Effectiveness of Acceptance and Commitment Therapy in Adolescents: A Systematic Review

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Published: Apr 30, 2025
DOI: https://doi.org/10.28932/humanitas.v9i1.10566
Keywords:
Acceptance and commitment therapy, remaja, terapi Acceptance and commitment therapy, adolescents, therapy

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Anak Agung Sri Sanjiwani
STIKES Wira Medika Bali, Denpasar, Indonesia
Ni Luh Khrisna Ratna Sari
Klinik Utama Sidanta Denpasar, Indonesia

Abstract

The dynamics of the developmental process in adolescence not only involve physical changes but also require adjustments in terms of psychological and social. This study aims to examine the effect of ACT (Acceptance and Commitment Therapy) as a therapy for adolescents on mental and physical health problems including cognitive, emotional and behavioural aspects. The method used was Systematic Literature Review using 4 databases including Science Direct, PubMed, Springer Link, and Scopus, and critical appraisal was carried out and resulted in 7 literatures with the category of adolescents aged 10-21 years. The results show that based on the 7 literatures that have been reviewed, ACT is proven to be effective as a therapy for adolescents. Based on the diversity in the characteristics of adolescents studied, it shows that the application of ACT contributes positively to adolescents with ASD (autism spectrum disorder), SLD (specific learning disorder), obesity and mental health problems including psychological distress such as stress, anxiety, depression, self-defences mechanisms, flexibility in dealing with problems. Several factors that may be associated with the effectiveness of ACT therapy include the number of sessions, duration, media of presentation and self-assignment. Adolescents showed a positive effect on online and offline method at 4-8 sessions, duration of 30-90 minutes and delivery media involving pictorial media in ACT-online as well as flexibility in the time of therapy implementation.

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Sanjiwani, A. A. S., & Sari, N. L. K. R. (2025). Effectiveness of Acceptance and Commitment Therapy in Adolescents: A Systematic Review. Humanitas (Jurnal Psikologi), 9(1), 155–172. https://doi.org/10.28932/humanitas.v9i1.10566
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Vol. 9 No. 1 (2025)
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Articles
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

References

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Baveja, D., Shukla, J., & Srivastava, S. (2022). Utility of acceptance and commitment therapy among adolescents - A systematic review. Current Psychiatry Research and Reviews, 18(2), 108–124. https://doi.org/10.2174/2666082218666220301142201

Center for Reproductive Health, University of Queensland, & J. B. H. S. of P. H. (2022). Indonesia – National Adolescent Mental Health Survey (I-NAMHS): Laporan Penelitian.

Dara, S., & Arora, S. (2023). Adolescent health problems and strategies to improve them. International Journal of Community Medicine and Public Health, 10(7), 2645–2651. https://doi.org/https://doi.org/10.18203/2394-6040.ijcmph20232066

Das, J. K., Salam, R. A., Lassi, Z. R., Khan, M. N., Mahmoon, W., Patel, V., & Bhutta, Z. A. (2016). Intervention for Adolescent Mental Health: An Overview of Systematic Reviews. Journal of Adolescent Health, 59, 549–560.

Dixon, M. R., Hayes, S. ., & Belisle, J. (2023). Acceptance and commitment therapy for behavior analysts. Routledge.

Doorley, J. D., Goodman, F. R., Kelso, K. C., & Kashdan, T. B. (2020). Psychological flexibility: What we know, what we do not know, and what we think we know. Social and Personality Psychology Compass, 14(12), 1–11. https://doi.org/10.1111/spc3.12566

Döpfner, M., & Hanisch, C. (2020). Psychological Treatment of Mental Health Problems in Children and Adolescents. In Mental Health and Illness of Children and Adolescents (pp. 575–590). Springer Nature Singapore Ltd. https://doi.org/10.1007/978-981-10-2348-4_48

Fatemi, V. A., Abadi, A. S., Khalatbari, J., & Farhangi, A. (2022). The effectiveness of Cognitive-behavioral therapy on self-harming thoughts and psychological well-being in students’ dissolution of romantic relationships. Applied Family Therapy Journal, 3(4), 150–168. https://doi.org/10.61838/kman.aftj.3.4.9

Garcia, Y., Keller-Collins, A., Andrews, M., Kurumiya, Y., Imlay, K., Umphrey, B., & Foster, E. (2022). Systematic Review of Acceptance and Commitment Therapy in Individuals with Neurodevelopmental Disorders, Caregivers, and Staff. Behavior Modification, 46(5), 1236–1274. https://doi.org/10.1177/01454455211027301

