Mechanisms of change: exploratory outcomes from a randomised controlled trial of acceptance and commitment therapy for anxious adolescents

Highlights: Exploratory multiple mediation analyses from an RCT of ACT for adolescent anxiety. ; Limited support for the full hexaflex model in mediating therapeutic outcomes. ; Mixed specific effects observed for defusion, acceptance and mindfulness/self-as-context. ; In contrast to predictions, mediation effects were predominantly treatment-common. ; Despite their differences ACT and CBT may be underpinned by analogous mechanisms