Jason B Luoma

In this study we assessed the construct validity of the recently published White Racial Affect Scale (WRAS; Grzanka et al., 2020). Specifically, we assessed the convergent, criterion related, and incremental evidence for construct validity of the White guilt, White shame, and White defensiveness (called “White negation” in the original paper) facto...

Background Instruments to measure substance use stigma are emerging, however little is known regarding their psychometric properties. While research has evolved to view substance use stigma as a context sensitive international phenomenon that is embedded within cultures, validated self-report measures are lacking and comprehensive reviews of the ex...

Psychological flexibility has been proposed as a core process of change when psychedelics are used for therapeutic purposes, but to date empirical outcomes have only documented changes on the Acceptance and Action Questionnaire (AAQ-II), a very general measure of psychological flexibility. This pilot study measured outcomes from psilocybin administ...

Background and aims Because psychedelic-assisted therapy (PAT) is likely to be provided by interdisciplinary professional teams comprised of social workers, psychologists, and psychiatrists, understanding the acceptability of this treatment approach among these professional disciplines is essential as the treatment advances through approval process...

Background Social anxiety disorder (SAD) is a serious and prevalent psychiatric condition that heavily impacts social functioning and quality of life. Though efficacious treatments exist for SAD, remission rates remain elevated and a significant portion of those affected do not access effective treatment, suggesting the need for additional evidence...

3,4-Methylenedioxymethamphetamine (MDMA) is currently being tested as an adjunct to psychotherapy in multiple controlled trials, including two completed Phase 3 trials. If approved by regulatory authorities, MDMA could become a legally available medicine used in the context of psychotherapy, i.e., MDMA-assisted therapy (MDMA-AT), within the next co...

Background Stigma associated with substance use and criminal involvement is pervasive and creates a barrier to evidence-based addiction care within the criminal legal system. Research has yet to examine a multi-level stigma intervention which targets the intersection of these stigmas among both criminal legal staff and legally-involved clients. Me...

Background: People who inject drugs (PWID) living with HIV may be disproportionately impacted by pandemic restrictions. This study qualitatively explored the impacts of the SARS-CoV-2 pandemic on PWID with HIV in St. Petersburg, Russia. Methods: In March and April 2021, we conducted remote, semi-structured interviews with PWID with HIV, health c...

Knowles and colleagues’ 3D model (2014) describes the strategies White people use to manage the identity threat posed by their privilege: deny and distance from their privilege or dismantle the systems that maintain their privilege. The purpose of this study was to investigate whether alternative explanations of privilege would be more likely to tr...

This study audited publications in the Journal of Contextual Behavioral Science (JCBS) to characterize the extent to which articles published by the journal 2020 - 2021 used commonly accepted open science practices that enhance transparency & reproducibility.

Background: People with HIV who inject drugs experience intersecting forms of stigma that adversely impact care access. This RCT aimed to evaluate effects of a behavioral intersectional stigma coping intervention on stigma and care utilization. Methods: We recruited 100 participants with HIV and past-30-day injection drug use at a non-government...

Shame is one of the leading barriers to successful recovery in substance use treatment settings. This secondary analysis study examined measurement invariance of the Internalized Shame Scale (ISS) and explored changes in shame during treatment. Participants (N = 105) in the parent study were recruited from a nonprofit residential treatment center f...

Research suggests the link between self-criticism and low social belonging is partially explained by lower expression of positive emotions (Luoma & Chwyl, 2020), however, it is not well understood why high self-critics (HSCs) express less positive emotions. The purpose of this study is to investigate the underlying mechanisms that might explain thi...

Shame is considered central in body dysmorphic disorder (BDD) and empirical accounts highlight the link between shame and BDD symptoms as well as common negative psychosocial effects of the disorder, yet there is a lack of interventions addressing shame in this context. In the past decade, Acceptance and commitment therapy (ACT) and interventions t...

As evidence for psychedelic-assisted therapy accumulates, legalization becomes more likely. As a result, there is an increasing need for psychologists to become educated about psychedelics and their therapeutic effects as they will play an important role in disseminating this treatment. Therefore, understanding psychologists’ current attitudes towa...

