| Background The phenomenon of adolescents with school refusal leading school absenteeism has increasingly become a prominent issue. Acceptance and Commitment Therapy (ACT) can effectively improve the depression, anxiety, psychological flexibility of adolescents. However, there are limited studies on the intervention of ACT in depression, anxiety, psychological flexibility and return-to-school rate of absenteeism adolescents. Objective To explore the effect of ACT on the depression, anxiety, psychological flexibility and return-to-school rate of school absenteeism adolescents, and to provide reference for improving depression and anxiety, psychological flexibility and return-to-school rate of absenteeism adolescents. Methods From May to June 2024, 50 adolescents with Shenzhen school status who had been suspended from school for more than 1 month for school refusal were included through Wechat official account as the research objects. The adolescents were divided into study group and control group by random number table method. Both groups received psychological education with the theme of "Causes and solutions of school refusal", and the study group received ACT intervention once a week for 6 weeks for 1 hour each time. At baseline and after treatment, Patients' Health questionnaire Depression Scale (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7) and Comprehensive assessment of Acceptance and Commitment Therapy processes (CompACT) were used to evaluate the adolescents. Results A total of 45 adolescents completed the study, including 25 in the study group and 20 in the control group. The results of covariance analysis showed that the PHQ-9 score and GAD-7 score of the study group were lower than those of the control group after treatment, while the CompACT total score , open dimension score and awareness dimension score were higher than those of the control group, with statistical significance(F=7.786, 10.334, 12.922, 14.374, 3.075, P<0.05). The rate of return-to-school in the study group (40.00%) was higher than the control group (10.00%) (χ2=5.114, P<0.05) after intervention. Conclusions ACT may reduce depression and anxiety of school absenteeism adolescents, improve their psychological flexibility and increase the return-to-school rate. |