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Effects of ACT on trauma-related symptoms: a systematic review and meta-analysis

This article examines the effectiveness of ACT for reducing trauma-related symptoms through a systematic review and meta-analysis. Here are the key points:

  • ACT has shown promise for trauma but no meta-analyses have examined its impact specifically on trauma symptoms.
  • The meta-analysis included 11 studies (N=716) that compared ACT to CBT, placebo therapies, no treatment, and treatment as usual. Overall, ACT had a moderate effect (g=-0.423) in reducing trauma symptoms immediately post-treatment.
  • Subgroup analyses found greater reductions for interpersonal trauma and medical trauma compared to military and unspecified trauma. Comparator group and study design did not significantly impact outcomes.
  • Recommendations include using detailed, manualised ACT protocols that target trauma processing, increasing sample sizes, assessing long-term outcomes, and improving methodological quality (e.g., blinding, treatment adherence).

In summary, ACT can effectively reduce trauma symptoms for adults. Clinicians may consider ACT as an alternative or addition to traditional CBT approaches.

Recommendations for practice

  • Clinicians can implement a trauma-focused ACT protocol such as that outlined by Walser and Westrup (2007) to target acceptance, defusion, values-consistent behavior change, and exposure.
  • Manualised ACT protocols for trauma should include 8-12 weekly sessions and target trauma processing through exposure exercises.
  • Clinicians should monitor treatment adherence, conduct therapist training, and supervise to ensure quality ACT delivery.
  • Initial CBT may be preferable for some clients but adding ACT skills could improve outcomes by targeting experiential avoidance.
  • ACT may be especially helpful for clients with interpersonal or medical trauma types.

 

Reference

Rowe-Johnson, M. K., Browning, B., & Scott, B. (2024). Effects of acceptance and commitment therapy on trauma-related symptoms: A systematic review and meta-analysis. Psychological Trauma: Theory, Research, Practice, and Policy. Advance online publication. https://doi.org/10.1037/tra0001785

 

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