Acceptance and Commitment Therapy (ACT) emphasizes a focus on theory-driven processes and mediating variables, a laudable approach. The implementation of this approach would be advanced by addressing five challenges, including: 1) distinguishing ACT processes in measurement contexts; 2) developing and rigorously validating measures of ACT processes...

This paper focused on identifying patterns of emotional expression that may account for the relationship between self-criticism and social disconnection. In particular, the study examined whether self-criticism was related to three aspects of emotional openness and expressivity—increased expressive suppression, reduced expression of positive emotio...

The acute subjective effects of psychedelics are responsive to users’ expectations and surroundings (i.e., “set and setting”). Accordingly, a great deal of thought has gone into designing the psychosocial context of psychedelic administration in clinical settings. But what theoretical paradigms inform these considerations about set and setting? Her...

Background Evidence suggests that psychedelic-assisted therapy carries transdiagnostic efficacy in the treatment of mental health conditions characterized by low mood and the use of avoidance coping strategies. Aims While preliminary evidence suggests that psychological flexibility and emotion regulation processes play an important role within psy...

Objective Shame is a transdiagnostic emotion of strong clinical and research interest. Yet, there is a lack of consensus on the definition and varying methods employed across self-report measures, potentially affecting our ability to accurately study shame and examine whether clinical interventions to alter shame are effective. This paper offers a...

Psychedelic-assisted therapy may represent an upcoming paradigm shift in the treatment of mental health problems as recent clinical trials have demonstrated strong evidence of their therapeutic benefits. While psychedelics are currently prohibited substances in most countries, the growing popularity of their therapeutic potential is leading many pe...

Objective Researchers have suggested that psychotherapy may be enhanced by the addition of 3,4-methylenedioxymethamphetamine (MDMA), particularly in the treatment of disorders wherein interpersonal dysfunction is central, such as social anxiety disorder. We review literature pertaining to three potential processes of change that may be instigated d...

Background HIV-positive people who inject drugs (PWID) experience stigma related to their substance use and HIV, with adverse consequences to their health care utilization and mental health. To help affected individuals cope with their intersectional stigma and reduce its negative impact on health and health care, we adapted a behavioral stigma cop...

Psychological inflexibility has been linked to a variety of mental health disorders, including posttraumatic stress disorder (PTSD). The purpose of this cross-sectional self-report study was to examine how psychological inflexibility, along with closely related concepts such as mindfulness and self-compassion, are associated with PTSD among a clini...

While the concept of values has been present in behavioral traditions dating back to Skinner, the analysis of the role of values in modern contextual behavioral science (CBS) in relation to motivation has greatly expanded over the past 30 years. In particular, values are important in a modern understanding of the role of human language in modifying...

Social anxiety disorder (SAD) is a prevalent and often debilitating psychiatric disorder that can assume a chronic course even when treated. Despite the identification of evidence-based pharmacological and behavioral treatments for SAD, much room for improved outcomes exists and 3,4-methylenedioxymethamphetamine (MDMA) has been proposed as a promis...

Psychologists are a vital component of mental health treatment and their perceptions of psychedelic-assisted therapy are critical for future implementation. This cross-sectional quasi-experimental electronic survey study explored the attitudes about psychedelics used in treatment among 366 clinical psychologists in the United States. Participants e...

Little is known about the intersection of HIV stigma and substance use stigma. Using data from 188 HIV-positive people who inject drugs (PWID) in Russia, we examined the associations of these stigmas and their interaction with access and utilization of healthcare. While substance use stigma was significantly associated with poor access to care (AOR...

Psychological Inflexibility (PI) is reliably associated with adverse psychological outcomes but little research has explored how PI may affect therapeutic process in psychotherapy. The current study examined the longitudinal influence of PI measured at pre-treatment on likelihood of client non-disclosure of treatment-relevant information at 15-week...

After a two-decade hiatus in which research on psychedelics was essentially halted, placebo-controlled clinical trials of psychedelic-assisted therapy for mental health conditions have begun to be published. We identified nine randomized, placebo-controlled clinical trials of psychedelic-assisted therapy published since 1994. Studies examined psilo...

