Effectiveness of a web-based acceptance and commitment therapy program for adolescent career preparation: A randomized controlled trial

Highlights

• This study examined ninth-grade adolescents' career preparation.

• The efficacy of a web-based Acceptance and commitment therapy (ACT) program was examined.

• ACT was effective for career-related insecurity and career-choice self-efficacy, but not for preparation against setbacks.

• ACT-based online intervention programs have potential to promote adolescent career preparation.

• Such interventions might be especially effective for subgroups of adolescents.

Abstract

Acceptance and commitment therapy (ACT) programs have rarely been used as tools for promoting adolescents' career preparation. This randomized controlled trial examined the possibility to promote the career preparation of Finnish ninth-grade adolescents (n = 249, 49% females) with a web-based five-week ACT-based online intervention program. Participants were randomly assigned to three conditions, of which two groups received an iACT including support via SMS (iACTface: iACT+two face-to-face sessions; only iACT: iACT with no face-to-face sessions) and the third (control) group received no treatment. The results showed that career-related insecurity decreased as a result of the intervention irrespective of adolescent gender or academic achievement. Intervention effects in career-choice self-efficacy, in turn, were moderated by gender as such that girls benefited more from face-to-face support during intervention than boys. All the detected immediate effects were maintained at the six-month follow-up. In turn, delayed intervention effects in career-related insecurity and career-choice self-efficacy were mainly observed among adolescents with low academic achievement. The effect sizes of the found intervention effects were moderate. The results suggest that ACT-based online intervention programs have potential to promote adolescent career preparation. However, such interventions might be especially effective for subgroups of adolescents.

Introduction

Career preparation including clarifying vocational preferences and specifying and implementing educational choices is considered among the most important developmental tasks for adolescents (Super, 1980, Super, 1990). The successful performance of this developmental task has been shown to promote personal growth, psychological and economic well-being, and vocational careers (Germeijs & Verschueren, 2007; Lent & Brown, 2013). Career preparation and career control might be particularly important nowadays when future career prospects are more insecure and unstable due to major changes occurring in working life (e.g., Briscoe, 2015; Guest & Rodrigues, 2015). Not only adolescents' goals, values and interests, but also self-efficacy and coping skills play a central role in their educational and vocational choices as well as in their future careers (e.g., Betz, 2007; Briscoe, 2015; Gainor, 2006; Lent, 2013).

Among adults, Acceptance and Commitment Therapy (ACT) interventions in an occupational context have been found to promote employees' job performance, productivity and innovation potential (Bond et al., 2010; Bond & Bunce, 2003), and reduce absenteeism as well as job burnout (Bond & Flaxman, 2006; Flaxman & Bond, 2010; Puolakanaho et al., 2018). In general, ACT interventions aim to support individuals' personal growth and resilience, with an emphasis on clarification of interests and values and acting in accordance with one's values (Hayes et al., 2006; Hoare et al., 2012). ACT also emphasizes building acceptance skills or a flexible behavioral repertoire in relation to one's own inner experiences (e.g. self-critical thoughts, anxiety; Hayes et al., 2006), which can increase adaptability and the ability to pursue long-term goals that, in turn, are related to career preparation (see Lent, 2013). According to Hoare et al. (2012), ACT has potential to offer a holistic approach to career development interventions and enhance individuals' cognitive and emotional functioning in regard to career planning. Thus, ACT-based interventions may also promote the goals of adolescent career preparation. However, no previous studies have examined the effectiveness of ACT interventions to promote adolescents' career preparation, which we focus on.

Specifically, our study focuses on the career preparation of 15- to 16-year-old Finnish adolescents in the ninth grade fall before they make critical educational choices regarding upper secondary education (i.e., vocational vs. academic track) after compulsory basic education. In Finland, this is the first milestone in transition from school to working life in adolescents' educational track.

