Document Type
Article
Journal/Book Title/Conference
Journal of Clinical Psychology
Volume
82
Issue
10
Publisher
John Wiley & Sons, Inc.
Publication Date
8-4-2026
Journal Article Version
Accepted Manuscript
First Page
1
Last Page
32
Abstract
An understanding of the relations between psychological flexibility processes and quality of life among autistic adults could help inform treatment development to improve the acceptability of mental health care among autistic adults. This pre-registered (https://osf.io/t3pws) secondary analysis of a mixed methods pilot open trial provides a preliminary test of which subprocesses of psychological flexibility are associated with improvements in quality of life among a sample of 56 autistic adults who received a 6-week digital self-help acceptance and commitment therapy (ACT) intervention. Online self-report assessments were collected at pre-treatment, 6-weeks (post-treatment), and 10-weeks (1-month follow-up). Pre- to post-treatment improvements in values progress and valued action, but not openness to experience, behavioral awareness, or values obstruction, were associated with pre- to follow-up improvements in quality of life. Qualitative themes suggested ways psychological flexibility with thoughts, emotions, and behaviors may be experienced as impacting quality of life. An exploratory analysis found that greater adherence to the digital ACT program was associated with greater pre- to post-treatment improvements in awareness and values obstruction, but not other psychological flexibility subprocesses. Although these are preliminary associative findings limited by a single-arm design, they suggest psychological flexibility, especially values, are a promising candidate for future research on mechanisms for improving quality of life among autistic adults.
Recommended Citation
Levin ME, Aller TB, Kelley HH, Klimczak KS, Covington B. Preliminary Examination of Associations Between Psychological Flexibility Processes of Change and Quality of Life in Digital Acceptance and Commitment Therapy for Autistic Adults. J Clin Psychol. 2026 Oct;82(10):1673-1682. doi: 10.1002/jclp.70191. Epub 2026 Aug 4. PMID: 42549502; PMCID: PMC13544500.
Comments
This is the peer reviewed version of the following article: Levin ME, Aller TB, Kelley HH, Klimczak KS, Covington B. Preliminary Examination of Associations Between Psychological Flexibility Processes of Change and Quality of Life in Digital Acceptance and Commitment Therapy for Autistic Adults. J Clin Psychol. 2026 Oct;82(10):1673-1682. doi: 10.1002/jclp.70191. Epub 2026 Aug 4. PMID: 42549502; PMCID: PMC13544500., which has been published in final form at https://doi.org/10.1002/jclp.70191. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.