Research Article

Web-Based Self-Help for Preventing Mental Health Problems in Universities: Comparing Acceptance and Commitment Training to Mental Health Education

Corresponding Author

Michael E. Levin

Utah State University

Please address correspondence to: Michale E. Levin, Utah State University, 2810 Old Main Hill, Logan, UT 84322. E-mail: [email protected]Search for more papers by this author

Steven C. Hayes,

Steven C. Hayes

University of Nevada, Reno

Search for more papers by this author

Jacqueline Pistorello,

Jacqueline Pistorello

University of Nevada, Reno

Contextual Change LLC

Search for more papers by this author

John R. Seeley,

John R. Seeley

University of Oregon

Oregon Research Institute

Search for more papers by this author

Michael E. Levin,

Corresponding Author

Michael E. Levin

Utah State University

Please address correspondence to: Michale E. Levin, Utah State University, 2810 Old Main Hill, Logan, UT 84322. E-mail: [email protected]Search for more papers by this author

Steven C. Hayes,

Steven C. Hayes

University of Nevada, Reno

Search for more papers by this author

Jacqueline Pistorello,

Jacqueline Pistorello

University of Nevada, Reno

Contextual Change LLC

Search for more papers by this author

John R. Seeley,

John R. Seeley

University of Oregon

Oregon Research Institute

Search for more papers by this author

First published: 19 January 2016

https://doi.org/10.1002/jclp.22254

Citations: 80

This research was supported by a grant from the University of Nevada Reno, Graduate Student Association awarded to Drs. Levin and Hayes.

This research was conducted with a program developed by a commercial business, Contextual Change LLC, of which the first author is an associate and the second and third authors are owners. The results of this research may inform and be used for future commercial products.

Share a link

Email
Wechat
Bluesky

Abstract

Objective

This study sought to test the feasibility of a web-based Acceptance and Commitment Training (ACT) prototype prevention program called ACT on College Life (ACT-CL).

Method

A sample of 234 university students was randomized to either the ACT-CL website or a mental health education (MHE) website.

Results

Findings indicated a lower level of user engagement and satisfaction ratings with the prototype of ACT-CL than the MHE website. There were no significant differences between conditions on outcome measures at post or follow-up. However, statistical trends suggested the MHE condition actually led to greater remission of severe symptoms than the ACT-CL condition among those with severe symptoms at baseline. There were no differences between conditions on ACT process of change measures. Changes in psychological flexibility were predictive of changes in mental health across conditions, but relations dissipated over time. Furthermore, greater engagement in some components of ACT-CL predicted improvements in psychological flexibility, though not on mental health outcomes.

Conclusions

The effects of the ACT-CL program on mental health outcomes and ACT process measures were largely equivalent to those of an education website, although there was a lower level of program engagement with ACT-CL. Findings are discussed in the context of feasibility issues and lessons learned for program revisions.

