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A self-help based Acceptance and Commitment Therapy programme using Internet delivery: effect on adults intending to work who have utilized their sick leave due to depressive symptoms

Maki Tei-Tominaga


Rationale: The aim of this study was to develop a self-help based Acceptance and Commitment Therapy (ACT) programme using Internet delivery, which can be practised at the workplace or at home and to examine its effect on adults intending to work who have utilized their sick leave due to depressive symptoms.

Method: A one-group, baseline-to-post-intervention design was utilized with participants in Japan. Among the participants (N = 35), 26 completed the self-help based programme and answered all questionnaire surveys on 3 occasions: baseline (T1), after 3 weeks (T2) and after 6 weeks when the programme ended (T3). As the primary outcome, depressive symptoms were assessed using the Zung Self-Rating Depression Scale. As the secondary outcome, psychological flexibility was assessed using the Japanese version of the revised Acceptance and Action Questionnaire. Additionally, 3 items to assess process were administered and participants’ written comments were organized by content.

Results: Although the number of participants who showed mild and moderate depressed states decreased, depressive symptom scores did not significantly change over time. Psychological flexibility at T3 significantly improved compared to baseline, while the effect size was relatively low (Cohen’s d = 0.35). One of the scores from the process measures showed a significant difference between T2 and T3. There were 5 positive and 5 negative comments.

Conclusions: Along with participants’ comments, the findings suggested the effectiveness of the self-help based ACT programme using Internet delivery. This has the potential to help develop mindfulness and acceptance skills in adults who are intending to return to work after taking sick leave for depressive symptoms.


Acceptance and Commitment Therapy (ACT), adult, depressive symptoms, Internet, mental health, mindfulness, person-centered healthcare, psychological flexibility, return to work programme, self-help, sick leave

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