ernst T. Bohlmeijer, PhD, University of Twente, Department of Psychology, Health and Technology, Enschede, The Netherlands.
authors.forename: Ernst T
authors.initials: ET
authors.lastname: Bohlmeijer
mesh_terms: D064869:Acceptance and Commitment Therapy / Q000379:methods*; D000328:Adult; D000368:Aged; D003376:Counseling; D003863:Depression / Q000628:therapy*; D005260:Female; D006801:Humans; D020407:Internet / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010349:Patient Compliance; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome; D055815:Young Adult