Psychological FlexibilityNCT06139718
Examining the Efficacy of a Single Session Online Mental Health Program
A study testing ACT Guide Lite in people with Psychological Flexibility and Psychological Distress, run by Utah State University at 1 site in United States.
Trial summary
There is a large body of evidence demonstrating that Acceptance and Commitment Therapy (ACT) can be delivered in a self-guided format to improve mental health among college students. Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Psychological Flexibility, Psychological Distress, Psychological Well-Being
- What is being tested?
- ACT Guide Lite
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 61 participants
- Where
- 1 siteUnited States
- Study dates
- 8 Jan 2024to 17 May 2024
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- 18 years or older
- a current USU student
- not have used any of the USU ACT Guide programs before
Who cannot join
- NA
Trial locations and contacts
1 site in 1 country.
About this study
Official title: A Randomized Controlled Trial Examining the Efficacy of a Single Session Online Mental Health Program
There is a large body of evidence demonstrating that Acceptance and Commitment Therapy (ACT) can be delivered in a self-guided format to improve mental health among college students. However, previous research indicates there are challenges in engaging students in adhering to these time intensive, multi-session self-guided resources. Brief self-guided single session interventions could provide an accessible and acceptable intervention that is easier to adhere to, given their lower intensity and response effort for participation. This proposed study seeks to evaluate a single session online ACT Guide Lite intervention in a sample (n = 100) of Utah State University (USU) college students 18 years of age or older. A randomized controlled trial (RCT) design will be used in which students are randomized to receive ACT Guide Lite or to a waitlist condition in order to test the following predictions: (1) participants assigned to ACT Guide Lite will improve more on the primary therapeutic process of change, psychological flexibility, relative to those not receiving intervention, (2) participants assigned to ACT Guide Lite will improve more on distress, well-being, and interest in seeking help, relative to those not receiving intervention, (3) ACT Guide Lite will be acceptable to college students as indicated by recruitment rates, rates of completing ACT Guide Lite, and self-reported program satisfaction, and (4) areas for future program revisions will also be identified through participants' written feedback on their experiences using the program. USU students will be recruited to participate in the study through the SONA research platform in the Fall 2023 semester. All study procedures will be completed through the secure Qualtrics online research platform, in addition to email and phone contacts prompting relevant steps for the study. All analyses will be run with multilevel modeling with the full intent-to-treat sample to test time by condition interactions.
- Being tested
- ACT Guide Lite
- Medical subject headings
- Psychological Well-Being
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
ACT Guide LiteBehavioural
Also called Single session digital mental health intervention
ACT Guide Lite is a single session online mental health program that is designed to take 30-45 minutes to complete. The single session self-guided intervention includes a series of sections that teach key ACT skills.
| Study group | Role | What they receive |
|---|---|---|
| ACT Guide Lite | Experimental | Those randomly assigned to the ACT condition after completing baseline assessment will be automatically directed to the registration for ACT Guide Lite. Participants in the ACT condition will be asked to complete the intervention at that time, but they will have the option to take a break before starting. If an ACT participant does not complete the intervention, they will be prompted to login by a research assistant. Receives: Behavioral: ACT Guide Lite |
| Waitlist control | No intervention | Participants assigned to the waitlist condition will be asked to simply wait to complete the scheduled 1-week and 1-month follow up assessments before accessing the intervention. After they complete the 1-month follow up assessment we will direct participants in the waitlist to access ACT Guide Lite, but at that point their participation in the study will be complete and we will not analyze their use of or responses to the program as part of the study aims. |
What is being measured
The primary outcome is the main question the study is designed to answer.
CompACT (to assess psychological flexibility)
This 23-item measure will be used to measure the ACT process of change, psychological flexibility, including subscales for openness to experience, behavioral awareness, and valued action. The CompACT will serve as the primary outcome for this study in order to test whether a single session intervention is sufficient to target the ACT process of change of psychological flexibility.
