ACT in the workplace: A meta-analytic examination of randomized controlled trials

Abstract

Occupational stress is a crucial risk factor for the development of somatic and mental disorders and for the reduction of overall well-being. Acceptance and Commitment Therapy (ACT) is an established treatment in clinical practice and its use as a non-clinical workplace intervention proliferated in recent years. This study provides an up-to-date meta-analysis on how face-to-face ACT interventions affect occupational stress as well as psychological distress, psychological flexibility, and well-being. Random-effects meta-analyses were conducted exploring ACT's efficacy concerning the four constructs. Sub-group analyses and meta-regressions were performed to investigate individual, workplace-related, and treatment effects. A total of 17 studies including 860 participants allocated to ACT conditions and 736 participants allocated to control conditions were extracted. ACT outperformed control conditions (passive and active control) regarding psychological distress (Hedges' g = −0.38, 95% CI [-0.57; -0.19]) psychological flexibility (g = 0.33, 95% CI [0.13; 0.54]); and well-being (g = 0.24, 95% CI [0.02; 0.47]) at post-treatment, and regarding stress (g = −0.22, 95% CI [-0.41; −0.04]), psychological flexibility (g = 0.31, 95% CI [0.16; 0.47]), and well-being (g = 0.26, 95% CI [0.03; 0.49]) at follow-up. Additional analyses revealed ACT to be most effective for office employees while showing little to no effect for health care workers. Findings demonstrate ACT to be an effective treatment to reduce psychological distress and stress, and to increase psychological flexibility and general well-being in a non-clinical, workplace setting. An application for employees working in an office setting appears to be most promising.