ACTV Research
Evidence of effectiveness
Does ACTV work?
TITLE: A Randomized Controlled Trial of Acceptance and Commitment Therapy for Aggressive Behavior
SUMMARY: This study was the first to provide scientific evidence that an ACT-based group intervention could be beneficial in reducing physical and psychological partner aggression among adults with one or more clinical diagnoses.
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This study investigated the effects of an Acceptance and Commitment Therapy (ACT) group-based treatment on reducing physical and psychological partner aggression among adults compared to a support-and-discussion-based control group. Additionally, the researchers were interested in studying how experiential avoidance (i.e. unwillingness to remain in contact with aversive thoughts, feelings, and sensations) and emotion dysregulation (i.e. inability to effectively manage emotions) were related to partner aggression and whether focusing on these constructs through an ACT-based group treatment would help reduce the incidence of partner aggression.
The study sample consisted of 101 participants who had engaged in at least two acts of partner aggression. Participants’ ages ranged from 19 to 67 years and, on average, were 31 years old. Most of the participants identified as educated (86.3%), white (82%), and female (68%). Participants met diagnoses for a range of mental health disorders including mood disorder, generalized anxiety disorder, social phobia, and borderline and antisocial personality disorder. Participants were randomly assigned to one of two groups: ACT and support-and-discussion control, each of which comprised a total of 24 hours spread across 12 weeks. Participants were assessed pretreatment, during treatment, posttreatment, and 3 and 6 months after completion of group.
Overall, the results indicated that the ACT curriculum led to significant reductions in psychological and physical aggression compared to the control group. Additionally, the gains achieved at posttreatment were retained or rather improved over the 6-month follow-up period. Furthermore, the ACT group reduced experiential avoidance and emotion dysregulation, and these reductions partially accounted for decreased acts of partner violence.
TITLE: Evaluation of Acceptance and Commitment Therapy for Domestic Violence Offenders
SUMMARY: This study builds on the initial evidence for ACTV’s effectiveness as a successful intervention program for reducing recidivism among men arrested for domestic assault. Posttreatment, ACTV participants were half as likely to be charged with violent offenses compared to participants attending standard batterers intervention programs (BIPs).
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This study examined the impact of two domestic violence intervention programs (BIPs and ACTV) on reducing new criminal charges 1-year from initial treatment. BIPs center discussions on power and control in interpersonal relations and on changing cognitions to reduce violent recidivism. ACTV or Achieving Change Through Values-Based Behavior stems from Acceptance and Commitment Therapy and promotes engagement in value-based behaviors, independent from internal experiences that may get in the way (e.g., lack of confidence, anger, shame).
Data were analyzed from a sample of 3,474 men who were arrested for domestic assault and were subsequently required by the court to participate in a BIP. Men identified primarily as White (59.3%), were around 33 years old on average and were single at the time of the study (44.6%). Men in both groups had an average of two previous charges at the beginning of the program.
The investigators found that although more men completed the BIP compared to the ACTV group (BIP=73%; ACTV=61%), fewer men in the ACTV program received a charge during treatment than those in the BIP (BIP=16.3%; ACTV=11.9%). Program differences were greater posttreatment, such that even fewer ACTV participants were charged at 1-year following program completion compared to men in the BIP group (BIP=27.9%; ACTV=21.3%). More specifically, ACTV participants were half as likely to be charged with violent offenses than BIP participants posttreatment (BIP=10.9%; ACTV=5.2%). Overall, comparing recidivism rates between ACTV and BIPs 1-year postintervention, ACTV participants were significantly less likely to be arrested for any charge, domestic assault charges, and any violent charges.
TITLE: Comparing Recidivism Rates Among Domestically Violent Men Enrolled in ACTV Versus Duluth/CBT
SUMMARY: Along with other research studies that demonstrate the effectiveness of ACTV compared to other standard domestic violence treatment approaches, this study indicated the usefulness of ACTV outside of its founding state of Iowa. Researchers found continued evidence that ACTV participants were 50% less likely than treatment as usual (TAU) participants to receive any new convictions following treatment.
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This study examined how an acceptance-based treatment approach for domestic violence (Achieving Change Through Value-Based Behavior; ACTV) compared to existing standard treatment protocols (e.g., the Duluth Model, cognitive-behavioral approach) in reducing recidivism. To achieve this objective, 725 men in Minnesota convicted of domestic assault were assigned to participate in either ACTV or treatment-as-usual (TAU). The study participants were 35 years old on average and the majority identified as Black/African American (61.9%). Recidivism was assessed up to 5 years posttreatment.
