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Educational Psychology

Utah State University

Acceptance and commitment therapy

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The Role Of Psychological Inflexibility And Self-Compassion In Acceptance And Commitment Therapy For Clinical Perfectionism, Clarissa W. Ong, Jennifer L. Barney, Tyson Barrett, Eric B. Lee, Michael Levin, Michael P. Twohig Jun 2019

The Role Of Psychological Inflexibility And Self-Compassion In Acceptance And Commitment Therapy For Clinical Perfectionism, Clarissa W. Ong, Jennifer L. Barney, Tyson Barrett, Eric B. Lee, Michael Levin, Michael P. Twohig

Psychology Faculty Publications

The current study examined psychological inflexibility and self-compassion as theoretically relevant mediators and moderators of outcomes following acceptance and commitment therapy (ACT) for clinical perfectionism. Fifty-three participants with clinical perfectionism were randomized to either a 10-session ACT condition or a 14-week waitlist control condition (only 39 completed the post treatment assessment). Outcomes tested include concern over mistakes, doubting of actions, personal standards, quality of life, symptom distress and functional impairment, and valued action. Multilevel modeling analyses showed reduced psychological inflexibility mediated the relationship between condition and higher quality of life and increased self-compassion mediated the relationship between condition and decreased ...


A Randomized Controlled Trial Of Acceptance And Commitment Therapy For Clinical Perfectionism, Clarissa W. Ong, Eric B. Lee, Jennifer Krafft, Carina L. Terry, Tyson S. Barrett, Michael E. Levin, Michael P. Twohig Jan 2019

A Randomized Controlled Trial Of Acceptance And Commitment Therapy For Clinical Perfectionism, Clarissa W. Ong, Eric B. Lee, Jennifer Krafft, Carina L. Terry, Tyson S. Barrett, Michael E. Levin, Michael P. Twohig

Psychology Faculty Publications

Clinical perfectionism is characterized by imposing excessively high standards on oneself and experiencing severe distress when standards are not met. It has been found to contribute to the development and maintenance of various clinical presentations including anxiety, obsessive-compulsive, and eating disorders. The present study tested the efficacy of ten weekly individual sessions of acceptance and commitment therapy (ACT) relative to a waitlist control on clinical perfectionism and global outcomes among 53 individuals with clinical perfectionism. ACT is a process-based therapy that targets maladaptive underlying processes (e.g., rigid adherence to unrealistic high standards) rather than symptom topography (e.g., anxiety ...


A Review Of Aaq Variants And Other Context-Specific Measures Of Psychological Flexibility, Clarissa Ong, Eric B. Lee, Michael Levin, Michael P. Twohig Jan 2019

A Review Of Aaq Variants And Other Context-Specific Measures Of Psychological Flexibility, Clarissa Ong, Eric B. Lee, Michael Levin, Michael P. Twohig

Psychology Faculty Publications

Psychological flexibility refers to a way of interacting with internal experiences and the external environment that advances one toward chosen values whereas psychological inflexibility reflects rigid adherence to ineffective responses such that valued living is compromised. Psychological flexibility is a critical variable of interest in acceptance and commitment therapy, thus, accurate assessment of this construct is pertinent to professionals in the field. Numerous measures of psychological flexibility for specific conditions exist and the psychometric validation of each of these measures varies in breadth and depth. To orient professionals to the scope of available measures as well as their psychometric properties ...


Adding Acceptance And Commitment Therapy To Exposure And Response Prevention For Obsessive-Compulsive Disorder: A Randomized Controlled Trial, Michael P. Twohig, Jonathan S. Abramowitz, Brooke M. Smith, Laura E. Fabricant, Ryan J. Jacoby, Kate L. Morrison, Ellen J. Bluett, Lillian Reuman, Shannon M. Blakey, Thomas Ledermann Jun 2018

Adding Acceptance And Commitment Therapy To Exposure And Response Prevention For Obsessive-Compulsive Disorder: A Randomized Controlled Trial, Michael P. Twohig, Jonathan S. Abramowitz, Brooke M. Smith, Laura E. Fabricant, Ryan J. Jacoby, Kate L. Morrison, Ellen J. Bluett, Lillian Reuman, Shannon M. Blakey, Thomas Ledermann

