ACT gains ground in RCTs
Acceptance and Commitment Therapy (ACT)—which emphasizes accepting unwanted thoughts while committing to valued action—is showing up in randomized trials for public‑speaking anxiety, workplace stress, and chronic worry, challenging CBT’s dominance for certain presentations. The process‑based framing is getting traction for prevention and brief interventions. (independent.ie)
The Association for Contextual Behavioral Science maintains a living catalogue of ACT randomized controlled trials dating back to 1986 and lists its RCT register as last updated in March 2026. (contextualscience.org) A 2023 randomized trial of virtual‑reality ACT for social and public‑speaking anxiety randomized 76 university students (VRACT n=37; waitlist n=39), delivered three VR sessions (~2 hours total), and reported moderate reductions in social/communication anxiety (d≈0.55–0.61) and a psychological‑flexibility gain of ~0.61. (researchgate.net) A 2022 PLOS ONE workplace RCT randomised 98 healthcare employees to a four‑session ACT programme versus waitlist, found significant reductions in psychological distress over a three‑month evaluation, and reported 48% of ACT participants with reliable improvement at four‑week post‑intervention (46.15% meeting clinically significant change). (plos.org) A brief, two‑session RNT‑focused ACT randomized trial (N=48) targeting repetitive negative thinking reported a very large effect (d=2.42) at one‑month follow‑up, with 94.12% of the ACT arm showing clinically significant change versus 9.09% in the waitlist, and effects maintained at three months. (psycnet.apa.org) A 2023 JAMA Psychiatry network meta‑analysis of 65 RCTs (5,048 participants) found cognitive behavioural therapy and “third‑wave” CBTs outperformed treatment‑as‑usual for generalized anxiety disorder, but only CBT showed evidence for long‑term effectiveness after excluding high‑risk‑bias studies. (jamanetwork.com) Foundational process‑based therapy papers by Hayes, Hofmann, and colleagues (Clin Psychol Rev 2020; DOI 10.1016/j.cpr.2020.101908) articulate a shift toward targeting core biopsychosocial change processes rather than syndrome‑specific protocols, a framework underpinning many recent ACT trial designs. (europepmc.org) Trial authors and the ACT evidence registry both call for larger, longer follow‑up RCTs and cost‑effectiveness analyses to confirm scalability (Prudenzi et al., PLOS ONE 2022), and the ACBS register notes an international surge in non‑English ACT trials with a 2024 initiative to upload non‑English PDFs for translation and inclusion. (plos.org (contextualscience.org))
