A Prospective and Experimental Study on the Effect of One-Day of Acceptance and Commitment Therapy (ACT) on Psychological Flexibility, Psychological Capital, Anxiety and Depression Among Undergraduate Students. (ACT)

July 1, 2026 updated by: Akmar Nabila Binti A Bakar, Universiti Teknologi Malaysia

The Effect of a One-Day Acceptance and Commitment Therapy (ACT) on Psychological Flexibility and Psychological Capital in Students With Anxiety and Depression : A RCT Study

The goal of this study is to examine the effect of a one-day ACT intervention on psychological flexibility and psychological capital among undergraduate students at UTM who have anxiety and depression. Undergraduate students who scored moderate or above on anxiety and depression questionnaires during screening and volunteered to participate will be invited to a one-day ACT intervention. The participants will be randomly divided into two groups, which are the intervention and waitlist groups. Assessment of psychological flexibility, psychological capital, anxiety, and depression levels will be given online at the pre-intervention phase (T1), post-intervention phase (T2), and follow-up after one month phase (T3).

The main questions it aims to answer are the following:-

  1. To what extent does the intervention affect psychological flexibility, psychological capital, anxiety, and depression as measured by Cohen's d?
  2. How does a one-day ACT intervention affect university students' psychological flexibility, psychological capital, anxiety, and depression over time?
  3. How does a one-day ACT intervention affect university students' psychological flexibility, psychological capital, anxiety, and depression between groups?

Participants will:

  • The intervention group will participate in a one-day Acceptance and Commitment Therapy (ACT) intervention during data collection while the waitlist group receives it after the data completion.
  • Answer set of questionnaires during pre-intervention (T1), post-intervention (T2) and follow-up after one month (T3).

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This is a prospective and experimental study. A prospective study approach is used to examine the changes in outcome measures along with the data collection timeline. Data will be collected at four different points. Also, this is an experimental study, a randomised controlled trial study, and consists of two arms: a one-day ACT intervention and waitlist groups. The effect of a one-day ACT intervention will be evaluated using a randomised controlled trial approach by comparing the differences between intervention and waitlist groups.

(T0) - Screening phase - A set of questionnaires of the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) will be distributed through the student portal for screening. Potential participants who score moderate and above will be invited to the One-Day ACT intervention. The details of potential participants will be recorded.

(T1) - During pre-intervention, participants will be divided into two groups: a waitlist and a group that will receive batteries of questionnaires. The questionnaires included the demographic survey, BAI, BDI, Acceptance and Action Questionnaire II (AAQ-II) and Psychological Capital Questionnaires (PCQ) for participants before receiving the ACT intervention. Those who answer the questionnaires will receive a One-Day ACT intervention. In addition, respondents will be fully informed regarding the objectives and procedure of this research, and consent information will be gathered.

One-Day Intervention: -

A one-day ACT intervention will be conducted in three sessions, each lasting 40 minutes. The intervention is based on a module developed by Shari et al. (2020) and aims to help respondents manage their issues, such as unpleasant thoughts and feelings. The first session will build a therapeutic relationship and icebreak, using animated video (unwanted guest) presentations to explain how ACT can help manage issues. The second session will focus on acceptance and defusion concepts, emphasizing the importance of letting go of unproductive emotion-control techniques by using animated video (response ability). The third session, 'Show Up', will increase awareness of undesirable thoughts and feelings through structured mindfulness exercises and observing surroundings. The therapist will explain the metaphor of dropping the anchor and emphasize the importance of being present and aware of oneself. The final session, 'Get Moving', will connect values to practical action plans, using animated video (Values VS Goals) presentations to help respondents define their values and identify significant life steps.

(T2)-post-intervention, where a one-day ACT intervention has been completed and a set of questionnaires distributed to participants. The questionnaires include the BAI, BDI, AAQ-II, and PCQ.

(T3) - After one month of intervention, participants who received a one-day ACT intervention answered the BAI, BDI, AAQ-II and PCQ questionnaires.

Data analysis will be performed using SPSS version 30, including the calculation of effect sizes. To evaluate the research objectives, a repeated-measures MANOVA will be conducted.

Study Type

Interventional

Enrollment (Actual)

61

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Malaysia
    • Johor
      • Johor Bahru, Johor, Malaysia, 81310
        • Universiti Teknologi Malaysia

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Local Malaysian Students
  • 18 years old and above
  • Students who scored moderate or above for the Beck Depression Inventory (BDI) or Beck Anxiety Inventory (BAI) during the screening phase.

Exclusion Criteria:

  • International UTM students, due to the intervention being conducted in Bahasa Malaysia
  • Students who have a neurodevelopmental condition or those currently receiving psychiatric treatment or attending psychotherapy sessions, including ACT-based interventions
  • Students with a clinically diagnosed psychotic disorder confirmed by a psychiatrist.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Intervention
This group will receive one-day Acceptance and Commitment Therapy (ACT). The therapy includes 4 sessions that explain and guide participants to understand the concept of ACT and apply it in their daily lives for the purpose of increasing their psychological flexibility.
Behavioral: Acceptance and Commitment Therapy

A one-day Acceptance and Commitment Therapy (ACT) will be held with three (3) sessions. The sessions start with ice breaking, and follow by,

The first session will build a therapeutic relationship and icebreaking, using animated video (unwanted guest) presentations to explain how ACT can help manage issues.

