|Empirical Evaluations of Mechanisms of Change in Acceptance and Commitment Therapy
|Sunday, May 25, 2008
|9:00 AM–10:20 AM
|Area: CBM; Domain: Service Delivery
|Chair: Katherine A. Peterson (Utah State University)
|Abstract: The processes through which psychological treatments achieve their outcomes are not widely known for many therapeutic approaches. This is problematic because it allows for procedural changes to occur when there are no advances at the level of processes of change. As a result, the field can have many different looking treatments that really do the same thing. This symposium will attempt to clarify the mechanisms of action through which Acceptance and Commitment Therapy produces its outcomes. Specifically, this symposium includes investigations on obsessive compulsive disorder, self evaluations, mood, and social emotional functioning. Hopefully, this symposium will elucidate the processes through which ACT produces its outcomes and facilitate additional studies in this area.
|An Evaluation of Mechanisms of Action in ACT, CT, and ERP for OCD.
|MIKE P. TWOHIG (Utah State University), Maureen Whittal (University of British Columbia Hospital)
|Abstract: The availability of treatment options for OCD are increasing in response to limited effectiveness of existing treatments and scientific developments within the field. Unfortunately, it appears that the procedural development of these interventions is moving faster than our understanding of whey they work. This study attempts to clarify why these three psychological interventions: Acceptance and Commitment Therapy, Cognitive Therapy, and Exposure with Response Prevention work. Six adults with OCD were treated with 12 sessions of either ACT, CT, or ERP. They completed weekly measures of symptom severity and process of change. While results are preliminarily, it appears that these treatments work through distinct mechanisms, and that in some cases the changes in processes preceded the changes in outcome. If these treatments do indeed work through different mechanisms of action, it supports the further development of each intervention as a distinct addition to the field, and suggests further research on who is appropriate for each intervention.
|Training Psychology Students in CBT and ACT: Treatment Processes and Psychological Flexibility.
|RAIMO LAPPALAINEN (University of Jyväskylä, Finland), Henna-Riikka Tuomela (University of Jyväskylä, Finland), Tuula Lehtonen (University of Tampere, Finland), Steven C. Hayes (University of Nevada, Reno)
|Abstract: We investigated the effectiveness of the treatments delivered by psychology students who had received a very brief training in ACT. Students who had very limited training in psychotherapy before taking the intervention course which was a part of their studies. Each student treated one client by CBT or by a combination of CBT and ACT during 10 sessions. Our results show that these treatments done by the novice therapists after a very brief training were effective.
Process of change was measured using Acceptance and Avoidance Questionnaire (AAQ-8), and measuring clients’ subjective experiences after every session. ACT approaches to CBT increased psychological acceptance. CBT sessions decreased negative and increased positive feelings. Combinations of CBT+ACT sessions increased positive feelings and mood but did not decrease negative feelings. Overall, change in psychological acceptance or flexibility was associated with mood at the end of the sessions,the pleasantness and difficulty of the sessions were evaluated, and clients evaluated the importance of the issues dealt with the therapists during the session.
|Is Experiential Avoidance a Pre-Cursor to Socio-Emotional Problems in Adolescents?
|JOSEPH CIARROCHI (University of Wollongong), Sunila Supavadeeprasit (University of Wollongong), Patrick Heaven (University of Wollongong)
|Abstract: The tendency to avoid private experiences (experiential avoidance) has been implicated as a potential cause of psychopathology. A cross-lagged panel design was used to assess whether experiential avoidance was a likely precursor or consequence of social-emotional functioning from grades 9 to 10. Eight hundred eighty-four students participated in the study. Structural Equation Modeling indicated that experiential avoidance was a precursor to decreasing social support and to increasing hostility and fear. There was evidence for reciprocal effects, with hostility, fear, and sadness predicting increasing experiential avoidance. We discuss the implications of these findings for the potential importance of acceptance-based interventions in adolescence.
|Impacting Distress Levels and Believability Associated with Negative Self-Evaluations Using Defusion and Restructuring.
|JOHN TANNER BLACKLEDGE (Morehead State University), Dana Bassett (University of Wollongong, Australia), Joseph Ciarrochi (University of Wollongong)
|Abstract: Acceptance and commitment therapy (ACT) makes heavy use of cognitive defusion and self as context interventions in an effort to attenuate the problematic effects of language on subsequent behavior. To investigate whether a brief “observer perspective” intervention impacted the believability and distress associated with negative self-evaluations under tightly controlled conditions, 57 psychology students completed a computer-based task in which they rated the believability and distress of five negatively self-evaluative statements. Each participant was then randomly assigned to either a control condition, or a cognitive defusion or cognitive restructuring condition in which the statement he/she rated as most believable was directly targeted, before rating the statements again. Results indicated that while both defusion and restructuring both significantly decreased the believability of all five statements relative to the control condition, only the defusion condition significantly decreased distress levels elicited by all five statements relative to the control condition.