Terapia de aceptación y compromiso en el tratamiento del consumo de sustancias psicoactivas: tendencias investigativas
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Fecha
2026
Autores
Mercado Calderín, Richard Antonio
Ojeda Gallego, Duberlys Adriana
Oliveros Mejía, Robinson Augusto
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Ediciones Universidad Simón Bolívar
Facultad de Ciencias Jurídicas y Sociales
Facultad de Ciencias Jurídicas y Sociales
Resumen
Los trastornos por consumo de sustancias psicoactivas constituyen un problema de salud pública por su impacto en la salud física y mental, la elevada probabilidad de recaída y las barreras de acceso a tratamiento. En este contexto, la Terapia de Aceptación y Compromiso (ACT), como intervención de tercera generación, propone el fortalecimiento de la flexibilidad psicológica mediante procesos como la aceptación, la defusión cognitiva, el contacto con el momento presente, los valores y la acción comprometida. El objetivo de esta monografía fue identificar la evidencia científica sobre intervenciones basadas en ACT para el tratamiento del trastorno por consumo de sustancias psicoactivas durante el periodo 2020–2024, así como describir sus características y revisar limitaciones metodológicas, contextuales y clínicas reportadas. Se realizó una revisión de literatura siguiendo las recomendaciones en la base de datos de Web of Science. Se identificó inicialmente 31 artículos, tras aplicar criterios de inclusión, se excluyeron 24 por no emplear ACT como intervención principal o no cumplir criterios metodológicos, y se incluyeron finalmente 7 estudios. Los trabajos revisados abarcaron intervenciones presenciales y grupales, coaching telefónico y modalidades digitales como aplicaciones móviles y plataformas web, aplicadas principalmente a tabaquismo, y en menor proporción a consumo de cocaína y uso de drogas inyectables, incluyendo poblaciones con comorbilidad psiquiátrica y contextos de vulnerabilidad. En general, los estudios reportaron hallazgos favorables en variables relevantes del proceso terapéutico, como aceptación de señales internas, afrontamiento del craving, participación y satisfacción con la intervención. Sin embargo, los resultados sobre abstinencia o reducción del consumo fueron heterogéneos y no siempre mostraron diferencias significativas frente a comparadores activos. En conjunto, la evidencia revisada sugiere que la ACT se ha implementado en múltiples formatos y poblaciones, con adecuada factibilidad y aceptabilidad, lo que indica un camino importante a seguir en cuanto al desarrollo e implementación de tratamientos psicológicos innovadores dentro de los procesos de rehabilitación y resolución de los consumos problemáticos de sustancias y adicciones. Por lo anterior, esta monografía no establece conclusiones definitivas sobre efectividad, pero sí aporta una síntesis crítica del estado de la evidencia reciente y resalta la necesidad de investigaciones futuras con diseños más robustos, muestras más diversas y evaluaciones comparables a mediano y largo plazo.
Substance use disorders constitute a major public health concern due to their impact on physical and mental health, the high likelihood of relapse, and persistent barriers to treatment access. In this context, Acceptance and Commitment Therapy (ACT), as a third-wave behavioral intervention, aims to strengthen psychological flexibility through processes such as acceptance, cognitive defusion, contact with the present moment, values clarification, and committed action. The aim of this monograph was to identify scientific evidence on ACT-based interventions for the treatment of substance use disorders during the period 2020–2024, as well as to describe their characteristics and examine the methodological, contextual, and clinical limitations reported. A literature review was conducted following database search procedures in Web of Science. An initial total of 31 articles was identified. After applying inclusion criteria, 24 studies were excluded for not employing ACT as the primary intervention or for failing to meet methodological standards, resulting in a final sample of seven studies. The reviewed studies included face-to-face and group-based interventions, telephone coaching, and digital modalities such as mobile applications and web-based platforms. These interventions were primarily applied to tobacco use, and to a lesser extent to cocaine use and injection drug use, including populations with psychiatric comorbidities and individuals in vulnerable contexts. Overall, the studies reported favorable findings in key therapeutic process variables, such as acceptance of internal cues, coping with craving, engagement, and satisfaction with the intervention. However, outcomes related to abstinence or reduction in substance use were heterogeneous and did not consistently demonstrate significant differences compared to active control conditions. Taken together, the reviewed evidence suggests that ACT has been implemented across multiple formats and populations with adequate feasibility and acceptability, indicating a promising direction for the development and implementation of innovative psychological treatments within rehabilitation processes and the resolution of problematic substance use and addictions. Accordingly, this monograph does not establish definitive conclusions regarding effectiveness; rather, it provides a critical synthesis of the current state of the evidence and highlights the need for future research employing more robust designs, more diverse samples, and comparable medium- and long-term outcome evaluations.
Substance use disorders constitute a major public health concern due to their impact on physical and mental health, the high likelihood of relapse, and persistent barriers to treatment access. In this context, Acceptance and Commitment Therapy (ACT), as a third-wave behavioral intervention, aims to strengthen psychological flexibility through processes such as acceptance, cognitive defusion, contact with the present moment, values clarification, and committed action. The aim of this monograph was to identify scientific evidence on ACT-based interventions for the treatment of substance use disorders during the period 2020–2024, as well as to describe their characteristics and examine the methodological, contextual, and clinical limitations reported. A literature review was conducted following database search procedures in Web of Science. An initial total of 31 articles was identified. After applying inclusion criteria, 24 studies were excluded for not employing ACT as the primary intervention or for failing to meet methodological standards, resulting in a final sample of seven studies. The reviewed studies included face-to-face and group-based interventions, telephone coaching, and digital modalities such as mobile applications and web-based platforms. These interventions were primarily applied to tobacco use, and to a lesser extent to cocaine use and injection drug use, including populations with psychiatric comorbidities and individuals in vulnerable contexts. Overall, the studies reported favorable findings in key therapeutic process variables, such as acceptance of internal cues, coping with craving, engagement, and satisfaction with the intervention. However, outcomes related to abstinence or reduction in substance use were heterogeneous and did not consistently demonstrate significant differences compared to active control conditions. Taken together, the reviewed evidence suggests that ACT has been implemented across multiple formats and populations with adequate feasibility and acceptability, indicating a promising direction for the development and implementation of innovative psychological treatments within rehabilitation processes and the resolution of problematic substance use and addictions. Accordingly, this monograph does not establish definitive conclusions regarding effectiveness; rather, it provides a critical synthesis of the current state of the evidence and highlights the need for future research employing more robust designs, more diverse samples, and comparable medium- and long-term outcome evaluations.
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Palabras clave
Intervención, Terapia de aceptación ycompromiso, Consumo de sustancias psicoactivas, Salud mental, Craving
