Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jul 8, 2023
Date Accepted: Oct 23, 2024
Effectiveness of Internet-based Self-help Acceptance and Commitment Therapy Program on Medical Students’ Mental Well-being: Randomized Controlled Follow-up Study
ABSTRACT
Background:
Psychological distress is a growing problem among medical students worldwide. This highlights the need for psychological interventions to focus on mental health and improve well-being in this population.
Objective:
This study developed an internet-based self-help Acceptance and Commitment Therapy Program (iACT 2.0), aiming to examine its effectiveness in reducing depression, anxiety, stress, psychological inflexibility, and obsessive-compulsive symptoms among medical students.
Methods:
A total of 520 Chinese postgraduate medical students were randomly assigned to either an iACT 2.0 intervention group (n = 260; 6 online lessons, once every five days) or a control condition (n = 260; without interventional character). Participants completed questionnaires including the 21-item Depression Anxiety Stress Scale (DASS-21), the revised Obsessive-Compulsive Inventory (OCI-R), and the Multidimensional Psychological Flexibility Inventory (MPFI) at pre-intervention (T1), post-intervention (T2), and 1-month follow-up (T3). No therapist support was provided during the one-month iACT 2.0 intervention period. Data were collected via online platform and analyzed using Repeated-measures ANOVA.
Results:
Participants in the intervention group demonstrated a significant decrease in depression, anxiety, stress, psychological inflexibility, and obsessive-compulsive symptoms compared to the control group after the intervention. The intervention group showed significant reductions in all measured outcomes from pre-intervention to post-intervention and at the 1-month follow-up, while no significant changes were observed in the control group over the same period. The groups did not differ significantly at baseline, and significant differences were noted at both post-intervention and follow-up.
Conclusions:
The study demonstrated that the newly developed, self-help iACT 2.0 program was effective in reducing depression, anxiety, stress, psychological inflexibility, and obsessive-compulsive symptoms. Notably, the positive effects of the intervention persisted at the 1-month follow-up. This program can offer a useful addition to existing mental illness treatment, and lead to improvements in clinical and psychotherapy planning while simultaneously reducing the burden on traditional counseling and services. Clinical Trial: Chinese Clinical Trial Registry (registration number: ChiCTR2300070725). https://www.chictr.org.cn/
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