The aim of the current randomized controlled trial was to examine the effects of acceptance and values-based skill training during the five-week online ACT intervention program on ninth grade adolescents' career preparation, measured as career choice self-efficacy, career-related insecurity, and preparation against career setbacks. Additionally, the current study examined whether intervention efficacy was moderated by gender and academic achievement.

Acceptance and commitment therapy (ACT) is a so-called third wave, process-based cognitive behavioral therapy (Hayes, Pistorello, et al., 2012; Hayes, Strosahl, et al., 2012). ACT does not attempt to manipulate or change the form or the frequency of individual thoughts. Instead, it aims to alter the function that the thought, emotional reaction or behavior has. The aim of ACT is to create a “mind” that is more flexible and open to the new opportunities and more aware of consequences of actions (Hayes, Pistorello, et al., 2012; Hayes, Strosahl, et al., 2012). The ACT-model proposes that adolescents' ineffective actions or problems can be caused by entangled mind processes leading to poorly developed self-awareness, failure to see the perspective of others, and weak skills to pursue for one's own goals and solve challenging life events.

Psychological flexibility is a key concept in the ACT theory, referring to individuals' capability to focus on their current situation and, depending on the opportunities provided by the situation, to act towards achieving their personal goals and values, even in the presence of unwanted thoughts, emotions, physiological sensations and memories (Bond et al., 2008; Flaxman et al., 2013; Hayes, Pistorello, et al., 2012; Hayes, Strosahl, et al., 2012). Essentially, ACT intervention models focus on promoting six inter-related psychological processes: (a) remaining flexibly and purposefully in the present moment and being mindful of thoughts, feelings, bodily sensations, and action potentials; (b) maintaining a perspective-taking attitude on thoughts and emotional reactions; (c) clarifying one's hopes, values, and goals in life; (d) acting in line with identified personal hopes, values, and goals; (e) willingly experiencing unwanted inner experiences to engage in valued action; and (f) observing and recognizing the thoughts that interfere with one's experienced life events and valued actions and seeing them as thoughts rather than literal truths (Flaxman et al., 2013; Hayes, Strosahl, et al., 2012; Puolakanaho et al., 2019). Each of these processes is a psychological skill that can be useful in planning one's own actions and committing to pursuing long-term goals (characterized in the current paper as career-related goals) as well as addressing possible barriers or setbacks (characterized in the current paper as career—related setbacks) including inner experiences that may function as barriers to action (e.g. self-doubt).

Essentially, ACT-based interventions are thought to be a process-based psychological treatments that potentially influence psychologically derived obstacles and challenges in multiple different life domains, including that of career (Dindo et al., 2017; Hayes & Hofmann, 2017; Hayes, Pistorello, et al., 2012; Muto et al., 2011; Pistorello, 2013). A growing number of studies have successfully used the ACT approach with adolescents, for example, to alleviate depression and stress (e.g., Petts et al., 2017), to alter unwanted behavior (e.g., Armstrong et al., 2013), and to relieve physical conditions, such as pain (e.g., Wicksell et al., 2009). Furthermore, ACT-based interventions have shown positive effects in alleviating psychological symptoms, increasing quality of life, and enhancing psychological flexibility in adolescents (Puolakanaho et al., 2019; Lappalainen et al., 2021; Swain et al., 2015) and in university students (e.g., Levin et al., 2017; Muto et al., 2011; Pistorello, 2013; Räsänen et al., 2016). Among adults ACT has also been found to enhance self-efficacy, performance, productivity and innovation potential in occupational settings (Flaxman et al., 2013). Current literature suggests that ACT may have the potential to promote school engagement and decrease the risk of adolescents dropping out of school (Moore et al., 2003). However, as far as we know, no previous studies have examined the efficacy of ACT in promoting adolescent's career preparation which we focus on in the current paper. In the present study career preparation was examined through career choice preparedness, including the readiness to take advantage of opportunities and the readiness to deal with barriers and setbacks in the domain of career choice (Koivisto et al., 2011; Sweeny et al., 2006; Vuori et al., 2008).