Hämäläinen, T., Lappalainen, P., Puolakanaho, A., Lappalainen, R., & Kiuru, N. (2023). A guided online ACT intervention may increase psychological well-being and support school engagement in adolescents. Journal of Contextual Behavioral Science, 27(December 2022), 152–159. https://doi.org/10.1016/j.jcbs.2023.02.002

Hayes, S. C., & King, G. A. (2024). Acceptance and commitment therapy: What the history of ACT and the first 1,000 randomized controlled trials reveal. Journal of Contextual Behavioral Science, 33(December 2023), 100809. https://doi.org/10.1016/j.jcbs.2024.100809

Kementrian Republik Indonesia. (2018). Hasil Riset Kesehatan Dasar Tahun 2018.

Khurshid, S., Manzoor, S., & Amin, F. (2024). Adolescents and Psychosocial Issues: An Empirical Study. Adolescents and Psychosocial Issues: An Empirical Study, 26(1). https://doi.org/https://doi.org/10.1177/09720634231223629

Kusumawardhani, S. J., & Poerwandari, E. K. (2019). Efektivitas Acceptance Commitment Therapy dalam Meningkatkan Subjective Well-Being pada Dewasa Muda Pasca Putusnya Hubungan Pacaran. Jurnal Ilmiah Psikologi MIND SET, 9(1), 78–97. https://doi.org/https://doi.org/10.35814/mindset.v9i01.727

Lappalainen, P., Lappalainen, R., Keinonen, K., Kaipainen, K., Puolakanaho, A., Muotka, J., & Kiuru, N. (2023). In the shadow of COVID-19: A randomized controlled online ACT trial promoting adolescent psychological flexibility and self-compassion. Journal of Contextual Behavioral Science, 27, 33–44. https://doi.org/10.1016/j.jcbs.2022.12.001

Ma, J., Ji, L., & Lu, G. (2023). Adolescents’ experiences of acceptance and commitment therapy for depression: An interpretative phenomenological analysis of good-outcome cases. Frontiers in Psychology, 14(March), 1–9. https://doi.org/10.3389/fpsyg.2023.1050227

Moazzezi, M., Moghanloo, V. A., Moghanloo, R. A., & Pishvaei, M. (2015). Impact of cceptance and commitment therapy on perceived stress and special health self-efficacy in seven to fifteen-year-old children with diabetes Mellitus. Iran J Psychiatry Behav Sci, 9(2).

Moghanloo, V. A., Moghanloo, R. A., & Moazzezi, M. (2015). Effectiveness of acceptance and commitment therapy for depression, psychological well-being and feeling of guilt in 7 - 15 years Old diabetic children. Iran J Pediatry, 25(4).

Mousavi, S. S., Molanorouzi, K., Shojaei, M., & Bahari, S. M. (2023). Physical activity plus acceptance and commitment therapy can decrease anxiety Symptoms and insomnia severity among individuals with poor sleep quality. Sleep Medicine Research, 14(2), 88–97. https://doi.org/10.17241/smr.2022.01543

Nebhinani, N., & Jain, S. (2019). Adolescent mental health: Issues, challenges, and solutions. Annals of Indian Psychiatry, 3(1), 4. https://doi.org/https://doi.org/10.4103/aip.aip_24_19

Nemati, S., Pourtaleb, N., Badrigargari, R., Hashemi, T., Deetjen, R., & Shojaeian, N. (2022). The Effectiveness of Acceptance and Commitment Training Program on the Level of Academic Stress and Academic Burnout in Students with Specific Learning Disability. Advances in Neurodevelopmental Disorders. https://doi.org/DOI:10.1007/s41252-022-00307-0

Pahnke, J., Lundgren, T., Hursti, T., & Hirvikoski, T. (2014). Outcomes of an acceptance and commitment therapy-based skills training group for students with high-functioning autism spectrum disorder: A quasi-experimental pilot study. Autism, 18(8), 953–964. https://doi.org/10.1177/1362361313501091

Petersen, J. M., Ona, P. Z., & Twohig, M. P. (2024). A Review of acceptance and commitment therapy for adolescents: developmental and contextual considerations. Cognitive and Behavioral Practice, 31(1), 72–89. https://doi.org/https://doi.org/10.1016/j.cbpra.2022.08.002

Petersen, J. M., & Pimentel, S. S. (2024). Acceptance and Commitment Therapy for Insomnia. Acceptance and Commitment Therapy for Insomnia, 366–372. https://doi.org/10.1007/978-3-031-50710-6

Pitil, P., P., & Ghazali, S. R. (2023). The impact of acceptance and commitment therapy (ACT) on the psychological defense mechanism and weight loss program: A randomized controlled trial among university students during COVID-19 movement control order. Journal of Contextual Behavioral Science, 29, 171–181.

