Key messages from scientific research that's ready to be acted on
Got It, Hide thisYe F, Lee JJ, Xue D, et al. Acceptance and Commitment Therapy Among Informal Caregivers of People With Chronic Health Conditions: A Systematic Review and Meta-Analysis. JAMA Netw Open. 2023;6:e2346216.
In informal caregivers who take care of family, friends, or neighbours who have chronic health conditions, what is the effect of acceptance and commitment therapy (ACT) on their psychological health?
Informal caregiving of family members or friends who have chronic illness can be stressful. ACT is a type of cognitive behaviour therapy that encourages people to accept their negative feelings and thoughts and to commit to healthy activities to help them manage their experiences. This review looked at research on ACT to determine if it improves psychological wellbeing and to uncover the best ways to offer ACT to informal caregivers.
The researchers did a systematic review of studies available up to February 2023. They found 29 randomized controlled trials that included 2010 people. On average, the caregivers were 46 years of age, and most were women.
The key features of the studies were:
Compared with active controls or usual care, ACT programs:
ACT was more likely to work when it was delivered face-to-face using a mixed individual- and group-based format over a greater number of sessions.
Acceptance and commitment therapy improved the psychological health of informal caregivers of people with chronic health conditions.
Outcomes | Time point | Number of trials (and people) | Effect of ACT on psychological health compared with control† |
Experiential avoidance* | At the end of ACT | 23 (1422) | Reduced by a large amount |
| After 1 to 6 months | 15 (979) | Reduced by a large amount |
Value-based living* | At the end of ACT | 9 (305) | Improved by a large amount |
| After 1 to 6 months | 5 (159) | No difference in effect |
Mindfulness* | At the end of ACT | 7 (330) | No difference in effect |
| After 1 to 6 months | 3 (125) | Improved by a large amount |
Cognitive fusion* | At the end of ACT | 6 (264) | Reduced by a moderate amount |
| After 1 to 6 months | 3 (116) | Reduced by a moderate amount |
Depressive symptoms | At the end of ACT | 14 (945) | Reduced by a large amount |
| After 1 to 6 months | 9 (668) | Reduced by a large amount |
Anxiety symptoms | At the end of ACT | 13 (885) | Reduced by a large amount |
| After 1 to 6 months | 10 (708) | Reduced by a large amount |
Stress symptoms | At the end of ACT | 18 (1270) | Reduced by a moderate amount |
| After 1 to 6 months | 12 (874) | Reduced by a large amount |