Measured: baseline, 1-week follow-up, 1-month follow-up
Secondary outcomes (4)
Depression, Anxiety and Stress Scale (DASS-21)
This 21-item measure will be used to assess the subscales of depression, anxiety, and stress, with a total score representing overall psychological distress.
Measured: baseline, 1-week follow-up, 1-month follow-up
Mental Health Continuum - Short Form (MHC-SF; to assess positive mental health)
This 14-item measure assesses positive mental health, with a total score as well as subscales for emotional, psychological and social wellbeing.
Measured: baseline, 1-week follow-up, 1-month follow-up
General Help Seeking Questionnaire (GHSQ; to assess intention to seek help for a mental heath concern)
We will use an adapted version of the GHSQ as a measure of intentions to seek help for a mental health concern. This includes rating a variety of formal (e.g., psychologist, PCP) and informal supports (e.g., friends, family) on a 7-point scale from 1 "extremely likely" to 7 "extremely unlikely." We previously adapted the GHSQ for a prior lab study (Levin et al., 2018) by adding options for self-help/online treatment resources and we have found this measure to be sensitive to detecting the effects of online ACT on increasing intentions to seek treatment (Davis, Donahue, et al., under review).
Measured: baseline, 1-week follow-up, 1-month follow-up
Program satisfaction (Responses to a series of single item Likert-scale items about satisfaction with the intervention)
A series of program satisfaction items will be asked in the ACT condition immediately post-intervention and at 1-week and 1-month follow up based on items used in our previous online ACT trials (Levin et al., 2020). This will include a series of items assessing features of program satisfaction (e.g., overall satisfaction, helpfulness, perceived fit, if the program was too short or long, etc…) on a scale from 1 (strongly disagree) to 6 (strongly agree). In addition, participants will be asked to type responses to open ended questions assessing what they learned from the program and areas needing further revision.
Measured: 1-week follow-up, 1-month follow-up
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted18 Nov 2023
- Study start8 Jan 2024
- Primary completion17 May 2024
- Study completion17 May 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (19)Papers the sponsor has linked to this study.
- Other trials for Psychological FlexibilityStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 61 participants (actual)
Sponsor and investigators
- Lead sponsor
- Utah State University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Michael Levin, Utah State University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06139718
- Sponsor's protocol ID
- IRB: #13673
- Status last verified
- Mar 2025
- First submitted
- 14 Nov 2023
- Last updated
- 28 Mar 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Davis CH, Donahue ML, Gaudiano BA, Uebelacker LA, Twohig MP, Levin ME. Adding online storytelling-based acceptance and commitment therapy to antidepressant treatment for primary care patients: a randomized clinical trial. Cogn Behav Ther. 2024 Jan;53(1):48-69. doi: 10.1080/16506073.2023.2265560. Epub 2024 Jan 2.
PubMed 37855277Davis CH, Klimczak K, Aller TB, Twohig MP, Levin ME. Reach, adoption, and maintenance of online acceptance and commitment therapy at a university: An implementation case study. Psychol Serv. 2024 May;21(2):355-361. doi: 10.1037/ser0000834. Epub 2024 Jan 8.
PubMed 38190219Davis CH, Twohig MP, Levin ME. Choosing ACT or CBT: A preliminary test of incorporating client preferences for depression treatment with college students. J Affect Disord. 2023 Mar 15;325:413-420. doi: 10.1016/j.jad.2022.12.097. Epub 2023 Jan 4.
PubMed 36608854Dochat C, Wooldridge JS, Herbert MS, Lee MW, Afari N. Single-Session Acceptance and Commitment Therapy (ACT) Interventions for Patients with Chronic Health Conditions: A Systematic Review and Meta-Analysis. J Contextual Behav Sci. 2021 Apr;20:52-69. doi: 10.1016/j.jcbs.2021.03.003. Epub 2021 Mar 6.
