Digital acceptance and commitment therapy for adults with chronic health conditions: Results from a waitlist-controlled trial

Digital mental health interventions (DMHIs) provide a promising avenue for addressing the mental health needs of adults with chronic health conditions (CHCs). Transdiagnostic DMHIs, which apply to a range of conditions by focusing on common core processes of change (e.g., acceptance and commitment therapy; ACT), are particularly needed to address the various ways a wide range of CHCs impact quality of life. The present study evaluated an ACT DMHI designed to improve quality of life and mental health transdiagnostically for adults with CHCs. A sample of 100 adults with CHCs were randomized to ACT or waitlist, with baseline, 6-week, and 10-week assessment points. Recruitment (100 participants in 3 months with a wide range of CHCs), retention (84% at follow-up), and adherence rates (M = 4 of 6 sessions) indicated feasibility, with high program satisfaction ratings for acceptability. Only psychological flexibility improved more in ACT versus waitlist at post-intervention (6week follow-up), with no differences on other outcomes until 10-week follow-up. Participants in ACT improved significantly more than waitlist at 10-week follow-up on the primary outcome of quality of life as well as functional impairment from CHCs and psychological flexibility. An exploratory moderation test suggested participants with elevated mental health symptoms at baseline improved more on these symptoms in ACT relative to waitlist at 10-week follow-up. Overall, results support the feasibility, acceptability, and efficacy of a transdiagnostic ACT DMHI to improve quality of life and mental health for adults with a wide range of CHCs. Clinicaltrialsgov identifier: NCT06179264.