Acceptance and Commitment Therapy in China: A Systematic Review with Narrative Synthesis of Randomized Controlled Trials

We also evaluated the article quality and risk bias of each article using the Cochrane Risk of Bias tool (RoB) (Higgins et al., 2011). The article found that acceptance commitment therapy can significantly improve psychological flexibility (such as reducing the score of AAQ-II scale) and improve symptoms in a variety of disease conditions, including depression (32 studies), anxiety disorder (19 studies), schizophrenia (9 studies), cancer (such as colorectal cancer, breast cancer, liver cancer; 52 studies), stroke (15 studies), diabetes (7 studies) and student population (18 studies).

The wide range of effect values (standardized mean difference of 0.05-7.95) reflects the diversity of research background and methodology. The cultural adaptation plan that integrates Confucian concepts such as family harmony and perseverance with Taoist thought further enhances the participation and efficacy of treatment. However, methodological limitations are prominent, especially in terms of blinding and allocation concealment, which pose a high risk of bias. In short, acceptance commitment therapy is an intervention method that is in line with the Chinese cultural background and has empirical effectiveness, which improves psychological and physical health problems by enhancing psychological flexibility.

The compatibility of this therapy with local philosophical ideas and collectivist values has promoted its successful practice in China. Future research should focus on enhancing methodological rigor, strengthening mechanism exploration, and promoting the implementation of scientific research to optimize the integration and application of this therapy in the Chinese healthcare system.