The relationship between acceptance and commitment therapy processes and the well-being of adults with acquired facial palsy

Psychological flexibility, a key process in Acceptance and Commitment Therapy (ACT), underpins adaptive coping and well-being in chronic conditions but has not been examined in adults with facial palsy (FP). This study explored associations between psychological flexibility processes, functioning, and well-being in this population. A cross-sectional online survey was completed by 124 adults with acquired facial palsy (FP) across the UK and Northern Ireland. Measures included psychological flexibility processes (valued action, openness to experience, behavioural awareness), social and physical functioning, well-being, anxiety, and depression. Hierarchical multiple regressions examined covariates of well-being, anxiety, and depression, entering demographics (age, gender) at Step 1, functioning at Step 2, and psychological flexibility at Step 3. Social functioning was the most consistent covariate across models, associated with greater well-being and lower anxiety and depression. Psychological flexibility processes contributed to well-being and anxiety, with valued action, behavioural awareness, and openness to experience predicting greater well-being, while openness to experience and behavioural awareness predicted greater anxiety. Psychological flexibility was not associated with depression. Findings suggest that psychological flexibility processes contribute uniquely to well-being and anxiety among adults with FP, beyond demographic and functional factors. In contrast, depressive symptoms were primarily associated with reduced social functioning. ACT-informed interventions that strengthen valued action and behavioural awareness, alongside support targeting social functioning, may be beneficial for this population.