接纳承诺疗法的作用机制——基于元分析结构方程模型

接纳承诺疗法(Acceptance and Commitment Therapy, ACT)被认为是行为治疗“第三浪潮”的重要代表。本研究使用元分析结构方程模型, 考察ACT的作用机制。通过数据库检索与筛选, 最终纳入文献50篇。结果发现: ACT所假设的心理灵活性、接纳、此时此刻、价值的中介作用都达到统计显著, 认知解离这一中介变量并不显著; 中介机制在网络化干预中仍然得到检验; 相较之传统CBT, ACT在所假设的机制上有其区别于CBT的优势。后续临床研究应更全面地测量6大核心机制, 关注对美好生活提升的影响, 采用多点瞬时评价法, 并尽可能使用更高级、更先进的统计方法检验其作用机制。

Mechanisms of the Acceptance and Commitment Therapy: A meta-analytic structural equation model

Following the Behavioral Therapy and the Cognitive-Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT) is considered as one of the third wave of behavioral therapies. ACT is based on the relational frame theory, and its therapeutic model includes 6 components (i.e., acceptance, cognitive defusion, self-as-context, committed action, contact with the present moment, values) and psychological flexibility. What is the empirical evidence for these hypothesized components or mechanisms? In recent years, integrating meta-analysis and structural equation modeling, the meta-analytic structural equation model (MASEM) has made it possible to systematically examine the mechanisms of psychotherapy. Compared to the traditional single randomized controlled trial (RCT) studies, the MASEM combines multiple samples to increase statistical power and obtain more robust model estimates. The current study utilized two-stage structural equation modeling (TSSEM) to examine three aspects of the mechanisms of ACT, including: (1) the mediational effects of psychological flexibility and the 6 components, (2) the unique mechanisms of ACT compared to CBT, and (3) the generalizability of these mechanisms to internet-based ACT interventions.