Abstract Background Psychological distress is highly prevalent among patients with inflammatory bowel disease (IBD) and negatively affects quality of life, treatment adherence, and disease management. Acceptance and Commitment Therapy (ACT) aims to enhance psychological flexibility through acceptance, mindfulness, and values-based action, making it particularly suitable for chronic conditions such as IBD, where emotional avoidance and symptom-related distress are common. Despite international recommendations, structured psychological interventions remain scarce in routine gastroenterological care. This study evaluated the effectiveness and feasibility of a group-based ACT programme integrated into multidisciplinary IBD outpatient care. Methods This prospective effectiveness study consecutively enrolled adult outpatients with Crohn’s disease (CD) and ulcerative colitis (UC). Participants completed an eight-session group-based Acceptance and Commitment Therapy (ACT) programme. Psychological distress was assessed before and after the intervention using the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE-OM). Clinical disease activity (Harvey–Bradshaw Index for CD; Partial Mayo Score for UC) was recorded as part of routine clinical care. A 2 × 2 mixed-design ANCOVA was conducted using IBM SPSS Statistics, with time as the within-subject factor and diagnosis as the between-subject factor, controlling for disease activity. Participants were divided into seven treatment groups, stratified by size, completion, and age range (Table 1). Results Of 51 enrolled patients, 44 completed the programme (86.3% retention). A significant main effect of time indicated a reduction in psychological distress from pre- to post-intervention, as measured by the CORE-OM (F(1,41)=4.216, p=.046) (see Fig. 1). Both CD and UC patients showed parallel improvements, with no significant main effect of diagnosis or time × diagnosis interaction, confirming that the intervention was equally beneficial across conditions. Disease activity did not influence outcomes, suggesting that psychological improvement was not dependent on clinical severity. Attendance was high across groups, and dropouts were mainly related to external or organisational factors rather than treatment-related issues, supporting the acceptability and tolerability of the programme. Conclusion A structured group-based ACT programme can be successfully implemented within a gastroenterology outpatient service, producing a significant reduction in psychological distress in patients with IBD, regardless of diagnosis and disease activity. This supports the integration of ACT into multidisciplinary IBD care pathways, highlighting its clinical robustness and feasibility in real-world practice. References: 1. Marchese SH, Naftaly JP, Pandolfino J. Acceptance and commitment therapy for the treatment of irritable bowel syndrome and inflammatory bowel disease: a narrative review. Transl Gastroenterol Hepatol. 2024;9:43. Published 2024 Jun 24. doi:10.21037/tgh-24-10 2. Naude C, Skvarc D, Maunick B, et al. Acceptance and Commitment Therapy for Adults Living With Inflammatory Bowel Disease and Distress: A Randomized Controlled Trial. Am J Gastroenterol. 2024;120(8):1839-1851. Published 2024 Aug 20. doi:10.14309/ajg.0000000000003032 3. Wynne B, McHugh L, Gao W, et al. Acceptance and Commitment Therapy Reduces Psychological Stress in Patients With Inflammatory Bowel Diseases. Gastroenterology. 2019;156(4):935-945.e1. doi:10.1053/j.gastro.2018.11.030 Conflict of interest: Dr. Spagnolo, Giorgia: No conflict of interest Ferrarese, Daniele: No conflict of interest Di Vincenzo, Federica: None Iaccarino, Jacopo: No conflict of interest Vecchione, Michele: No conflict of interest D’Onofrio, Antonio Maria: No conflict of interest Camardese, Giovanni: No conflict of interest Sani, Gabriele: No conflict of interest Gasbarrini, Antonio: No conflict of interest Chieffo, Daniela Pia Rosaria: No conflict of interest Scaldaferri, Franco: Consultancy fee/board for Janseen, Takeda, Pfizer, MSD, Sandoz, Galapagos, Celltrion, Ferring, Abbvie, Lilly, Alfasigma, Abivax
Spagnolo et al. (2026) studied this question.