Cognitive Behavioral Therapy vs Acceptance and Commitment Therapy for Depression
Recruiting in Palo Alto (17 mi)
Overseen byIony D Ezawa, PhD
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University of Southern California
Disqualifiers: Other diagnosis, Suicide risk, others
No Placebo Group
Trial Summary
What is the purpose of this trial?This study will compare two psychological treatments for major depressive disorder (MDD): cognitive-behavioral therapy (CBT) and acceptance and commitment therapy (ACT). Both treatments are well-studied and supported by evidence as effective options for people experiencing depression. These treatments will be delivered in an online group format via Zoom.
The study will enroll up to 150 participants with depression. Half of the participants will receive online group CBT and half will receive online group ACT. There will be up to 10 members in each group. For both conditions, treatment will be provided over 8 weeks, with a 6-month follow-up period. Enrollment will be ongoing and groups will occur simultaneously.
Potential participants are asked to complete an initial screening and an intake evaluation to determine eligibility. They will then receive 8-weeks of treatment. Participants will complete self-report questionnaires throughout their time in the study.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It focuses on psychological treatments for depression, so it's best to discuss your medications with the study team.
What data supports the effectiveness of Acceptance and Commitment Therapy (ACT) for treating depression?
Research shows that Acceptance and Commitment Therapy (ACT) is effective for treating depression, with studies indicating it can be as effective as Cognitive Behavioral Therapy (CBT). ACT focuses on increasing psychological flexibility, which helps people manage their depression by accepting their thoughts and feelings and committing to actions that align with their values.
12345Is Acceptance and Commitment Therapy (ACT) safe for treating depression?
The research does not specifically mention safety concerns for Acceptance and Commitment Therapy (ACT) or Cognitive Behavioral Therapy (CBT) for depression, suggesting they are generally considered safe for use in humans.
12367How does Acceptance and Commitment Therapy (ACT) differ from Cognitive Behavioral Therapy (CBT) for treating depression?
Acceptance and Commitment Therapy (ACT) is unique because it focuses on increasing psychological flexibility through mindfulness and acceptance, helping individuals commit to actions aligned with their values, whereas Cognitive Behavioral Therapy (CBT) primarily targets changing negative thought patterns. ACT can be delivered in various formats, including individual, group, or self-help, and emphasizes processes like cognitive defusion, which are distinct from traditional CBT approaches.
12348Eligibility Criteria
This trial is for individuals with major depressive disorder (MDD) who are comfortable receiving psychological treatment in an online group setting. Participants will be screened and evaluated to ensure they meet the study's requirements.Inclusion Criteria
Lives in California
Access to a private location with a stable internet connection and a working video camera
Able and willing to give informed consent
+3 more
Exclusion Criteria
I have a mental health condition that is not primarily depression and needs different treatment.
Clear indication of secondary gain (e.g., court ordered treatment)
Current suicide risk or significant intentional self-harm in the last six months sufficient to preclude treatment on an outpatient basis.
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
1-2 weeks
1 visit (virtual)
Intake Evaluation
Participants complete an intake evaluation to determine eligibility
1 week
1 visit (virtual)
Treatment
Participants receive 8 weeks of online group therapy (CBT or ACT)
8 weeks
8 sessions (virtual)
Follow-up
Participants complete monthly follow-up surveys for 6 months
6 months
6 visits (virtual)
Participant Groups
The study compares two evidence-supported treatments for depression: Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT), both delivered online over 8 weeks, with a follow-up after 6 months.
2Treatment groups
Active Control
Group I: Cognitive Behavioral TherapyActive Control1 Intervention
Over 8 sessions, clients learn techniques to challenge and change maladaptive thought and behavioral patterns
Group II: Acceptance and Commitment TherapyActive Control1 Intervention
Over 8 sessions, clients learn techniques to accept their negative internal experiences and commit to action in line with their values
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
University of Southern CaliforniaLos Angeles, CA
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Who Is Running the Clinical Trial?
University of Southern CaliforniaLead Sponsor
References
Development and Evaluation of Acceptance and Commitment Therapy Delivered by Psychologists and Non-Psychologists in an NHS Community Adult Mental Health Service: a Preliminary Analysis. [2018]Previous studies have demonstrated that acceptance and commitment therapy (ACT) is effective for depression and may be useful for complex transdiagnostic clients.