Pramudita, F. A., Daulima, N. H. C., & Hargiana, G. (2024). Reducing Anxiety with Acceptance and Commitment Therapy (ACT) in Hypertensive Clients. Jurnal Keperawatan Sumba (JKS), 2(2), 50–57. https://doi.org/https://doi.org/10.31965/jks.v2i2.1416

Refanthira, N., & Hasanah, U. (2020). Adolescent problem in psychology: A review of adolescent mental health studies. Proceedings of the 5th ASEAN Conference on Psychology, Counselling, and Humanities. https://doi.org/https://doi.org/10.2991/assehr.k.200120.004

Salik, S., Sadiq, M., & Masroor, U. (2022). Specific Learning Disorder (Sld) and Associated Psychosocial Difficulties in Emerging Adolescents: an Exploratory Study. Pakistan Journal of Social Research, 04(04), 366–374. https://doi.org/10.52567/pjsr.v4i04.820

Santrock, J. W. (2016). Adolescence (16th Ed). Mc Graw Hill Education.

Sappenfield, O., Alberto, C., Minnaert, J., Donney, J., Lebrun-Harris, L., & Ghandour, R. (2024). Adolescent mental and behavioral health 2023.

Sulistiyowati, L., Keliat, B. A., & Hargiatna, G. (2023). Manfaat Intervensi Acceptance and Commitment Therapy dalam Menurunkan Kecemasan dan Perilaku Adiktif pada Pasien NAPZA. Jurnal Keperawatan Silampari, 6(2), 1664–1671. https://doi.org/https://doi.org/10.31539/jks.v6i2.5737

Takahashi, F., Ishizu, K., Matsubara, K., Ohtsuki, T., & Shimoda, Y. (2020). Acceptance and commitment therapy as a school-based group intervention for adolescents: An open-label trial. Journal of Contextual Behavioral Science, 16(February), 71–79. https://doi.org/10.1016/j.jcbs.2020.03.001

Tayyebi, G., Alwan, N. H., Hamed, A. F., Shallal, A. A., Abdulrazzaq, T., & Khayayi, R. (2024). Application of Acceptance and Commitment Therapy (ACT) in Children and Adolescents Psychotherapy: An Umbrella Review. Iranian Journal of Psychiatry, 19(3), 337–343. https://doi.org/10.18502/ijps.v19i3.15809

Trompetter, H. R., Bohlmeijer, E. T., Fox, J.-P., & Schreurs, K. M. G. (2015). Psychological flexibility and catastrophizing as associated change mechanisms during online Acceptance & Commitment Therapy for chronic pain. Behaviour Research and Therapy, 74, 50–59.

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Baveja, D., Shukla, J., & Srivastava, S. (2022). Utility of acceptance and commitment therapy among adolescents - A systematic review. Current Psychiatry Research and Reviews, 18(2), 108–124. https://doi.org/10.2174/2666082218666220301142201

Center for Reproductive Health, University of Queensland, & J. B. H. S. of P. H. (2022). Indonesia – National Adolescent Mental Health Survey (I-NAMHS): Laporan Penelitian.

Dara, S., & Arora, S. (2023). Adolescent health problems and strategies to improve them. International Journal of Community Medicine and Public Health, 10(7), 2645–2651. https://doi.org/https://doi.org/10.18203/2394-6040.ijcmph20232066

Das, J. K., Salam, R. A., Lassi, Z. R., Khan, M. N., Mahmoon, W., Patel, V., & Bhutta, Z. A. (2016). Intervention for Adolescent Mental Health: An Overview of Systematic Reviews. Journal of Adolescent Health, 59, 549–560.

Dixon, M. R., Hayes, S. ., & Belisle, J. (2023). Acceptance and commitment therapy for behavior analysts. Routledge.