Career development is a dynamic process that continues over the span of one's career (which encompasses much of the life span) and where the formation of career-related choices is particularly relevant and active during adolescence (Lent & Brown, 2013). Adolescents' high abilities to cope with career decisional tasks have been shown to predict their subsequent academic commitment and adjustment in higher education, which, in turn, has been associated with successful vocational careers (Germeijs & Verschueren, 2007; Keller & Whiston, 2008).

Lent (2013, see also Lent et al., 1994) launched an integrative social cognitive career theory (SCCT) to understand educational and occupational behavior. SCCT proposes that experiences of one's own skill development at young age shape career choice-related self-efficacy, expectations and interest and ultimately career development. Indeed, high career choice–related self-efficacy has shown to positively associate with career exploration (Brown & Lent, 2016; Creed et al., 2007), career persistence (Choi et al., 2012; Lent et al., 1994) and promote actual career-related choices and performance (Betz & Hackett, 1981; Brown & Lent, 2016; Lent et al., 1993). Outcome expectations, e.g., experiences of career and labour market insecurity, in turn, have been shown to complement self-efficacy in the prediction of educational and vocational intentions (Fouad & Smith, 1996; Lent et al., 1993), educational choice goals (Lent et al., 2005), and impaired self-management (Alisic & Wiese, 2020). In SCCT, self-efficacy and outcome beliefs are seen as jointly influencing career-related interests, which tend to foster career choice goals (i.e., intentions to pursue a particular career path) that are congruent with one's interests (Lent, 2013; Lent et al., 1994).

Following this boosting self-efficacy beliefs and outcome expectations related to career preparation has become one of the most important proximal goals in career-related interventions (for reviews, see Betz, 2007; Gainor, 2006). Therefore, the present study focuses on adolescents' experienced career-choice self-efficacy and career-related insecurity (closely related to career outcome expectations) as key indicators of career preparation. As context factors (e.g. societal structures, feedback from others, media coverage etc.) can also influence career development (Lent, 2013; Lent et al., 1994), it is important to develop competence to prepare for overcoming problems when facilitating career choices (Creed et al., 2007; Koivisto et al., 2011). Therefore, the present study focuses also on preparation against career setbacks as an indicator of career preparation.

Previous studies have provided evidence that various preventive interventions can be successful in increasing an adolescent's efficacy in making career decisions (Betz, 2007; Brown & Ryan Krane, 2000; Gainor, 2006; Koivisto et al., 2011). For example, Koivisto et al. (2011) showed for a community sample of youth that a one-week workshop program intervention successfully promoted ninth graders' career choice preparedness and positive attitude towards career planning. Web-based interventions to promote exploring career options and searching for career-related information have also been found to be useful tools in career counseling for adolescents and university students (Betz & Borgen, 2009; Fowkes & McWhirter, 2007; Tirpak & Schlosser, 2013; Turner & Lapan, 2005).

However, most previous preventive interventions (for a review, see Lent, 2013) have been educational with the emphasis on promoting capabilities in information seeking, crystallizing vocational interests, and promoting effective career decision-making. Less attention has been paid to the role of psychological processes and emotional functioning in career preparation (Hoare et al., 2012; Kidd, 2004, Kidd, 2008). An important part of ACT's potential contribution to career counseling and preventing career interventions is that it may enable counselors and clients to better address adolescents' interests (i.e., Brown, 2007), relationships (i.e., Schultheiss, 2003), and emotions (i.e., Kidd, 2004, Kidd, 2008) as they pertain to the career-related issues (see also Hoare et al., 2012). The ACT model integrates psychological theories and practices as well as career counseling, offering a new model to understand career preparation and to identify the life domains in which adolescents are struggling to carry out valued activities, to recognize and tackle the obstacles related to emotional and cognitive barriers (Hoare et al., 2012).

