ACT in Groups

Abstract This article offers an up-to-date selective review of acceptance and commitment therapy (ACT) conducted in the group format. ACT in the group format differs from ACT in the individual format; its potential advantages and disadvantages are discussed in general and in terms of the six ACT hexaflex processes. Reviewed in this article are select large randomized clinical trials on ACT in groups, and highlighted are innovative group delivery modes and the diversity of problem areas to which this format has been applied. Major considerations for conducting ACT in groups are briefly discussed, including reasons to form an ACT group, who and what to include in an ACT group, how to start group sessions, and their length and frequency. The authors consider challenges, including the dearth of studies that directly compare group to individual delivery of ACT and whether group ACT operates similarly at the process level as individual ACT; address the needs of diverse individuals; and evaluate cost effectiveness. Building on the growing number of trials of group ACT interventions, the authors offer recommendations for future research, including strategies to evaluate how ACT groups work and for whom they work best.