Where Mind Meets Medicine—Supporting Treatment Adherence through Psychological Flexibility
Evidence for Change Series: Immunology in Focus
Psychological flexibility—a key concept in Acceptance and Commitment Therapy (ACT)—is gaining attention in healthcare for its role in helping individuals manage the emotional and cognitive challenges of long-term treatment.
Unlike rigid coping strategies, psychological flexibility helps patients stay aligned with their values even when motivation declines, making it a strong predictor of sustained adherence.
Interventions based on ACT and mindfulness-based approaches that enhance psychological flexibility can be powerful tools that can be leveraged to optimize adherence and treatment engagement in those living with chronic health conditions.
Evidence for Change Series: Immunology in Focus
Psychological flexibility—a key concept in Acceptance and Commitment Therapy (ACT)—is gaining attention in healthcare for its role in helping individuals manage the emotional and cognitive challenges of long-term treatment.
Unlike rigid coping strategies, psychological flexibility helps patients stay aligned with their values even when motivation declines, making it a strong predictor of sustained adherence.
Interventions based on ACT and mindfulness-based approaches that enhance psychological flexibility can be powerful tools that can be leveraged to optimize adherence and treatment engagement in those living with chronic health conditions.
Optimizing Immunology Patient Support
Our findings reveal new and current insights into the relationship between adherence and psychological flexibility. They demonstrate the need to provide targeted, personalized, and holistic patient support for those with autoimmune conditions.
As part of immunology patient support programs, interventions should be designed using the latest behavioral science and health psychology insights to effectively foster psychological flexibility. Optimizing immunology patient support programs this way will enable and empower those living with autoimmune conditions to Change for Good
To explore these findings and their implications for patient engagement strategies, including how psychological flexibility can be supported, contact Dr Kate Perry—our Global Head of Behavioral Science and Lead Researcher—for a 30-minute online discussion: Click Here to contact Kate and request a meeting and receive a free copy of our study report.
Read about our expertise & behavioral science insights.
Introduction
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At Atlantis Health, we prioritize embedding the patient perspective into everything we do, with the aim of driving better outcomes—particularly in treatment adherence. To do this effectively, we regularly carry out original research to build a richer understanding of the lived patient experience.
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As part of our ongoing Evidence for Change research series, we surveyed 152 people living with autoimmune conditions across the globe to gain insight into their day-to-day realities and identify new ways to provide support.
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This year, our focus centered on the role of psychological flexibility—a concept emerging evidence suggests has strong potential to positively influence patient outcomes.
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The study followed a mixed-methods, observational approach that combined validated psychological measures with open-text questions, allowing us to capture both quantitative and qualitative insights.
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You can find more detail on our study approach and participant demographics here.
Psychological Flexibility
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Psychological flexibility is the ability to stay open, present, and engaged in meaningful action—even when facing difficult thoughts, emotions, or symptoms.
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For people living with long-term and challenging health conditions—such as autoimmune diseases—psychological flexibility can support better coping, improved wellbeing, and greater treatment adherence—especially when dealing with unpredictability, fatigue, or flare-ups.
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The CompACT-151 is a validated self-report tool that assesses psychological flexibility exploring three key areas:
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Openness to Experience – Willingness to face discomfort
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Behavioral Awareness – Mindful presence
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Valued Action – Acting in line with what personally matters
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How people score on the CompACT-15 offers a picture of how people manage and adapt to life with an autoimmune disease.
Psychological Flexibility and Nonadherence
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Using the MARS-52 to assess treatment adherence, we compared psychological flexibility between adherent and non-adherent groups.
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Non-adherent individuals scored significantly lower on overall psychological flexibility (CompACT-15 total score).
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Non-adherent individuals also showed significantly lower scores in:
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Openness to Experience
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Behavioral Awareness
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Overall, individuals with lower adherence had lower psychological flexibility, highlighting a valuable opportunity to support patients at risk of nonadherence with targeted tools or strategies designed to enhance psychological flexibility.
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Individuals reporting lower psychological flexibility may particularly benefit from Acceptance and Commitment Therapy (ACT)-based approaches, which are showing promise as supportive interventions in chronic illness management.
Opportunity & Implications for Intervention
These findings suggest that supporting psychological flexibility could help improve treatment adherence. ACT-based interventions to enhance psychological flexibility might include:
- Mindfulness-based approaches to increase present-moment awareness
- Acceptance strategies to help patients face difficult thoughts or symptoms without avoidance
- Values-based coaching to reconnect patients with personally meaningful treatment goals
Targeting these skills may help patients manage emotional and physical challenges more effectively—and stay engaged with their treatment.
References
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Hsu, T., Hoffman, L., & Thomas, E. B. K. (2023). Confirmatory measurement modeling and longitudinal invariance of the CompACT-15: A short-form assessment of psychological flexibility. Psychological Assessment, 35(5), 430–442. https://doi.org/10.1037/pas0001214
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Chan, A. H. Y., Horne, R., Hankins, M., & Chisari, C. (2020). The Medication Adherence Report Scale: A measurement tool for eliciting patients' reports of nonadherence. British journal of clinical pharmacology, 86(7), 1281–1288. https://doi.org/10.1111/bcp.14193