The link between stress, well-being, and psychological flexibility during an Acceptance and Commitment Therapy self-help intervention

Int J Clin Health Psychol. 2018 Jan-Apr;18(1):60-68. doi: 10.1016/j.ijchp.2017.09.002. Epub 2017 Oct 17.

Abstract

Background/Objective: Prolonged stress can overwhelm coping resources, leading people to seek mental health care. Acceptance and commitment therapy (ACT) is an intervention that enhances well-being and reduces distress, assumedly by means of increasing psychological flexibility (PF). We examined the association between a total increase in PF during an intervention and decreases in stress and increases in well-being during and after the intervention. Method: The intervention was a randomized controlled trial of an ACT-based self-help intervention. Participants were 91 individuals reporting elevated levels of work-related stress. Measurements were completed at preintervention, postintervention, and 3-month follow-up. Results: Structural equation models revealed that the total increase in PF during the intervention was negatively associated with a decrease in stress (b = -0.63, SE = 0.14, p < .001) and positively associated with an increase in well-being during the intervention (b = 0.48, SE = 0.11, p < .001), but not with a decrease in stress (b = 0.03, SE = 0.27, p > .05) and well-being (b = -0.04, SE = 0.39, p > .05) following the intervention. Conclusions: Our study provides empirical support for decreasing stress and promoting well-being through ACT and emphasizes the potential of PF in promoting well-being.

Antecedentes/Objetivo: El estrés prolongado puede inhibir los recursos de adaptación, llevando a las personas a solicitar servicios de salud mental. La Terapia de Aceptación y Compromiso (ACT) es una intervención que fomenta el bienestar y reduce la ansiedad, presuntamente mediante el aumento de la flexibilidad psicológica (PF). Examinamos la asociación entre un aumento total en PF durante una intervención y el descenso del estrés y el aumento del bienestar durante y después de la intervención. Método: En un ensayo aleatorio controlado de una intervención de autoayuda con base en ACT participaron 91 individuos con niveles elevados de estrés laboral. Completaron mediciones pre, post y seguimiento a tres meses. Resultados: Modelos de ecuaciones estructurales revelaron que el aumento total en PF durante la intervención está negativamente asociado a la reducción del estrés (b = -0,63, SE = 0,14, p < 0,001) y positivamente asociado con el aumento del bienestar durante la intervención (b = 0,48, SE = 0,11, p < 0,001), pero no con el descenso del estrés (b = 0,03, SE = 0,27, p > 0,05) y el bienestar (b = -0,04, SE = 0,39, p > 0,05) después de la intervención. Conclusiones: Se proporciona base empírica de la reducción del estrés y el fomento del bienestar mediante ACT, enfatizando el potencial de PF para fomentar el bienestar.

Keywords: Acceptance and commitment therapy; Experiment; Psychological flexibility; Stress; Well-being.