Showing papers on "Acceptance and commitment therapy published in 2020"

The Empirical Status of Acceptance and Commitment Therapy: A Review of Meta-Analyses

Abstract: The efficacy of Acceptance and Commitment Therapy (ACT) has been evaluated in many randomized controlled trials investigating a broad range of target conditions. This paper reviews the meta-analytic evidence on ACT. The 20 included meta-analyses reported 100 controlled effect sizes across n = 12,477 participants. Controlled effect sizes were grouped by target conditions and comparison group. Results showed that ACT is efficacious for all conditions examined, including anxiety, depression, substance use, pain, and transdiagnostic groups. Results also showed that ACT was generally superior to inactive controls (e.g. waitlist, placebo), treatment as usual, and most active intervention conditions (excluding CBT). Weaknesses and areas for future development are discussed.

Health Anxiety and Mental Health Outcome During COVID-19 Lockdown in Italy: The Mediating and Moderating Roles of Psychological Flexibility

Abstract: The COVID-19 emergency has severely affected the Italian population. During a pandemic, those with high health anxiety are at risk of adverse mental health outcomes, including peritraumatic distress and mood disturbance. No prior research has explored the role of psychological flexibility in protecting people at high risk of poorer mental health impacts due to health anxiety during a pandemic. Psychological flexibility is the cornerstone of psychological health and resiliency. According to acceptance and commitment therapy (ACT), it involves behaving consistently with one’s chosen values even in the presence of emotional and mental discomfort. This study examined the mediating and moderating roles of psychological flexibility in the link between trait health anxiety and three mental health outcomes: COVID-19 peritraumatic distress, anxiety, and depression. We hypothesized that higher psychological flexibility would decrease the negative impacts of trait health anxiety on mental health outcomes. During the mandatory national lockdown (M = 35.70 days, SD = 8.41), 944 Italian adults (75.5% female, M = 38.86 years, SD = 13.20) completed an online survey consisting of standardized measures of psychological flexibility, trait health anxiety, COVID-19 distress, anxiety, and depression. Results indicated that psychological flexibility did not moderate the link between trait health anxiety and mental health outcomes. Rather, greater psychological flexibility mediated decreases in the adverse effects of trait health anxiety on COVID-19 distress, anxiety, and depression. In particular, two psychological flexibility processes, observing unhelpful thoughts rather than taking them literally (defusion) and values-based action (committed action), mediated decreases in the negative effects of trait health anxiety on all mental health outcomes. In contrast, the psychological flexibility process acceptance, which involves openness to inner discomfort, mediated increases in negative mental health outcomes. Overall, the combination of these processes mitigated the detrimental impacts of trait health anxiety on mental health during the emergency mandatory COVID-19 nationwide lockdown. Consistent with the ACT conceptualization of psychological flexibility, findings suggest embracing (rather than avoiding) inner discomfort and observing associated unhelpful thoughts, while also engaging in values-based action, increases resilience during adversity. Evidenced-based large-scale online public health interventions that target psychological flexibility in those experiencing health anxiety in the context of a pandemic are urgently needed. Many empirically-based ACT interventions are suited for this purpose.

Psychological flexibility in the context of COVID-19 adversity: Associations with distress.

Abstract: The COVID-19 pandemic has led to hardship for individuals across the globe, and research to-date has indicated a significant impact of the pandemic on mental health functioning. In order to promote psychological resilience during this time, it is important to understand modifiable targets for clinical intervention. The current study examined demographic characteristics, pandemic-related adversity, and psychological flexibility in relation to general and peritraumatic distress in a sample of United States survey respondents during May of 2020. Participants were recruited from Amazon Mechanical Turk (MTurk), N = 485. Participants completed measures of pandemic-related adversity, psychological flexibility components (openness to experience, behavioral awareness, and valued action), peritraumatic distress, and general distress. Hierarchical regression analyses examined whether demographic characteristics, pandemic-related adversity, and components of psychological flexibility were associated with general and peritraumatic distress. Results indicated that higher pandemic-related adversity, lower openness to experience, and lower behavioral awareness were significantly associated with higher general distress. Greater pandemic-related adversity, lower openness to experience, lower behavioral awareness, and higher valued action were significantly associated with higher peritraumatic distress. Adding the components of psychological flexibility to the model increased the amount of variance accounted for in both measures of distress. The results indicated that psychological flexibility components may be particularly important targets for prevention and intervention efforts in the midst of the COVID-19 pandemic. Transdiagnostic interventions, such as Acceptance and Commitment Therapy, that target psychological flexibility may be useful as the impact of the pandemic continues to unfold.

