Acceptance and commitment therapy (ACT) among U.S. veterans: A systematic review

Abstract

Veterans of the United States military represent a large sample of the population and a distinctive culture. Veterans have a high prevalence rate of a variety of psychological disorders and disabilities. Research on treatments that meet the needs of this culturally unique group is essential. Acceptance and Commitment Therapy (ACT) may meet this need with its unified treatment approach and its focus on functioning rather than diagnosis. In this study we examine the current state of the literature of ACT for U.S. Veterans. A systematic review of 249 papers found 34 unique relevant studies involving 21 single arm studies, eight randomized clinical trials, two non-randomized controlled trials, and three case studies that met inclusion criteria. Overall, results suggest ACT is a promising intervention for Veterans across multiple conditions (e.g., anxiety disorders, depression, chronic pain) as well as intervention delivery (in-person and telehealth) and type (group and individual therapy). Limitations highlighted include recruitment methods of studies included, lack of active control conditions, and the limited number of randomized trials. Future researchers should continue to examine which presentations respond to ACT and seek to understand what types of adaptations may be necessary to increase the effectiveness of ACT for U.S. Veterans.