Surviving and Thriving During Stress: A Randomized Clinical Trial Comparing a Brief Web-Based Therapist-Assisted Acceptance-Based Behavioral Intervention Versus Waitlist Control for College Students

Randomized controlled trial of a web‐based Acceptance and Commitment Therapy (ACT) program to promote mental health in university students

“…Lower rates of attrition were documented in several ACT web‐based studies with student populations (e.g., Levin et al, ; Levin, Hayes et al, ; Rasanen et al, ); however, they also targeted clinically distressed students, included some therapist contact, and provided participation incentives. In contrast, other ACT intervention studies with therapist involvement, and one with an assessment completion incentive, also recorded similar completion rates to the present study, highlighting the variability of completion rates within this population (e.g., Eustis et al, ; Levin et al, ). High levels of attrition in standalone web‐based programs do not necessarily indicate low student acceptability or effectiveness.…”

“…Further analyses investigating data not missing at random due to specific outcome measures, found 2.3% was not missing at random, which is small enough to ignore (Scheffer, ). Loss of participant data appeared to be due to attrition at the assessment points and these percentages are similar to those found in the YOLO Program pilot study (Viskovich & Pakenham, ) and other web‐based ACT intervention studies with similar intervention completion rates (Eustis, Hayes‐Skelton, Orsillo, & Roemer, ; Levin, Pistorello, Hayes, Seeley, & Levin, ).…”

Evaluation of a web-based Acceptance and Commitment Therapy (ACT) program to increase self-care and mental health skills in university students

“…It is worth noting that standalone clinical, preventative, and promotional web-based interventions to improve mental health tend to have higher rates of drop-out and lower effect sizes than interventions with adminstrator or therapist support. This is the case in both adult (Christensen, Griffiths, Groves, & Korten, 2006;Farrand & Woodford, 2013;French et al, 2017;Melville, Casey, & Kavanagh, 2010;Richards & Richardson, 2012) and student populations (Cavanagh et al, 2013;Clarke et al, 2009;Eustis et al, 2018;Horgan, McCarthy, & Sweeney, 2013;Li et al, 2013;Lintvedt et al, 2013;Shandley, Austin, Klein, & Kyrios, 2010;van der Zanden, Kramer, Gerrits, & Cuijpers, 2012).…”

“…In adult and university student samples, evidence indicates that web-based programs, with varied levels of practitioner support, are as effective as face-to-face therapy (Barak, Hen, Boniel-Nissim, & Shapira, 2008;Bricker, Bush, Zbikowski, Mercer, & Heffner, 2014;Christensen, Pallister, Smale, Hickie, & Calear, 2010;Eustis, Hayes-Skelton, Orsillo, & Roemer, 2018;Rasanen, Lappalainen, Muotka, Tolvanen, & Lappalainen, 2016); in some instances (e.g., with adults), they have even been shown to be more effective (e.g., adults;…”

“…In a meta-analysis of web-based interventions for depression, Richards and Richardson (2012) Drop-out in mental health promotion interventions was also high, reported at between 42.4% and 67% (Li et al, 2013;Shandley et al, 2010). Web-based interventions with some therapist contact have been found to produce similar results to face-to-face therapy, with medium to large effect sizes for ACT (Eustis et al, 2018;Lappalainen et al, 2014;Rasanen et al, 2016) and CBT (Cuijpers, Donker, van Straten, Li, & Andersson, 2010). However, due to the large number of students requiring support, demands on time and resources often prevent the viability of practitioner-involved interventions.…”