Acceptance and commitment therapy for breast cancer survivors with fear of cancer recurrence: A 3‐arm pilot randomized controlled trial

Abstract: BACKGROUND Fear of cancer recurrence (FCR) has a profound negative impact on quality of life (QOL) for many cancer survivors. Breast cancer survivors (BCS) are particularly vulnerable, with up to 70% reporting clinically significant FCR. To the authors' knowledge, evidence-based interventions for managing FCR are limited. Acceptance and commitment therapy (ACT) promotes psychological flexibility in managing life's stressors. The current study examined the feasibility and preliminary efficacy of group-based ACT for FCR in BCS. METHODS Post-treatment BCS (91 patients with stage I-III disease) with clinical FCR randomly were assigned to ACT (6 weekly 2-hour group sessions), survivorship education (SE; 6 weekly 2-hour group sessions), or enhanced usual care (EUC; one 30-minute group coaching session with survivorship readings). FCR severity (primary outcome) and avoidant coping, anxiety, post-traumatic stress, depression, QOL, and other FCR-related variables (secondary outcomes) were assessed at baseline (T1), after the intervention (T2), 1 month after the intervention (T3), and 6 months after the intervention (T4) using intent-to-treat analysis. RESULTS Satisfactory recruitment (43.8%) and retention (94.5%) rates demonstrated feasibility. Although each arm demonstrated within-group reductions in FCR severity over time, only ACT produced significant reductions at each time point compared with baseline, with between-group differences at T4 substantially favoring ACT over SE (Cohen d for effect sizes, 0.80; P < .001) and EUC (Cohen d, 0.61; P < .01). For 10 of 12 secondary outcomes, only ACT produced significant within-group reductions across all time points. By T4, significant moderate to large between-group comparisons favored ACT over SE and EUC with regard to avoidant coping, anxiety, depression, QOL, and FCR-related psychological distress. CONCLUSIONS Group-based ACT is a feasible and promising treatment for FCR and associated outcomes in BCS that warrants testing in larger, fully powered trials.

Randomized controlled trial of a web-based Acceptance and Commitment Therapy (ACT) program to promote mental health in university students.

Abstract: OBJECTIVE This study evaluated a 4-week web-based Acceptance and Commitment Therapy (ACT) mental health promotion intervention for university students. METHOD Participants were randomized to intervention (n = 596) or waitlist control (n = 566). Assessment of primary outcomes (depression, anxiety, stress, well-being, self-compassion, life satisfaction, and academic performance) and ACT processes (acceptance, cognitive fusion, education values, valued living, and present moment awareness) occurred at pre- and post-intervention and 12-week follow-up for intervention participants, and the same pre-post interval for waitlist control participants. RESULTS Analyses showed significant improvements from pre- to post-intervention compared with waitlist control on all primary outcomes and ACT processes. All intervention gains were maintained at follow-up. Improvements on all primary outcomes were mediated by three or more ACT processes in both samples. Intervention effects were consistent across both sample groupings. CONCLUSION Findings provide support for a web-based ACT mental health promotion intervention for university students.

Learning to Let Go: A Cognitive-Behavioral Model of How Psychedelic Therapy Promotes Acceptance.