This study examined the association between self-criticism and the fulfillment of psychological needs. Informed by Self-Determination Theory, we tested the influence of participant self-criticism on the satisfaction of autonomy, relatedness, and competence needs among their peers. We also investigated whether the influence of relationship closeness...

After a two-decade hiatus in which research on psychedelics was essentially halted, placebo-controlled clinical trials of psychedelic-assisted therapy for mental health conditions have begun to be published. We identified nine randomized, placebo-controlled clinical trials of psychedelic-assisted therapy published since 1994. Studies examined psilo...

After a two-decade hiatus in which research on psychedelics was essentially halted, placebo-controlled clinical trials of psychedelic-assisted therapy for mental health conditions have begun to be published. We identified nine randomized, placebo-controlled clinical trials of psychedelic-assisted therapy published since 1994. Studies examined psilo...

Changes in psychological flexibility were tracked in a combined protocol of exposure and response prevention (ERP) and acceptance and commitment therapy (ACT) for adults with OCD to assess if changes in psychological flexibility processes were unique to ACT intervention (e.g., not impacted by ERP). Using a non-concurrent multiple baseline design, f...

People who drink alcohol to cope with negative affect tend to drink more and experience more frequent negative alcohol-related consequences. Experiential avoidance-the tendency to avoid, suppress, or otherwise attempt to control unwanted inner experiences-is a largely pathological process that may help account for how negative affect is linked to i...

Scientific research on the therapeutic use of psychedelics has rapidly expanded over the past decade and, over the next decade, they may be approved for clinical use. Psychedelics have been used for centuries in ritual, community, and spiritual contexts and yet the potential for a scientific approach to these drugs has possibly never been greater t...

Psychedelic assisted therapy comprises three stages: Preparation, Psychedelic Session, and Integration. Preparation is key for maximising the potential of a beneficial psychedelic experience and integration is important for prolonging improvements. The psychological flexibility model (PFM) appears to be a promising one to guide psychedelic preparat...

After two decades of quiescence, clinical psychedelic research re-started in the 1990s and is rapidly accelerating. Early evidence for effectiveness is promising, but understanding of the psychological processes of change underlying observed benefits is limited. This paper outlines contextual behavioral science (CBS) as an ideal framework for under...

Shame has been hypothesized to both contribute to and protect against problematic substance use, yet no systematic reviews of these relationships exist. We identified 42 studies of the empirical associations between shame and substance use or substance use-related problems in order to elucidate this relationship. A meta-analysis of 14 samples found...

Practice-based research is an important means of bridging the gap between the science and practice of psychotherapy. Unfortunately, numerous barriers exist for clinicians who want to conduct research in practice settings. One specific barrier that has received minimal attention in the literature—lack of access to institutional review board (IRB) ov...

Between-subjects studies show that people with higher levels of shame tend to experience more negative drinking-related consequences than people with lower levels of shame. However, within-subjects studies of the association between daily fluctuations in shame and subsequent drinking have yielded mixed findings. This study aimed to resolve these in...

Background: Empirical studies of the relationships between shame, guilt, and drinking are sparse and sometimes appear contradictory. However, a more coherent picture emerges when researchers differentiate between measures of experienced of guilt and shame (i.e., questionnaires that ask how often people experience thoughts, feelings, and sensations...

Shame and dissociation cooccur in trauma survivors. Bypassed shame theory posits that dissociation reduces pain by interrupting shame. We tested this theory by inducing dissociation. The hypothesis that higher baseline shame would predict larger increases in dissociation following the induction was marginally supported. However, in contrast to bypa...

Experiential avoidance (EA) is a generalized risk factor for psychopathology and is defined as an unwillingness to remain in contact with private events. A number of behavioral tasks have demonstrated potential in assessing EA, including a limited number of studies using the Implicit Relational Assessment Procedure (IRAP). IRAP studies of EA to dat...

American Psychological Association (APA) guidelines require that all psychologists be trained to integrate science and practice in their work. The majority of psychologists have been trained in a scientist-practitioner model to both utilize and produce scientific research. However, the day-to-day integration of research and clinical practice is rar...

Research to-date on generalized prejudice has focused primarily on personality factors. Further work is needed identifying manipulable variables that directly inform antiprejudice interventions. This study examined three such variables: empathic concern, perspective taking, and psychological inflexibility/flexibility with prejudiced thoughts, as a...

