SYSTEMATIC REVIEW article
Front. Psychiatry
Sec. Psychological Therapy and Psychosomatics
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1506822
Effect of Acceptance and Commitment Therapy for Adolescent Depression: a meta-analysis
Provisionally accepted
- 1School of Special Education and Rehabilitation, BinZhou Medical University, Yantai, China
- 2Shandong Mental Health Center, Jinan, Shandong Province, China
- 3Department of psychiatry, Institute of mental Health, Occupational Diseases Hospital of Shandong First Medical University, Jinan, Shandong Province, China
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Objectives: This study conducted a systematic review of published randomized controlled trials (RCTs) to evaluate the efficacy of acceptance and commitment therapy (ACT) for adolescent depression, while also examining its pertinent characteristics.We conducted systematic searches of electronic databases in accordance with PRISMA guidelines to ensure rigorous screening, data extraction, and quality assessment.Additionally, we employed random-effects models and performed subgroup analyses.A meta-analysis of 25 studies with 2,352 participants showed that ACT significantly reduced depressive symptoms in adolescents. Improvements in psychological flexibility significantly predicted reductions in depression. Subgroup analysis revealed that, at post-test, ACT was significantly more effective than wait-list controls in reducing depressive symptoms, though it was not superior to Treatment As Usual or active treatment groups. Furthermore, offline ACT was significantly more effective than Internet-based ACT in reducing depressive symptoms. Comparisons of intervention settings also indicated that ACT was more effective in group settings than individual ones. However, no significant difference was found between clinical and non-clinical samples.The current study suggests that ACT effectively reduces depressive symptoms, with psychological flexibility playing a crucial role in this improvement.Intervention forms and sample types should be considered when implementing ACT interventions. Extensive research is still needed for further exploration. A protocol for this review was preregistered with PROSPERO (CRD42023494677).
Keywords: Acceptance and Commitment Therapy, Adolescent, Depression, Randomized control, Meta-analysis
Received: 06 Oct 2024; Accepted: 23 Apr 2025.
Copyright: © 2025 Yu, Zhao, Yin, Zhang, Qu, Cheng and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xiaojing Cheng, Department of psychiatry, Institute of mental Health, Occupational Diseases Hospital of Shandong First Medical University, Jinan, Shandong Province, China
Xu Chen, Shandong Mental Health Center, Jinan, 17035517, Shandong Province, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.