Abstract: The efficacy of psychedelic-assisted therapies for mental disorders has been attributed to the lasting change from experiential avoidance to acceptance that these treatments appear to facilitate. This article presents a conceptual model that specifies potential psychological mechanisms underlying such change, and that shows substantial parallels between psychedelic therapy and cognitive behavioral therapy: We propose that in the carefully controlled context of psychedelic therapy as applied in contemporary clinical research, psychedelic-induced belief relaxation can increase motivation for acceptance via operant conditioning, thus engendering episodes of relatively avoidance-free exposure to greatly intensified private events. Under these unique learning conditions, relaxed avoidance-related beliefs can be exposed to corrective information and become revised accordingly, which may explain long-term increases in acceptance and corresponding reductions in psychopathology. Open research questions and implications for clinical practice are discussed.

Psilocybin-assisted therapy of major depressive disorder using Acceptance and Commitment Therapy as a therapeutic frame

Abstract: Psychedelic-assisted therapy is based on the premise that psychedelic substances can act as catalysts or adjuncts to psychotherapeutic processes. Recent clinical trials involving psychedelic-assisted therapy have generally employed a similar three-part structure consisting of preparation, support during the dosing sessions, and subsequent “integration.” However, the content of these sessions and the frame through which the therapists approach participants and understand the clinical process has thus far been inconsistent among studies. In designing a manualized therapy protocol for a small clinical trial of psilocybin-assisted therapy for major depressive disorder, our group sought to delineate an explicit and replicable, evidence-based model that intentionally builds upon both the neurobiological actions of the medication and the phenomenology of the drug experience. Having identified considerable concordance in proposed mechanisms of change between Acceptance and Commitment Therapy (ACT) and psilocybin therapy, we employed ACT as an overarching psychotherapeutic framework. We hypothesize that the psilocybin experience can provide direct experiential contact with ACT processes that increase psychological flexibility, and that these deeply felt experiences may in turn be reinforced during ACT-informed follow-up therapy sessions. In this paper, we describe the rationale for selecting ACT, areas of potential synergism between ACT and psilocybin-therapy, the basic structure of our treatment model, and limitations to this approach.

Post-Psychedelic Reductions in Experiential Avoidance Are Associated With Decreases in Depression Severity and Suicidal Ideation.

Abstract: Psychedelic therapy shows promise as a novel intervention for a wide range of mental health concerns but its therapeutic action is incompletely understood. In line with acceptance and commitment therapy's (ACT's) transdiagnostic model, qualitative research has suggested that reductions in experiential avoidance are an important component of therapeutic outcomes associated with psychedelics. However, limited research has quantitatively explored the association between decreases in experiential avoidance and therapeutic outcomes associated with psychedelics. Therefore, in two prospective studies, using convenience samples of individuals with plans to use a psychedelic, we explored the impact of psychedelic use on experiential avoidance, depression severity, and suicidal ideation, as well as relationships between changes in these outcomes. Participants (Study 1, N=104; Study 2, N=254) completed self-report questionnaires of depression severity, suicidal ideation, and experiential avoidance: 1) before using a psychedelic (in ceremonial and non-ceremonial contexts), as well as 2) 2-weeks and 3) 4-weeks after psychedelic use. Across both studies, repeated measures ANOVAs indicated significant decreases in experiential avoidance, depression severity, and suicidal ideation after psychedelic use. Furthermore, decreases in experiential avoidance were significantly associated with decreases in depression severity and suicidal ideation. These results suggest that psychedelics may lead to significant decreases in experiential avoidance, depression severity, and suicidal ideation. Additionally, these findings imply that reduced experiential avoidance may be a transdiagnostic mechanism mediating treatment success within psychedelic therapy. We conclude that integrating psychedelics with psychotherapeutic interventions that target experiential avoidance (e.g. ACT) may enhance therapeutic outcomes.

Profiles of Psychological Flexibility: A Latent Class Analysis of the Acceptance and Commitment Therapy Model

Abstract: There exists uncertainty for clinicians over how the separate subcomponent processes of psychological flexibility, a core construct of the Acceptance and Commitment Therapy model, interact and influence distress experienced. The present study (N = 567) employed latent class analysis to (a) identify potential classes (i.e., subgroups) of psychological flexibility based on responses on measures of key subcomponent process and (b) examine whether such classes could reliably differentiate levels of self-reported psychological distress and positive and negative emotionality. We found three distinct classes: (a) High Psychological Flexibility, (b) Moderate Psychological Flexibility, and (c) Low Psychological Flexibility. Those in the Low Psychology Flexibility class reported highest levels of psychological distress, whereas those in the High Psychological Flexibility class reported lowest levels of psychological distress. This study provides a clearer view to clinicians of the profile of the broader spectrum of the psychological flexibility model to facilitate change in clients.

