Trial reportBMC psychiatry2016
How and for whom does web-based acceptance and commitment therapy work? Mediation and moderation analyses of web-based ACT for depressive symptoms.
Trial report in BMC psychiatry, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 3 syntheses or guidelines pooled it, 46 citations in OpenAlex.
- The effect of acceptance and commitment therapy on depression in parents of children with special needs: a meta-analysis.Frontiers in psychology · 2025Pooled it
- Digital Psychotherapies for Adults Experiencing Depressive Symptoms: Systematic Review and Meta-Analysis.JMIR mental health · 2024Pooled it
- Pooled it
- Trial
- Mechanisms of change in an online acceptance and commitment therapy intervention for insomnia.Scientific reports · 2025Trial
- The effect of acceptance and commitment therapy on work-related rumination and job fatigue of medical emergency and accident management center staff: an experimental study.BMC psychiatry · 2024Trial
- Effects and Mechanisms of a Web- and Mobile-Based Acceptance and Commitment Therapy Intervention for Anxiety and Depression Symptoms in Nurses: Fully Decentralized Randomized Controlled Trial.Journal of medical Internet research · 2023Trial
- The role of psychological flexibility in acceptance-enhanced behavior therapy for trichotillomania: Moderation and mediation findings.Behaviour research and therapy · 2023Trial
- Cognitive functioning and treatment outcomes in a randomized controlled trial of internet-delivered drug and alcohol treatment.The American journal on addictions · 2018Trial
- Validation of the Finnish Translation of the Acceptance and Action Questionnaire-II Among Finnish Mental Health Professionals.Scandinavian journal of caring sciences · 2026Article
- Through the extended evolutionary meta-model, and what ACT found there: ACT as a process-based therapy.Journal of contextual behavioral science · 2024Article
- Acceptance and Commitment Therapy for Major Depressive Disorder: Navigating Depression Treatment in Traditional and Digital Settings with Insights from Current Research.Advances in experimental medicine and biology · 2024Review
- The effectiveness and cost-effectiveness of Acceptance and Commitment Therapy as a transdiagnostic intervention for transitional-age youth: study protocol of a randomized controlled trial.BMC psychiatry · 2023Article
- Moderators and mediators of change of an internet-based mindfulness intervention for college students: secondary analysis from a randomized controlled trial.Frontiers in digital health · 2023Article
- Efficacy and mechanisms of mobile application-delivered Acceptance and Commitment Therapy for posttraumatic stress disorder in China: Study protocol for a randomized controlled trial.Internet interventions · 2022Article
- Acceptance and Commitment Therapy for Major Depressive Disorder: Insights into a New Generation of Face-to-Face Treatment and Digital Self-Help Approaches.Advances in experimental medicine and biology · 2021Article
- Examining mediators of change in wellbeing, stress, and depression in a blended, Internet-based, ACT intervention for university students.Internet interventions · 2020Article
- Serious Gaming During Multidisciplinary Rehabilitation for Patients With Chronic Pain or Fatigue Symptoms: Mixed Methods Design of a Realist Process Evaluation.Journal of medical Internet research · 2020Article
- A User-Centered Approach to an Evidence-Based Electronic Health Pain Management Intervention for People With Chronic Pain: Design and Development of EPIO.Journal of medical Internet research · 2020Article
- Psychological Flexibility in Depression Relapse Prevention: Processes of Change and Positive Mental Health in Group-Based ACT for Residual Symptoms.Frontiers in psychology · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAcceptance and Commitment Therapy (ACT) has been demonstrated to be effective in reducing depressive symptoms. However, little is known how and for whom therapeutic change occurs, specifically in web-based interventions. This study focuses on the mediators, moderators and predictors of change during a web-based ACT intervention.
methodsData from 236 adults from the general population with mild to moderate depressive symptoms, randomized to either web-based ACT (n = 82) or one of two control conditions (web-based Expressive Writing (EW; n = 67) and a waiting list (n = 87)), were analysed. Single and multiple mediation analyses, and exploratory linear regression analyses were performed using PROCESS and linear regression analyses, to examine mediators, moderators and predictors on pre- to post- and follow-up treatment change of depressive symptoms.
resultsThe treatment effect of ACT versus the waiting list was mediated by psychological flexibility and two mindfulness facets. The treatment effect of ACT versus EW was not significantly mediated. The moderator analyses demonstrated that the effects of web-based ACT did not vary according to baseline patient characteristics when compared to both control groups. However, higher baseline depressive symptoms and positive mental health and lower baseline anxiety were identified as predictors of outcome across all conditions. Similar results are found for follow-up.
conclusionsThe findings of this study corroborate the evidence that psychological flexibility and mindfulness are distinct process mechanisms that mediate the effects of web-based ACT intervention. The results indicate that there are no restrictions to the allocation of web-based ACT intervention and that web-based ACT can work for different subpopulations.
trial registrationNetherlands Trial Register NTR2736 . Registered 6 February 2011.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.