The effectiveness of technology-based acceptance and commitment therapy for anxiety and depression in family caregivers: a systematic review and meta-analysis

Family caregivers often experience anxiety and depression. Technology-based Acceptance and Commitment Therapy (technology-based ACT) provides new treatment options, but its effectiveness for family caregivers needs further research. To explore the effectiveness of technology-based ACT in relieving family caregivers’ anxiety and depression symptoms. Search databases of PubMed, Web of Science, Cochrane Library, CINAHL, and Embase from inception to January 6, 2026. Then, use the Cochrane Risk of Bias Assessment Tool, Version 2 to evaluate study quality. Finally, conduct statistical analysis with Stata 17.0 and Review Manager 5.4. A total of 1067 papers were initially retrieved, among which 7 met the inclusion criteria. The meta-analysis showed a statistically significant improvement in anxiety symptoms (SMD = -0.42; 95% CI -0.64 to -0.19; p < 0.001). For depressive symptoms, the fixed-effect analysis indicated a small statistically significant improvement (SMD = -0.28; 95% CI -0.51 to -0.06; p = 0.014); however, this effect was not statistically significant under the random-effects sensitivity analysis, indicating limited robustness to model choice. Exploratory subgroup analyses suggested greater improvements in anxiety among caregivers of care recipients with relatively mild conditions, while studies”’ using the GAD-7 showed a larger estimated effect than those using other anxiety measures. Greater improvements in depressive symptoms were observed among caregivers of care recipients with relatively mild conditions and in interventions lasting ≥ 8 weeks. Given the small number of studies, these subgroup findings should be interpreted cautiously. Technology-based ACT may improve anxiety symptoms among family caregivers, while the evidence for depressive symptoms is less robust and should be interpreted cautiously. Given the limited number of included RCTs and participants, these findings should be considered preliminary and require confirmation in larger, adequately powered trials.