Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.


35th Annual Convention; Phoenix, AZ; 2009

Event Details

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Symposium #517
Acceptance and Commitment Therapy for Coping with Chronic Medical Conditions
Tuesday, May 26, 2009
9:00 AM–10:20 AM
North 222 AB
Area: CBM; Domain: Applied Behavior Analysis
Chair: Merry Sylvester (University of Nevada, Reno)
Abstract: Acceptance and Commitment Therapy (ACT) has shown growing promise for use with behavioral medicine populations. When people cope with a chronic medical condition, they may be faced with a number of adversities including physical pain, medication regimens that produce severe side-effects, disability, cognitive impairment, financial difficulty, and lack of social support. It is not surprising then, that many people become depressed when coping with a chronic medical condition. Given the focus on common core processes (e.g., experiential avoidance) which may manifest in diverse clinical presentations, ACT is uniquely suited for the myriad treatment targets (e.g., disability adjustment, treatment adherence, depression, etc.) which may arise as a person copes with the diagnosis and progression of chronic medical conditions. In this symposium, we will discuss the application of ACT to three/four chronic medical conditions: lupus, multiple sclerosis, traumatic brain injury, and chronic pain.
Chronic Pain: Increasing Quality of Life via Acceptance and Values
JENNIFER PLUMB (University of Nevada Reno), Steven C. Hayes (University of Nevada, Reno)
Abstract: One in five Americans struggles with chronic pain. Some forms of pain, such as fibromyalgia, are often under-treated as effective medications can lead to dependence. Pain which is poorly managed is associated with increased functional impairment, disability, stress, and depression. Experiential avoidance, or the tendency to attempt to avoid pain and pain-related private experiences has been identified as a maintaining variable for chronic pain and predictor of disability above pain severity (McCracken, Vowles & Eccelston, 2004). Identifying values can increase clients’ motivation to engage in important life activities that may have become restricted in service of avoiding pain, and acceptance has been shown to foster willingness to experience pain and related symptoms as one engages in these important life activities. Both values and acceptance have increased subjective quality of life and important life activities in chronic pain sufferers (Dahl et al, 2004; Vowles & McCracken, 2008). The application of acceptance and commitment therapy for persons with chronic pain, including fibromyalgia, will be discussed along with the implications of this treatment in reducing functional impairments and the risk of disability.
Acceptance and Commitment Therapy in the Treatment of Psychological Problems associated with Lupus
TOMAS QUIROSA-MORENO (Behaviour Analysis Group of University of Almeria, Spain), Carmen Luciano Soriano (University Almer&íacute;a, Spain), N Navarrete-Navarrete (University Hospital "Virgen de las Nieves"), O Gutiérrez-Martánez (Behaviour Analysis Group of University of Almeria), J.M. Sabio-SÁnchez (University Hospital "Virgen de las Nieves"), J. Jiménez-Alonso (University Hospital "Virgen de las Nieves)
Abstract: Quality of life can often be negatively affected in systemic lupus erythematosus (SLE). Recent studies suggest that coping with the compound effects of diagnosis, treatment and consequences of the disease can often lead to an unwillingness to experience thoughts, feelings, and sensations related to the disease, or experiential avoidance (EA). Further, in attempts to avoid pain or prevent flare ups, valued living can become restricted Acceptance has been shown to alter EA in patients with cancer, chronic pain, epilepsy and diabetes. An 11-hour intervention for women with SLE was tested and compared to wait-list control (N=12). Patients in the ACT group (n=6) showed improvements in all psychological measures; acceptance of chronic pain, quality of life, anxiety, depression, and reduction in believability of private events as barriers to living. Subsequent Mann-Whitney analyses showed that there were no significant changes from pre to post in biological measures including biological markers of SLE, or number of flare ups,. However, there was a significant reduction in consumption of all classes of drugs (pharmacological, pain-relief, tranquilizers, anti-inflammatories)..These results provide promising evidence that ACT treatment can increase quality of life as well as reduce dependence upon drugs as one copes with lupus.
Acceptance and Commitment Therapy for Coping with Persistent Cognitive and Emotional Sequelae of Traumatic Brain Injury
MERRY SYLVESTER (University of Nevada, Reno), Steven C. Hayes (University of Nevada, Reno)
Abstract: Each year, approximately 90,000 Americans sustain a traumatic brain injury (TBI) that results in lasting impairments in cognitive, emotional, and behavioral domains. Unusual private experiences are common following TBI and are likely to persist despite the effectiveness of cognitive remediation and neuropsychological treatment in ameliorating other sequelae to brain injury (Prigitano, 1991). Rather than targeting a change in the topography of unusual private experiences, treatments informed by clinical behavior analysis would elucidate how these internal stimuli function to restrict the behavioral repertoires or engagement in valued activities. Acceptance and Commitment Therapy (ACT) is one such approach that may be effective in addressing the negative effects of internal sequelae to brain injury on quality of life. The potential benefits and challenges of implementing ACT with persons with TBI will be discussed, along with the need for idiographic modifications of the therapy in order to match the demands in the therapy context with the level of functioning of persons with TBI.
An Open Trial of a Half-Day ACT Workshop for Psychosocial Problems Associated with Multiple Sclerosis
SEAN SHEPPARD (SUNY - Albany), John P. Forsyth (University at Albany, SUNY), Edward Hickling (University at Albany, SUNY)
Abstract: Multiple sclerosis (MS) is a chronic, degenerative, and unpredictable disease of the central nervous system with a lifetime risk of 1 in 400 (Vollmer, 2007). MS is associated with depression, anxiety, fatigue, cognitive impairments, and impoverished quality of life (Chawastiak & Ehde, 2007). As there is no cure for MS, best treatment practices involve effective management of primary symptoms (Metz, Patten, & McGowan, 1999), with little attention to psychosocial problems or quality of life issues. A growing body of evidence indicates that Acceptance and Commitment Therapy (ACT) may be effective in treating depression, anxiety, and chronic pain (Hayes, Luoma, Bond, Masuda, & Lillis, 2006). The present study investigated the effectiveness of two half-day ACT workshops in reducing psychological and physical indices of MS disability and increasing overall quality of life. Participants (n=23) were assessed at baseline and 3-month follow-up. Preliminary analyses from the first workshop indicate positive change on several outcome measures (e.g., depression, quality of life scales) as well as on measures of MS symptomatology. Relevant change processes will be discussed, along with the structure and delivery of ACT treatment components important in brief, focused interventions aimed at improving the quality of life for individuals with multiple sclerosis.



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