A growing body of research within the acceptance and mindfulness-based therapies suggests that these treatments may function in part by reducing or eliminating (i.e., decoupling) the normative relationships between internal experiences and other internal/overt behavior. Examples of decoupling effects found in this review include reduced relationshi...

Within the past decade, empirical evidence has emerged supporting the use of Acceptance and Commitment Therapy (ACT) targeting shame and self-stigma. Little is known about the role of self-compassion in ACT, but evidence from other approaches indicates that self-compassion is a promising means of reducing shame and self-criticism. The ACT processes...

Regular peer consultation can be an important means to continually develop clinical skills. This paper describes our journey in creating a peer consultation group aimed at helping people learn and practice Acceptance and Commitment Therapy (ACT). Across several years, we have refined and shaped our meeting format, created documents outlining the fo...

Background: Stigma has been suggested as a possible contributor to the high rates of treatment attrition in substance-dependent individuals, but no published empirical studies have examined this association. Objectives: The present paper assessed the relationship between baseline stigma variables and length of treatment stay in a sample of patie...

Reincarceration rates are high among substance-involved criminal offenders. This study (conducted during 2010-2011 in an urban area and funded by a Washington State University-Vancouver mini-grant) used a randomized design to examine the effectiveness of mindfulness-based relapse prevention (MBRP) as compared to relapse prevention (RP), as part of...

Exposure is considered one of the most effective interventions for PTSD. There is a large body of research for the use of imaginal and in vivo exposure in the treatment of PTSD, with prolonged exposure (PE) therapy being the most researched example. Acceptance and commitment therapy (ACT) has sometimes been called an exposure-based treatment, but h...

Little attention has been paid to the examination and measurement of self-stigma in substance misuse. This paper aims to fill this gap by reporting on the development of a new scale to measure self-stigma experienced by people who are misusing substances, the Substance Abuse Self-Stigma Scale. Content validity and item refinement occurred through a...

Acceptance and Commitment Therapy (ACT) training often includes experiential elements aimed at improving therapist psychological flexibility, yet the effects of ACT training on therapist psychological flexibility have yet to be evaluated. This pilot study examines the effects of experiential phone consultation as an adjunct to a standard continuing...

The current study sought to develop and test the Acceptance and Action Questionnaire – Stigma (AAQ-S), a measure of psychological flexibility with stigmatizing thoughts. A sample of 604 undergraduate students completed an online survey, which included an initial pool of 43 AAQ-S items as well as measures related to psychological flexibility and sti...

Suicidal behavior is exhibited by a diverse population of individuals and spans many diagnostic categories. In order to develop effective prevention and treatment programs, it is important to identify transdiagnostic processes that impact the many pathways to suicidality, are amenable to intervention, and affect clinical outcomes when modified. A g...

Shame has long been seen as relevant to substance use disorders, but interventions have not been tested in randomized trials. This study examined a group-based intervention for shame based on the principles of acceptance and commitment therapy (ACT) in patients (N = 133; 61% female; M = 34 years old; 86% Caucasian) in a 28-day residential addiction...

Although work-site factors have been shown to be a consistent predictor of burnout, the importance of mindfulness and values-based processes among addiction counselors has been little examined. In this study, we explored how strongly experiential avoidance, cognitive fusion, and values commitment related to burnout after controlling for well-establ...

Psychological flexibility is a relatively new clinical construct targeted by Acceptance and Commitment Therapy, a behavior analytic treatment incorporating mindfulness and values interventions, among other processes. Poor psychological flexibility has been shown to relate to clinical problems as well as normative life challenges, and efforts to inc...

The Implicit Relational Assessment Procedure (IRAP) is a relatively new measure of implicit cognition that tests cognition as relational behavior instead of an associative activity and thus may provide a more specific measure of cognitive repertoires, including those for social biases, than better known implicit measures such as the Implicit Associ...

Stereotypes and judgments about people with substance misuse problems are extremely prevalent and negative. These negative evaluations are made not only by those who abstain from substance use, termed public stigma, but also by those who themselves use and abuse substances, termed self-stigma. While the exact form of discrimination may vary across...

