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Acceptance and Commitment Therapy for Anxiety Disorders : A Practitioner's Treatment Guide to Using Mindfulness, Acceptance, and Values-Based Behavior Change Strategies / G.H. Eifert, J.P. Forsyth ; pról. de S.C. Hayes.
... Paradoksal olarak bu "korkunun korkusu", kaygı yaratan uyaranla bir sonraki karşılaşmada kaygıyı artırmakta ve giderek daha katı davranış kalıplarının gelişmesine yol açmaktadır (Eifert & Forsyth, 2005). ...
... Yaşantısal kaçınma, bilişler, fiziksel duyumlar ve duygusal durumlar dahil olmak üzere belirli içsel deneyimleri yaşamayı reddetme ve aktif olarak değiştirmeye çalışma anlamına gelir (Hayes vd., 1996). Yaşantısal kaçınma, adaptif kaygı ile patolojik kaygıyı birbirinden ayırır (Eifert & Forsyth, 2005). Bilişsel birleşme ve yaşantısal kaçınma, patolojik anksiyetenin ve diğer psikopatoloji türlerinin varsayılan nedeni olan psikolojik katılıkla sonuçlanmaktadır (Hayes vd., 2006 (Lønfeldt vd., 2017). ...
... Başka bir deyişle, kaygının sıkıntı verici ve tahammül edilemez olarak algılanması, kaygı yaşamamanın hayati önem taşıdığı fikrine yol açabilir (Hayes, 2004). Paradoksal olarak bu "korkunun korkusu", kaygı yaratan uyaranla bir sonraki karşılaşmada kaygıyı körükler ve giderek daha katı davranış kalıplarının gelişmesine yol açar (Eifert & Forsyth, 2005). Örneğin agorafobik kaçınma, mekanların kendisinden kaçınmaktan ziyade, halka açık yerlerde ortaya çıkan ve panikle bağlantılı olan sıkıntı verici psikolojik fenomenlerden kaçınma olarak kavramsallaştırılır (Friman vd., 1998). ...
Araştırmanın genel amacı Kabul ve Kararlılık Terapisi (ACT) ve Bilişsel Davranışçı Terapi (BDT) temelli psikoeğitim programlarının ön ergenlerin kaygı düzeyleri üzerindeki etkiliklerinin karşılaştırılmasıdır. Bu bağlamda deneysel uygulama iki deney (BDT ve ACT) ve bir kontrol grubu ile ön-test, son-test, bir aylık ve üç aylık izleme ölçümlerini içeren 3x4’lük karışık desen ile yapılandırılmıştır. Araştırmanın çalışma grubunu üç farklı devlet okulunda okuyan ve altıncı sınıfa devam eden 38 (ACT=10, BDT=13, Kontrol=15) ön ergen oluşturmaktadır. Deneysel desende gerçekleştirilen araştırmada veri toplama araçları olarak Çocuklarda Anksiyete ve Depresyon Ölçeği-Yenilenmiş (ÇADÖ-Y) Çocuk Formu, Kaçınma ve Birleşme Ölçeği-Gençler 8 (KBÖ-G8), Çocuklar İçin Bilişsel Esneklik Ölçeği (ÇBEÖ) ve Akran İlişkileri Ölçeği (AİÖ) kullanılmıştır. Deney gruplarında yer alan ön ergenlere 8 haftalık BDT ve ACT’ye dayalı psikoeğitim programları uygulanmış, kontrol grubuna ise herhangi bir müdahalede bulunulmamıştır. Verilerin analizinde ise karışık ölçümler için iki faktörlü ANOVA kullanılmıştır. Araştırma sonuçları hem ACT hem de BDT temelli programların ön ergenlerin kaygı düzeylerini azaltmada etkili olduğunu ve bu etkinin izleme dönemlerinde de sürdüğünü göstermektedir. Bunun yanı sıra ACT grubunda yer alan ön ergenlerin psikolojik katılık düzeylerinde anlamlı azalma ve akran ilişkileri düzeylerinde ise artış olduğu görülmüştür. BDT grubundaki ön ergenlerin ise psikolojik katılık ve akran ilişkileri düzeylerinde herhangi bir anlamlı değişim meydana gelmemiştir. Ayrıca her iki grupta yer alan ön ergenlerin bilişsel esneklik düzeylerinde anlamlı bir değişim olmadığı gözlenmiştir. Araştırma bulguları hem BDT hem ACT’nin ön ergenlerin kaygı düzeylerini azaltma konusunda etkili birer yaklaşım olduklarına yönelik önemli veriler sunmaktadır.
... The first two therapy sessions focused on establishing rapport, providing psychoeducation about anxiety and fear, introducing the interactive and participatory nature of ACT, and defining the goals of ACT in the context of the client's values (Eifert & Forsyth, 2005). Further, these sessions also focused on establishing a queer-oriented, accepting space in the therapy room. ...
... Notably, for the first time since her move, Cynthia began drawing and painting again. She also continued to show sustained progress, and thus, treatment shifted to Phase 2, where the goals included identifying values and increasing mindful acceptance and perspectivetaking skills when experiencing anxious thoughts and feelings (Eifert et al., 2009;Eifert & Forsyth, 2005). ...
... Values Clarification and Valued Directions. Though some of Cynthia's values were clear at intake, further clarification added depth and specificity (Eifert & Forsyth, 2005), helping to define workability and what successful treatment might look like. As part of this process Cynthia participated in a values card sort, which she later described as fun but challenging. ...
The current case describes the implementation of Acceptance and Commitment Therapy (ACT) and self-compassion interventions with a 37-year-old Queer Hispanic woman “Cynthia” (pseudonym). Cynthia presented to a university training clinic, reporting pervasive difficulties with anxiety, an associated pattern of depressive episodes, and a trauma history. The therapist conceptualized Cynthia’s presenting problems through an ACT-based psychological flexibility framework. Functional analysis indicated intolerance of uncertainty, fusion to self-critical thoughts, and experientially avoidant behaviors (e.g., pervasive worry) contributed to Cynthia’s anxiety. Values clarification, as well as mindfulness- and acceptance-based interventions, were met with gains in quality-of-life scores and decreases in worry scores as treatment progressed. Additionally, self-compassion interventions were implemented to address pervasive self-criticism and feelings of low self-worth. Across 37 sessions, from pre-to-post treatment, Cynthia’s quality of life scores increased by 62.5%, and worry decreased by 52.8%. These results provide support for using ACT and self-compassion interventions for anxiety and co-occurring depression with a Queer, Hispanic woman.
... One of the strategies gaining popularity in clinical and coaching settings is Acceptance and Commitment Therapy (ACT), a newer third-wave intervention framework (Eifert and Forsyth, 2005;Juncos and de Paiva Pona, 2018;Hill and Oliver, 2019). ACT is based on the philosophy that thoughts and emotions need not be managed in order to live a valued and meaningful life (Eifert and Forsyth, 2005). ...
... One of the strategies gaining popularity in clinical and coaching settings is Acceptance and Commitment Therapy (ACT), a newer third-wave intervention framework (Eifert and Forsyth, 2005;Juncos and de Paiva Pona, 2018;Hill and Oliver, 2019). ACT is based on the philosophy that thoughts and emotions need not be managed in order to live a valued and meaningful life (Eifert and Forsyth, 2005). Instead of controlling our internal private world, ACT focuses on accepting unwanted thoughts and feelings, whose occurrence and disappearance cannot be controlled, and on commitment and action toward living a. ...
... valued life (Eifert and Forsyth, 2005). In the case of Music Performance Anxiety (MPA), ACT suggests that anxiety need not stand in the way of doing what one loves, in this case, music performance (Eifert and Forsyth, 2005;Juncos et al., 2017). ...
Introduction
Most of the anxiety disorders, particularly social anxiety, seem to develop either during childhood or adolescence. Adolescent singers who experience physical, mental and emotional changes along with voice change are particularly prone to the development of MPA. However, adolescence also seems to be an opportune time to instil healthy behaviours in singing students as they are more likely to remember these coping strategies, owing to the release of dopamine and the ‘reminiscence bump’. As this period of a singer’s life is wrought with inevitable anxiety development, the additional aim of the study was to develop a coaching framework which can be used by singing teachers in their practice. Mindset training for adolescents seems crucial to help them continue singing through puberty so they do not drop out of singing lessons or choir during voice change and identity development.
Methods
The study aimed to determine if Acceptance and Commitment coaching could be used with adolescent singers with MPA and to record and analyse rich qualitative data in the form of semi-structured participant interviews and questionnaires.