A Randomized Controlled Trial in Routine Clinical Practice Comparing Acceptance and Commitment Therapy with Cognitive Behavioral Therapy for the Treatment of Major Depressive Disorder. [2019]Since current therapies for depression are effective but not for all patients alike, we need to further improve available treatments. Existing research suggests that acceptance and commitment therapy (ACT) may effectively treat major depressive disorder (MDD). We compared ACT with cognitive behavioral therapy (CBT) for depression, testing the hypothesis that CBT would outperform ACT.
Acceptance and Commitment Therapy for Major Depressive Disorder: Insights into a New Generation of Face-to-Face Treatment and Digital Self-Help Approaches. [2021]Major depressive disorder (MDD) represents a key contributor to the global burden of mental illness given its relatively high lifetime prevalence, frequent comorbidity, and disability rates. Evidence-based treatment options for depression include pharmacotherapy and psychotherapy, such as cognitive behavioral therapy (CBT). Beyond traditional CBT, over 15 years ago, Hayes proclaimed a new generation of contextualistic and process-orientated so-called third wave of CBT interventions, including acceptance and commitment therapy (ACT). Using mindfulness and acceptance as well as commitment and behavior change processes, the transdiagnostic ACT approach aims to increase psychological flexibility as universal mechanism of behavior change and to build a value-driven orientation in life. ACT for MDD can be provided as either stand-alone individual, group, or self-help formats (e.g., apps) or combined with other approaches like behavioral activation. To date, a steadily growing empirical support from outcome and process research suggests the efficacy of ACT, which appears to work specifically through the six proposed core processes involved in psychological flexibility, such as defusion. In view of an ongoing interest of clinicians in "third-wave" CBTs and the important role of clients' preferences in providing therapy choices that work, the purpose of this chapter is to give a brief overview on the application of ACT in the treatment of MDD in adults.
Acceptance and commitment therapy and behavioral activation for the treatment of depression: description and comparison. [2022]The field of clinical behavior analysis is growing rapidly and has the potential to affect and transform mainstream cognitive behavior therapy. To have such an impact, the field must provide a formulation of and intervention strategies for clinical depression, the "common cold" of outpatient populations. Two treatments for depression have emerged: acceptance and commitment therapy (ACT) and behavioral activation (BA). At times ACT and BA may suggest largely redundant intervention strategies. However, at other times the two treatments differ dramatically and may present opposing conceptualizations. This paper will compare and contrast these two important treatment approaches. Then, the relevant data will be presented and discussed. We will end with some thoughts on how and when ACT or BA should be employed clinically in the treatment of depression.
Acceptance and commitment therapy: a meta-analytic review. [2018]There are now a substantial number of controlled trials investigating the efficacy of acceptance and commitment therapy (ACT). This meta-analysis combined multiple well-controlled studies to help clarify the overall impact of ACT relative to waiting lists, psychological placebos, treatment as usual, and established therapies.
Acceptance and commitment therapy - pathways for general practitioners. [2012]Acceptance and commitment therapy (ACT) focuses on helping patients to behave more consistently with their own values and apply mindfulness and acceptance skills to their responses to uncontrollable experiences.
Outcomes of Acceptance and Commitment Therapy for depression and predictors of treatment response in Veterans Health Administration patients. [2023]Acceptance and Commitment Therapy for depression (ACT-D) is a promising depression treatment which has not been evaluated on a large scale within VA. This study aimed to evaluate ACT-D's effectiveness in a national, treatment-seeking sample of Veterans.
Processes of change in acceptance and commitment therapy and cognitive therapy for depression: a mediation reanalysis of Zettle and Rains. [2019]Several articles have recently questioned the distinction between acceptance and commitment therapy (ACT) and traditional cognitive therapy (CT). This study presents a reanalysis of data from Zettle and Rains that compared 12 weeks of group CT with group ACT. For theoretical reasons, Zettle and Rains also included a modified form of CT that did not include distancing, and no intent-to-treat analysis was included. Particularly because that unusual third condition did somewhat better than the full CT package, it contaminated the direct comparison of ACT and CT, which has of late become theoretically interesting. In the present study, data from participants in the ACT and CT conditions were reanalyzed. ACT was shown to produce greater reductions in levels of self-reported depression using an intent-to-treat analysis. Posttreatment levels of cognitive defusion mediated this effect at follow-up. The occurrence of depressogenic thoughts and level of dysfunctional attitudes did not function as mediators. This study adds additional evidence that ACT works through distinct and theoretically specified processes that are not the same as CT.