Doorley, J. D., Goodman, F. R., Kelso, K. C., & Kashdan, T. B. (2020). Psychological flexibility: What we know, what we do not know, and what we think we know. Social and Personality Psychology Compass, 14(12), 1–11. https://doi.org/10.1111/spc3.12566

Döpfner, M., & Hanisch, C. (2020). Psychological Treatment of Mental Health Problems in Children and Adolescents. In Mental Health and Illness of Children and Adolescents (pp. 575–590). Springer Nature Singapore Ltd. https://doi.org/10.1007/978-981-10-2348-4_48

Fatemi, V. A., Abadi, A. S., Khalatbari, J., & Farhangi, A. (2022). The effectiveness of Cognitive-behavioral therapy on self-harming thoughts and psychological well-being in students’ dissolution of romantic relationships. Applied Family Therapy Journal, 3(4), 150–168. https://doi.org/10.61838/kman.aftj.3.4.9

Garcia, Y., Keller-Collins, A., Andrews, M., Kurumiya, Y., Imlay, K., Umphrey, B., & Foster, E. (2022). Systematic Review of Acceptance and Commitment Therapy in Individuals with Neurodevelopmental Disorders, Caregivers, and Staff. Behavior Modification, 46(5), 1236–1274. https://doi.org/10.1177/01454455211027301

Hämäläinen, T., Lappalainen, P., Puolakanaho, A., Lappalainen, R., & Kiuru, N. (2023). A guided online ACT intervention may increase psychological well-being and support school engagement in adolescents. Journal of Contextual Behavioral Science, 27(December 2022), 152–159. https://doi.org/10.1016/j.jcbs.2023.02.002

Hayes, S. C., & King, G. A. (2024). Acceptance and commitment therapy: What the history of ACT and the first 1,000 randomized controlled trials reveal. Journal of Contextual Behavioral Science, 33(December 2023), 100809. https://doi.org/10.1016/j.jcbs.2024.100809

Kementrian Republik Indonesia. (2018). Hasil Riset Kesehatan Dasar Tahun 2018.

Khurshid, S., Manzoor, S., & Amin, F. (2024). Adolescents and Psychosocial Issues: An Empirical Study. Adolescents and Psychosocial Issues: An Empirical Study, 26(1). https://doi.org/https://doi.org/10.1177/09720634231223629

Kusumawardhani, S. J., & Poerwandari, E. K. (2019). Efektivitas Acceptance Commitment Therapy dalam Meningkatkan Subjective Well-Being pada Dewasa Muda Pasca Putusnya Hubungan Pacaran. Jurnal Ilmiah Psikologi MIND SET, 9(1), 78–97. https://doi.org/https://doi.org/10.35814/mindset.v9i01.727

Lappalainen, P., Lappalainen, R., Keinonen, K., Kaipainen, K., Puolakanaho, A., Muotka, J., & Kiuru, N. (2023). In the shadow of COVID-19: A randomized controlled online ACT trial promoting adolescent psychological flexibility and self-compassion. Journal of Contextual Behavioral Science, 27, 33–44. https://doi.org/10.1016/j.jcbs.2022.12.001

Ma, J., Ji, L., & Lu, G. (2023). Adolescents’ experiences of acceptance and commitment therapy for depression: An interpretative phenomenological analysis of good-outcome cases. Frontiers in Psychology, 14(March), 1–9. https://doi.org/10.3389/fpsyg.2023.1050227

Moazzezi, M., Moghanloo, V. A., Moghanloo, R. A., & Pishvaei, M. (2015). Impact of cceptance and commitment therapy on perceived stress and special health self-efficacy in seven to fifteen-year-old children with diabetes Mellitus. Iran J Psychiatry Behav Sci, 9(2).

Moghanloo, V. A., Moghanloo, R. A., & Moazzezi, M. (2015). Effectiveness of acceptance and commitment therapy for depression, psychological well-being and feeling of guilt in 7 - 15 years Old diabetic children. Iran J Pediatry, 25(4).