Results
When their perception of MPA symptoms and physiological and psychological arousal before a performance changed, their behaviour and reactions changed accordingly. The change took place over a period of time, which was characterised by discoveries about themselves, confusion in understanding new concepts and letting go of old habits. Interestingly, by the end of the coaching sessions, their preoccupation with pleasing the audience and appearing perfect on stage was replaced by a new-found delight in pursuing values and goals related to their singing. Along with this came the acceptance of themselves and others as individuals with the potential for growth and change and the capacity to learn from mistakes.
Discussion
This study marks the first investigation into the effectiveness of using of ACC as an intervention for MPA in adolescent singers undergoing puberty by a singing teacher. The results are promising and suggest that ACC is an effective MPA intervention for adolescent singers to cope with inevitable development-related anxieties and keep them engaged in the activity of singing during their pubertal years.
... The items of the CA-IRAP were created in this study. The authors gathered descriptions of change Psychol Rec agendas from preexisting ACT literature (Bach & Moran, 2008;Eifert & Forsyth, 2005;Hayes & Smith, 2005;Hayes, Strosahl, & Wilson, 2012), and selected the combination that most represented the concept of a change agenda according to six ACT practitioners (three doctoral candidates with clinical psychologist licensure, and three master's students). Items using vocabulary that Japanese people felt more familiar with were preferentially selected. ...
... Finally, we expected that the acceptance-negative trial type (If I accept negative feelings-feel worse) would not show a clear D score. For ACT learners, we predicted that their scores for the acceptance-negative trial type would not be low because we were unable to find phrases similar to "If I accept negative feelings, I will feel worse" within various widely used ACT books (Bach & Moran, 2008;Eifert & Forsyth, 2005;Hayes & Smith, 2005;Hayes et al., 2012). Meanwhile, because accepting negative feelings is painful and not easy in general (Tartakovsky, 2014), it is possible that ACT learners and nonlearners have both learned the relational response that "If you accept negative feelings, you will feel worse" to similar degrees. ...
This research examined the reliability and validity of the Change Agenda Implicit Relational Assessment Procedure (CA-IRAP). Change agendas that lead people to think that “reducing or removing undesirable thoughts and feelings will solve problems and lead to a more successful life” are considered unworkable in acceptance and commitment therapy (ACT). For acceptance-based interventions to succeed, relinquishing change agendas is important. However, currently available methods for measuring these types of change agendas are limited to explicit measures, which are vulnerable to distortion from social desirability and demand characteristics. The authors attempted to measure change agendas using the IRAP. A total of 131 undergraduate and graduate students (40 male, 91 female; mean age = 21.93, SD = 3.19) participated. First, we examined the CA-IRAP’s discriminant validity in relation to explicit measures such as the Acceptance and Action Questionnaire-II in 83 participants who were able to pass the CA-IRAP. The correlations between the CA-IRAP and the explicit measures were low, confirming the discriminant validity of the CA-IRAP. Second, we examined the predictive validity of the CA-IRAP. Nineteen respondents had learned ACT and 34 respondents had never learned ACT. Non-ACT learners’ CA-IRAP scores were higher than those of ACT learners, which confirmed the CA-IRAP’s predictive validity. Finally, we examined the CA-IRAP’s test–retest reliability, which was confirmed across some CA-IRAP trial types. In conclusion, the authors submit that the CA-IRAP has strong potential as a valid instrument for measuring the relative strength of relational responses around change agendas while controlling for variables such as demand characteristics.
... The items of the CA-IRAP were created in this study. The authors gathered descriptions of change Psychol Rec agendas from preexisting ACT literature (Bach & Moran, 2008;Eifert & Forsyth, 2005;Hayes & Smith, 2005;Hayes, Strosahl, & Wilson, 2012), and selected the combination that most represented the concept of a change agenda according to six ACT practitioners (three doctoral candidates with clinical psychologist licensure, and three master's students). Items using vocabulary that Japanese people felt more familiar with were preferentially selected. ...
... Finally, we expected that the acceptance-negative trial type (If I accept negative feelings-feel worse) would not show a clear D score. For ACT learners, we predicted that their scores for the acceptance-negative trial type would not be low because we were unable to find phrases similar to "If I accept negative feelings, I will feel worse" within various widely used ACT books (Bach & Moran, 2008;Eifert & Forsyth, 2005;Hayes & Smith, 2005;Hayes et al., 2012). Meanwhile, because accepting negative feelings is painful and not easy in general (Tartakovsky, 2014), it is possible that ACT learners and nonlearners have both learned the relational response that "If you accept negative feelings, you will feel worse" to similar degrees. ...
This research examined the reliability and validity of the Change Agenda Implicit Relational Assessment Procedure (CA-IRAP). Change agendas that lead people to think that “reducing or removing undesirable thoughts and feelings will solve problems and lead to a more successful life” are considered unworkable in acceptance and commitment therapy (ACT). For acceptance-based interventions to succeed, relinquishing change agendas is important. However, currently available methods for measuring these types of change agendas are limited to explicit measures, which are vulnerable to distortion from social desirability and demand characteristics. The authors attempted to measure change agendas using the IRAP. A total of 131 undergraduate and graduate students (40 male, 91 female; mean age = 21.93, SD = 3.19) participated. First, we examined the CA-IRAP’s discriminant validity in relation to explicit measures such as the Acceptance and Action Questionnaire-II in 83 participants who were able to pass the CA-IRAP. The correlations between the CA-IRAP and the explicit measures were low, confirming the discriminant validity of the CA-IRAP. Second, we examined the predictive validity of the CA-IRAP. Nineteen respondents had learned ACT and 34 respondents had never learned ACT. Non-ACT learners’ CA-IRAP scores were higher than those of ACT learners, which confirmed the CA-IRAP’s predictive validity. Finally, we examined the CA-IRAP’s test–retest reliability, which was confirmed across some CA-IRAP trial types. In conclusion, the authors submit that the CA-IRAP has strong potential as a valid instrument for measuring the relative strength of relational responses around change agendas while controlling for variables such as demand characteristics.
... The resulting escalating intrusion of the experiences people had been attempting to avoid causes them to invest more mental resources into the control agenda, setting off a feedback loop in which they give progressively more ground to anxiety, spending ever more time and energy cordoning off anxiety-arousing areas of existence until the space they have left to live in is claustrophobic and cramped. To avoid feeling bad, people deprive themselves of opportunities to feel good and end up suffering more from their own efforts to control anxiety than from the feelings of anxiety itself (Eifert & Forsyth, 2005). Even activities people ought to genuinely enjoy become tainted when used as distractions, leading them to enjoy less and less (Gross & John, 2003;) and feel increasingly inauthentic over time ( John & Gross, 2004). ...
... Death holds an incredible power to cut away everyday concerns and reveal what truly matters, which is why imagining one's own funeral is an exercise at the start of almost every ACT workbook (Dahl, 2010;Eifert & Forsyth, 2005;Mazza, 2020). When people advise to "live like you're dying," this is what they mean. ...
Climate crisis presents a near-term existential threat to the human species, one that society has neither the physical nor psychological infrastructure to manage. Eco-anxiety increases as awareness about climate crisis spreads. Despite an urgent need for resources on how to help people cope with the psychological ramifications of climate crisis, there is little literature that both addresses people’s apocalyptic fears and takes the scientific bases of those fears seriously. In this article, I synthesize research on existential psychology, Acceptance and Commitment Therapy, grief, and end-of-life care to present an original perspective on how people, individually and collectively, can become psychologically resilient to climate crisis. First, I establish that death anxiety underlies eco-anxiety. Second, I demonstrate that preparing psychologically for eco-apocalypse requires people to cultivate death acceptance. Finally, I illustrate how commitment to palliative values can enable people to live rich and meaningful lives despite their most likely imminent end.
... Especially, common vulnerabilities between and comorbidity of depressive and anxious mood also necessitate the integration of transdiagnostic processes into the available treatment protocols (Mennin et al., 2007;Trosper et al., 2009) that can mediate or explain therapeutic change. We suggest that in the evidence-based practices of CBT models including but not limited to Acceptance and Commitment Therapy for depression and anxiety (Eifert and Forsyth (2005); Kuyken et al., 2005), parental attachment insecurity and emotion regulation difficulties specifically the regulation of negative emotions should be considered and targeted. We specifically elaborate on how an attachment theory perspective can inform clinical work below. ...
