Acceptance and Commitment Therapy for Health Behavior Change: A Contextually-Driven Approach

Overview

Journal Front Psychol

Date 2018 Jan 30

PMID 29375451

Citations 48

Authors

Chun-Qing Zhang

Emily Leeming

Patrick Smith

Pak-Kwong Chung

Martin S Hagger

Steven C Hayes

Affiliations

Soon will be listed here.

Abstract

Promoting health behavior change presents an important challenge to theory and research in the field of health psychology. In this paper, we introduce a context-driven approach, the Acceptance and Commitment Therapy (ACT) model which is built on Relational Frame Theory. The ACT-based intervention aims to promote individuals' new health behavior patterns through the improvement of the key construct of psychological flexibility, which is defined as the ability to contact the present moment more fully with acceptance and mindfulness as a conscious human being. Building on the psychological flexibility model, implemented through the six core ACT processes, individuals improve maintenance of long term health behavior change through committed acts in service of chosen values while acknowledging and accepting the existence of contrary thoughts, rules, and emotions as part of themselves but not determinant of their behaviors. Taking advantage of this context-driven approach of health behavior change, we recommend researchers and practitioners to design their health behavior change intervention programs based on ACT.

Citing Articles

Acceptance and commitment therapy for mild traumatic brain injury (ACTion-mTBI): a quasiexperimental feasibility study.

Faulkner J, Prouty D, Devlin L, Appleton D, Roche M, Below K BMJ Open. 2025; 15(2):e089727.

PMID: 39956598 PMC: 11831269. DOI: 10.1136/bmjopen-2024-089727.

Effectiveness of psychotherapy for Hwa-Byung: A systematic review of interventional studies.

Kwon C, Lee B Medicine (Baltimore). 2025; 104(6):e41315.

PMID: 39928831 PMC: 11813000. DOI: 10.1097/MD.0000000000041315.

Adolescents' Daily Lives (ADL) project: an intensive longitudinal design study protocol examining the associations between physical literacy, movement behaviours, emotion regulation and mental health.

Ames M, Srinivasa Gopalan S, Sihoe C, Craig S, Garcia-Barrera M, Liu S BMJ Open. 2024; 14(11):e094225.

PMID: 39572095 PMC: 11580315. DOI: 10.1136/bmjopen-2024-094225.

Chinese translation and validation of the Personalized Psychological Flexibility Index (PPFI) for medical college students.

Jiang Y, Tian T, Li F, Sun J, Guo Q, Wang D BMC Psychol. 2024; 12(1):630.

PMID: 39506865 PMC: 11542442. DOI: 10.1186/s40359-024-02121-w.

Hallmarks of primary headache: part 1 - migraine.

Raggi A, Leonardi M, Arruda M, Caponnetto V, Castaldo M, Coppola G J Headache Pain. 2024; 25(1):189.

PMID: 39482575 PMC: 11529271. DOI: 10.1186/s10194-024-01889-x.

References

Vowles K, McNeil D, Gross R, McDaniel M, Mouse A, Bates M . Effects of pain acceptance and pain control strategies on physical impairment in individuals with chronic low back pain. Behav Ther. 2007; 38(4):412-25. DOI: 10.1016/j.beth.2007.02.001. View

Bricker J, Mull K, Kientz J, Vilardaga R, Mercer L, Akioka K . Randomized, controlled pilot trial of a smartphone app for smoking cessation using acceptance and commitment therapy. Drug Alcohol Depend. 2014; 143:87-94. PMC: 4201179. DOI: 10.1016/j.drugalcdep.2014.07.006. View

Lillis J, Hayes S, Bunting K, Masuda A . Teaching acceptance and mindfulness to improve the lives of the obese: a preliminary test of a theoretical model. Ann Behav Med. 2009; 37(1):58-69. DOI: 10.1007/s12160-009-9083-x. View

Levin M, Hildebrandt M, Lillis J, Hayes S . The impact of treatment components suggested by the psychological flexibility model: a meta-analysis of laboratory-based component studies. Behav Ther. 2012; 43(4):741-56. DOI: 10.1016/j.beth.2012.05.003. View

