Acceptance and commitment therapy interventions in secondary schools and their impact on students? mental health and well-being: A systematic review

In order to meet the growing need for mental health provision for young people, more attention has turned to schools to provide evidence-based interventions. Acceptance and Commitment Therapy (ACT) has been demonstrated in recent reviews and meta-analyses to be effective with young people, however to date no sys-tematic reviews have examined the use of ACT as a school-based intervention.This systematic review aimed to evaluate the methodological quality and examine the effectiveness of all peer-reviewed literature on ACT interventions based in secondary schools.The PsycInfo, Scopus and Web of Science databases were searched for studies published in any year reporting on the use of ACT interventions based in secondary schools aiming to prevent or reduce mental health difficulties or promote wellbeing. Both universal and targeted studies were eligible for inclusion. Nine studies met inclusion criteria, with a total of 1324 participants across studies (age range 13-21 years).Outcomes measured across all studies were depression, anxiety, anger, psychological capital, stress, wellbeing, life satisfaction, psychological health, emotional problems and mental health symptoms. Six studies also used process measures to explore different constructs linked to psychological flexibility, the mechanism of change in ACT. There was significant variation in methodological quality across studies.Despite methodological weaknesses across studies, there are some promising results to show support for the use of ACT as a school-based intervention. As existing studies were heterogeneous with regard to design and outcomes measured, this review was unable to draw firm conclusions regarding the efficacy of ACT or the moderating influence of program type, program format or program delivery. More highly powered studies comparing ACT to other active treatments are needed in order to explore these questions further.