Parental rejection in childhood is an empirical developmental vulnerability factor for mental health problems, dysfunctional relationship orientations, and emotion regulation difficulty. However, theoretical models combining interpersonal acceptance-rejection theory with attachment theory and examining the links among parental rejection, insecure attachment styles, and associated emotion regulation problems in the context of mood symptoms are scarce. This study examines the associations among the recollections of parental rejection in childhood, insecure attachment styles in parental relationships, regulation of positive and negative emotions, and mood symptoms in young adulthood. Hence, a structural equation model including the direct associations of maternal and paternal rejection with mood symptoms and the indirect roles of insecure attachment styles and emotion regulation difficulties in this association was tested in a sample of Turkish young adults. A sample of 411 young adults completed the relevant self-report measures with a cross-sectional design. The hypothesized model explained a substantial amount of variance in young adults’ mood symptoms. The results further revealed significant associations between maternal rejection and maternal attachment anxiety and paternal rejection and paternal attachment avoidance. The corresponding attachment styles were in turn associated with positive and negative emotion regulation difficulties, but following only negative emotion regulation difficulty was significantly associated with mood symptoms. The findings and implications are discussed with respect to theory, previous research, and relevant cultural context.
... Experiential avoidance is defined as the efforts individuals make to avoid painful experiences (Hayes et al., 2006). Anxiety, on the other hand, can lead to the emergence of numerous unwanted emotions, thoughts, and bodily sensations (Eifert & Forsyth, 2005). Individuals who perceive thoughts, feelings, and bodily sensations that arise during anxiety as intolerable often engage in experiential avoidance behaviors to avoid experiencing them (Hayes et al., 1996;Luoma et al., 2007). ...
This research aims to investigate the serial mediating role of optimism and self-compassion between anxiety and experiential avoidance among university students. A total of 411 university students participated in the research, with 263 (64%) being female and 148 (36%) being male. According to the results of the mediation analysis, it was seen that both optimism and self-compassion had mediating roles in the relationship between anxiety and experiential avoidance. In addition, it was concluded that the serial mediating role of optimism and self-compassion in the relationship between anxiety and experiential avoidance was significant. The mediation findings obtained in the study reveal that high levels of optimism and self-compassion in university students can help them cope better with anxious situations, reduce their anxiety levels, and therefore reduce experiential avoidance tendencies. This study highlights significant findings regarding the mechanism underlying the relationship between anxiety and experiential avoidance, particularly concerning positive variables.
... These approaches criticize interventions that focus solely on modifying the content of cognitions. For instance, Eifert and Forsyth (2005) argue that internal experiences such as thoughts and emotions cannot be controlled and that cognitive reappraisal may increase the avoidance and suppression of unwanted thoughts. ...
The primary objective of this study was to investigate a proposed model of valued living, focusing on the roles of acceptance and cognitive reappraisal. A total of 158 university students completed various questionnaires that assessed acceptance, cognitive reappraisal, repetitive thinking, the obstruction of valued living, and progress in valued living. Through structural equation modeling, the model displayed a satisfactory fit, indicating that acceptance indirectly influenced valued living through decreasing obstruction and repetitive thinking. Furthermore, cognitive reappraisal indirectly impacted repetitive thinking through the mediation of acceptance. Moreover, cognitive reappraisal directly and positively influenced the progress of valued living and acceptance. The findings of this study have practical and research implications, suggesting the positive role of cognitive reappraisal and acceptance of internal experiences in valued living among the nonclinical population.
... In fact, these strategies of control/suppression and of experiential avoidance (efforts made to avoid emotions, thoughts, memories, and other internal and external events) work as an omnipresent process, learned in the early years and reinforced by the socioverbal community throughout life. These strategies may promote psychological inflexibility, which leads to the exaggeration of human suffering (Eifert & Forsyth, 2005;Hayes et al., 1999). ...
This study aimed to test a comprehensive model in adolescent athletes that explores the effect of shame on sports anxiety and whether psychological inflexibility and mindfulness influence this association. The sample study included 210 young Portuguese athletes from different competitive sports. The path analysis results confirmed the adequacy of the proposed model, which explained 49% of the variance in sports anxiety. Results demonstrated that athletes who experienced higher levels of shame tended to exhibit elevated levels of sports anxiety through lower levels of mindfulness and higher psychological inflexibility. The study offers new empirical data that may be relevant for clinical and sport psychology practitioners. These findings seem to underline the importance of addressing shame and, consequently, sports anxiety in adolescent athletes by developing greater psychological flexibility and, inherently, more mindfulness skills among adolescent athletes who are in a phase of their lives where sport can play a crucial role.
... Problem-solving (11), acting against negative emotions (12), behavioral activation (13), and seeking social support in dealing with stress (14,15) are known as adaptive emotion regulation strategies. Although psychopathology literature has placed focus on healthy (like behavioral activation, gaining social support, distraction, and committed action) and unhealthy behavioral strategies (namely avoidance and withdrawal) when experiencing negative emotions (16)(17)(18), no specific measurement has been yet designed for integrative assessment of behavioral emotion regulation strategies. ...
Background: The Behavioral Emotion Regulation Questionnaire (BERQ) has been designed to assess the adaptive and maladaptive strategies for emotion regulation. Objectives: The current investigation aimed to study the psychometric properties of the BERQ in a sample of Iranian students. Methods: To assess the psychometric properties of the BERQ (2020 - 2021), 301 students (150 males and 151 females) at Kermanshah University of Medical Sciences (KUMS) were selected using convenience sampling. In addition to the BERQ, the participants completed the Cognitive Emotion Regulation Questionnaire (CERQ), the Penn State Worry Questionnaire (PSWQ), and the Depression Anxiety Stress Scales (DASS). Afterward, Cronbach's alpha coefficient, convergent and divergent validity, and confirmatory factor analysis were calculated and applied using LISREL V 8.80 and SPSS V 20. Results: The results of factor analysis supported the five-factor structure of the BERQ (including seeking distraction, seeking social support, actively approaching, withdrawal, and ignoring) in the Iranian student sample (RMSEA = 0.08, comparative fit index (CFI) = 0.90, normed fit index (NFI) = 0.90). Furthermore, the positive subscales of the BERQ were significantly and positively correlated with the positive cognitive emotion regulation strategies in the CERQ. They also had a significant negative correlation with depression, anxiety, stress, and worry. Moreover, withdrawal and ignoring were significantly and positively correlated with anxiety, stress, worry, depression, and negative emotion regulation strategies of the CERQ (P < 0.05). Conclusions: The Persian version of the BERQ has suitable psychometric properties. This questionnaire could be utilized for assessing the healthy and unhealthy reactions of individuals.
... Anxiety Help for Adolescents is an evidence-based transdiagnostic internet treatment based on ACT and CBT interventions to treat anxiety in young people (Fang & Ding, 2020;Gloster et al., 2020;Reynolds et al., 2012). The program is based on the ACT treatment structure designed by Hayes et al. (2012), with modifications specifically focused on anxiety (Eifert & Forsyth, 2005) and adapted to suit young people in accordance with the work of Bailey et al. (2012) and Hayes & Ciarrochi (2015). The content, overall structure, language level, concretization of theoretical concepts, and clinical examples in the program have been adapted to suit the age and maturity of adolescents and young adults. ...
Early access to evidence-based help is crucial for adolescents with anxiety disorders. Internet-delivered acceptance and commitment therapy (iACT) may offer adolescents increased access to care and more flexibility in engaging with treatment when and how they prefer. Process-based therapies, such as ACT, focus on theoretically derived and empirically tested key mechanisms in treatment that enable change. This study aimed to investigate the effectiveness of iACT for adolescents with anxiety disorders. The study also assessed the relationship between psychological flexibility and treatment outcomes and the relationship between participating adolescents' and therapists' perceived alliance and treatment outcomes. This was a randomized controlled trial comparing a 10-week intervention group with a wait-list control group. The 52 participants, aged 15 to 19, were recruited from all over Sweden. The treatment was effective in increasing quality of life and psychological flexibility, with moderate between-group effect sizes based on observed values. Changes in psychological flexibility was associated with changes in anxiety symptoms. The results further showed a statistically significant between-group difference in post-treatment diagnoses. No significant time per group interaction was found for anxiety symptoms, as both groups improved. Working alliance was rated as high by both participating adolescents and therapists but showed no significant relationship with treatment outcomes. Participants found the treatment an acceptable intervention. This study shows promising results for iACT in treating adolescents with anxiety disorders. The results suggest the model of psychological flexibility as an important process of change in treatment outcomes. Future research should validate these findings in larger samples and clinical contexts.
... ACT brings this idea to life through the use of metaphors. In our clinical experience, two metaphors which particularly resonate with people who stutter are 'stuck in quicksand' (Harris, 2009) and 'dropping the rope' (Eifert & Forsyth, 2005). ...
The book Dialogue without barriers: A comprehensive approach to dealing with stuttering is the result of Norwegian-Polish cooperation undertaken in the project LOGOLab – Dialogue without barriers. Three partners have been involved in the production of this book, namely, the University of Silesia in Katowice, Poland, the UiT Arctic University of Norway in Tromsø, and the Agere Aude Foundation for Knowledge and Social Dialogue. The project was implemented under the Education Program financed by the EEA Grants (EEA / 19 / K1 / D1 / W / 0031).