Participants enrolled in ACTV were significantly more likely to complete the domestic violence program compared to TAU participants (ACTV=59.9%; TAU=50.3%). Following program completion, men who participated in ACTV were less likely to receive any new convictions overall (ACTV=34.0%; TAU=69.9%). Moreover, men participating in ACTV were less likely to receive new convictions for violent crimes (ACTV=9.5%; TAU=28.5%) and domestic assault (ACTV=18.4%; TAU=40.3%) compared to those who participated in TAU. Finally, participants who were convicted of a crime post-treatment were more likely to receive a conviction sooner after attending TAU as compared to ACTV participants. Taken together, men who participated in ACTV were over 50% less likely to receive any new convictions following treatment compared to those in TAU.
TITLE: A Randomized Clinical Trial of Acceptance and Commitment Therapy and the Duluth Model Classes for Men Court Mandated to a Domestic Violence Program
SUMMARY: Along with strengthening the evidence for the effectiveness of an ACT-based approach for reducing recidivism compared to existing standard treatment protocols, this study broadened the assessment of intimate partner violence and incorporated victim reports in addition to self-report questionnaires.
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This study compared the impact of two domestic violence curricula (ACT and Duluth Model) on reducing intimate partner violence and criminal charges. The first curriculum was based on Acceptance and Commitment Therapy (ACT), a form of cognitive behavioral therapy. This approach promotes value-driven behaviors and flexible thinking using experiential activities. The second curriculum, the Duluth Model, is an educational approach that is based on feminist theory. This approach promotes a change in attitude towards women and a deeper reflection of one’s motivation for power and control.
The sample comprised men who were court-mandated to complete a domestic assault program after being convicted of assault against a female partner. A total of 338 men were randomly assigned to attend a 24-session non-violence class focusing on either the ACT program or the Duluth Model. Participants were 33 years old on average, mostly identified as White non-Hispanic (61.8%), and were assessed to be at moderate to high risk for recidivism.
The results indicated that participants who attended ACT classes acquired significantly fewer violent charges than those who participated in the Duluth Model at 1-year follow-up. Similarly, the incidence of nonviolent charges also significantly differed across the two groups; while 30% of men in the Duluth group were charged with nonviolent offenses, only 18.7% of men in the ACT group received nonviolent charges at the 1-year follow-up. No significant differences were observed in domestic violence charges across the two groups. In addition to analyzing criminal justice outcomes for program participants, this study also explored responses from domestic assault victims (N =98) pre-and-post-treatment. Victim reports indicated that ACT participants engaged in significantly less aggressive, controlling, and stalking behaviors at 1-year follow-up compared to Duluth participants.
ACTV Adaptations
Cognitive, Emotion Regulation, and Behavioral Skills Program (CERB)
At least 25% of women and 5% of men are sexually assaulted during college (RAINN, 2019). Sexual misconduct can include intimidation (sexual threat, indecent exposure), exploitation (non-consensually recording, voyeurism) harassment (non-consensually texting, calling, etc.) and assault (including rape). Unfortunately, few incidents of sexual assault lead to expulsion. Moreover, current disciplinary action, or lack thereof, does not end the end violence.
As such, researchers at the University of Iowa adapted the Acceptance and Commitment Therapy (ACT) framework to create an intervention for sexual misconduct on college campuses called Cognitive, Emotion Regulation, and Behavioral Skills Training (CERB). The program included 21-25 students from 2017-2021 who were mandated to complete the program.
Preliminary results suggest that CERB may reduce cognitive fusion, avoidance, difficulties in emotion regulation and increase connection with values. Initial qualitative data suggests that most participants change the way they thought about the incident and have new strategies to behave differently in the future.
Building Resilience and Emotional Awareness through Knowledge Program (BREAK)
A reported 60–70% of adolescents detained in the juvenile justice system meet criteria for a mental health disorder, as compared to 20% of the general adolescent population. Unfortunately, mental health symptoms often worsen during detainment and the vast majority of adolescents do not receive mental health services. Taken together, these adolescents, who often identify as a member from an underserved and minoritized population, are unlikely to receive needed mental health care and the lack of interventions in detention centers may exacerbate inequities of contact with the criminal justice system in adulthood.
As such, researchers piloted an Acceptance and Commitment Therapy-based intervention to be implemented in juvenile detention centers called Building Resilience and Emotional Awareness through Knowledge Program (BREAK). Study participants included 128 males aged 14–17 who resided in a juvenile detention center.
Following program completion, results indicated that BREAK participants demonstrated significant pre- to post-intervention declines in anxiety symptoms, and in ACT-based constructs of experiential avoidance, cognitive fusion, and perceived barriers to moving toward their values.
Duchschere, J.E., O’Hara, K.L., Reznik, S.J., Shanholtz, C.E., Gerson, N., Beck, C.J., & Lawrence, E. (2022). Addressing a mental health intervention gap in juvenile detention: A pilot study. Evidence-Based Practice in Child and Adolescent Mental Health. doi:10.1080/23794925.2022.2042873.
Additional ACTV Scholarship
“Toward an integrated, empirically supported theory of intimate partner violence”
“Emotion regulation and experiential avoidance in intimate partner violence”