Modeling suicide risk among parents during the COVID-19 pandemic: Psychological inflexibility exacerbates the impact of COVID-19 stressors on interpersonal risk factors for suicide.

Abstract: Public health researchers have raised the concern that both the 2019 coronavirus disease (COVID-19) pandemic and the ensuing public health response will increase interpersonal stressors associated with suicide risk. The Acceptance and Commitment Therapy (ACT) framework conceptualizes psychological flexibility as an important way to reduce the impact of painful and even catastrophic events on psychological suffering. The current study examines psychological flexibility as a potential moderator of the prevailing interpersonal model of suicide risk. METHODS: A sample of 1003 parents (73% female, 82% Caucasian 86% in romantic relationships) were recruited as part of a larger study on the COVID-19 pandemic and family functioning from Mach 27th to the end of April 2020, the height of the United States’ “first wave.” Participants completed measures of psychological flexibility (the Multidimensional Psychological Flexibility inventory; MPFI), interpersonal constructs (perceived burdensomeness and thwarted belongingness), desire for death, COVID-19 related stressors (resource strain and loss due to COVID-19). RESULTS: Moderated-mediation path models highlighted a significant indirect association between COVID-19 stressors and desire for death mediated by perceived burdensomeness to others. This indirect pathway was moderated by psychological inflexibility such that links were strongest at high levels of inflexibility and weak or non-significant at low levels of inflexibility. Results were generally consistent across five of the six facets of inflexibility. DISCUSSION: The findings highlight the value of targeting psychological inflexibility as an important strategy to reduce suicide risk during the COVID-19 pandemic. Implications of patterns of results across different facets for treatment approach are discussed.

A meta-analysis of the efficacy of acceptance and commitment therapy for children

Abstract: Compared to the use of Acceptance and Commitment Therapy (ACT) in the treatment of adult psychopathology, there are fewer empirical studies on children, which makes it difficult to summarize the use of ACT in children. The current study presented the results of a meta-analysis of 14 randomized controlled trials (RCTs) on the efficacy of ACT for 1189 children. Compared with treatment as usual (TAU) and waitlist, ACT significantly improved the symptoms of primary outcome measures such as anxiety and depression [SMD = −0.59, CI(-0.87, −0.31), p

The effect of acceptance and commitment therapy on insomnia and sleep quality: A systematic review.

Abstract: Acceptance and Commitment Therapy (ACT), as a type of behavioral therapy, attempts to respond to changes in people’s performance and their relationship to events. ACT can affect sleep quality by providing techniques to enhance the flexibility of patients’ thoughts, yet maintaining mindfullness. Therefore, for the first time, a systematic review on the effects of ACT on sleep quality has been conducted. This systematic review was performed to determine the effect of ACT on insomnia and sleep quality. To collect articles, the PubMed, Web of Science (WOS), Cochrane library, Embase, Scopus, Science Direct, ProQuest, Mag Iran, Irandoc, and Google Scholar databases were searched, without a lower time-limit, and until April 2020. Related articles were derived from 9 research repositories, with no lower time-limit and until April 2020. After assessing 1409 collected studies, 278 repetitive studies were excluded. Moreover, following the primary and secondary evaluations of the remaining articles, 1112 other studies were removed, and finally a total of 19 intervention studies were included in the systematic review process. Within the remaining articles, a sample of 1577 people had been assessed for insomnia and sleep quality. The results of this study indicate that ACT has a significant effect on primary and comorbid insomnia and sleep quality, and therefore, it can be used as an appropriate treatment method to control and improve insomnia.

Acceptance and Commitment Therapy for Trichotillomania: A Randomized Controlled Trial of Adults and Adolescents.

