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Evaluating the Impact of a Web-Based Acceptance & Commitment Therapy Intervention on Mental Health Skills in University Students

Conheady, H. (2020). Evaluating the Impact of a Web-Based Acceptance & Commitment Therapy Intervention on Mental Health Skills in University Students. (Unpublished Doctoral thesis, City, University of London)


Objective Transdiagnostic web-based Acceptance and Commitment Therapy (ACT) interventions have been shown to be effective in improving mental health outcomes in university students in the USA (Levin, Haeger, & Cruz, 2019), Australia (Viskovich & Pakenham, 2018), and Finland (Rasanen, Lappalainen, Muotka, Tolvanen, & Lappalainen, 2016). However, these interventions have not yet been evaluated in the UK, where university students are experiencing a mental health crisis (The Insight Network, 2019). This study evaluated a transdiagnostic web-based ACT self-help intervention called LifeToolbox designed specifically for university students.

Method A total of 112 undergraduate (22%) and postgraduate (78%) students attending university in the UK were randomised to the immediate treatment (ACT) or waiting-list control (WLC) condition with online self-report assessments at baseline and two further timepoints. A waitlist crossover design was used such that participants in the WLC condition transferred to the active arm following the second assessment. Primary outcomes assessed: academic distress, alcohol use, generalised anxiety, depression, eating concerns, hostility, self-compassion, social anxiety and overall distress. Processes assessed: cognitive defusion, mindful awareness, psychological inflexibility, valued living, and self-compassion.

Results Overall results were mixed. However, relative to the waiting-list control group, participants receiving ACT significantly improved on mindful awareness, F(l, 55.70) = 19.14, p < .001, self-compassion, F(l, 56.47) = 6.63,p = .01, and social anxiety, F(l, 59.86) = 6.30, p = .02, in the intention-to-treat sample. Within-subjects analyses showed significant improvements on the combined mental health variables between the start and end of the course, F(l4, 26) = 4.20, p = .001, Pillai's V = .69, 11l = .69, on half of the primary outcomes (generalised anxiety, hostility, social anxiety, and overall distress) and on all ACT processes in the completer sample. All ACT processes mediated changes on one or more primary outcomes, with cognitive fusion being the most frequent mediator. Participants rated the program as 'excellent' on a standardised measure.

Conclusions These preliminary findings suggest that web-based ACT self help programs merit more attention as a cost-effective and easily disseminated treatment platform for the promotion of mental health skills in university students.

Publication Type: Thesis (Doctoral)
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Departments: Doctoral Theses
School of Health & Psychological Sciences > Psychology
School of Health & Psychological Sciences > School of Health & Psychological Sciences Doctoral Theses
[thumbnail of HConheady DPsych Thesis REDACTED.pdf]
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