https://orcid.org/0000-0003-1369-9052
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ABSTRACT
Objective
This systematic review and meta-analysis aimed to examine the effects of acceptance and commitment therapy (ACT) on depressive symptoms, anxiety, pain intensity, quality of life, acceptance, and functional impairment in individuals with neurological disorders.
Method
A comprehensive search was conducted within four databases to identify relevant randomised controlled trials (RCTs). The quality of the included RCTs was assessed using the Cochrane Collaboration risk of bias tool. Either a random effects model or fixed effects model was used. Subgroup analyses were conducted according to the types of control groups.
Results
Twenty-four RCTs met the eligibility criteria. This meta-analysis found that ACT had medium-to-large effects in the immediate post-test and follow-up on reducing depressive symptoms, anxiety, pain intensity, and perceived functional impairment and improving quality of life and acceptance in individuals with neurological disorders. The overall risk of bias was unclear.
Conclusions
Relatively fewer studies were conducted to compare the effects of ACT to active control groups compared to studies involving passive control conditions. Future high-quality studies that compare ACT to active control conditions in individuals with neurological disorders are needed to determine whether practitioners should be routinely providing ACT for this population instead of other evidence-based treatments.
Key Points
What is already known about this topic:
Living with a neurological disorder can have a significant negative impact on an individual’s mental health and quality of life and restrict participation in personally valued activities and roles.
A growing body of literature suggests that mindfulness and acceptance may help individuals better adjust to living with a neurological disorder, decrease psychological and physical symptoms (e.g., depression, anxiety, and pain intensity) and increase quality of life among individuals with neurological disorders.
Acceptance and commitment therapy (ACT) is an empirically supported transdiagnostic approach that involves mindfulness and acceptance processes and behaviour change processes for valued living, and a growing body of research has found beneficial effects of ACT in individuals with neurological disorders.
What this topic adds:
This was the first systematic review incorporating meta-analysis to measure the effects of ACT on outcomes in individuals with neurological disorders, including depressive symptoms, anxiety, pain intensity, quality of life, acceptance, and functional impairment.
This meta-analysis found medium-to-large effects of ACT on reducing depression, anxiety, pain intensity, and perceived functional impairment and improving quality of life and acceptance in individuals with neurological disorders at the immediate post-test and follow-up.
ACT can be provided for individuals with neurological disorders based on professional judgement and client preferences, but future high-quality studies are needed to better understand whether the ACT is comparable or superior to other evidence-based treatments in varied outcomes of individuals with neurological disorders.
Disclosure statement
No potential conflict of interest was reported by the authors.
Data availability statement
Data for each of the included studies (including means, standard deviations, and sample sizes of each of the intervention and control groups and characteristics of the studies) and meta-analysis results are reported in the main text, figures, and supplemental materials.