Acceptance and Commitment Therapy (ACT)
Author(s): Paul. E. Flaxman & Frank W. Bond Country: United Kingdom
Is the intervention sector specific?	No
Is the intervention usable with different enterprise sizes?	Yes
Is the intervention equally applicable to both genders?	Yes
Is the intervention based on theory?	Yes
Can the intervention approach be adapted/ tailored?	Yes
Does the intervention promote CSR and how?	The intervention was not explicitly linked to responsible business practices although it does promote employee well-being
Does the intervention promote social dialogue and how?	Social dialogue is not a core component of ACT
Overview (including risk assessment and law – legal requirements etc.): The overall aim of Acceptance and Commitment Therapy (ACT) is to enhance psychological flexibility; a psychological construct that has two related components: (a) a willingness to experience all internal events (thought, feelings, etc), and include those that are undesirable without trying to control, change or remove them; and (b) a commitment to engage in goal–orientated action, even when faced with difficult psychological content. This approach promotes and teaches, through a fully developed intervention protocol, mindfulness strategies to promote acceptance, rather than change or modify difficult psychological content, and commitment and behavioural strategies to help people build larger patterns of values-based action. There is a growing body of research to demonstrate that ACT is an effective method of stress management, and has been demonstrated to significantly improve employees’ mental health and to improve work-related outcomes: such as, increased learning at work (Bond & Bunce, 2000; Dahl et al., 2004; Flaxman & Bond, 2006; Hayes et al., 2004).
Implementation: The ACT programme can be delivered during working hours to small groups of employees at the organisation. In recent ACT research, participants received three sessions of training on two consecutive weeks, and the third, and final, session three months later. Each training session lasted approximately half a day. The training consisted of a mixture of group discussion, didactic teaching and practice of ACT techniques. Additionally, participants were also encouraged to complete homework assignments between sessions. The content of the intervention was based on the fully developed ACT protocol, and additionally two subsequent ACT manuals that have a concentrated focus on group worksite interventions.
Practical applications: ACT has a standardized protocol manual; thus making it easily applicable at a practical level. However, the authors note that in order to implement the protocol effectively, the trainer requires a good understanding of ACT’s underlying processes (see Hayes et al., 2006). ACT has been successfully implemented in a variety of occupational sectors, including both the public and private sector; and in both medium and large scale organisations.
Innovative aspects: Many traditional cognitive behavioural approaches are designed to instruct employees on how to change or modify ‘dysfunctional’ or (stress-related) cognitions; and , in turn, how to reduce unpleasant emotional arousal. In contrast to the traditional change-orientated cognitive behavioural approach, a ‘third-wave of cognitive behavioural therapy has emerged, which places greater emphasis on ‘acceptance’ and ‘mindfulness’. One such approach, at the forefront of this ‘third-wave’ movement in cognitive behavioural approaches, is ACT.
Evaluation (including process issues, outcomes and sustainability): Participating individuals were randomly assigned to one of three groups: (1) acceptance and commitment training (ACT) – a mindfulness-based approach; (2) stress inoculation training (SIT) - a cognitive restructuring approach; or (3) a wait list control group. Participants were asked to complete a questionnaire assessing overall levels of wellbeing at three time points: pre-intervention (baseline), 3 months later; and at a 6 month follow up.
Benefits (including cost effectiveness): The aforementioned evaluation of ACT demonstrated the following benefits: Participating employees, with high levels of distress prior to the intervention, experienced large statistically (and clinically) significant improvements in mental health and these observed benefits were maintained at the 6 months follow-up assessment. The authors conclude that there is a lot of evidentiary support for the use of cognitive behavioural therapy-based interventions in improving employees’ psychological well-being. Additionally, the evidence supports the efficacy of using ACT in the workplace
References: Bond, F. W., & Bunce, D. (2000). Mediators of change in emotion-focused and problem-focused worksite stress management interventions. Journal of Occupational Health Psychology, 5, 156-163. Dahl, J., Wilson, K. G., & Nilsson, A. (2004). Acceptance and commitment therapy and the treatment of persons at risk for long-term disability resulting from stress and pain symptoms: A preliminary randomized trial. Behavior Therapy, 35, 785-801. Flaxman, P. E., & Bond, F. W. (2006). Acceptance and commitment therapy in the workplace. In R. A. Baer (Ed.), Mindfulness-based treatment approaches.San Diego, CA: Elsevier. Flaxman, P.E. & Bond, F.W. (2006). For whom, and to what extent, is worksite stress management effective? In S. McIntyre & J. Houdmont Occupational Health Psychology: Key Papers of the European Academy of Occupational Health Psychology (pg.92-93).Edicoes ISMAI: Castelo da Maia, Portugal. Flaxman, P.E. & Bond, F.W. (2006b). Cognitive-behavioural therapy (CBT) – based stress management interventions (SMIs): Investigating the mechanisms of change. Retrieved from http://www.ejtassociates.co.uk/Cognitive.pdf. Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment theory: Model, processes and outcomes. Behaviour Research and Therapy, 44, 1-25. Hayes, S. C., Bissett, R., Roget, N., Padilla, M., Kohlenberg, B. S., Fisher, G., et al. (2004). The impact of acceptance and commitment training and multicultural training on the stigmatizing attitudes and professional burnout of substance abuse counselors. Behavior Therapy, 35, 821-835.
Comments: The authors note that ACT has been demonstrated as an effective method to address both the management of occupational stress (secondary level intervention) and in the rehabilitation of employee experiencing stress-related illness (tertiary level intervention).