PubMed 33868913Firestone, J., Cardaciotto, L., Levin, M.E., Goldbacher, E., Vernig, P. & Gambrel, L.E. (2019). A web-based self-guided program to promote valued-living in college students: A pilot study. Journal of Contextual Behavioral Science, 12, 29-38.
Francis, A. W., Dawson, D. L., & Golijani-Moghaddam, N. (2016). The development and validation of the Comprehensive assessment of Acceptance and Commitment Therapy processes (CompACT). Journal of Contextual Behavioral Science, 5(3), 134-145. doi:10.1016/j.jcbs.2016.05.003
Henriques, C.A., Cardaciotto, L., Levin, M.E. & Armstrong, S.L. (2020). Implementing a web-based cognitive defusion program to target negative self-referential thoughts in college students: A pilot study. Journal of Contextual Behavioral Science, 16, 183-191.
Keyes CL. Mental illness and/or mental health? Investigating axioms of the complete state model of health. J Consult Clin Psychol. 2005 Jun;73(3):539-48. doi: 10.1037/0022-006X.73.3.539.
PubMed 15982151Klimczak KS, San Miguel GG, Mukasa MN, Twohig MP, Levin ME. A systematic review and meta-analysis of self-guided online acceptance and commitment therapy as a transdiagnostic self-help intervention. Cogn Behav Ther. 2023 May;52(3):269-294. doi: 10.1080/16506073.2023.2178498. Epub 2023 Feb 27.
PubMed 36847182Klimczak KS, Twohig MP, Peacock GG, Levin ME. Using peer-support coaching to improve adherence to online ACT self-help for college mental health: A randomized controlled trial. Behav Res Ther. 2023 Jan;160:104228. doi: 10.1016/j.brat.2022.104228. Epub 2022 Nov 13.
PubMed 36455430Krafft, J., Twohig, M.P., & Levin, M.E. (2020). A randomized trial of acceptance and commitment therapy and traditional cognitive-behavioral therapy self-help books for social anxiety. Cognitive Therapy and Research, 44, 954-966.
Levin, M.E., An, W., Davis, C. & Twohig, M.P. (2020). Evaluating acceptance and commitment therapy and mindfulness-based stress reduction self-help books for college student mental health. Mindfulness, 11, 1275-1288.
Levin ME, Haeger JA, Pierce BG, Twohig MP. Web-Based Acceptance and Commitment Therapy for Mental Health Problems in College Students: A Randomized Controlled Trial. Behav Modif. 2017 Jan 1;41(1):141-162. doi: 10.1177/0145445516659645. Epub 2016 Jul 20.
PubMed 27440189Levin ME, Krafft J, Hicks ET, Pierce B, Twohig MP. A randomized dismantling trial of the open and engaged components of acceptance and commitment therapy in an online intervention for distressed college students. Behav Res Ther. 2020 Mar;126:103557. doi: 10.1016/j.brat.2020.103557. Epub 2020 Jan 22.
PubMed 32014692Levin ME, Pistorello J, Seeley JR, Hayes SC. Feasibility of a prototype web-based acceptance and commitment therapy prevention program for college students. J Am Coll Health. 2014;62(1):20-30. doi: 10.1080/07448481.2013.843533.
