Effectiveness of acceptance and commitment therapy for addictive behaviors: A systematic review and meta-analysis

The use of acceptance and commitment therapy (ACT) has expanded in the field of addictive disorders in recent years. This systematic review and meta-analysis examined the effectiveness of ACT compared to other active interventions in terms of treatment completion, addiction-related outcomes, and cha...

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Bibliographic Details
Published in:Journal of contextual behavioral science 2024-04, Vol.32, p.100773, Article 100773
Main Authors: Krotter, Andrea, Aonso-Diego, Gema, González-Menéndez, Ana, González-Roz, Alba, Secades-Villa, Roberto, García-Pérez, Ángel
Format: Article
Language:English
Subjects:
Acceptance and commitment therapy
Addictive behaviors
Effectiveness
Meta-analysis
Moderators
Substance use
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Summary:The use of acceptance and commitment therapy (ACT) has expanded in the field of addictive disorders in recent years. This systematic review and meta-analysis examined the effectiveness of ACT compared to other active interventions in terms of treatment completion, addiction-related outcomes, and changes in psychological flexibility. Searches were conducted in PsycINFO, PubMed, Scopus, and Web of Science. Four random-effects meta-analyses were conducted to assess the effectiveness of ACT in terms of completion rates and abstinence at the end of treatment (EOT), in the short term (≤6 months follow-up), and in the long term (>6-month follow-up). Participants’ sex and age, the number of ACT sessions, the characteristics of the experimental condition (i.e., ACT combined with pharmacological intervention or non-combined) and the comparison condition (i.e., ACT compared to cognitive-behavioral therapy [CBT] or non-CBT interventions), treatment modality (face-to-face or technology-based approaches), and the targeted addictive behavior were examined as moderators. A total of 28 studies were included in the systematic review and 22 in the meta-analysis. There were no differences in EOT completion rates (Log RR = 0.0038; 95% CI: −0.026, 0.034). ACT increased the odds of abstinence at EOT (Log RR = 0.264; 95% CI: 0.046, 0.482) and at short-term follow-up (Log RR = 0.295; 95% CI: 0.108, 0.483), but not in the long term (Log RR = 0.164; 95% CI: −0.101, 0.430). ACT demonstrated higher abstinence rates than CBT conditions at EOT (p = 0.002). A lower age increased abstinence rates in the short (p = 0.004) and long term (p 
ISSN:2212-1447
2212-1455
DOI:10.1016/j.jcbs.2024.100773