References

Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13, 27–45.
10.1177/1073191105283504
PubMed Web of Science® Google Scholar
Bangor, A, Kortum, P. T., & Miller, J. T. (2008). An empirical evaluation of the system usability scale. International Journal of Human-Computer Interaction, 24, 574–594.
10.1080/10447310802205776
Web of Science® Google Scholar
Biglan, A., Hayes, S. C., & Pistorello, J. (2008). Acceptance and commitment: Implications for prevention science. Prevention Science, 9, 139–152.
10.1007/s11121-008-0099-4
PubMed Web of Science® Google Scholar
Blanco, C., Okuda, M., Wright, C., Hasin, D. S., Grant, B. F., … Olfson, M. (2008). Mental health of college students and their non-college-attending peers: Results from the national epidemiologic study on alcohol related conditions. Archives of General Psychiatry, 65, 1429–1437.
10.1001/archpsyc.65.12.1429
PubMed Web of Science® Google Scholar
Bricker, J., Wyszynski, C., Comstock, B., & Heffner, J. L. (2013). Pilot randomized controlled trial of web-based acceptance and commitment therapy for smoking cessation. Nicotine and Tobacco Research, 15, 1756–1764.
10.1093/ntr/ntt056
PubMed Web of Science® Google Scholar
Chase, J. A., Houmanfar, R., Hayes, S. C., Ward, T. A., Vilardaga, J. P., & Follette, V. (2013). Values are not just goals: Online ACT-based values training adds to goal setting in improving undergraduate college student performance. Journal of Contextual Behavioral Science, 2, 79–84.
10.1016/j.jcbs.2013.08.002
Google Scholar
Christensen, H., Griffiths, K. M., & Jorm, A. F. (2004). Delivering interventions for depression by using the Internet: Randomized controlled trial. British Medical Journal, 328, 265–269.
10.1136/bmj.37945.566632.EE
PubMed Web of Science® Google Scholar
Ciarrochi, J., Blackledge, J. T., & Heaven, P. (2006). Initial validation of the Social Values Survey and Personal Values Questionnaire. Presented at the Second World Conference on ACT, RFT, and Contextual Behavioural Science, London, England, 2006.
Google Scholar
Cohen, J. (1988). Statistical power analysis for the behavioral sciences ( 2nd ed.). Hillsdale, NJ: Erlbaum.
10.1046/j.1526-4610.2001.111006343.x
Google Scholar
Croom, K., Staiano-Coico, L., Lesser, M. L., Lewis, D. K., Reyna, V. F., Marchell, T. C., … Ives, S. (2015). The glass is half full: Evidence for efficacy of Alcohol-Wise at one university but not the other. Journal of Health Communication, 20, 627–638.
10.1080/10810730.2015.1012239
PubMed Web of Science® Google Scholar
Ferssizidis, P., Adams, L. M., Kashdan, T. B., Plummer, C., Mishra, A., & Ciarrochi, J. (2010). Motivation for and commitment to social values: The roles of age and gender. Motivation and Emotion, 34, 354–362.
10.1007/s11031-010-9187-4
Web of Science® Google Scholar
Fledderus, M., Bolmeijer, E. T., Pieterse, M. E., & Schreurs, K. M. G. (2011). Acceptance and commitment therapy as guided self-help for psychological distress and positive mental health: A randomized controlled trial. Psychological Medicine, 1–11.
Google Scholar
Gallagher, R. (2006). National Survey of Counseling Center Directors. Pittsburgh, PA: University of Pittsburgh.
Google Scholar
Gallagher, R. (2014). National Survey of Counseling Centers 2013. Section one: 4-year directors. Pittsburgh, PA: University of Pittsburgh.
Google Scholar
Greco, L. A., Lambert, W., & Baer, R.A. (2008). Psychological inflexibility in childhood and adolescence: Development and evaluation of the avoidance and fusion questionnaire for youth. Psychological Assessment, 20, 93–102.
10.1037/1040-3590.20.2.93
PubMed Web of Science® Google Scholar
Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behavior Research and Therapy, 44, 1–25.
10.1016/j.brat.2005.06.006
PubMed Web of Science® Google Scholar
Hayes, S. C., Strosahl, K., & Wilson, K. G. (2012). Acceptance and commitment therapy: The process and practice of mindful change ( 2nd ed.). New York: Guilford Press.
Google Scholar
Heffner, J. L., Vilardaga, R., Mercer, L. D., Kientz, J. A., & Bricker, J. B. (2015). Feature-level analysis of a novel smartphone application for smoking cessation. The American Journal of Drug and Alcohol Abuse, 41, 68–73.
10.3109/00952990.2014.977486
PubMed Web of Science® Google Scholar
Hesser, H., Gustafsson, T., Lundén, C., Henrikson, O., Fattahi, K., Johnsson, E., … Andersson, G. (2012). A randomized controlled trial of internet-delivered cognitive behavior therapy and acceptance and commitment therapy in the treatment of tinnitus. Journal of Consulting and Clinical Psychology, 80(4), 649–661.
10.1037/a0027021
PubMed Web of Science® Google Scholar
Jorm, A. F. (2012). Mental health literacy: Empowering the community to take action for better mental health. American Psychologist, 67, 231–243.
10.1037/a0025957
PubMed Web of Science® Google Scholar
