Acceptance and Commitment Therapy in Occupational Therapy: A Scoping Review

ImportanceAcceptance and Commitment Therapy (ACT) emphasizes psychological flexibility and engagement in valued activities, aligning with occupational therapy's focus on participation. However, the published literature describing occupational therapy practitioners' use of ACT has not been synthesized.ObjectiveTo map the existing literature describing occupational therapy practitioners' use of ACT, including its use in evaluation and intervention, client concerns addressed, practice settings, and reported outcomes.Data SourcesA comprehensive search was conducted across PubMed, Embase, Scopus, CINAHL, PsycINFO, OTSeeker, OTDBase, SciELO, ProQuest Dissertations and Theses, MedNar, and Google Scholar from 1982 through 2025.Study Selection and Data CollectionThis scoping review followed Joanna Briggs Institute methodology and PRISMA-ScR guidelines. Studies were included if they described the use of ACT by occupational therapy practitioners. Two reviewers independently screened and extracted data using a standardized tool.FindingsTwenty-five sources were included, primarily involving adults with chronic pain in interdisciplinary rehabilitation settings. ACT was most often used within intervention, with limited description of its role in evaluation. Outcomes predominantly reflected improvements in psychological flexibility, acceptance, emotional distress, and participation. Occupation-specific outcomes were infrequently reported, and occupational therapy-specific contributions were often unclear within interdisciplinary models.Conclusions and RelevanceAcross the included studies, ACT was reported to be used by occupational therapy practitioners within intervention approaches, particularly in chronic pain and mental health contexts. However, its application remains inconsistently articulated in occupation-based evaluation and outcomes. Greater clarity in occupational therapy-specific implementation and measurement is needed to advance ACT as an occupation-centered approach.