We wanted to provide comprehensive coverage of current issues in the field of
stuttering, and invited an international group of specialists to write chapters for
the book. The result is a collaborative effort of researchers, practitioners, and professionals, some of whom have personal experience with stuttering. In addition to authors from Norway and Poland, other experts from Australia, Belgium, Canada,
United Kingdom, Greece, Germany, Lebanon, Malta and the United States have contributed. The book consists of 16 chapters, involving 25 contributing authors. Thanks to their generosity, the English version of this volume was created, which we are presenting to you herewith.
We expect the book to be useful for diverse groups worldwide. The book’s
authors present a holistic approach to speech therapy intervention in stuttering, taking into account the multi-faceted nature of the phenomena that concern
them, and the consequences for speech therapists’ work. They consider effective
prevention strategies, multi-dimensional diagnosis, and Evidence-based treatment
methods. The book describes in detail topics related to the change of social attitudes towards stuttering and Evidence-based practice. The following contemporary therapeutic programs are also presented: Camperdown Program, KIDS (German title: Kinder dürfen stottern, which translates to: Children should be allowed to stutter in English), Lexipontix Programme, and MIST (Multidimensional Individualized Stuttering Therapy). Topics such as becoming an SLT with high competence in developmental and acquired stuttering, practical aspects of group therapy, prevention of school bullying, and stuttering and multi-lingualism are also covered. Furthermore, issues such as the use of humor, creativity, and modern technologies in speech therapy interventions are included.
... Additionally, two studies (Foret, 2012;Rohani et al., 2018) conducted group rather than individual therapy. Three studies (Eifert et al., 2009;Main-Wegielnik, 2009;Thompson et al., 2021) use an ACT manual for anxiety by Eifert and Forsyth (2005) while Twohig and colleagues (2018) adapted an OCD treatment manual by Foa and Kozak (2004). ...
... Counselors lack understanding in terms of fostering a consultative commitment to deal with counselee problems with language and counseling methods (Eifert & Forsyth, 2005). This means that the counselor does not understand that in consulting services, problem solving is carried out directly by the consultant to the counselee after the consultant has carried out the consultation stage to the counselor. ...
This article aims to comprehensively describe the evaluation of guidance and counseling in the perspective of Stuffelbeam and Dahir Stone. Implementation of guidance and counseling evaluation requires instruments accurate, to produce accurate data. The problems that arise are not yet available the instruments used to carry out the evaluation. This research method uses the literature study method. The data obtained were compiled, analyzed, and concluded so as to obtain conclusions regarding the study of literature. The stages in the literature review are 1) planning, 2) conducting, 3) reporting. The data of the study that was carried out included a study of understanding, philosophical foundations and evaluation principles based on the perspective of Stuffelbeam and Dahir stone. The results of this study are in the form of a study of the Stuffelbeam and Dahir stone perspectives, namely the study of understanding, philosophy, and evaluation principles as a research basis related to the evaluation of guidance and counseling.
... Acceptance represents accepting all our experiences as they are without fighting them and being disposed to engage in new behavior (Hayes et al., 2012). Accepting the emotions and thoughts one has and behaving in accordance with the determined direction a person has about life increases psychological flexibility (Eifert & Forsyth, 2005). Therefore, one of the best ways to reduce the effect of negative thoughts and emotions in an individual is not to fight them, but to accept them (Harris, 2016). ...
This study examines the intermediary role of rumination in the relationship between childhood traumas in young adults and cognitive defusion, psychological acceptance, and suppression which is one of the emotion regulation strategies. In the quantitative stage of the study formed according to the explanatory sequential design, the intermediary role of rumination by using a structural equation model while in the qualitative stage, the intermediary role of rumination was analyzed through interviews using the interpretive phenomenology design. Personal Information Form, Childhood Trauma Scale, Short Form Ruminative Response Scale, Acceptance and Action Form II, Drexel Defusion Scale, and Emotion Regulation Scale were used in the research. At the end of the research, it was determined that childhood traumas have a negative effect on cognitive defusion and acceptance, while they have a positive effect on suppression. It was seen that rumination has a partial intermediary role in the relationship of childhood traumas with cognitive defusion, acceptance, and suppression. As a result of the qualitative analysis, twelve themes such as "Constantly thinking about the past, not being able to move away from childhood traumas, not being able to forgive their parents, inability to get rid of negative thoughts, living in the past, moving away from a value-driven life, false expression of emotion, suppression of emotions, emotions reflected in behavior, coping with negative emotions and desired emotion regulation" emerged concerning participants' experiences of cognitive defusion, acceptance, and suppression. Although one of the purposes of using AAQ-II in the study was to support discussions about the scale via qualitative results, this was a limitation for the study. Therefore, although a high rate was obtained, it is not possible to infer that childhood traumas and rumination can explain acceptance behaviors. For this, much more quantitative and qualitative studies are needed. Other qualitative research findings are thought to support quantitative research findings.
... Identifying the mechanisms contributed to the severity of ROCD symptoms can significantly enhance our understanding of this disorder and expand our knowledge of the factors related to its development and exacerbation. Although the leading cause of ROCD is not known yet, factors such as attachment styles [1,2,4,5], difficulty in emotion regulation [15,20,17], and experiential avoidance [13,21,65] may have a significant role. Previous studies have shown that insecure attachment styles are related to ROCD symptoms [1,2], and difficulties in emotion regulation and experiential avoidance are associated with insecure attachment styles [5,6,[24][25][26]. ...
Objectives Relationship obsessive-compulsive disorder (ROCD) is one of the forms of Obsessive-Compulsive Disorder, focusing on intimate relationships. Identifying the mechanisms of ROCD can significantly expand our knowledge of the factors related to its development and exacerbation. This study aims to determine the mediating role of difficulties in emotion regulation and experiential avoidance in the relationship between attachment styles and the severity of ROCD symptoms. Methods Five hundred thirty-one participants (455 females and 76 males) were selected using convenient sampling from the general population of Iran. They completed the Experiences in close relationships-revised (ECR-R), the difficulties in emotion regulation scale (DERS), the acceptance and action questionnaire-II (AAQ-II), and the Relationship Obsessive-Compulsive Inventory (ROCI) online. SPSS software, version 22 and AMOS version 24 were used to analyze data. Results Attachment styles had a significant correlation with difficulties in emotion regulation, experiential avoidance, and ROCD symptoms (P<0.01). Moreover, the two variables of difficulties in emotion regulation and experiential avoidance had a mediating role in the relationship between attachment styles and ROCD symptoms. Conclusion Attachment styles can predict the ROCD symptoms directly and indirectly by the difficulties in emotion regulation and experiential avoidance. Difficulties in emotion regulation and experiential avoidance should be considered in treatment of ROCD symptoms, especially in those with insecure attachment styles.
... In this study, the ACT protocol [29] in Table 1 was used. The ACT intervention was performed in 10 sessions for 5 weeks (two sessions per week). ...
Background and Objectives: Spirituality and psychological interventions are effective in promoting mental health and treating patients undergoing hemodialysis. The present study seeks to evaluate the effectiveness of treatment based on acceptance and commitment therapy (ACT) before dialysis, with and without mindfulness exercises during dialysis, on the spiritual health of these patients. Methods: The research design was quasi-experimental with a control group (two experimental groups and one control group) and a two-month follow-up. The study population included all patients on hemodialysis referring to hospitals affiliated to Imam Zaman Hospital in Mashhad City, Iran, from July to December 2020. A total of 60 patients were selected by a purposive sampling method based on the inclusion criteria. Then, they were randomly divided into three groups. The research instrument included a spiritual health questionnaire, and data analysis was performed by repeated-measures analysis of variance. Results: The results showed that both experimental groups of ACT before dialysis (P<0.001), with or without mindfulness plus exercises during dialysis (P=0.004), were effective on spiritual health in patients on hemodialysis. Conclusion: ACT alone as an effective intervention can be used in medical centers to increase the spiritual health of patients on hemodialysis.
... This will help people find their desired life so that they can only behave in line with their goals. In this connection, therapeutic efforts are related to behaviors that are aligned with the values prioritized by the individual (Eifert & Forsyth, 2005) since other components of acceptance and commitment (including acceptance, diffusion, and mindfulness) all serve one's values to observe the internal experiences and see committed actions through (Reilly et al., 2019). ...
