The impact of ACT interventions on psychological flexibility and minority stress within sexual minority groups - a mixed-methods evaluation

Problem Statement: Sexual minorities experience disproportionately higher rates of mental health difficulties compared to heterosexual individuals. Meyer’s (2003) Minority Stress (MS) theory explains this disparity, reporting stigmatising processes and stressful social environment that sexual minorities encounter as a unique contribution to mental health issues. Furthermore, sexual minorities report MS related experiences impact access to support, which exacerbate mental health challenges. Tailored interventions that are accessible for sexual minorities are crucial to address disparities but are understudied. Psychological Flexibility (PF) as a key aim of Acceptance Commitment Therapy (ACT), has shown promise for reducing the impact of MS in sexual minorities. ACT interventions have been identified as effective for improving PF and supporting individual coping with stressors, improving wellbeing and resilience. Limited research exploring the effectiveness of specific ACT interventions addressing MS in sexual minorities is highlighted. Bridging this gap could offer a practical solution for interventions effectively addressing sexual minorities mental health disparities. Aims: This thesis aimed to investigate the effectiveness of brief ACT interventions in enhancing PF and reducing MS among sexual minorities. By focusing on specific core PF processes via tailored ACT interventions, this thesis sought to understand the impact of brief ACT interventions in supporting sexual minorities wellbeing. It was hypothesised that participants engaging with brief ACT interventions would show improvements in PF and reductions in the impact of MS experiences post-intervention. Method: A mixed-methods approach involved 64 sexual minority adults being randomly assigned to one of three brief ACT intervention groups: openness, awareness, or engagement. Participants attended a four-week online intervention specific to their core ACT processes. Quantitative data collected via online surveys measured PF and MS before and after the intervention. A 3x2 mixed factorial Analysis of Variance (ANOVA) evaluated the overall impact of the interventions on PF and MS. Paired samples t-tests separately explored brief ACT interventions impact on core PF processes. Qualitative interviews with 10 participants were analysed using Reflexive Thematic Analysis (RTA) to explore participants experiences of their intervention's impact on PF and MS. Results: Quantitative results indicated significant improvements in PF and reductions in MS for all intervention groups. The Mixed factorial ANOVA showed a significant effect of time for PF (F(1,49) = 229.953, p<001, n2=0.824) and MS (F(1,49) = 81.055, p<0.001, n2=0.623). Paired samples t-tests indicated PF improvements for all intervention groups. The Awareness group showed the broadest improvements in core PF processes, from demonstrating the most correlations for core PF processes for sub-scores on valued actions (r=0.566, p=0.022), openness to experiences (r=0.533, p=0.034) and overall PF (r=0.563, p=0.023. Qualitative analysis revealed participants benefited from skills promoting present moment, detaching from thoughts and valued living. Group support and recognising MS were additionally helpful to participants. Conclusion: Brief ACT interventions effectively enhanced PF and reduced MS in sexual minorities. ACT interventions targeting present-moment awareness and acceptance could be particularly beneficial. Findings support tailored ACT interventions like “defusion” and “dropping anchor” exercises, delivered in affirming groups. The findings support brief ACT interventions being integrated into clinical practice for sexual minorities experiencing MS.

Citation

Washington, C. (2025) The impact of ACT interventions on psychological flexibility and minority stress within sexual minority groups - a mixed-methods evaluation. University of Wolverhampton. https://wlv.openrepository.com/handle/2436/625944

Publisher

University of Wolverhampton

URI

https://wlv.openrepository.com/handle/2436/625944

Type

Thesis or dissertation

Language

en

Description

A thesis submitted in partial fulfilment of the requirements of the University of Wolverhampton for the degree of Doctor of Counselling Psychology.

Collections

Theses and Dissertations