The relationship between flexible perspective taking and emotional well-being: a systematic review of the “self-as-context” component of acceptance and commitment therapy

One of the core processes of acceptance and commitment therapy (ACT) is “self-as-context” (SAC). SAC is conventionally taught as an extension of mindfulness, which enables individuals to focus on a stable, grounded, and enduring sense of self that is able to have a flexible perspective. There has been a growing number of studies that have evaluated the effects of the SAC component in improving emotional well-being in various samples. The objective of this systematic review was twofold: (a) to evaluate whether SAC can be effectively taught and assessed in component analyses, and (b) to evaluate whether SAC improves emotional well-being. The electronic databases of PsycInfo and Medline were searched to identify relevant studies with the final search completed in August 2019. All studies that examined SAC as a stand-alone construct were considered. A total of 20 studies (published in 14 papers) met inclusion criteria for this review. Seven studies were based on a single-session lab trial, two studies were based on intervention trials, and 11 studies utilized cross-sectional assessment designs. On the basis of four identified studies, there is only provisional but very limited evidence to suggest that SAC can be effectively taught and implemented as a stand-alone process to manage emotional well-being. Mixed findings emerged in relation to SAC improving emotional well-being. The methodological quality of the studies was variable, which contributed to the mixed outcomes. There is limited evidence to support the use of the SAC component as a stand-alone process in ACT-based interventions, and research recommendations are discussed.