Objectives
Specific learning disability (SLD) is one of the most prevalent neurodevelopmental disorders that leads to many psychological consequences for students with such disorders. The present study aimed to determine the effect of acceptance and commitment training programs on the level of academic stress and burnout in students with SLD.Methods
This study was a quantitative research conducted with a pre-test/post-test quasi-experimental design and a control group. The research population consisted of female students with SLD in Tabriz, Iran, selected through random cluster sampling method. The data were collected using Gadzella’s Student-Life Stress Inventory (SLSI) and School Burnout Inventory (SBI).ResultsMultivariate analysis of covariance was used to analyze the data. Given the results of the data analysis, the application of acceptance and commitment therapy (ACT) was seen to reduce the amount of academic stress and academic burnout in students with SLD. Since acceptance and commitment training can reduce academic stress and burnout in this group of students, it could be considered an effective intervention to reduce students’ psychological distress.Conclusions
The present findings will pave the way for further research in the field of interventions associated with the psychological problems of students with SLD.
... The fact that the client knew what she wanted for her life in a clear way ("I want to be a mother and overcome my anxiety problems"), can be used to direct and target the intervention. More than overcoming anxiety problems, clients try to live a meaningful life according to their goals and values (Eifert & Forsyth, 2005). ...
At the beginning of the therapeutic process, clients frequently feel immersed in their problems, and demoralized, with a negative perspective of different areas of their lives. The clients´ discourse is specially focused on difficulties and previous ineffective attempts to overcome their problems. Even though positive aspects of the clients’ life continue to exist, such as resources and strengths, they have little visibility in the clients’ speech and, consequently, in the therapist’s assessment and intervention planning. Moreover, most psychotherapy models emphasize a focus on the deficits of the clients, centered on the correction of difficulties as a way to achieve mental health. In this context, we highlight the importance of integrating resources and strengths of the clients’ life in case assessment, clinical formulation, and treatment planning. This information can be collected in the assessment phase, but in order to make it explicit the relevance of this information we created a protocol designed for this purpose (Feedback Initiated Narrative Development Protocol [FIND]). The first component of FIND invites clients to reflect on aspects beyond their problem like their personal strengths, significant values, positive autobiographical episodes, and useful strategies that have been adopted in the past. This interview was largely influenced by narrative therapy and innovative moments research, and it provides information regarding clients’ resources that may be useful to psychotherapists from different approaches. In this paper, we presented a clinical case formulation considering resources evaluated with the FIND protocol.
... Segal et al., 2002), wird unter anderem zur Rückfallprävention von Depressionen angewandt (Teasdale et al., 2000). Auch die Akzeptanzund Commitmenttherapie (ACT) von Hayes, Wilson und Strosahl (Hayes et al., 2011), welche beispielsweise bei sozialen Ängsten, Depressions-und Angstsymptomen Anwendung findet, hat sich in der klinischen Praxis bewährt (Eifert & Forsyth, 2005). ...
Die Ergebnisse von Studien aus der klinischen Psychologie und der Neurowissenschaften deuten darauf hin, dass Achtsamkeit eine wirksame Strategie zur Optimierung von im Sport leistungsrelevanten Faktoren sein könnte (Jekauc & Kittler, 2015). Diese Dissertation erläutert den Entwicklungsprozess des Berliner Achtsamkeitstrainings zur Leistungsoptimierung (BATL) und gibt die begleitende wissenschaftliche Analyse von möglichen Wirkmechanismen achtsamkeitsbasierten Trainings im Leistungssport wieder. Das Dissertationsprojekt umfasst drei Studien im Prä-Post-Design mit Kontrollgruppen und quantitativen Methoden sowie eine Fall-Studie mit Mixed-Methods. Die erste Untersuchung konnte zunächst zeigen, dass das BATL wirksam die Achtsamkeit bei den Teilnehmenden steigern kann. Die Ergebnisse der Folgestudie offenbarten einen indirekten positiven Effekt des BATLs auf das Emotionsmanagement von Sportlerinnen und Sportlern. Durch eine Steigerung der Achtsamkeit bewirkt das Programm eine Senkung der Anwendungswahrscheinlichkeit maladaptiver Bewältigungsstrategien. In einer weiteren Studie im Sportschulkontext deuteten die Ergebnisse darauf hin, dass das BATL sowohl die Daueraufmerksamkeit als auch die selektive Aufmerksamkeit bei jungen Sportler:innen verbessert und dass mehr Training im gleichen Zeitraum zu besseren Aufmerksamkeitsleistungen führt. Die Daten deuteten auch darauf hin, dass Teilnehmende, die nach der Intervention weiterhin selbständig übten, bei der Langzeitmessung ebenfalls bessere Leistungen erzielten. Die abschließende Fallstudie im Leistungssportkontext konnte aufzeigen, dass mehr Unterstützung für Athlet:innen bei der Integration von Achtsamkeitsübungen in den Alltag den Effekt von Achtsamkeitsinterventionen steigern könnte. Über das Dissertationsprojekt hinweg konnte verifiziert werden, dass das entwickelte Achtsamkeitsprogramm BATL die sportliche Leistungsfähigkeit steigern kann. Die grundlegende Hypothese, dass achtsamkeitsbasiertes Training eine vielversprechende Ergänzung zu herkömmlichen sportpsychologischen Interventionen im deutschsprachigen Raum darstellen kann, konnte damit bestätigt werden.
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Research findings from clinical psychology and neuroscience suggest that mindfulness could be an effective strategy for optimizing factors relevant to performance in sport (Jekauc & Kittler, 2015). This dissertation details the development process of the Berliner Achtsamkeitstraining zur Leistungsoptimierung (Berlin Mindfulness Training for Performance Optimization; BATL) and provides the accompanying scientific analysis of potential impact factors of mindfulness-based training in competitive sport. The dissertation project includes three randomized control trial studies in pre-post design and quantitative methods, as well as a case study with mixed methods. The first investigation initially demonstrated that the BATL was effective in increasing mindfulness in participants. The results of the follow-up study revealed an indirect positive effect of the BATL on athletes' emotion management. By increasing mindfulness, the program causes a decrease in the probability of using maladaptive coping strategies. The results of a further study indicated that the BATL improves both sustained attention and selective attention in young athletes and that more training in the same amount of time leads to better attentional performance. The data also suggested that participants who continued to practice independently after the intervention also performed better in the long-term measurement. The final case study in a competitive sports context revealed that more support for athletes in integrating mindfulness practice into daily life could increase the effect of mindfulness interventions. Across the dissertation project, it was verified that the developed mindfulness program, BATL, could enhance athletic performance. The foundational hypothesis that mindfulness-based training can be a promising addition to conventional sports psychology interventions in German-speaking countries could thus be confirmed.
... For example, depressed clients are often characterized by behavioral passivity and lack of motivation ( Zettle, 2007 ), and those struggling with anxiety disorders tend to reallocate time and energy that could be invested in pursuing valued goals to engaging in actions that seek to minimize emotional distress ( Michelson et al., 2011 ). Not surprisingly, ACT treatment protocols for both depression ( Zettle, 2007 ) and anxiety disorders ( Eifert & Forsyth, 2005 ) have included the instigation of committed action as an integral component. The apparent role of acting in value-based ways as a key therapeutic process is further affirmed in particular by the efficacy of behavioral activation in treatment of depression ( Dimidjian et al., 2014 ). ...
Process-based cognitive behavior therapy (PB-CBT) may be informed by identifying shared mechanisms of disorder linked to shared processes of therapeutic change. Repetitive negative thinking (RNT) is a molar pathogenic process common to both generalized anxiety disorder and depression. Acceptance and commitment therapy (ACT) and metacognitive therapy (MCT) offer separate models of the relationship between RNT and emotional distress. In a pair of related studies, the relative degree to which processes specific to the two models accounted for variability in levels of generalized anxiety and depression in college student samples was evaluated. Across both studies, processes of cognitive fusion and obstructed valued living within the ACT model and beliefs about the negative consequences of RNT within the MCT model were most predictive of variability in levels of emotional distress. Limitations of this project as well as implications for further research and practice of PB-CBT for disorders of emotional distress are discussed.
... Given the relative prevalence and the chronic nature of BDD, the successful treatment of the disease could signi cantly improve the mental health in individuals with BDD symptoms. It is evident from studies that ACT has a positive effect on other mental disorders such as anxiety disorders (20), depression (21), body image dissatisfaction (22) and promoting well-being (23). ...
Background
Body dysmorphic disorder (BDD) is the most distressing body image disorders. The aim of this study was to evaluate the efficacy of acceptance and commitment therapy (ACT) in improving psychological problems in individuals with BDD symptoms.
Methods
This was a randomized clinical trial study with 34 eligible patients with BDD symptoms were recruited from Kashan city in 2021. These individuals were randomly assigned to either an intervention group (n = 17) with 8 weekly ACT sessions or a placebo group (n = 17). Used assessments included Yale-Brown Obsessive-Compulsive Scale Modified for Body Dysmorphic Disorder (Y-BOCS-BDD), Depression Anxiety Stress Scales 21-item version (DASS-21), Cognitive Fusion Questionnaire (CFQ), and Body-Image Acceptance and Action Questionnaire (BI-AAQ). Data were analyzed by using SPSS 26.
