Cognitive Fusion, Emotional Distress, Experiential Avoidance, Psychological Flexibility, Psychological Well-Being
Conditions
Keywords
Acceptance and Commitment Therapy, Psychological Flexibility, Single-Case Experimental Design, Brief Psychological Intervention, Mental Health
Brief summary
The goal of this clinical trial is to evaluate the effects of a brief Acceptance and Commitment Therapy (ACT)-based group intervention on psychological flexibility, values-based functioning, and psychological well-being in university students aged 18 to 28 years presenting elevated levels of emotional distress and psychological risk indicators. The main questions it aims to answer are: Does a brief ACT-based intervention reduce experiential avoidance and cognitive fusion in university students? Does the intervention improve present-moment awareness, values-based functioning, life satisfaction, and psychological flourishing? Participants will: Complete repeated self-report assessments across 13 measurement points distributed throughout baseline, intervention, and follow-up phases. Participate in five weekly ACT-based group intervention sessions delivered by trained clinical psychologists. Engage in experiential ACT exercises focused on acceptance, mindfulness, cognitive defusion, values clarification, and committed action. Complete between-session activities and behavioral practices related to the ACT processes addressed during the intervention. Participate in follow-up assessments to evaluate maintenance of treatment effects over time.
Detailed description
University students frequently experience elevated levels of emotional distress, including symptoms of anxiety, depression, stress, worry, and psychological maladjustment. Brief interventions based on Acceptance and Commitment Therapy (ACT) have shown promising results in reducing experiential avoidance and cognitive fusion while promoting psychological flexibility and well-being. The present study evaluates the effects of a brief ACT-based intervention protocol delivered in a group format using a Single-Case Experimental Design (SCED) with repeated measurements across baseline, intervention, and follow-up phases. The intervention focuses on core ACT processes, including acceptance, cognitive defusion, present-moment awareness, values clarification, and committed action. Participants completed repeated assessments of psychological flexibility processes and well-being indicators across thirteen measurement points distributed throughout the study phases. The investigators hypothesize that the ACT-based intervention will produce reductions in experiential avoidance and cognitive fusion, together with improvements in present-moment awareness, values-based functioning, life satisfaction, and flourishing.
Interventions
BEHAVIORALAcceptance and Commitment Therapy (ACT)-Based Brief Group Intervention
The intervention consisted of a brief group-based Acceptance and Commitment Therapy (ACT) protocol designed to promote psychological flexibility and psychological well-being in university students presenting elevated emotional distress and psychological risk indicators. The protocol was grounded in the functional contextual approach and targeted core ACT processes, including acceptance, cognitive defusion, present-moment awareness, values clarification, and committed action. Participants were organized into small groups of 5 to 8 individuals and attended five weekly intervention sessions conducted by trained clinical psychologists with at least five years of clinical experience. Prior to implementation, therapists completed specialized ACT training delivered by an expert clinician with extensive experience in Acceptance and Commitment Therapy. The intervention protocol included an initial preliminary session focused on motivational engagement, informed consent procedures, feedback rega
Sponsors
Universidad del Valle, Colombia
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Masking description
This was an open-label single-case experimental study. Participants, intervention providers, and investigators were aware of the intervention procedures, and no masking procedures were implemented.
Intervention model description
The study employed a Single-Case Experimental Design (SCED) with repeated longitudinal measurements across three phases: baseline, intervention, and follow-up. Participants completed thirteen repeated assessments distributed across the study phases. The intervention consisted of five weekly ACT-based group sessions focused on psychological flexibility processes.
Eligibility
Sex/Gender
ALL
Age
18 Years to 28 Years
Healthy volunteers
Yes
Inclusion criteria
University students aged 18 years or older Interest in strengthening mental health and psychological well-being Voluntary agreement to participate in the study High-risk scores on at least one of the following screening instruments: Depression Anxiety Stress Scales (DASS-21) General Health Questionnaire (GHQ-12) State Worry Questionnaire-11 (SWQ-11)
Exclusion criteria
Current psychological or psychiatric treatment Current use of psychiatric medication Diagnosis related to developmental or learning difficulties Failure to attend intervention sessions Incomplete participation in study assessments
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Mindful Attention Awareness Scale (MAAS) | Weekly during baseline (4 weeks), intervention (6 weeks), and follow-up (3 weeks), up to 13 weeks | The Mindful Attention Awareness Scale (MAAS) is a 15-item self-report questionnaire designed to assess present-moment attention and awareness in daily life. Items are rated on a 6-point Likert-type scale ranging from 1 ("almost always") to 6 ("almost never"). Total scores are calculated by summing item responses, with higher scores indicating greater mindfulness and present-moment awareness. |
| Acceptance and Action Questionnaire-II (AAQ-II) | Weekly during baseline (4 weeks), intervention (6 weeks), and follow-up (3 weeks), up to 13 weeks. | The Acceptance and Action Questionnaire-II (AAQ-II) is a 7-item self-report questionnaire designed to assess experiential avoidance and psychological inflexibility. Items are rated on a 7-point Likert-type scale ranging from 1 ("never true") to 7 ("always true"). Total scores are calculated by summing item responses, with higher scores indicating greater experiential avoidance and psychological inflexibility. |
| Cognitive Fusion Questionnaire (CFQ) | Weekly during baseline (4 weeks), intervention (6 weeks), and follow-up (3 weeks), up to 13 weeks. | The Cognitive Fusion Questionnaire (CFQ) is a 7-item self-report questionnaire designed to assess cognitive fusion. Items are rated on a 7-point Likert-type scale ranging from 1 ("never true") to 7 ("always true"). Total scores are calculated by summing item responses, with higher scores indicating greater cognitive fusion. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Valuing Questionnaire - Obstruction Subscale (VQ-Obstruction) | Weekly during baseline (4 weeks), intervention (6 weeks), and follow-up (3 weeks), up to 13 weeks. | The Valuing Questionnaire - Obstruction Subscale (VQ-Obstruction) is a 5-item self-report measure designed to assess barriers and interference with values-based living. Items are rated on a 7-point Likert-type scale ranging from 0 ("not at all true") to 6 ("completely true"). Higher scores indicate greater obstruction in valued living. |
| Satisfaction With Life Scale (SWLS) | Weekly during baseline (4 weeks), intervention (6 weeks), and follow-up (3 weeks), up to 13 weeks. | The Satisfaction With Life Scale (SWLS) is a 5-item self-report questionnaire designed to assess global life satisfaction. Items are rated on a 7-point Likert-type scale ranging from 1 ("strongly disagree") to 7 ("strongly agree"). Total scores are calculated by summing item responses, with higher scores indicating greater life satisfaction. |
| Flourishing Scale (FS) | Weekly during baseline (4 weeks), intervention (6 weeks), and follow-up (3 weeks), up to 13 weeks. | The Flourishing Scale (FS) is an 8-item self-report questionnaire designed to assess psychological flourishing, including meaning in life, interpersonal relationships, competence, and optimism. Items are rated on a 7-point Likert-type scale ranging from 1 ("strongly disagree") to 7 ("strongly agree"). Total scores are calculated by summing item responses, with higher scores indicating greater psychological flourishing. |
Countries
Colombia
Outcome results
None listed