Monitoring Clinically Relevant Behaviors and Experiential Avoidance Throughout the Course of Acceptance and Commitment Therapy: A Single-Case Quasi-Experimental Study.
Daily ACT tracking in students is doable and shows mild gains, but expect noisy data and no clear sign of what improves first.
01Research in Context
What this study did
Three university students met with a therapist for ten weekly ACT sessions.
Each day they logged clinically relevant behaviors and experiential avoidance on their phones.
The team asked: do these scores improve, and does one change before the other?
What they found
Two students felt better by the end. Daily scores crept up, but the line wiggled a lot.
There was no clear 'first one, then the other' pattern between behaviors and avoidance.
How this fits with other research
Morrison et al. (2017) ran a web ACT program for college students and saw medium gains in distress, anxiety, and depression without any face-to-face contact. Their bigger effect sizes may come from a larger, randomized sample.
Paliliunas et al. (2018) trimmed ACT to six 50-minute modules focused on values and still lifted graduate-student academic performance. The shorter, skills-only format matched the modest gains seen here.
Krafft et al. (2019) tested a self-guided ACT-matrix phone app. Adults using the full app felt a little better, but students in the same study did not. Together these studies show that ACT helps young adults most when it is either therapist-led or at least personally guided, not fully self-help.
Why it matters
If you already run ACT with college clients, keep tracking daily behaviors and avoidance. The data will bounce around, so look for trends across weeks, not day-to-day jumps. Pair the logs with brief check-ins to keep students engaged; pure app-only tools may fall flat for this age group.
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02At a glance
03Original abstract
The present single-case quasi-experimental study monitored changes in target behavior and experiential avoidance (EA) in an individually delivered, 10-session weekly acceptance and commitment therapy intervention. Participants were three university students with elevated EA who endorsed varying mental health concerns. Primary outcome and process variables were daily measures of clinically relevant behavioral excesses (CRB-E) and daily participant-rated EA, respectively. Additionally, we collected weekly measures of EA, along with pre-, mid-, post-treatment, and 3-month follow-up clinical outcome measures. Overall, synchrony across daily, weekly, and pre/post nomothetic measures was largely observed across participants, and findings suggested improvement in clinical outcomes for two of three participants. Daily measurements of CRB-E and EA fluctuated considerably within both baseline and intervention phases. Cross-lagged correlation analyses revealed no evidence of temporal precedence of change in daily measured EA over change in daily measured CRB-E (or vice versa). Implications of these findings and directions for future research are discussed.
Behavior modification, 2025 · doi:10.1177/01454455251343301