Evaluating Acceptance and Commitment Therapy and Mindfulness-Based Stress Reduction Self-Help Books for College Student Mental Health

Objectives Self-help has the potential to improve access to mental health resources for college students. However, solutions are needed to improve sustainable delivery and cost-effectiveness, and to know which resources are most useful. Methods A sample of 109 college students were randomly assigned to read either an acceptance and commitment therapy (ACT) or mindfulness-based stress reduction (MBSR) self-help book through the university library website over 8 weeks with assessments at baseline, midtreatment (4 weeks), and posttreatment (8 weeks). Results The majority of participants reported reading over half of their assigned book and high satisfaction ratings were given for both books. Both conditions demonstrated equivalent medium to large effect sizes for improvements over time on outcomes (psychological distress, positive mental health, academic distress) and processes of change (psychological inflexibility, mindfulness, cognitive fusion). However, the ACT condition produced improvements on obstruction with valued action more quickly than MBSR. Across conditions, baseline to midtreatment improvements in psychological inflexibility, valued action, cognitive fusion, and mindfulness, all predicted baseline to posttreatment improvements in psychological distress. Improvements in psychological inflexibility more strongly predicted improvements in positive mental health in the MBSR condition. Conclusions Overall, results suggest the potential benefits of both ACT and MBSR self-help books for improving student mental health and the potential promise of delivering these books through online university library systems.