Acceptance and commitment therapy as a school-based intervention for mental health and wellbeing

Knight, Laura 2021. Acceptance and commitment therapy as a school-based intervention for mental health and wellbeing. ClinPsy Thesis, Cardiff University. Item availability restricted.

	PDF (DClinPsy) - Accepted Post-Print Version Download (2MB)
	PDF (Publication form) - Supplemental Material Restricted to Repository staff only Download (179kB)

Abstract

Abstract In order to meet the growing need for mental health provision for young people, more attention has turned to schools to provide evidence-based interventions. Acceptance and Commitment Therapy (ACT) has been demonstrated in recent reviews and meta-analyses to be effective with young people, however to date no systematic reviews have examined the use of ACT as a school-based intervention. This systematic review aimed to evaluate the methodological quality and examine the effectiveness of all peer-reviewed literature on ACT interventions based in secondary schools. The PsycInfo, Scopus and Web of Science databases were searched for studies published in any year reporting on the use of ACT interventions based in secondary schools aiming to prevent or reduce mental health difficulties or promote wellbeing. Both universal and targeted studies were eligible for inclusion. Nine studies met inclusion criteria, with a total of 1324 participants across studies (age range 13-21 years). Methodological quality of the included studies was assessed using the Psychotherapy Outcome Study Methodology Rating Form (POMRF), and findings related to mental health and wellbeing outcomes were summarised using a narrative synthesis. Outcomes measured across all studies were depression, anxiety, anger, psychological capital, stress, wellbeing, life satisfaction, psychological health, emotional problems and mental health symptoms. Six studies also used process measures to explore different constructs linked to psychological flexibility, the mechanism of change in ACT. There was significant variation in methodological quality across studies. The most common methodological weaknesses were a low sample size, lack of a follow up data point, lack of checks for treatment adherence and therapist competence, and lack of comparison with another active treatment. The existing evidence for the effectiveness of ACT-based interventions delivered in school settings on improving mental health and wellbeing is somewhat variable. This review found statistical significance for outcomes of depression in one study, psychological capital in one study, stress in three studies and anxiety in one 9 study. Other studies did not find statistically significant results, however large effect sizes were found across a number of the outcomes measured, suggesting that more highly powered research may be needed to obtain significance. Despite methodological weaknesses across studies, there are some promising results to show support for the use of ACT as a school-based intervention. As existing studies were heterogeneous with regard to design and outcomes measured, this review was unable to draw firm conclusions regarding the efficacy of ACT or the moderating influence of program type, program format or program delivery. More highly powered studies comparing ACT to other active treatments are needed in order to explore these questions further. This systematic review is registered on the PROSPERO database under the ID CRD42020197295.

Item Type:	Thesis (DClinPsy)
Date Type:	Completion
Status:	Unpublished
Schools:	Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Date of First Compliant Deposit:	22 September 2021
Last Modified:	22 Sep 2022 01:30
URI:	https://orca.cardiff.ac.uk/id/eprint/144347

Actions (repository staff only)

Edit Item