PubMed 24313693
Study at a glance
From the registry record, last updated by the sponsor on 28 Mar 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Randomized Controlled Trial Examining the Efficacy of a Single Session Online Mental Health Program
- ClinicalTrials.gov ID
- NCT06139718
- Acronym / sponsor ID
- IRB: #13673
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 61 participants (actual)
- Lead sponsor
- Utah State UniversityUniversity, hospital or other
- Study start
- 8 Jan 2024 (actual)
- Primary completion
- 17 May 2024 (actual)
- Study completion
- 17 May 2024 (actual)
- First posted
- 18 Nov 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
There is a large body of evidence demonstrating that Acceptance and Commitment Therapy (ACT) can be delivered in a self-guided format to improve mental health among college students. However, previous research indicates there are challenges in engaging students in adhering to these time intensive, multi-session self-guided resources. Brief self-guided single session interventions could provide an accessible and acceptable intervention that is easier to adhere to, given their lower intensity and response effort for participation. This proposed study seeks to evaluate a single session online ACT Guide Lite intervention in a sample (n = 100) of Utah State University (USU) college students 18 years of age or older. A randomized controlled trial (RCT) design will be used in which students are randomized to receive ACT Guide Lite or to a waitlist condition in order to test the following predictions: (1) participants assigned to ACT Guide Lite will improve more on the primary therapeutic process of change, psychological flexibility, relative to those not receiving intervention, (2) participants assigned to ACT Guide Lite will improve more on distress, well-being, and interest in seeking help, relative to those not receiving intervention, (3) ACT Guide Lite will be acceptable to college students as indicated by recruitment rates, rates of completing ACT Guide Lite, and self-reported program satisfaction, and (4) areas for future program revisions will also be identified through participants' written feedback on their experiences using the program. USU students will be recruited to participate in the study through the SONA research platform in the Fall 2023 semester. All study procedures will be completed through the secure Qualtrics online research platform, in addition to email and phone contacts prompting relevant steps for the study. All analyses will be run with multilevel modeling with the full intent-to-treat sample to test time by condition interactions.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| ACT Guide Lite | Experimental | Behavioral: ACT Guide LiteThose randomly assigned to the ACT condition after completing baseline assessment will be automatically directed to the registration for ACT Guide Lite. Participants in the ACT condition will be asked to complete the intervention at that time, but they will have the option to take a break before starting. If an ACT participant does not complete the intervention, they will be prompted to login by a research assistant. |
| Waitlist control | No intervention | –Participants assigned to the waitlist condition will be asked to simply wait to complete the scheduled 1-week and 1-month follow up assessments before accessing the intervention. After they complete the 1-month follow up assessment we will direct participants in the waitlist to access ACT Guide Lite, but at that point their participation in the study will be complete and we will not analyze their use of or responses to the program as part of the study aims. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- 18 years or older
- a current USU student
- not have used any of the USU ACT Guide programs before
Key exclusion criteria (1 listed)
- NA
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| ACT Guide LiteAlso: Single session digital mental health interventionACT Guide Lite is a single session online mental health program that is designed to take 30-45 minutes to complete. The single session self-guided intervention includes a series of sections that teach key ACT skills. | Behavioural | ACT Guide Lite |
Primary outcome
CompACT (to assess psychological flexibility)
Time frame: baseline, 1-week follow-up, 1-month follow-up
This 23-item measure will be used to measure the ACT process of change, psychological flexibility, including subscales for openness to experience, behavioral awareness, and valued action. The CompACT will serve as the primary outcome for this study in order to test whether a single session intervention is sufficient to target the ACT process of change of psychological flexibility.
4 secondary outcomes
Depression, Anxiety and Stress Scale (DASS-21)
Time frame: baseline, 1-week follow-up, 1-month follow-up
Mental Health Continuum - Short Form (MHC-SF; to assess positive mental health)
Time frame: baseline, 1-week follow-up, 1-month follow-up
General Help Seeking Questionnaire (GHSQ; to assess intention to seek help for a mental heath concern)
Time frame: baseline, 1-week follow-up, 1-month follow-up
Program satisfaction (Responses to a series of single item Likert-scale items about satisfaction with the intervention)
Time frame: 1-week follow-up, 1-month follow-up
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 28 Mar 2025.
- Background: PubMed 37855277Davis CH, Donahue ML, Gaudiano BA, Uebelacker LA, Twohig MP, Levin ME. Adding online storytelling-based acceptance and commitment therapy to antidepressant treatment for primary care patients: a randomized clinical trial. Cogn Behav Ther. 2024 Jan;53(1):48-69. doi: 10.1080/16506073.2023.2265560. Epub 2024 Jan 2.