Abstract: The purpose of this study was to examine acceptance and commitment therapy (ACT) as a standalone treatment for trichotillomania in a randomized controlled trial of adults and adolescents. Participants consisted of a community sample of treatment seeking adults and adolescents with trichotillomania. Of the eligible 39 participants randomized into treatment and waitlist groups, 25 completed treatment and were included in the final analysis. Treatment consisted of a 10-session ACT protocol. Multiple mixed models repeated measures analyses were utilized to evaluate changes in trichotillomania symptom severity, daily number of hairs pulled and urges experienced, and experiential avoidance from pretreatment to posttreatment. Findings indicated significant changes in symptom severity and daily hairs pulled, but not daily urges experienced or psychological flexibility. However, psychological flexibility saw a 24.5% decrease in the treatment group and reduced from clinical to subclinical levels on average. This study suggests that ACT alone is an effective treatment for adults and adolescents with trichotillomania. Outcomes appear to be similar to trials that combined ACT and habit reversal training (HRT).

A psychometric comparison of psychological inflexibility measures: Discriminant validity and item performance

Abstract: Psychological inflexibility is a rigid behavioral pattern that interferes with engagement in personally meaningful activities; it is the hypothesized root of suffering in acceptance and commitment therapy (ACT). Thus, the quality of its measurement affects the research, theory, and practice of ACT. The current study aimed to evaluate the discriminant validity and item performance of four measures of psychological inflexibility: the Acceptance and Action Questionnaire—II (AAQ-II), a revised version of the AAQ-II (AAQ-3), the Brief Experiential Avoidance Questionnaire (BEAQ), and the Comprehensive assessment of Acceptance and Commitment Therapy processes (CompACT). We analyzed data from community (n = 253), student (n = 261), and treatment-seeking samples (n = 140) using exploratory factor analysis and multigroup graded-response models. The CompACT had the strongest discriminant validity followed by the AAQ-3, whereas items in the CompACT Behavioral Awareness and Valued Action subscales performed most consistently across groups. No single measure emerged as clearly superior to others; rather, appropriate selection of measures depends on the goals and context of assessment. Scientific and clinical implications are discussed.

Treatment Outcomes and Mechanisms for an ACT-Based 10-Week Interdisciplinary Chronic Pain Rehabilitation Program

Abstract: Background Interdisciplinary pain rehabilitation programs are an evidence-based biopsychosocial treatment approach for chronic pain. The purpose of the current study is to assess outcomes for a 10-week interdisciplinary, acceptance and commitment therapy (ACT)-based, outpatient treatment model and to evaluate the relationship between psychological process variables (ie, pain catastrophizing, pain acceptance, pain self-efficacy) and treatment outcomes. Methods 137 adults with chronic pain completed an interdisciplinary pain rehabilitation program. Measures of pain, pain interference, health-related quality of life, anxiety, depressed mood, insomnia, pain catastrophizing, pain acceptance, and pain self-efficacy were completed at admission and discharge. Data were also collected on demographic and clinical variables, including opioid use. Results Results indicated significant changes in all measures at program discharge compared to admission. Opioid doses were also reduced. Results of within-subjects meditational analyses indicated that pain catastrophizing accounted for a significant portion of the treatment effect for pain severity, pain interference, and depressed mood. Pain acceptance was a mediator for change in depressed mood, whereas pain self-efficacy was a mediator for pain interference outcomes. Conclusions This study supports a 10-week, ACT-based treatment model for interdisciplinary chronic pain rehabilitation. In addition, pain catastrophizing, pain acceptance, and pain self-efficacy were each found to be mechanisms by which individuals achieve successful treatment outcomes. This research provides further support for interdisciplinary rehabilitation approaches for chronic pain.