Kwasnicka D, Dombrowski S, White M, Sniehotta F . Theoretical explanations for maintenance of behaviour change: a systematic review of behaviour theories. Health Psychol Rev. 2016; 10(3):277-96. PMC: 4975085. DOI: 10.1080/17437199.2016.1151372. View

Bricker J, Copeland W, Mull K, Zeng E, Watson N, Akioka K . Single-arm trial of the second version of an acceptance & commitment therapy smartphone application for smoking cessation. Drug Alcohol Depend. 2016; 170:37-42. PMC: 5183543. DOI: 10.1016/j.drugalcdep.2016.10.029. View

Butryn M, Forman E, Hoffman K, Shaw J, Juarascio A . A pilot study of acceptance and commitment therapy for promotion of physical activity. J Phys Act Health. 2011; 8(4):516-22. DOI: 10.1123/jpah.8.4.516. View

Moffitt R, Mohr P . The efficacy of a self-managed Acceptance and Commitment Therapy intervention DVD for physical activity initiation. Br J Health Psychol. 2014; 20(1):115-29. DOI: 10.1111/bjhp.12098. View

Hayes S, Luoma J, Bond F, Masuda A, Lillis J . Acceptance and commitment therapy: model, processes and outcomes. Behav Res Ther. 2005; 44(1):1-25. DOI: 10.1016/j.brat.2005.06.006. View

10.

Barnes-Holmes Y, Hayes S, Barnes-Holmes D, Roche B . Relational frame theory: a post-Skinnerian account of human language and cognition. Adv Child Dev Behav. 2001; 28:101-38. DOI: 10.1016/s0065-2407(02)80063-5. View

11.

Forman E, Butryn M . A new look at the science of weight control: how acceptance and commitment strategies can address the challenge of self-regulation. Appetite. 2014; 84:171-80. PMC: 4314333. DOI: 10.1016/j.appet.2014.10.004. View

12.

Biglan A, Hayes S, Pistorello J . Acceptance and commitment: implications for prevention science. Prev Sci. 2008; 9(3):139-52. PMC: 2727477. DOI: 10.1007/s11121-008-0099-4. View

13.

Kashdan T, Rottenberg J . Psychological flexibility as a fundamental aspect of health. Clin Psychol Rev. 2010; 30(7):865-78. PMC: 2998793. DOI: 10.1016/j.cpr.2010.03.001. View

14.

Lillis J, Kendra K . Acceptance and Commitment Therapy for weight control: Model, evidence, and future directions. J Contextual Behav Sci. 2014; 3(1):1-7. PMC: 4238039. DOI: 10.1016/j.jcbs.2013.11.005. View

15.

Hernandez-Lopez M, Luciano M, Bricker J, Roales-Nieto J, Montesinos F . Acceptance and commitment therapy for smoking cessation: a preliminary study of its effectiveness in comparison with cognitive behavioral therapy. Psychol Addict Behav. 2009; 23(4):723-30. DOI: 10.1037/a0017632. View

16.

Wegner D . Ironic processes of mental control. Psychol Rev. 1994; 101(1):34-52. DOI: 10.1037/0033-295x.101.1.34. View

17.

Barnes D, Keenan M . A transfer of functions through derived arbitrary and nonarbitrary stimulus relations. J Exp Anal Behav. 1993; 59(1):61-81. PMC: 1322076. DOI: 10.1901/jeab.1993.59-61. View

18.

Hayes S . Acceptance and Commitment Therapy, Relational Frame Theory, and the Third Wave of Behavioral and Cognitive Therapies - Republished Article. Behav Ther. 2016; 47(6):869-885. DOI: 10.1016/j.beth.2016.11.006. View

19.

Hayes S, Wilson K, Gifford E, Follette V, Strosahl K . Experimental avoidance and behavioral disorders: a functional dimensional approach to diagnosis and treatment. J Consult Clin Psychol. 1996; 64(6):1152-68. DOI: 10.1037//0022-006x.64.6.1152. View

20.

Gifford E, Kohlenberg B, Hayes S, Pierson H, Piasecki M, Antonuccio D . Does acceptance and relationship focused behavior therapy contribute to bupropion outcomes? A randomized controlled trial of functional analytic psychotherapy and acceptance and commitment therapy for smoking cessation. Behav Ther. 2011; 42(4):700-15. DOI: 10.1016/j.beth.2011.03.002. View