A pilot study of the online Acceptance and Commitment Therapy Guide for Immigrant Resilience: A culturally adapted intervention for undocumented community members

Undocumented immigrants face chronic contextual stressors that undermine their mental health and limit their access to culturally adapted mental health interventions. This pilot implementation study evaluated the online Acceptance and Commitment Therapy (ACT) Guide for Immigrant Resilience, a seven-session self-guided program culturally adapted for young adults with liminal immigration status. Forty members of a national immigrant youth-led organization (62.5% undocumented) were given access to the ACT Guide for Immigrant Resilience and completed pre, mid, and post treatment outcome measures and a four-week follow-up. The study aimed to determine the level of engagement, acceptability/appropriateness/feasibility of the intervention, and gather preliminary effectiveness data. Participants engaged on average with 5.22 (SD = 2.59) of seven sessions and spent a median of 102.11 minutes with the program (Interquartile range [IQR] 25% = 54.96, 75% = 260.86). Implementation ratings were high, suggesting intervention acceptability, appropriateness, and feasibility. While low assessment engagement and the single-arm design limited causal inference, participant that completed post-assessment (n = 15) reported significant decreases in depression, anxiety, and stress, and values obstruction improvement. Reductions in depression and stress were also present at follow-up relative to baseline (n = 19). Qualitative feedback underscored self-compassion, values clarification, and mindfulness as being culturally relevant. Suggested improvements included clearer instructions, briefer modules, and audio options. Our findings provide preliminary support for the use of this self-guided intervention with young adults with liminal immigration status. However, randomized trials with adaptations to improve engagement are needed to further establish the efficacy of the ACT Guide for Immigrant Resilience.Author summary: Undocumented immigrants face many challenges that can harm their mental health, such as anti-immigrant policies, the threat of deportation, and difficulty accessing mental health care. Online mental health applications can make mental health care more accessible in this population. The ACT Guide for Immigrant Resilience is a self-paced online mental health tool designed for undocumented young adults. The focus of this study was to test the ACT Guide for Immigrant Resilience with a group of undocumented young adults. Forty members from a national immigrant youth-led organization participated in the study over the course of 12 weeks. The results suggest that the intervention helped reduce depression, anxiety, stress, and feelings of being disconnected from personal values. Based on written feedback from participants, it seemed that most believed that the content of the intervention was helpful and relatable to their experiences. These findings suggest that the intervention could be a useful and accessible mental health resource for undocumented communities.