Results
The results revealed that there was no significant difference in demographic variables of either age or gender. On the other hand, statistical analyze showed that two groups had the significant difference in term of body symptoms severity (F = 4.89), cognitive fusion (F = 9.18), emotional symptoms (depression F = 4.03, anxiety F = 4.02, and stress F = 4.87) in the post-test.
Conclusion
It can be said ACT has a positive effect on body image flexibility, cognitive fusion, and emotional symptoms of young people with body dysmorphic disorders and it can improve their symptoms.
... Metaphors: PAG members recollected some of the useful metaphors that they learnt from the in-person PMP as a useful way of understanding and retaining information. Particularly, participants shared making sense of threat response using an analogy of "Tiger in the room" [22]. Resources from the Explain Pain book [23], including Professor Moseley's story of a snakebite (understanding sensory processing of pain) and the Baker's story (as an example of pain memories triggering a threat response, which was represented by smell of the bread triggering a pain response) were recommended as valuable learning resources to be included. ...
Introduction
Current best practice recommends group-based pain management programmes for long-term improvements in persistent pain-related disability. However, there are barriers for people to access in-person delivered pain management programmes in Aotearoa.
Aims
To develop a co-designed, culturally responsive, online group-based pain management programme (iSelf-help) for people with persistent pain.
Methods
A modified participatory action research (PAR) framework was used to co-design contents and cultural-appropriateness of iSelf-help. The PAR team included: (1) seven end-users living with persistent pain, who had previously attended an in-person delivered group pain management programme, (2) two pain management clinicians, (3) two health researchers, (4) two digital health experts, and (5) a health literacy expert. Five meetings were held with the PAR group and a Nominal Group Technique was used to rank order the preferred features of content delivery. In parallel, to ensure cultural appropriateness of iSelf-help, three focus groups (n = 15) were held with Māori (the Indigenous population of Aotearoa) living with persistent pain in collaboration with a Māori community health trust. All contents were reviewed by a Māori Health literacy expert and core contents were translated into Te Reo (Māori language). All contents were finalised by iterative discussion among the PAR team and consultation with Māori stakeholders. The preliminary version of iSelf-help was pilot tested with the PAR group participants and Māori community members living with persistent pain and their feedback was included. The iterative co-design process occurred over a period of nine months.
Results
The finalised version of iSelf-help included a total of 130 resources organised in to 12 content relevant online modules plus a dedicated welcoming page and an online community forum. Each module included: short videos, animations explaining main concepts, patient stories, written content to accompany visual content, podcasts of relaxation techniques, illustrated texts, and evidence-summaries. A dedicated module of videos demonstrating cardiovascular and strengthening exercises of varying intensity was also included.
Conclusions
This is the first co-created, culturally appropriate, on-line group pain management programme for people with persistent pain, developed in Aotearoa. The next step is to evaluate the clinical and cost-effectiveness of iSelf-help compared to in-person delivered pain management programme.
... Terapia ACT ożywia tę ideę poprzez używanie metafor. Dwie metafory, które szczególnie odpowiadają osobom jąkającym się, to metafora ruchomych piasków (Harris, 2009) i puszczania liny (Eifert, Forsyth, 2005). ...
Publikacja Dialog bez barier – kompleksowa interwencja w jąkaniu. Wydanie polskie rozszerzone to podręcznik dla logopedów, studentów logopedii i innych specjalistów zajmujących się jąkaniem. Książka składająca się z 21 rozdziałów jest kompendium wiedzy teoretycznej i praktycznej na temat skutecznej interwencji w jąkaniu. W publikacji znalazły się rozdziały przygotowane przez badaczy i praktyków, a także specjalistów z osobistym doświadczeniem jąkania z różnych zakątków świata (z Australii, Belgii, Grecji, Kanady, Libanu, Malty, Niemiec, Norwegii, Polski, Stanów Zjednoczonych i Wielkiej Brytanii). Twórcy poszczególnych rozdziałów prezentują holistyczne podejście do interwencji logopedycznej w jąkaniu, uwzględniając wieloaspektowość zajmującego ich zjawiska i wynikające z tego konsekwencje dla pracy logopedy. Podejmują rozważania dotyczące skutecznej profilaktyki, wielowymiarowej diagnozy, poradnictwa ukierunkowanego na klienta/pacjenta i jego rodzinę oraz metod terapii opartych na dowodach. W tomie szczegółowo zaprezentowano współczesne programy terapeutyczne: Camperdown, KIDS, Lexipontix czy MIST. Omówiono temat pracy z grupą, zapobiegania mobbingowi szkolnemu, autoterapii bądź działalności samopomocowej. Poruszono również kwestie, takie jak: jąkanie a wielojęzyczność, zmiana społecznych postaw wobec jąkania, praktyka logopedyczna oparta na dowodach, stawanie się terapeutą zaburzeń płynności mowy, jąkanie neurogenne, a nawet wykorzystanie humoru, kreatywności i współczesnych technologii w interwencji logopedycznej. Publikacja powstała w ramach wdrażania polsko-norweskiej współpracy podjętej przy projekcie LOGOLab – Dialog bez barier (EOG/19/K1/D1/W/0031; partnerzy: Uniwersytet Śląski w Katowicach, Norweski Uniwersytet Arktyczny w Tromsø i Fundacja Wiedzy i Dialogu Społecznego Agere Aude w Chorzowie).
... Graduellement, il prend conscience que l'ouverture s'accompagne parfois d'un sentiment de liberté ou de contentement, que ses symptômes ne disparaissent pas par magie du moment où il arrive à incarner cette posture, mais qu'il perçoit ceux-ci différemment, avec paradoxalement, plus de distance et d'intimité. Plus important encore, il se rend compte que toute cette énergie consacrée à lutter contre son ressenti, peut être investie autrement, notamment dans des activités qui sont importantes à ses yeux (Eifert et Forsyth, 2005). ...
L’anxiété de performance est un motif de consultation courant chez les étudiants postsecondaires. Dans cet article, nous discutons du rôle que jouent l’évitement expérientiel et la fusion cognitive dans l’anxiété de performance, puis expliquons de quelle manière l’approche d’acceptation et d’engagement (ACT) peut aider les étudiants à vivre autrement avec ce type d’anxiété. Nous illustrons la forme que peut prendre cette approche en présentant une intervention de groupe développée en 2012 et offerte dans plusieurs établissements postsecondaires au Québec et en France. Nous concluons cet article en situant cette intervention à l’intérieur du cadre d’analyse systémique proposé par l’association des services aux étudiants des universités et collèges du Canada (ASEUCC).
Performance anxiety is a frequent motive for consultation among postsecondary students. In this article, we discuss the role of experiential avoidance and cognitive fusion in performance anxiety, and explain how Acceptance and Commitment Therapy (ACT) can help students cope with their anxiety differently. We illustrate the form this approach can take by presenting a group intervention developed in 2012 and offered in several postsecondary institutions in Quebec and France. We conclude this article by positioning this intervention within the student services framework proposed by the Canadian Association of College and University Student Services (CACUSS).
Background: Understanding variables that influence therapy outcomes can improve the results of interventions and reduce socio-health costs. The current study examined possible predictors and moderators of outcome (age, gender, duration of panic disorder, motivation to change, conscientiousness, and experiential avoidance) in Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT). Method: Eighty participants with a diagnosis of panic disorder, 56 women and 24 men, with an average age of 38 years, received 12 group sessions of CBT or ACT. They were assessed with several measures at pre-treatment, post-treatment, and 3-month follow-up. Results: CBT outperformed ACT among older subjects, men, and those with a shorter duration of panic disorder. ACT outperformed CBT among younger subjects, women, and those with a long duration of panic disorder. In general, the greatest improvements in both CBT and ACT were in older subjects, women, those with a long duration of panic disorder, those in the contemplation stage, and those with high experiential avoidance. Conclusions: Although future studies are necessary, there appear to be predictors and moderators of the effectiveness of CBT and ACT. Taking these variables into account can help improve treatment for people with panic disorder.
