Trialling a Novel Web-Based Therapy in Universities

Written by Harry Mansfield

Starting university is a stressful experience for many. It can mean leaving home for the first time, moving to a new city, adjusting to new surroundings, meeting new people, as well as a slew of new responsibilities. These are just some of the challenges students would typically face, let alone the unprecedented challenges students are being faced with in 2020 as they adjust to ‘blended’ learning and dramatically fewer social opportunities to ease them into their new environment. As such, it’s important that wellbeing services in universities offer effective methods to promote wellbeing, with many unsurprisingly looking at web-based therapy more seriously. One such therapy - web-based Acceptance and Commitment Therapy - was recently trialled with Australian undergraduate students in 2019 with promising results (Viskovich & Pakenham, 2018). 

Acceptance and commitment therapy (ACT) is a ‘new-wave’ therapy (Hayes, 2004) and has had tons of research devoted to it in the past couple of decades. Put simply, ACT is a type of therapy that aims to help patients accept what is out of their control, and commit instead to actions that enrichen their lives (Harris, 2013). So, Viskovich & Pakenham trialled a 4-week, web-based programme of Acceptance and Commitment Therapy (ACT) at the University of Queensland, with over 1000 students taking part. Participants were randomly allocated to either the intervention condition (n=596) or were put in the waitlist control condition (n=566). Viskovich & Pakenham measured a number of primary outcomes (depression, anxiety, stress, well-being, self-compassion, life satisfaction, and academic performance) before and after the ACT intervention to see what effect the therapy had on participants. Furthermore, after the initial 4-week therapy course, participants were measured on each of these primary outcomes after 12 weeks to monitor whether these effects continued.


The results were impressive; analyses showed significant improvements in the intervention group from pre- to post-intervention on all primary outcomes when compared to the waitlist control condition. What’s more, the improvements seen by participants over the course of the intervention were maintained at the 12-week follow-up. Now, when considering the design of this study, Viskovich & Pakenham lend a lot of credibility to their findings from their large sample size. With such a large sample size we can be more confident in the power of the effect observed in the study and that their sample is representative of their wider population. Consequently, we can be relatively assured that the effects observed in this study can be generalised to the wider Australian undergraduate population. The more pressing question is whether similar results are found across different cultures? So far, it’s a tentative ‘yes.’ Studies conducted in the UK (Pots et al., 2016), Finland (Räsänen, Lappalainen, Muotka, Tolvanen, & Lappalainen, 2016) and Iran (Zolfaghari, Bahrami, & Ghanji, 2018) have found similar results, providing further evidence for ACT being an effective therapy course for use in universities. Furthermore, a similar programme has already been trialled in a convenient smartphone app (Krafft, Potts, Schoendorff, & Levin, 2017) and as many of us adjust to blended learning formats, web-based therapy courses may be an excellent way of supporting students during these trying times.


There’s no doubt that the research study could have been improved with the addition of an active control condition but with such encouraging results and consistency of findings, chances are we’ll see more ACT-based therapy courses integrated into university well-being services and beyond. If you’re interested in learning about ACT, then we would recommend Acceptance and Commitment Therapy: 100 Key Points and Techniques by Richard Bennett and Joe Oliver.

References

Harris, R. (2013). Getting unstuck in ACT: A clinician's guide to overcoming common obstacles in acceptance and commitment therapy. New Harbinger Publications.

Hayes, S. (2004). Acceptance and Commitment Therapy, Relational Frame Theory, and the Third Wave of Behavioural and Cognitive Therapies, Behaviour Therapy, 35(4), pp. 639-665.

Krafft, J., Potts, S., Schoendorff, B., & Levin, M. E. (2019). A randomized controlled trial of multiple versions of an acceptance and commitment therapy matrix app for well-being. Behavior modification, 43(2), 246-272.

Pots, W. T. M., Fledderus, M., Meulenbeek, P. A. M., ten Klooster, P. M., Schreurs, K. M. G., & Bohlmeijer, E. T. (2016). Acceptance and Commitment Therapy as a Web-based Intervention for Depressive Symptoms: Randomised Controlled Trial, The British Journal of Psychiatry, 208, pp. 69-77.

Räsänen, P., Lappalainen, P., Muotka, J., Tolvanen, A., & Lappalainen, R. (2016). An online guided ACT intervention for enhancing the psychological wellbeing of university students: A randomized controlled clinical trial. Behaviour research and therapy, 78, 30-42.

Viskovich, S., & Pakenham, K. I. (2018). Pilot evaluation of a web‐based acceptance and commitment therapy program to promote mental health skills in university students. Journal of Clinical Psychology, 74(12), 2047-2069.

Zolfaghari, A., Bahrami, H., & Ganji, K. (2018). Effect of an Integrated Cognitive-Behavioral, Acceptance, and Commitment Intervention on Generalized Anxiety Disorder among University Students. J Educ Community Health, 4(4), 32-38.