title: Web-based acceptance and commitment therapy for depressive symptoms with minimal support: a randomized controlled trial.
abstract: Low-intensity interventions for people suffering from depressive symptoms are highly desirable. The aim of the present study was to investigate the outcomes of a web-based acceptance and commitment therapy (ACT)-based intervention without face-to-face contact for people suffering from depressive symptoms. Participants (N = 39) with depressive symptoms were randomly assigned to an Internet-delivered acceptance and commitment therapy (iACT) intervention or a waiting list control condition (WLC). Participants were evaluated with standardized self-reporting measures (Beck Depression Inventory [BDI-II], Symptom Checklist-90 [SCL-90], Acceptance and Action Questionnaire [AAQ-2], Five Facet Mindfulness Questionnaire [FFMQ], Automatic Thoughts Questionnaire [ATQ], and White Bear Suppression Inventory [WBSI]) at pre- and post-measurement. Long-term effects in the iACT group were examined using a 12-month follow-up. The iACT program comprised home assignments, online feedback given by master's-level students of psychology over a 7-week intervention period, and automated email-based reminders. Significant effects were observed in favor of the iACT group on depression symptomatology (between effect sizes [ESs] at post-treatment, iACT/WLC, g = .83), psychological and physiological symptoms (g = .60), psychological flexibility (g = .67), mindfulness skills (g = .53), and frequency of automatic thoughts (g = .57) as well as thought suppression (g = .53). The treatment effects in the iACT group were maintained over the 12-month follow-up period (within-iACT ES: BDI-II, g = 1.33; SCL-90, g = 1.04; ATQF/B [Frequency/Believability], FFMQ, WBSI, AAQ-II, g = .74-1.08). The iACT participants stated that they would be happy to recommend the same intervention to others with depressive symptoms. We conclude that an ACT-based guided Internet-delivered treatment with minimal contact can be effective for people with depressive symptoms.
authors.affiliation: University of Jyväskylä, Finland paivi.k.lappalainen@jyu.fi.
authors.forename: Päivi
authors.initials: P
authors.lastname: Lappalainen
authors.affiliation: University of Oulu, Finland.
authors.forename: Sitwat
authors.initials: S
authors.lastname: Langrial
authors.affiliation: University of Oulu, Finland.
authors.forename: Harri
authors.initials: H
authors.lastname: Oinas-Kukkonen
authors.affiliation: University of Jyväskylä, Finland.
authors.forename: Asko
authors.initials: A
authors.lastname: Tolvanen
authors.affiliation: University of Jyväskylä, Finland.
authors.forename: Raimo
authors.initials: R
authors.lastname: Lappalainen
mesh_terms: D064869:Acceptance and Commitment Therapy / Q000379:methods*; D000328:Adult; D015928:Cognitive Behavioral Therapy; D003863:Depression / Q000628:therapy*; D003866:Depressive Disorder; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D064866:Mindfulness; D011569:Psychiatric Status Rating Scales; D057566:Self Report; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Internet treatment; acceptance and commitment therapy; depressive symptoms; minimal support; reminders