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Remote ACT-based integrative therapy for trauma: Exploring quality of life and psychological outcomes for young people during the COVID-19 pandemic. A mixed-methods study.

Doran, M. (2023). Remote ACT-based integrative therapy for trauma: Exploring quality of life and psychological outcomes for young people during the COVID-19 pandemic. A mixed-methods study.. (Unpublished Doctoral thesis, City, University of London)



Emotional and physiological regulation, as well as psychological flexibility (PF), are important elements in improving coping with trauma symptoms. Trauma-focused acceptance and commitment therapy (TF-ACT) is emerging as having positive outcomes in reducing trauma symptoms as well as being linked to positive outcomes such as improved quality of life.

Post-traumatic stress disorder (PTSD) and Complex PTSD (CPTSD) are debilitating conditions which are linked to comorbid conditions such as anxiety and depression and experiential avoidance (EA), and furthermore, when young people suffer from PTSD or CPTSD, this can have long-term detrimental outcomes and negatively affect their life course.

Given that the remote ACT-based integrative intervention delivered in this study includes somatic experiencing (SE) and psychosensory elements, it is aimed at increasing PF and emotional and physiological regulation, which holds potential for reducing EA and fostering improved quality of life via pursuit of intrinsic values.


This study used a mixed-methods, multiple single-case design to explore the acceptability and effects of a six-week remote ACT-based integrative intervention for four 18–25-year-old participants experiencing trauma symptoms.


Overall PF improvements were replicated and maintained in all four participants at follow-up. Effect size of change calculated using percentage of non-overlapping data showed ranges from small to large effect (28%–100%). All participants rated the intervention as acceptable and also experienced reliable decrease in depression levels with moderate to large effect size (42.85%–100% PND).

Significant and reliable improvements in quality of life were replicated and maintained in three of the four participants. Significant and reliable improvements were also replicated for PTSD symptoms in all four participants. Three participants saw a reliable and significant decrease in CPTSD symptoms, although one participant showed an increase in CPTSD levels baseline to follow-up. Three participants also showed significant and reliable decrease in anxiety levels effect size ranging from 42.85% to 87.71% (PND). Qualitative data added further validity to the importance of the ACT processes’ contribution to perceived change and the participants’ attribution for this.


This study was exploratory in nature and the resulting evidence points towards this intervention being of benefit to many young people with trauma symptoms, particularly in the development of self-regulation and reducing the intrusive nature of trauma. It seems that this form of intervention can be efficacious in improving overall psychological flexibility. Although there were many improvements in several measures for all of the participants, for one particular participant there was an increase in CPTSD levels, which prompts discussion around the effectiveness of this intervention for some individuals.

Publication Type: Thesis (Doctoral)
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Departments: School of Health & Psychological Sciences > Psychology
School of Health & Psychological Sciences > School of Health & Psychological Sciences Doctoral Theses
Doctoral Theses
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