Kass, A. E., Trockel, M., Safer, D. L., Sinton, M. M., Cunning, D., Rizk, M. T., … Taylor, C. B. (2014). Internet-based preventive intervention for reducing eating disorder risk: A randomized controlled trial comparing guided with unguided self-help. Behaviour Research and Therapy, 63, 90–98.
10.1016/j.brat.2014.09.010
PubMed Web of Science® Google Scholar
Keyes, C. L. M. (2005). Mental illness and/or mental health? Investigating axioms of the complete state model of health. Journal of Consulting and Clinical Psychology 73, 539–548.
10.1037/0022-006X.73.3.539
PubMed Web of Science® Google Scholar
Lappalainen, P., Granlund, A., Siltanen, S., Ahonen, S., Vitikainen, M., Tolvanen, A., & Lappalainen, R. (2014). ACT Internet-based vs face-to-face? A randomized controlled trial of two ways to deliver Acceptance and Commitment Therapy for depressive symptoms: An 18-month follow-up. Behaviour Research and Therapy, 61, 43–54.
10.1016/j.brat.2014.07.006
PubMed Web of Science® Google Scholar
Levin, M. E., Hildebrandt, M., Lillis, J., & Hayes, S. C. (2012). The impact of treatment components suggested by the psychological flexibility model: A meta-analysis of laboratory-based component studies. Behavior Therapy, 43, 741–756.
10.1016/j.beth.2012.05.003
PubMed Web of Science® Google Scholar
Levin, M. E., MacLane, C., Daflos, S., Pistorello, J., Hayes, S. C., Seeley, J., & Biglan, A. (2014). Examining psychological inflexibility as a transdiagnostic process across psychological disorders. Journal of Contextual Behavioral Science, 3, 155–163.
10.1016/j.jcbs.2014.06.003
PubMed Google Scholar
Levin, M. E., Pistorello, J., Hayes, S. C., & Seeley, J. (2014). Feasibility of a prototype web-based acceptance and commitment therapy prevention program for college students. Journal of American College Health, 62, 20–30.
10.1080/07448481.2013.843533
PubMed Web of Science® Google Scholar
Levin, M. E., Pistorello, J., Hayes, S. C., Seeley, J. R., & Levin, C. (2015). Feasibility of an acceptance and commitment therapy adjunctive web-based program for counseling centers. Journal of Counseling Psychology, 62, 529–536.
10.1037/cou0000083
PubMed Web of Science® Google Scholar
Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the Depression Anxiety Stress Scales ( 2nd ed.). Sydney: Psychology Foundation of Australia.
Google Scholar
Mohr, D. C., Cuijpers, P., & Lehman, K. (2011). Supportive accountability: A model for providing support to enhance adherence to eHealth interventions. Journal of Medical Internet Research, 13, e30.
10.2196/jmir.1602
PubMed Web of Science® Google Scholar
Munoz, R. F., Cuijpers, P., Smit, F., Barrera, A. Z., & Leykin, Y. (2010). Prevention of major depression. Annual Review of Clinical psychology, 6, 181–212.
10.1146/annurev-clinpsy-033109-132040
PubMed Web of Science® Google Scholar
Muto, T., Hayes, S. C., & Jeffcoat, T. (2011). The effectiveness of acceptance and commitment therapy bilbiotherapy for enhancing the psychological health of Japanese college students living abroad. Behavior Therapy, 42, 323–335.
10.1016/j.beth.2010.08.009
PubMed Web of Science® Google Scholar
Ruiz, F. J. (2010). A review of Acceptance and Commitment Therapy (ACT) empirical evidence: Correlational, experimental psychopathology, component and outcome studies. International Journal of Psychology and Psychological Therapy, 10, 125–162.
Google Scholar
Schmalz, J. E., & Murrell, A. R. (2010). Measuring experiential avoidance in adults: The avoidance and fusion questionnaire. International Journal of Behavioral Consultation and Therapy, 6, 198–213.
10.1037/h0100908
Google Scholar
Schmidt, N. B., Eggleston, A. M., Woolaway-Bickel, K., Fitzpatrick, K. K., Vasey, M. W., & Richey, J. A. (2007). Anxiety sensitivity amelioration training (ASAT): A longitudinal primary prevention program targeting cognitive vulnerability. Journal of Anxiety Disorders, 21, 302–319.
10.1016/j.janxdis.2006.06.002
PubMed Web of Science® Google Scholar
Trompetter, H. R., Bohlmeijer, E. T., Veehof, M. M., & Schreurs, K. M. G. (2015). Internet-based guided self-help intervention for chronic pain based on acceptance and commitment therapy: A randomized controlled trial. Journal of Behavioral Medicine, 38, 66–80.
10.1007/s10865-014-9579-0
PubMed Web of Science® Google Scholar
Tullis, T., & Albert, W. (2008). Measuring the user experience. San Francisco, CA: Morgan Kaufmann.
Google Scholar

Citing Literature

Volume72, Issue3

March 2016

Pages 207-225

Web-Based Self-Help for Preventing Mental Health Problems in Universities: Comparing Acceptance and Commitment Training to Mental Health Education

Abstract

Objective

Method

Results

Conclusions

References

Citing Literature

References

Information

About Wiley Online Library

Help & Support

Opportunities

Connect with Wiley

Web-Based Self-Help for Preventing Mental Health Problems in Universities: Comparing Acceptance and Commitment Training to Mental Health Education

Abstract

Objective

Method

Results

Conclusions

References

Citing Literature

References

Related

Information