Tacting the Functions of Behavior and College Mental Health: A Mobile App-Based Approach to Developing Psychological Flexibility

This study evaluated a brief Acceptance and Commitment Therapy (ACT) Matrix app to improve college student mental health in a randomized waitlist-controlled trial. It was hypothesized that participants assigned to the ACT Matrix app would report greater improvements than the waitlist condition on measures of psychological inflexibility (e.g., Acceptance and Action Questionnaire-II; Tacting of Function [TOF] scale), distress (e.g., Patient Health Questionnaire), and functioning (e.g., Satisfaction with Life Scale) as well as that changes in psychological inflexibility variables would predict improvements in distress and functioning at post-intervention and 4-week follow up. The sample included 106 students reporting elevated depression or anxiety symptoms. There were no significant differences between the ACT Matrix app and waitlist condition on any mental health outcomes over time. There were also no differences between conditions on most psychological flexibility measures, including the TOF process that the app focused on targeting. However, participants in the ACT condition did improve more than waitlist on two general measures of psychological inflexibility and mindfulness. Furthermore, changes in both TOF and psychological flexibility during the intervention correlated with improvements in mental health outcomes. Overall, results were mixed for the mechanisms of change of the ACT Matrix app, but suggested this low intensity app is not sufficient for improving mental health.