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LIT-1844: Identifying the Underlying Mechanisms of Change During Acceptance and Commitment Therapy (ACT): A Systematic Review of Contemporary Mediation Studies

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StatusActive — read 2026-10-30 (NOTE-1456) from the accepted manuscript on White Rose Research Online (https://eprints.whiterose.ac.uk/id/eprint/137915/, CC BY-NC-ND), whose deposit lacks the tables, figures and quality appendix; worth reading as the systematic review of ACT mediation studies from 2006 to 2015 that updates Hayes et al. 2006 (LIT-555), and as a record that no study in that period tested the self as context. Read it knowing that it is narrative, with no pooled estimate, that all twelve studies were rated of moderate quality, and that only three established that the mediator changed before the outcome.
Tagspsychopathology-and-treatment
Cited as “paper” byNOTE-1456 — Stockton et al. — Mechanisms of change in ACT

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Stockton, D., Kellett, S., Berrios, R., Sirois, F., Wilkinson, N. & Miles, G. (2019). Behavioural and Cognitive Psychotherapy, 47(3), 332–362. doi:10.1017/S1352465818000553.

Key takeaways

  • Of ACT’s six processes, acceptance has the most consistent mediation evidence, and the only evidence of mediation specific to ACT against CBT-type comparisons.
  • Defusion and committed action mediate outcomes, but about as much in the comparison treatments, so they are not shown to be ACT’s own.
  • The self as context was never tested as a mediator in 2006–2015. Present-moment contact and values were tested once each.
  • The methodological complaints of Hayes et al. 2006 still held: small samples, self-report, unreliable measures, and the mediator rarely shown to change before the outcome.

Why this is here

THEORY-050 and THEORY-051 name Macri and Rogge’s 2024 meta-analysis (LIT-543) as the test that could move them, and it is Unavailable. This is the earlier systematic review of the same question.

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