The second session will focus on acceptance and defusion concepts, emphasizing the importance of letting go of unproductive emotion-control techniques by using animated video (response ability)

The third session, 'Show Up', will increase awareness of undesirable thoughts and feelings through structured mindfulness exercises and observing surroundings. The therapist will explain the metaphor of dropping the anchor and emphasize the
Other: Waitlist Group
After data completion, the waitlist group will receive a similar one-day ACT intervention. During data collection, this group did not receive any intervention in order to compare the level of psychological flexibility, psychological capital, anxiety and depression between the intervention group and the waitlist group.
Behavioral: Acceptance and Commitment Therapy

A one-day Acceptance and Commitment Therapy (ACT) will be held with three (3) sessions. The sessions start with ice breaking, and follow by,

The first session will build a therapeutic relationship and icebreaking, using animated video (unwanted guest) presentations to explain how ACT can help manage issues.

The second session will focus on acceptance and defusion concepts, emphasizing the importance of letting go of unproductive emotion-control techniques by using animated video (response ability)

The third session, 'Show Up', will increase awareness of undesirable thoughts and feelings through structured mindfulness exercises and observing surroundings. The therapist will explain the metaphor of dropping the anchor and emphasize the

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Acceptance and Action Questionnaire-II
Time Frame: One hour before intervention, one hour after intervention, and 1 month after intervention
). The AAQ-II is a 7-item self-report measure of psychological flexibility. Participants respond using a 7-point Likert scale, with higher scores reflecting greater psychological inflexibility.
One hour before intervention, one hour after intervention, and 1 month after intervention
Psychological Capital Questionnaire
Time Frame: One hour before intervention, one hour after intervention, and 1 month after intervention
Psychological capital will be measured using the Psychological Capital Questionnaire (PCQ) developed by Luthans (2007). The questionnaire consists of 22 items, divided into 6 existing scales, with answers ranging from "strongly disagree" to "strongly agree". In this scale, 6 items represent each dimension of PsyCap: hope, self-efficacy, resilience, and optimism. The final score indicated a person's level of positive PsyCap.
One hour before intervention, one hour after intervention, and 1 month after intervention
Beck Anxiety Inventory
Time Frame: Screening phase, one hour before intervention, one hour after intervention, and 1 month after intervention
The Beck Anxiety Inventory (BAI) will be used to measure anxiety. The BAI score is divided into 4 categories: 0-7 indicates minimal anxiety, 8-15 indicates mild anxiety, 16-25 indicates moderate anxiety, and 26-63 indicates severe anxiety.
Screening phase, one hour before intervention, one hour after intervention, and 1 month after intervention
Beck Depression Inventory
Time Frame: Screening phase, one hour before intervention, one hour after intervention, and 1 month after intervention
The Beck depression inventory (BDI) is used to measure depression level. The total score of the BDI is divided into 4 categories: 0-13 indicates minimal, 14-19 indicates mild, 20-28 indicates moderate, and 29-63 indicates severe depression
Screening phase, one hour before intervention, one hour after intervention, and 1 month after intervention

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Psychological capital and psychological flexibility.
Time Frame: Before and after participate the one-day acceptance and commitment therapy.
Psychological capital will be measured using the Psychological Capital Questionnaire (PCQ). Meanwhile Psychological flexibility is measured by using the Acceptance and action questionnaire (AAQ II)
Before and after participate the one-day acceptance and commitment therapy.
Psychological flexibility mediates the mechanism through which ACT improves mental health issues among university students.
Time Frame: Before and after participate the one-day acceptance and commitment therapy.
Mediation analysis is calculated by using PROCESS macro Version 3.5 developed by Andrew F. Hayes. Single mediator model will be used to analyse total, direct, and indirect effect of the mediator variables
Before and after participate the one-day acceptance and commitment therapy.

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Video presentations are effective in improving understanding of the ACT concepts.
Time Frame: Before and after participate the one-day acceptance and commitment therapy.
The score from the survey of The Learning Acceptance Scale will be calculated to determine the efficacy of video presentations in enhancing the understanding of ACT concepts. The score is...
Before and after participate the one-day acceptance and commitment therapy.
A one-day ACT intervention is feasible to be implemented in enhancing mental health and psychological capital among university students
Time Frame: After participate a one-day acceptance and commitment therapy
The score for The Treatment Satisfaction Questionnaire and at T3 will be computed into the total score to determine the level of satisfaction toward the therapy and the therapist.
After participate a one-day acceptance and commitment therapy

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Universiti Teknologi Malaysia

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

March 1, 2024

Primary Completion (Actual)

September 30, 2025

Study Completion (Actual)

February 28, 2026

Study Registration Dates

First Submitted

February 13, 2025

First Submitted That Met QC Criteria

February 13, 2025

First Posted (Actual)

February 18, 2025

Study Record Updates

Last Update Posted (Actual)

July 6, 2026

Last Update Submitted That Met QC Criteria

July 1, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • UTMREC-2024-83
  • Q.J130000.3853.31J93 (Other Grant/Funding Number: UTMER)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

In the inform consent, we agreed to keep the information private and confidential.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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