A Pilot Randomized Controlled Trial of a Single-Session Digital Acceptance and Commitment Therapy Intervention

Adherence challenges are common among digital mental health interventions (DMHIs). Single-session DMHIs may help by providing a low-intensity intervention that takes less time to complete. This pilot randomized controlled trial sought to evaluate the acceptability and preliminary efficacy of a single-session DMHI based on acceptance and commitment therapy (ACT) in a non-clinical sample of college students. The trial was pre-registered (NCT06139718). A total of 61 students were recruited, which was below the target of 100 participants. The participants were randomized to the single-session ACT DMHI or to a waitlist condition, with assessments completed at 1-week and 1-month follow-ups. The vast majority of participants (87%) completed the single-session ACT program. The participants provided high program satisfaction ratings. There were no differences between conditions on psychological flexibility, distress, or mental health help seeking. However, the participants assigned to ACT improved significantly more than the waitlist on well-being from baseline to 1-month follow-up (d = 0.29). Overall, the results were mixed, with some support for the acceptability and potential efficacy of a single-session ACT DMHI but also a lack of effect, most notably on psychological flexibility as the process of change in ACT.