Perceptions and experiences of acceptance and commitment therapy among people with mental disorders: A qualitative systematic review

Acceptance and Commitment Therapy (ACT) is an increasingly popular approach to the treatment of mental disorders. It is important to understand the perceptions and experiences of those who have been treated using this approach in order to inform the development and implementation of ACT and to enhance this population's psychological well-being. This study aimed to identify, appraise, and synthesize the qualitative literature regarding the perceptions and experiences of ACT among people with mental disorders who have been treated using this approach. A comprehensive literature search was conducted using nine English and Chinese databases to gather qualitative data related to ACT and mental disorders from the databases' inception to January 2023. A gray literature search was conducted using OpenGrey, Google, and Google Scholar. Hand searches of the reference lists of the included studies were performed. The Critical Appraisal Skills Programme checklist for qualitative studies was used to assess the quality of the studies. Data were extracted and analyzed using thematic synthesis. The degree of confidence in the findings was measured using the Grading of Recommendations Assessment, Development, and Evaluation Confidence in Evidence approach. A total of 10 studies were included, and five themes were identified: 1) developing a new way of relating to negative internal experiences, 2) gradually integrating oneself into the external world, 3) adopting a new way of living, 4) achieving personal growth, and 5) barriers hindering therapy. This study yields insights regarding positive experiences of using ACT, which reflect an ACT-facilitated mental health recovery process and an underlying mechanism of behavioral change. An understanding of the main barriers hindering learning about and practicing ACT was also gen-erated-these barriers deserve attention and further exploration. Review registration number: CRD42022359885.