Mousavi, S. S., Molanorouzi, K., Shojaei, M., & Bahari, S. M. (2023). Physical activity plus acceptance and commitment therapy can decrease anxiety Symptoms and insomnia severity among individuals with poor sleep quality. Sleep Medicine Research, 14(2), 88–97. https://doi.org/10.17241/smr.2022.01543

Nebhinani, N., & Jain, S. (2019). Adolescent mental health: Issues, challenges, and solutions. Annals of Indian Psychiatry, 3(1), 4. https://doi.org/https://doi.org/10.4103/aip.aip_24_19

Nemati, S., Pourtaleb, N., Badrigargari, R., Hashemi, T., Deetjen, R., & Shojaeian, N. (2022). The Effectiveness of Acceptance and Commitment Training Program on the Level of Academic Stress and Academic Burnout in Students with Specific Learning Disability. Advances in Neurodevelopmental Disorders. https://doi.org/DOI:10.1007/s41252-022-00307-0

Pahnke, J., Lundgren, T., Hursti, T., & Hirvikoski, T. (2014). Outcomes of an acceptance and commitment therapy-based skills training group for students with high-functioning autism spectrum disorder: A quasi-experimental pilot study. Autism, 18(8), 953–964. https://doi.org/10.1177/1362361313501091

Petersen, J. M., Ona, P. Z., & Twohig, M. P. (2024). A Review of acceptance and commitment therapy for adolescents: developmental and contextual considerations. Cognitive and Behavioral Practice, 31(1), 72–89. https://doi.org/https://doi.org/10.1016/j.cbpra.2022.08.002

Petersen, J. M., & Pimentel, S. S. (2024). Acceptance and Commitment Therapy for Insomnia. Acceptance and Commitment Therapy for Insomnia, 366–372. https://doi.org/10.1007/978-3-031-50710-6

Pitil, P., P., & Ghazali, S. R. (2023). The impact of acceptance and commitment therapy (ACT) on the psychological defense mechanism and weight loss program: A randomized controlled trial among university students during COVID-19 movement control order. Journal of Contextual Behavioral Science, 29, 171–181.

Pramudita, F. A., Daulima, N. H. C., & Hargiana, G. (2024). Reducing Anxiety with Acceptance and Commitment Therapy (ACT) in Hypertensive Clients. Jurnal Keperawatan Sumba (JKS), 2(2), 50–57. https://doi.org/https://doi.org/10.31965/jks.v2i2.1416

Refanthira, N., & Hasanah, U. (2020). Adolescent problem in psychology: A review of adolescent mental health studies. Proceedings of the 5th ASEAN Conference on Psychology, Counselling, and Humanities. https://doi.org/https://doi.org/10.2991/assehr.k.200120.004

Salik, S., Sadiq, M., & Masroor, U. (2022). Specific Learning Disorder (Sld) and Associated Psychosocial Difficulties in Emerging Adolescents: an Exploratory Study. Pakistan Journal of Social Research, 04(04), 366–374. https://doi.org/10.52567/pjsr.v4i04.820

Santrock, J. W. (2016). Adolescence (16th Ed). Mc Graw Hill Education.

Sappenfield, O., Alberto, C., Minnaert, J., Donney, J., Lebrun-Harris, L., & Ghandour, R. (2024). Adolescent mental and behavioral health 2023.

Sulistiyowati, L., Keliat, B. A., & Hargiatna, G. (2023). Manfaat Intervensi Acceptance and Commitment Therapy dalam Menurunkan Kecemasan dan Perilaku Adiktif pada Pasien NAPZA. Jurnal Keperawatan Silampari, 6(2), 1664–1671. https://doi.org/https://doi.org/10.31539/jks.v6i2.5737

Takahashi, F., Ishizu, K., Matsubara, K., Ohtsuki, T., & Shimoda, Y. (2020). Acceptance and commitment therapy as a school-based group intervention for adolescents: An open-label trial. Journal of Contextual Behavioral Science, 16(February), 71–79. https://doi.org/10.1016/j.jcbs.2020.03.001

Tayyebi, G., Alwan, N. H., Hamed, A. F., Shallal, A. A., Abdulrazzaq, T., & Khayayi, R. (2024). Application of Acceptance and Commitment Therapy (ACT) in Children and Adolescents Psychotherapy: An Umbrella Review. Iranian Journal of Psychiatry, 19(3), 337–343. https://doi.org/10.18502/ijps.v19i3.15809

Trompetter, H. R., Bohlmeijer, E. T., Fox, J.-P., & Schreurs, K. M. G. (2015). Psychological flexibility and catastrophizing as associated change mechanisms during online Acceptance & Commitment Therapy for chronic pain. Behaviour Research and Therapy, 74, 50–59.

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