A systematic review and meta-analysis of acceptance and commitment therapy for older adults

This review aims to synthesize recent studies on the efficacy of acceptance and commitment therapy (ACT) for older adults, both overall and for depression, anxiety, quality of life, and pain specifically. Studies were included if they evaluated ACT in a trial with an older adult population, reported pretreatment and posttreatment scores, and were written in English. Studies were excluded if they only reported secondary data, had less than three participants, or did not evaluate a full ACT protocol. The Cochrane Risk of Bias Version 2 and Risk of Bias in Non-Randomized Studies of Interventions tools were used to assess risk of bias. Random-effects meta-analysis was used. This synthesis was preregistered (Prospero: CRD42022376246). Twenty-five studies were included in the overall meta-analysis (n = 1,166 participants). Overall, our results showed a large and significant within-group effect in the primary outcomes in trials of older adults (Hedges's g = 0.88, 95% confidence interval, CI [0.54, 1.21]). Significant within-group effects ranging from small to large were also found for depression (g = 0.56, 95% CI [0.38, 0.74]), anxiety (g = 0.93, 95% CI [0.31, 1.55]), quality of life (g = 0.37, 95% CI [0.08, 0.67]), and pain (g = 0.75, 95% CI [0.32, 1.19]). In sum, existing research suggests ACT shows promise in reducing distress and pain and improving quality of life in older adults. Studies spanned a broad range of countries and settings. However, confidence in these results is very low due to the within-group method used, small sample sizes, inconsistency, and potential publication bias. (PsycInfo Database Record (c) 2026 APA, all rights reserved).