Apps With Maps—Anxiety and Depression Mobile Apps With Evidence-Based Frameworks: Systematic Search of Major App Stores

Abstract: Background: Mobile mental health apps have become ubiquitous tools to assist people in managing symptoms of anxiety and depression However, due to the lack of research and expert input that has accompanied the development of most apps, concerns have been raised by clinicians, researchers, and government authorities about their efficacy Objective: This review aimed to estimate the proportion of mental health apps offering comprehensive therapeutic treatments for anxiety and/or depression available in the app stores that have been developed using evidence-based frameworks It also aimed to estimate the proportions of specific frameworks being used in an effort to understand which frameworks are having the most influence on app developers in this area Methods: A systematic review of the Apple App Store and Google Play store was performed to identify apps offering comprehensive therapeutic interventions that targeted anxiety and/or depression The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist was adapted to guide this approach Results: Of the 293 apps shortlisted as offering a therapeutic treatment for anxiety and/or depression, 162 (553%) mentioned an evidence-based framework in their app store descriptions Of the 293 apps, 88 (300%) claimed to use cognitive behavioral therapy techniques, 46 (157%) claimed to use mindfulness, 27 (92%) claimed to use positive psychology, 10 (34%) claimed to use dialectical behavior therapy, 5 (17%) claimed to use acceptance and commitment therapy, and 20 (68%) claimed to use other techniques Of the 162 apps that claimed to use a theoretical framework, only 10 (62%) had published evidence for their efficacy Conclusions: The current proportion of apps developed using evidence-based frameworks is unacceptably low, and those without tested frameworks may be ineffective, or worse, pose a risk of harm to users Future research should establish what other factors work in conjunction with evidence-based frameworks to produce efficacious mental health apps

Can acceptance and commitment therapy facilitate psychological adjustment after a severe traumatic brain injury? A pilot randomized controlled trial.

Abstract: This study i⁠nvestigated if an Acceptance and Commitment Therapy (ACT) intervention (ACT-Adjust) can facilitate psychological adjustment and reduce psychological distress following severe traumatic brain injury (TBI). The study design comprised a single centre, two-armed, Phase II pilot randomized controlled trial. Nineteen individuals with severe TBI (PTA ≥7 days) who met a clinical threshold for psychological distress (Depression Anxiety Stress Scales-21; DASS > 9) were randomly allocated to either ACT-Adjust (n = 10) or an active control, Befriending Therapy (n = 9), in conjunction with a holistic rehabilitation programme. Primary (psychological flexibility, rehabilitation participation) and secondary (depression, anxiety & stress) outcomes were measured at three-time points (pre, post and follow up). Significant decreases were found for DASS-depression (group by time interaction, F1,17 = 5.35, p = .03) and DASS-stress (group by time interaction, F1,17 = 5.69, p = .03) in comparison to the Befriending group, but not for the primary outcome measures. The reduction in stress post-treatment was classed as clinically significant, however interaction differences for stress and depression were not maintained at one month follow up. Preliminary investigations indicate potential for ACT in decreasing psychological distress for individuals with a severe TBI with further sessions required to maintain treatment gains. The pilot results suggest further investigation is warranted in a larger scale clinical trial.

The moderating effect of psychological flexibility on the link between learned helplessness and depression symptomatology: A preliminary study

Abstract: Objective In accordance to ACT theory, psychological inflexibility may influence the well-known link between learned helplessness and depression symptomatology. This exploratory preliminary study aims to analyse whether psychological flexibility moderates the relationship between these variables. Methods A community sample of 84 Portuguese participants (30 men and 54 women), with a mean age of 33.98 (SD = 11.05), completed the LHS, CompACT, and DASS-21. The moderating effect of psychological flexibility on the relationship between learned helplessness and depression symptomatology was calculated using the PROCESS computation macro. Results The interaction term between learned helplessness and psychological flexibility was significant (b = −0.01, SE = 0.00, p Discussion Higher psychological flexibility seems to be protective for depression symptomatology, in particular for those individuals who experience higher levels of learned helplessness. Individuals who are most likely to struggle with learned helplessness are potentially those who could benefit the most of an intervention targeting psychological flexibility as a way to ameliorate depressive symptomatology. Future studies with larger and clinical samples are required to confirm these preliminary findings.

Cognitive Behavioral Therapy, Mindfulness-Based Cognitive Therapy and Acceptance Commitment Therapy for Anxiety Disorders: Integrating Traditional with Digital Treatment Approaches.

