Exploring the Role of Acceptance and Commitment Therapy in Addressing Shame Among Individuals with Lived Experience of Mental Distress
Year: 2026
Type: dissertation
Abstract: Shame is a distressing emotion affecting psychological health, wellbeing and aspects of functioning, notably impeding efforts to seek help. This thesis explored the literature relating to mindfulness-based and third wave interventions (MBTW) in addressing shame and self-stigma and evaluated the effects on shame of two interventions, with two separate populations. Study one comprised a systematic review of MBTW on shame and self-stigma and their effects on aspects of psychosocial functioning. The results suggested that MBTW, and particularly interventions with an explicit focus on compassion, along with ACT, may support efforts to address shame, self-stigma and aspects of psychosocial functioning such as quality of life and wellbeing. Study two evaluated the impact of a compassion-focused ACT intervention on shame and psychological flexibility among seven adults with experience of mental health difficulties. The study employed a SCED to analyze EMA data and assessed reliable and clinical change using standardized measures. The intervention comprised two online, individually facilitated sessions and two brief follow-on phone calls. The results were mixed, and recommendations included lengthier, and possibly, group-based interventions. Study three comprised an evaluation of an online, six session, individually facilitated ACT intervention targeting mental distress among six farmers. Farmer mental health and suicide in particular, are noted concerns in the literature with attitudes and shame likely impeding help seeking. This study presented an opportunity to assess whether an ACT intervention not specifically designed to address shame, could nonetheless influence levels of shame and acceptance of shame and embarrassment. A SCED was used with standardized measures to assess reliable and clinical change. Internal shame reliably improved for half of participants, albeit there was no change for most regarding acceptance of shame and embarrassment. Overall improvements were noted among participants in relation to psychological flexibility, with other significant gains in vitality, depression, life satisfaction and processes associated with psychological change. This thesis has furthered efforts to address the impacts of shame by identifying components of future interventions, including both content, design and possible delivery. In particular, future interventions are recommended to combine ACT interventions with explicit efforts to enhance compassion, perhaps incorporating a combination of meditative and self-compassionate letter writing exercises. Group-based interventions of at least six hours may offer increased impact. While telehealth interventions afford many advantages, some individuals may require practical supports to engage.
Author: Stynes, Gregory
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W7162731976