Adolescents need both developmental support and a set of compass and value-based competencies to effectively navigate and make sense of the present events and situations they meet, ultimately leading to a purposeful and fulfilling life. It is worth mentioning that there has been a significant increase in the development of psychological help, techniques, and theories in recent years to meet this demand. These theories also incorporate values. Acceptance and Commitment Therapy (ACT) strongly emphasizes identifying values as a central aspect of the therapeutic process. ACT places significant emphasis on studies focused on clarifying values and enhancing awareness, especially in individuals sensitive to developmental stages, such as adolescents. This study, provided information about the definition of ACT, effectivenes studies, and the definition and function of values in the ACT approach. This study provided information about the definition of ACT, effectiveness studies, and the definition and function of values in the ACT approach. This study aims to explain the importance of values in the ACT approach in working with adolescents and how ACT steps can clarify and increase awareness of values in adolescents by concretizing them with case examples. It also aims to explain the activities and tools that therapists can use when working with values in ACT and what they should pay attention to when working with values. The study discussed that adolescents can be helped to meet their developmental needs and make sense of the effects of positive/adverse events and experiences in their immediate and distant environments through values work. Finally, incorporating ACT with Turkish adolescent clients by including their values in counseling and associating it with primary, secondary, and tertiary studies can carry the studies to be carried out in environments where adolescents are present beyond being only crisis-oriented. Additionally, it has been recommended to conduct quantitative studies on the factors that influence adolescents' value clarification, using scales designed to highlight these values.
The COVID-19 outbreak posed significant challenges for teachers by forcing them to move from face-to-face teaching to online teaching. Against this background, teachers’ beliefs about, and practices of, online teaching became particularly important because they might influence teachers’ teaching effectiveness and children’s learning. However, little is known about the factors affecting teachers’ beliefs about, and practices of, online teaching during COVID-19. This study examined the associations of psychological distress and professional identity with perceived value of online courses and perceived quality of online teaching among 127 Chinese preschool teachers during COVID-19. Results showed that depression and loneliness were negatively associated with perceived value of online courses and perceived quality of online teaching, respectively, while professional identity was positively associated with both. Our findings highlight the unique roles of psychological distress and professional identity in shaping preschool teachers’ beliefs about, and practices of, online teaching during COVID-19. Policymakers should establish effective policies and guidelines to protect preschool teachers’ mental well-being and help alleviate their psychological distress, particularly depression and loneliness, in times of unforeseen disasters such as the pandemic. School leaders and teacher training professionals should prioritize professional identity as a crucial part of preschool teachers’ professional development during the COVID-19 outbreak.
Hypersexuality refers to the inability to control sexual desire. Despite it has shown serious consequences for physical, psychological and social health, the evidence of available psychological interventions is still insufficient. In this open-label pilot study, an Acceptance and Commitment Therapy (ACT) intervention was conducted with adults with clinically significant levels of hypersexuality aimed to examine its feasibility and usefulness. The intervention consisted of eight weekly online individual psychological intervention sessions. Outcome self-report measures were administered at baseline, after the intervention and a 3 months follow-up. Behavioral and subjective informed changes in sexual practices were weekly assessed through self-monitoring. Twelve participants (M age = 38.8 ± 11.5 years, 83.3% male, 66.7% homo or bisexual) completed the intervention. The feasibility was found to be good, with all the participants completing the training and high levels of satisfaction. Hypersexuality, psychological flexibility, cognitive fusion and mindfulness scores significantly improved after the ACT intervention, with large effect sizes. Clinically significant changes in hypersexuality were found for the vast majority of participants, besides reductions in the time dedicated to planning and practicing sex and the sexualized drug use. Results indicate that ACT-based interventions may be considered feasible and potentially effective therapeutic alternatives for hypersexuality.
Background: The satisfaction and quality of family life play a crucial role in the growth and development of family members. The present research aimed to compare the effectiveness of acceptance and commitment therapy (ACT) and cognitive-behavioral therapy (CBT) based on the approach of Muslim scientists on marital intimacy and resilience in couples. Methods: This research was a semi-experimental design with pretest-posttest in the experimental group (ACT) and the comparison group (CBT based on the approach of Muslim scientists), along with a control group. The statistical population included all couples referring to dispute resolution councils in the city of Kerman in the first half of 2023. The sample size consisted of 45 people selected purposefully, with 15 people randomly assigned to each group. The experimental group received ACT-based intervention and the comparison group received CBT-based intervention based on the approach of Muslim scientists, both for twelve 75-minute sessions, and the control group did not receive any intervention. The research tools included the Walker and Thompson’s Marital Intimacy Scale (1983) and the Connor-Davidson Resilience Scale (CD-RISC) (2003). Data analysis was conducted using SPSS version 27 software. Results: The results of the analysis of covariance (ANCOVA) revealed significant differences in the scores of intimacy and resilience among the ACT, the CBT based on the approach of Muslim scientists, and control groups. The comparison of training effectiveness indicated that the ACT group was 17% effective in improving marital intimacy and 17.7% effective in enhancing resilience. In contrast, the comparison of training effectiveness showed that the CBT based on the approach of Muslim scientists group showed 0.22% effectiveness in marital intimacy and 29.2% effectiveness in resilience. Conclusion: According to the results, CBT based on the approach of Muslim scientists can be used to promote marital intimacy and resilience in couples experiencing marital conflicts.
mindfulness and behavioural therapy learning resource manual
Introduction:
This study illustrates how mindfulness and acceptance-based intervention (MABI) can change metacognitions and executive functions among individuals with anxiety disorders.
Methods:
Forty-five Iranian individuals (mean [SD] age, 24.60 [4.94] years; 51.1 % female) with comorbid anxiety disorders participated in a randomized, waitlist-controlled trial of weekly group sessions of either MABI or waitlist control (WLC). Primary and process of change outcomes were assessed at baseline, post-intervention, and 1-month follow-up.
Results:
Significant changes were observed over time on anxiety symptoms (Cohen d = 1.04, 95% CI [0.40 ± 1.65]), as well as on metacognitive beliefs (Cohen d = 1.04, 95% CI [0.40 ± 1.64]), executive functions (Cohen d = 0.91, 95% CI [0.28 ± 1.51]), and mindfulness facets (Cohen d = 0.97, 95% CI [0.34 ± 1.58]), in favor of MABI over WLC.
Conclusions:
Overall, findings add to the knowledge in the field and provide cross-cultural evidence in support of MABIs as interventions that target anxiety symptoms, metacognitive beliefs and executive functions in a non-Western culture.
Acceptance and commitment therapy (ACT; Hayes et al. 1999) is a process-based third-wave cognitive-behavioral therapy and an evidence- based approach for the treatment of various psychological conditions including anxiety. In contrast to other approaches, ACT adopts the notion that when psychological processes (i.e., language, thoughts, emotions) are applied inflexibly and incongruently to the context, also known as psychological inflexibility, they may lead to psychological suffering. ACT aims fostering Psychological Flexibility via six core inter-related processes including acceptance, cognitive defusion, self as content, present moment awareness, values clarification and committed action. ACT therapy sessions can be tailored to fit the needs and severity of each client’s difficulties while learning and practicing the six core processes of ACT. In this chapter, we present an ACT-based functional analysis case conceptualization, a hypothesized mechanism of problem maintenance and treatment plan of a woman suffering from repetitive negative thinking and anxiety- related problems.
Objective The Acceptance and Action Questionnaire for Obsessions and Compulsions (AAQ-OC) is a version of the Acceptance and Action Questionnaire (AAQ) that specifically measures unwanted intrusive thoughts and responses (e.g., experiential avoidance) to them. This study aimed to investigate the reliability and validity of the Korean version of the AAQ-OC in clinical and nonclinical Korean samples.Methods In this study, 561 university students and 121 patients with obsessive–compulsive disorder (OCD) completed the AAQ-OC and several other psychological scales. Descriptive, correlation, and exploratory and confirmatory factor analyses as well as group comparisons were conducted.Results The results of the exploratory and confirmatory factor analyses indicated a two-factor structure that best fits the data in the university sample: Factors 1 and 2 matched the original Valued Action and Willingness subscales, respectively. The reliability analyses revealed that the AAQ-OC and its factors had excellent internal consistencies. As regards the concurrent validity, the AAQ-OC and its factors had a positive correlation with the AAQ-II and Cognitive Fusion Questionnaire. Compared with the university students, the OCD patients had higher AAQ-OC scores, and their obsessive–compulsive symptoms, particularly the two symptom dimensions of responsibility for harm and mistakes and unacceptable thoughts, were significantly associated with the AAQ-OC and two subscales.Conclusion The findings of this study confirm the reliability and validity of the Korean version of the AAQ-OC.
Despite the high prevalence, and high functional impairment associated with panic
disorder, programs targeting the prevention of panic psychopathology are still very limited. This article aims to guide panic disorder prevention programs, by analyzing different psychological risk factors, and their interactions in the pathogenesis of the psychopathology of panic disorder. The results show, on the one hand, that neuroticism, perceived control, emotional clarity, and anxiety sensitivity are causal risk factors for the development of panic disorder. On the other hand, several causal pathways involving complex chains of these factors lead to the development of panic disorder. These results may help guide panic disorder prevention interventions by guiding, on the one hand, decisions concerning the populations to be targeted for prevention efforts as well as, on the other hand, by identifying the risk and protective factors to be targeted to reduce the probability of occurrence of panic disorder.
