Examining all posttreatment measures as potential mediators, treatment utilization during follow-up was mediated only by differences in posttreatment levels of shame (point estimate = 1.73, 95% CI [0.01, 5.54]). The significant differential impact of ACT on treatment utilization, t(68) = 2.20, p < .05, became nonsignificant, t(68) = 1.53, p = .14, when accounting for the unexpected difference in posttreatment levels of shame (see Table 3; proportion mediated = .24). Reversed mediational analyses (treatment use as a mediator of either posttreatment or follow-up levels of shame) were nonsignificant (p = .5). While shame went down in the ACT condition from pre- to posttreatment, TAU had even lower levels of shame at post, t(68) = 2.04, p < .05, and controlling for treatment, higher levels of posttreatment shame led to marginally higher levels of treatment utilization, t(68) = 1.97, p = .06. Posttreatment levels of shame also showed a trend toward functioning as a mediator of weeks of use (p = .08), but when treatment utilization and shame were both entered in multiple mediator models, only treatment utilization remained significant, suggesting