As far as we know, no career interventions, based on ACT to promote adolescents' career preparation, have thus far been implemented. Since finding a purpose in life and obtaining flexibility and adaptation skills are particularly relevant aims for ensuring adolescents' successful careers (Bronk et al., 2009; Burrow et al., 2010; Eccles, 2004; Hill et al., 2013; Savickas, 2005), it is arguably feasible to test the efficacy of ACT also in the promotion of adolescents' career preparation.

Individuals may also differ in the extent to which they benefit from ACT interventions, implying that individual difference factors may moderate (weaken/strengthen) intervention outcomes. Even though little is thus far known about the factors that moderate the efficacy of ACT interventions, increasing understanding about such factors is important because it helps to improve the efficacy of interventions by tailoring intervention content to the needs of different individuals (Pots et al., 2016; Välimäki et al., 2017). In this intervention study, two potential moderating factors are considered: adolescent gender and academic achievement.

Poor academic achievement is related to more limited career options available and to a heightened need for making alternative plans if the primary educational choices are not realized. Hence, poor academic achievement may also hinder adolescents' career preparation, shown as lower self-efficacy in making career choices and increased experiences of career insecurity (see also Negru-Subtirica & Pop, 2016). Furthermore it has already been shown that youth career interventions are more effective among those who have learning difficulties (Vuori et al., 2008), which again might be linked with (poorer) academic achievement. These findings suggest that academic achievement may moderate the relationships between ACT intervention and career outcomes.

In previous studies, it has also been shown, somewhat paradoxically, that adolescent girls tend to outperform boys academically (Kiuru et al., 2007; Marcenaro-Gutierrez et al., 2017; Pomerantz et al., 2002) but at the same time are more vulnerable to school-related stress than boys (Currie et al., 2012; Hirvonen et al., 2019). In one previous study, the results showed that the efficacy of a web-based ACT intervention in alleviating adolescent stress and increasing their academic buoyancy did not depend on the level of adolescents' academic skills (Puolakanaho et al., 2019). However, no previous studies have examined whether adolescents' gender and academic achievement might moderate efficacy of ACT interventions to promote adolescent career preparation.

The goal of this study was to investigate the effects of the Youth Compass program (a web-based five-week ACT intervention) on career preparation i.e., career-choice self-efficacy, career-related insecurity, and preparation against career setbacks, among adolescents. A total of 249 ninth-grade adolescents were randomly assigned to three conditions of which two groups received an iACT including online support (iACTface: iACT + two face-to-face sessions; only iACT: iACT with no face-to-face sessions). These two iACT interventions were compared to a control group receiving only the usual support from the school. The following three research questions and hypotheses were addressed.

• Can adolescents' career preparation be promoted with the web-based Youth Compass program, and does intervention efficacy vary between the two intervention groups (i.e., iACTface vs. only iACT)? It is expected (H1) that the Youth Compass program promotes adolescents' career preparation in terms of higher career-choice self-efficacy, lower career-related insecurity, and higher preparation against career setbacks (closely related to career outcome expectations). Due to inconsistent previous research, no hypotheses are set regarding differences between intervention groups (i.e., iACTface vs. only iACT).

• Are the intervention results maintained at the six-month follow-up, and does maintenance of intervention effects vary between the two intervention groups (i.e., iACTface vs. only iACT)? It is expected (H2) that the positive intervention results persist at the six-month follow-up, indicating maintenance of intervention effects. Due to the lack of previous research, no hypotheses are nevertheless set regarding differences between intervention groups in the maintenance of intervention effects (i.e., i.e., iACTface vs. only iACT).

• Is the efficacy of Youth Compass in promoting adolescent career preparation moderated by adolescent gender and academic achievement? Adolescents with lower achievement, who likely need especially much further career guidance and counseling (see also Pope, 2015), were tentatively expected (H3) to particularly benefit from Youth Compass with regard to their career preparation. Due to the lack of previous research, no hypotheses are set regarding adolescent gender as a moderator of intervention effects. However, regarding practical implications it is important to find out whether girls and boys differentially benefit from the intervention.