A self-report measure of perceived stigma toward substance users was developed and studied. An initial measure was created based on a previously developed scale that was rated by experts for content validity and quality of items. The scale, along with other measures, was administered to 252 people in treatment for substance problems in the United S...

Stigma associated with being overweight or obese is widespread. Given that weight loss is difficult to achieve and maintain, researchers have been calling for interventions that reduce the impact of weight stigma on life functioning. Sound measures that are sensitive to change are needed to help guide and inform intervention studies. This study pre...

Little is known about the assessment and treatment of self-stigma in substance abusing populations. This article describes the development of an acceptance based treatment (Acceptance and Commitment Therapy–ACT) for self-stigma in individuals in treatment for substance use disorder. We report initial outcomes from a study with 88 participants in a...

Een recente ontwikkeling, met name bij cognitieve en gedragstherapie, is dat men gebruikmaakt van behandelingsprotocollen die gekoppeld zijn aan specifieke diagnosen uit het Diagnostic and Statistical Manual of Mental Disorders (DSM). Hoewel ACT-behandelingsprotocollen in verband met onderzoek soms specifiek voor bepaalde syndromen gelden, geeft AC...

Een mensenleven opbouwen dat gevrijwaard blijft van leed is onmogelijk. Het bekende gedicht van Edwin Arlington Robinson herinnert ons eraan dat elke dag wel iemand die – in elk geval van buitenaf bezien – alles heeft wat zijn hartje zou kunnen begeren, toch liever een einde aan zijn of haar leven maakt dan nog een minuut verder te leven. Als mense...

Taal is voor het menselijk bestaan een zegen en een vloek tegelijk. Alle processen in ACT zijn ontleend aan dit inzicht en aan het fundamentele onderzoek dat tot dit inzicht heeft geleid.

Leren dansen begint met het herhaaldelijk oefenen van de elementaire onderdelen van de dans: draaien, leiden, lichtjes op de bal van je voet steunen, de basispassen, de maat houden. Zodra je enige vaardigheid hebt opgedaan in elk van die aspecten, leer je hoe je ze tot een samenhangend patroon kunt samenvoegen. Naarmate je beter wordt, kun je gaan...

Tientallen jaren van onderzoek naar praktisch alle vormen van psychotherapie hebben tot de conclusie geleid dat de therapeutische relatie consistent samenhangt met het klinische resultaat (Martin, Garske & Davis, 2000). Het is echter niet duidelijk of dit empirische gegeven geresulteerd heeft in effectievere therapieën of therapeuten. Kennis van di...

This study examines whether adding psychologically focused group consultation to a standard 1-day continuing-education workshop on Group Drug Counseling (GDC), a group therapy with evidence of effectiveness in the treatment of substance abuse problems, improves GDC adoption. Counselors who had taken a 1-day workshop were randomly assigned to an 8-w...

This study examined the impact of stigma on patients in substance abuse treatment. Patients (N=197) from fifteen residential and outpatient substance abuse treatment facilities completed a survey focused on their experiences with stigma as well as other measures of drug use and functioning. Participants reported experiencing fairly high levels of e...

Client: So you're saying that I can't do anything about my anxiety? Therapist: I'm not telling you anything… I'd just like you to check what your experience has to say. As you've gone to war with your anxiety, has it gotten smaller and moved off to the side of your life, or have you seen it becoming, unbelievably, even larger and more central in yo...

The present article presents and reviews the model of psychopathology and treatment underlying Acceptance and Commitment Therapy (ACT). ACT is unusual in that it is linked to a comprehensive active basic research program on the nature of human language and cognition (Relational Frame Theory), echoing back to an earlier era of behavior therapy in wh...

Dialectical Behavior Therapy, Acceptance and Commitment Therapy, and Functional Analytic Psychotherapy have recently come under fire for “getting ahead of their data” (Corrigan, 2001). The current article presents a descriptive review of some of the actual evidence available. Dialectical Behavior Therapy and Acceptance and Commitment Therapy have a...

Because ACT is a contextual treatment, your attempts to conceptualize a presenting problem might be different from traditional case conceptualization models. The most important principle in contextual analysis is that you are not just assessing a particular symptom with a particular topography; you are also attempting to understand the functional i...