Effects of Internet-Based Acceptance and Commitment Therapy on College Students’ Mental Health: A Randomized Controlled Trial

Objectives: College students face increasing mental health challenges. Although Acceptance and Commitment Therapy (ACT) is effective, the efficacy of Internet-based ACT (iACT) needs further exploration. Methods: This study examines the efficacy of iACT on college students’ mental health through a randomized controlled trial. We recruited 90 college students (19.16 ± 1.02 years old) and randomly divided them into the iACT group, face-to-face ACT group, and control group. The effects of the interventions were evaluated using the comprehensive assessment of ACT processes (CompACT) and the Depression Anxiety Stress Scales (DASS-21). Results: Two-factor repeated measures ANOVA revealed a significant time main effect of iACT. Face-to-face ACT and iACT effectively improved college students’ psychological flexibility [F(2, 83) = 18.78, p < 0.001, η2 = 0.18] and alleviated their negative emotions [F(2, 82) = 41.17, p < 0.001, η2 = 0.36]. Face-to-face ACT exhibited sustained effects on improving participants’ psychological flexibility and alleviating their negative emotions (p < 0.001), while iACT showed no sustained effect on improving participants’ psychological flexibility (p > 0.05). Conclusion: While iACT and face-to-face ACT are effective short-term interventions, face-to-face ACT demonstrates superior sustainability. Integrating guided sessions into iACT may enhance long-term outcomes. These findings advocate for blended interventions to address college students’ mental health needs, particularly in resource-limited settings.