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Updated: Jun 11, 2026

The Trier Social Stress Test Protocol for Inducing Psychological Stress
Published on: October 19, 2011
A randomised worksite comparison of acceptance and commitment therapy and stress inoculation training
1Psychology Department, City University, Northampton Square, London EC1V 0HB, United Kingdom. paul.flaxman.1@city.ac.uk
Abstract:
In this comparative intervention study, 107 working individuals with above average levels of distress were randomly assigned to one of three conditions: acceptance and commitment therapy (ACT; n = 37); stress inoculation training (SIT; n = 37); or a waitlist control group (n = 33). The interventions were delivered to small groups in the workplace via two half-day training sessions. ACT and SIT were found to be equally effective in reducing psychological distress across a three month assessment period. Mediation analysis indicated that the beneficial impact of ACT on mental health resulted from an increase in psychological flexibility rather than from a change in dysfunctional cognitive content. Contrary to hypothesis, a reduction in dysfunctional cognitions did not mediate change in the SIT condition. Results suggest that the worksite may offer a useful, yet underutilised, arena for testing cognitive-behavioural theories of change.
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