Abstract: Anxiety disorders are an enormous societal burden given their high lifetime prevalence among adult populations worldwide. A variety of anxiety disorders can be successfully treated with psychological treatments such as cognitive behavioral therapy (CBT), mindfulness-based cognitive therapy (MBCT), and acceptance and commitment therapy (ACT), either as stand-alone individual or group treatment or as adjunctive treatment to pharmacotherapy. Furthermore, a growing body of evidence suggests that therapist-guided Internet-delivered CBT (iCBT) and, to some degree, digitalized mindfulness- and acceptance-based interventions may be an efficacious complement to traditional face-to-face therapy. In view of the current advances regarding the integration of traditional and innovative treatment approaches, this chapter provides an overview on the theory and evidence base for different delivery modes of CBT-related interventions for specific phobia, panic disorder, agoraphobia, social anxiety disorder, and generalized anxiety disorder in adults. Finally, implications for clinical practice and research will be derived, and future directions for the psychological treatment of anxiety disorders will be outlined.

A psychological flexibility -based intervention for Burnout:A randomized controlled trial

Abstract: A novel eight-week program based on Acceptance and Commitment Therapy (ACT) principles was created to alleviate burnout-related ill-being and to enhance well-being. This randomized controlled trial investigated the effectiveness of the program and explored whether changes in psychological flexibility mediated the results of the intervention. The program consisted of structured weekly face-to-face group meetings and daily practices provided via a website. Employees from varying professional backgrounds with burnout (mean age = 47 years, 79% female), who all received usual treatment, 1 were randomized into control (TAU, n = 80, receiving no other support) and ACT + TAU intervention (n = 88, receiving additional ACT support) groups. The ACT + TAU group outperformed the TAU group in all 14 scales used, indicating that burnout-related ill-being at work (between-group Cohen's d = 0.36–0.76) and psychological symptoms (d = 0.27–0.61) decreased and general well-being (d = 0.14–0.38) and psychological flexibility skills (d = 0.29–0.64) increased during the intervention. These gains were maintained during the one-year follow-up period. The changes in the psychological flexibility -factor mediated almost completely the changes in the outcome factors of burnout, well-being, and psychological symptoms. The study suggests that psychological flexibility skills can be crucial elements in job-related burnout interventions and that combined group and web-based interventions may offer an efficient treatment method.

Psychological flexibility: positive implications for mental health and life satisfaction

Abstract: New wave therapies such as Acceptance and Commitment Therapy aim to cultivate people's psychological flexibility in order for them to live a satisfying life. Psychological flexibility has also a role in promoting mental health, which may mediate the relationship with life satisfaction. The aim of this study was to determine whether mental health mediates the effect of psychological flexibility on life satisfaction. A convenience sample of 140 adults (32 males, M = 36.50 years, SD = 12.22; 107 females, M = 38.46 years, SD = 12.81; and a 45-year-old person of unknown gender) completed an online questionnaire assessing psychological flexibility, mental health and life satisfaction. Three of the four hypothesized components of psychological flexibility (experiential acceptance, cognitive alternatives and cognitive control) contributed to the latent construct of psychological flexibility, but cognitive defusion failed to contribute. Psychological flexibility had a direct, positive effect on life satisfaction and the hypothesis that mental health would mediate this relationship was supported. The results suggest that psychological flexibility is important for one's mental health and that both are integral to life satisfaction. The results also support a continued focus on third-wave therapies in cultivating psychological flexibility.

Acceptance and Commitment Training Within the Scope of Practice of Applied Behavior Analysis

Abstract: Acceptance and commitment therapy (ACT) is a contemporary behavior-analytic approach to intervening on verbal behavior for the purposes of bringing about socially meaningful overt behavior change. Although originally developed as a behavior-analytic approach to psychotherapy, the conceptual functional analyses and procedures that form the core of ACT have been disseminated broadly outside of clinical psychology, including within the field of applied behavior analysis (ABA). This article discusses the use of ACT within mainstream ABA practice and provides preliminary conceptual functional analyses and practical guidelines for incorporating ACT within the scope of practice of applied behavior analysts.