Efficacy of Trauma-Focused Single Session ACT in Adolescents of Southern Punjab, Pakistan: Two Years Following 2022 Torrential Flood

Abstract

Natural disasters pose significant psychological challenges, particularly for adolescents, who are developmentally vulnerable to trauma-related disorders. In 2022, widespread flooding in Southern Punjab, Pakistan, caused substantial loss. The present study evaluated the efficacy of Single-Session Acceptance and Commitment Therapy (SS-ACT) in reducing PTSD symptoms among adolescents aged 12–18 years in Taunsa, Pakistan. A two-arm randomized multiple baseline design was employed, with 85 participants equally distributed across experimental (n = 38) and control (n = 47) groups. The intervention was structured around the ACT Triflex model, emphasizing Be Present, Open Up, and Do What Matters. Outcome measures included the Child PTSD Symptom Scale (CPSS). Repeated-measures ANOVA revealed a significant reduction in PTSD symptoms in the experimental group immediately post-intervention F(3.38, 280.57) = 19.43, p < .001, η² = 0.19), with a significant time × group interaction F(3.38, 280.57) = 8.78, p < .001, η² = 0.10). Gender analyses indicated minor differences but no significant three-way interaction (time × group × gender). The findings suggest that SS-ACT is a feasible, culturally adaptable, and cost-effective intervention for post-disaster adolescent populations, and may serve as an early, stepped-care psychological support approach to help reduce acute symptoms. Implications for theory, clinical practice, policy, and future research underscore its potential integration into disaster-response frameworks and preventive mental health programs in resource-limited, disaster-prone regions.