TY - JOUR AU - Han, Areum AU - Kim, Tae Hui PY - 2022 DA - 2022/8/30 TI - The Effects of Internet-Based Acceptance and Commitment Therapy on Process Measures: Systematic Review and Meta-analysis JO - J Med Internet Res SP - e39182 VL - 24 IS - 8 KW - acceptance and commitment therapy KW - process measure KW - internet-based intervention KW - digital mental health KW - meta-analysis KW - mindfulness KW - systematic review AB - Background: Acceptance and commitment therapy (ACT) is based on a psychological flexibility model that encompasses 6 processes: acceptance, cognitive defusion, self-as-context, being present, values, and committed action. Objective: This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to examine the effects of internet-based ACT (iACT) on process measures. Methods: A comprehensive search was conducted using 4 databases. The quality of the included RCTs was assessed using the Cochrane Collaboration Risk of Bias Tool. A random-effects or fixed-effects model was used. Subgroup analyses for each outcome were conducted according to the type of control group, use of therapist guidance, delivery modes, and use of targeted participants, when applicable. Results: A total of 34 RCTs met the inclusion criteria. This meta-analysis found that iACT had a medium effect on psychological flexibility and small effects on mindfulness, valued living, and cognitive defusion at the immediate posttest. In addition, iACT had a small effect on psychological flexibility at follow-up. The overall risk of bias across studies was unclear. Conclusions: Relatively few studies have compared the effects of iACT with active control groups and measured the effects on mindfulness, valued living, and cognitive defusion. These findings support the processes of change in iACT, which mental health practitioners can use to support the use of iACT. SN - 1438-8871 UR - https://www.jmir.org/2022/8/e39182 UR - https://doi.org/10.2196/39182 UR - http://www.ncbi.nlm.nih.gov/pubmed/36040783 DO - 10.2196/39182 ID - info:doi/10.2196/39182 ER -