- Background: PubMed 38190219Davis CH, Klimczak K, Aller TB, Twohig MP, Levin ME. Reach, adoption, and maintenance of online acceptance and commitment therapy at a university: An implementation case study. Psychol Serv. 2024 May;21(2):355-361. doi: 10.1037/ser0000834. Epub 2024 Jan 8.
- Background: PubMed 36608854Davis CH, Twohig MP, Levin ME. Choosing ACT or CBT: A preliminary test of incorporating client preferences for depression treatment with college students. J Affect Disord. 2023 Mar 15;325:413-420. doi: 10.1016/j.jad.2022.12.097. Epub 2023 Jan 4.
- Background: PubMed 33868913Dochat C, Wooldridge JS, Herbert MS, Lee MW, Afari N. Single-Session Acceptance and Commitment Therapy (ACT) Interventions for Patients with Chronic Health Conditions: A Systematic Review and Meta-Analysis. J Contextual Behav Sci. 2021 Apr;20:52-69. doi: 10.1016/j.jcbs.2021.03.003. Epub 2021 Mar 6.
- BackgroundFirestone, J., Cardaciotto, L., Levin, M.E., Goldbacher, E., Vernig, P. & Gambrel, L.E. (2019). A web-based self-guided program to promote valued-living in college students: A pilot study. Journal of Contextual Behavioral Science, 12, 29-38.
- BackgroundFrancis, A. W., Dawson, D. L., & Golijani-Moghaddam, N. (2016). The development and validation of the Comprehensive assessment of Acceptance and Commitment Therapy processes (CompACT). Journal of Contextual Behavioral Science, 5(3), 134-145. doi:10.1016/j.jcbs.2016.05.003
- BackgroundHenriques, C.A., Cardaciotto, L., Levin, M.E. & Armstrong, S.L. (2020). Implementing a web-based cognitive defusion program to target negative self-referential thoughts in college students: A pilot study. Journal of Contextual Behavioral Science, 16, 183-191.
- Background: PubMed 15982151Keyes CL. Mental illness and/or mental health? Investigating axioms of the complete state model of health. J Consult Clin Psychol. 2005 Jun;73(3):539-48. doi: 10.1037/0022-006X.73.3.539.
- Background: PubMed 36847182Klimczak KS, San Miguel GG, Mukasa MN, Twohig MP, Levin ME. A systematic review and meta-analysis of self-guided online acceptance and commitment therapy as a transdiagnostic self-help intervention. Cogn Behav Ther. 2023 May;52(3):269-294. doi: 10.1080/16506073.2023.2178498. Epub 2023 Feb 27.
- Background: PubMed 36455430Klimczak KS, Twohig MP, Peacock GG, Levin ME. Using peer-support coaching to improve adherence to online ACT self-help for college mental health: A randomized controlled trial. Behav Res Ther. 2023 Jan;160:104228. doi: 10.1016/j.brat.2022.104228. Epub 2022 Nov 13.
- BackgroundKrafft, J., Twohig, M.P., & Levin, M.E. (2020). A randomized trial of acceptance and commitment therapy and traditional cognitive-behavioral therapy self-help books for social anxiety. Cognitive Therapy and Research, 44, 954-966.
- BackgroundLevin, M.E., An, W., Davis, C. & Twohig, M.P. (2020). Evaluating acceptance and commitment therapy and mindfulness-based stress reduction self-help books for college student mental health. Mindfulness, 11, 1275-1288.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing ACT Guide Lite in people with Psychological Flexibility and Psychological Distress, run by Utah State University at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 28 Mar 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
CompACT (to assess psychological flexibility) (time frame: baseline, 1-week follow-up, 1-month follow-up). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06139718, which also lists 19 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 28 Mar 2025.