Evidence-based practice inherently involves critical thinking and flexibility to deliver these treatments in an efficacious yet tailored manner. Experiences during the COVID-19 pandemic presented us with a new question: When is avoidance an adaptive response to a shifting and uncertain environment, and when is it a symptom? We discuss ways in which avoidance emerged following the start of the pandemic. Clinical and ethical considerations are also presented, with a focus on discerning when avoidance is problematic versus a reasonable response to a novel stressor, as well as how to responsibly proceed when the context of treatment dramatically changes.
Background/objectives:
To investigate the effectiveness, feasibility, and acceptability of sense of purpose (SOP) interventions in preventing or reducing anxiety or depression in youth aged 14-24 years.
Methods:
A systematic search was conducted of the academic (PubMed/MEDLINE, PsycINFO, EMBASE) and grey literature. We also consulted two SOP experts and an Australian and Indian youth advisory group with lived experience of anxiety and/or depression. Consultations focused on the feasibility and acceptability of reviewed interventions.
Results:
The search identified 25 studies reporting on 4408 participants from six countries (64.0 % of studies in the US). Multi-component interventions targeting several SOP components (i.e., value clarification, goal setting, gratitude enhancement) reported, on average, moderate reductions in depression and anxiety symptoms in youth. Interventions were generally more effective at reducing depression than anxiety symptoms. In terms of sub-populations or groups, there was some evidence for greater intervention effectiveness among youth with prior therapy experience, extraverted personalities, and those with already elevated anxiety/depression symptoms. Youth advisors and experts opined that group interventions were most acceptable to young people.
Limitations:
This review was limited to a recent 10-year timeframe and publications in English, potentially excluding relevant studies published prior to 2011 or in other languages.
Conclusions:
Fostering SOP can lead to better psychological wellbeing in youth. Potential harms resulting from interventions can occur without adequate consideration for a person's readiness for purpose discovery, environmental barriers, and familial and cultural settings. Further research in more diverse populations is required to determine who benefits and in what contexts.
Background and Aim Sexual function is an important part of menopausal women's lives, and changes in it, especially during menopause, can affect their health. The aim of this study was to compare the effectiveness of cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) on the sexual function of postmenopausal women.
Methods & Materials This research was a quasi-experimental with pre-test, post-test and follow-up design with control group. The statistical population of the study included postmenopausal women who referred to Zanjan Health Center in 2020 to receive services. Among them, 45 were selected using the available sampling method and were randomly assigned to three groups of 15, and control group using randomly assigned block allocation method. Therapeutic sessions were held in 8 sessions and each session was held for 2 hours. Data were collected by FSFI (Female Sexual Function Index) and were analyzed using ANOVA with repeated measures analysis via SPSS software, version 24.
Ethical Considerations This study was approved by the ethics committee of the Zanjan University of Medical Sciences (Code: IR.ZUMS.REC.1398.328).
Results In the post-test and follow-up phase, there was a significant difference between both CBT and ACT methods compared to the control group in sexual function respectively (P
This series of studies developed the Japanese version of the State Cognitive Fusion Questionnaire (SCFQ‐J) and examined its psychometric properties. In Study 1, 411 participants completed the questionnaire. Confirmatory factor analyses supported a one‐factor model for the SCFQ‐J. In Study 2, to examine the responsiveness of the SCFQ‐J to a brief defusion exercise, 40 Japanese participants were randomly assigned to either a cognitive defusion or control condition. The SCFQ‐J showed superior responsiveness to a brief defusion exercise than a commonly used measure (thought believability). In Study 3, to examine whether the SCFQ‐J was more sensitive to dissociated movements than the original Cognitive Fusion Questionnaire (CFQ‐J), 40 Japanese participants were randomly assigned to either an SCFQ‐J or CFQ‐J condition. The SCFQ‐J showed better sensitivity than the CFQ‐J to a brief defusion exercise, supporting its suitability for experimental studies. Our findings suggest that the SCFQ‐J is a valuable measure of state cognitive fusion in Japan.
Returning from injury in elite sport presents itself with numerous challenges. Although injury rehabilitation has featured extensively in sport psychology literature, the application of case specific interventions remains scarce. The current case study addresses the anxiety surrounding injury recovery, and presents a detailed intervention program that was delivered to an elite female hockey player. This intervention demonstrates the application acceptance commitment therapy (ACT; Hayes, Strosahl & Wilson, 1999), with mindfulness and relaxation strategies to reduce imagined pain associated with an old injury, and manage anxiety associated with return to play. Six key stages will be presented: background to case; formulation/assessment multidisciplinary; client education; learning mindfulness and ACT in context; assessing readiness to perform; intervention evaluation. The case concludes by summarising how ACT and mindfulness facilitated recovery from injury and return to performance, providing tentative advice for practitioners wishing to adopt an ACT based approach within the domain of pain management and injury recovery.
Several noninvasive neurostimulation brain interventions have been proposed for the treatment of anxiety disorders. The chapter surveys neurostimulation interventions such as transcranial direct current stimulation (tDCS), deep brain stimulation (DBS), vagus nerve stimulation (VNS), trigeminal nerve stimulation (TNS), electroconvulsive therapy (ECT), and others. Evidence-based talk therapies such as cognitive behavioral therapy (CBT) and acceptance-based therapy (ACT) are evaluated. Evidence for therapeutic components such as mindfulness and exposure are also assessed.
Dijitalleşme, modern yaşam ve gelişmelere olan yoğun bağımlılığın bir sonucu olarak insan hayatı, insanlıkla ve maneviyatla bağlarını kaybetme tehlikesiyle karşı karşıyadır. Bunun muhtemel bir çözümü, Büyük Kanyon’un enginliğine veya yüzlerce yıldızla dolu bir gökyüzüne tanık olmak veya mistik bir deneyim yaşamak gibi örneklerle açıklanabilecek, hayret ve hayranlığın duygusal bir algısı olan awe duygusunun beslenmesidir. Bu çalışmada öncelikle alan yazın titizlikle taranmış ve awe üzerine yapılan araştırmalar bu duygunun ne olduğu, formülasyonu, felsefesi çerçevesinde derlenmiştir. Daha sonra awenin Varoluşçu ve Transpersonel psikolojideki kullanım alanları verilmiş ve ayrıca hastalarda bu duyguyu güçlendirebilecek terapi önerileri de sunulmuştur. Sonuç olarak awenin halk sağlığının yükseltilmesi ve yaşam doyumunun yükseltilmesine yönelik tedavilerde daha fazla kullanılması gerektiğine inanıyoruz.
The study of Time has a long history, dating back to the earliest days of psychological science in the late 1800s. However, the conceptualization of time perspective has led to a better understanding of individuals' healthy and pathological attitudes toward time dimensions. Similarly, articulated psychological inflexibility components (i.e., Experiential Avoidance (EA) and Cognitive Fusion (CF)) have been found to have solid links with psychopathology, specifically psychological distress. The purpose of this study was to examine the serial mediating functions of EA and CF in the association between Deviation from Balanced Time Perspective (DBTP) and Depression and Anxiety symptoms. Also, a reversed model of serial mediation was tested. A total of 203 participants (155 female) aged between 17–73 (M = 28.45, SD = 11.43) completed measures of time perspective, CF, EA, anxiety, and depression. CF and EA functioned as mediators between DBTP and depression/anxiety in the first mediation model. However, in the reversed model, only the mediation effect for depression was observed. These results emphasize the need for tailoring treatments to the requirements of patients struggling with anxiety and depression symptoms, who may be more susceptible to imbalanced time perspectives and time-entrapped cognitive processes.
This study examined the relation between the intensity of CO2-induced psychophysiological responses and content-specific fear conditioning. Sex-balanced groups of undergraduates (N = 96) were assigned to 1 of 3 conditioned stimuli (CSs) differing in fear-relevance, and within each CS, to either 20% or 13% CO2-enriched air (unconditioned stimuli [UCS]). Several psychophysiological measures were assessed before, during, and following conditioning phases. Consistent with expectation, electrodermal and cardiac conditioned responses were larger and more resistant to extinction when associated with fear-relevant compared with fear-irrelevant stimuli, and this overall effect of fear-relevance was more robust to the more intense UCS. Severity and frequency of DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th ed.) panic symptoms also varied reliably with UCS intensity, and women reported more distress and symptoms than men. Overall, the findings suggest that content-specific fear conditioning is mediated, in part, by the intensity of the bodily response. The authors discuss clinical and theoretical implications for understanding fear onset in the absence of obvious environmental pain or trauma.