Increasing psychological flexibility is associated with positive therapy outcomes following a transdiagnostic ACT treatment

Ronja Rutschmann; Nina Romanczuk-Seiferth; Andrew Gloster; Christoph Richter

doi:10.3389/fpsyt.2024.1403718

Increasing psychological flexibility is associated with positive therapy outcomes following a transdiagnostic ACT treatment

Front Psychiatry. 2024 Jul 15:15:1403718. doi: 10.3389/fpsyt.2024.1403718. eCollection 2024.

Authors

Ronja Rutschmann^{1

2

3}, Nina Romanczuk-Seiferth^{2

3}, Andrew Gloster⁴, Christoph Richter^{1

2}

Affiliations

¹ Clinic for Psychiatry, Psychotherapy and Psychosomatics, Vivantes Klinikum Kaulsdorf, Berlin, Germany.
² Department of Psychiatry and Neurosciences, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
³ Department of Psychology, MSB Medical School Berlin, Berlin, Germany.
⁴ Faculty of Behavioral Sciences and Psychology, University of Lucerne, Lucerne, Switzerland.

Abstract

Objectives: Increasing psychological flexibility is considered an important mechanism of change in psychotherapy across diagnoses. In particular, Acceptance and Commitment Therapy (ACT) primarily aims at increasing psychological flexibility in order to live a more fulfilling and meaningful life. The purpose of this study is to examine 1) how psychological flexibility changes during an ACT-based treatment in a transdiagnostic day hospital and 2) how this change is related to changes in symptomatology, quality of life, and general level of functioning.

Methods: 90 patients of a psychiatric day hospital participated in the study. Psychological flexibility, symptomatology, and quality of life were assessed at three measurement time points (admission, discharge, and 3-month follow-up). The level of functioning was assessed at admission and discharge. Differences in psychological flexibility were tested via two-sided paired samples t-tests. Correlations of residualized change scores were calculated to detect associations between changes in psychological flexibility and other outcomes.

Results: Psychological flexibility increased significantly from pre-treatment to post-treatment (d = .43, p <.001) and from pre-treatment to follow-up (d = .54, p <.001). This change was significantly correlated to a decrease in symptomatology (r = .60 -.83, p <.001) and an increase in most dimensions of quality of life (r = -.43 - -.75, p <.001) and general level of functioning (r =-.34, p = .003).

Discussion: This study adds further evidence for psychological flexibility as a transdiagnostic process variable of successful psychotherapy. Limitations are discussed.

Keywords: AAQ-II; Acceptance and Commitment Therapy; psychological flexibility; transdiagnostic approach; unified treatment.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. We acknowledge financial support for publication fees from the Open Access Publication Fund of Charité -Universitätsmedizin Berlin, and from Medical School Berlin.