Psychology Faculty Publications

The objective of this study was to test whether treatment acceptability, exposure engagement, and completion rates could be increased by integrating acceptance and commitment therapy (ACT) with traditional exposure and response prevention (ERP). 58 adults (68% female) diagnosed with obsessive-compulsive disorder (OCD; M age = 27, 80% white) engaged in a multisite randomized controlled trial of 16 individual twice-weekly sessions of either ERP or ACT + ERP. Assessors unaware of treatment condition administered assessments of OCD, depression, psychological flexibility, and obsessional beliefs at pretreatment, posttreatment, and six-month follow-up. Treatment acceptability, credibility/expectancy, and exposure engagement were also assessed. Exposure engagement was high ...


The Influence Of A Personal Values Intervention On Cold Pressor-Induced Distress Tolerance, Brooke M. Smith, Jennifer L. Villatte, Clarissa W. Ong, Grayson M. Butcher, Michael P. Twohig, Michael Levin, S. C. Hayes Jun 2018

The Influence Of A Personal Values Intervention On Cold Pressor-Induced Distress Tolerance, Brooke M. Smith, Jennifer L. Villatte, Clarissa W. Ong, Grayson M. Butcher, Michael P. Twohig, Michael Levin, S. C. Hayes

Psychology Faculty Publications

Research has demonstrated that values and acceptance interventions can increase distress tolerance, but the individual contribution of each remains unclear. The current study examined the isolated effect of a values intervention on immersion time in a cold pressor. Participants randomized to Values (n = 18) and Control (n = 14) conditions completed two cold pressor tasks, separated by a 30-minute values or control intervention. Immersion time increased 51.06 seconds for participants in the Values condition and decreased by 10.79 seconds for those in the Control condition. Increases in self-reported pain and distress predicted decreases in immersion time for Control, but ...


The Role Of Experiential Avoidance In Problematic Pornography Viewing, Michael E. Levin, Eric B. Lee, Michael P. Twohig Jan 2018

The Role Of Experiential Avoidance In Problematic Pornography Viewing, Michael E. Levin, Eric B. Lee, Michael P. Twohig

Psychology Faculty Publications

Research suggests that online pornography use can have harmful consequences for some individuals, but the psychological processes that contribute to problematic viewing are unclear. This study sought to evaluate the role of experiential avoidance in the negative consequences of online pornography viewing in a small cross sectional survey sample of 91 male college students who reported viewing. Results indicated that viewing pornography for experientially avoidant motivations was related to more frequent viewing and predicted self-reported negative consequences of viewing over and above other motivations (e.g., sexual pleasure, curiosity, excitement seeking). Although more frequent viewing was related to more self-reported ...


Comparing Cognitive Defusion And Cognitive Restructuring Delivered Through A Mobile App For Individuals High In Self-Criticism, Michael E. Levin, Jack Haeger, Woolee An, Michael P. Twohig Jan 2018

Comparing Cognitive Defusion And Cognitive Restructuring Delivered Through A Mobile App For Individuals High In Self-Criticism, Michael E. Levin, Jack Haeger, Woolee An, Michael P. Twohig

Psychology Faculty Publications

There are ongoing questions regarding the similarities and differences in the clinical impact and processes of change for cognitive restructuring and cognitive defusion. This clinical component test compared 87 adults high in self-criticism randomized to a cognitive defusion mobile app, restructuring app, or waitlist condition for two weeks. Equivalent improvements were found from the defusion and restructuring apps relative to the waitlist in self-criticism and distress as well as decentering, self-compassion, and dysfunctional attitudes. However, the defusion condition had a more consistent pattern of improvements relative to waitlist. Improvements in cognitive decentering, self-compassion, and dysfunctional attitudes mediated effects for cognitive ...


Tailoring Acceptance And Commitment Therapy Skill Coaching In-The-Moment Through Smartphones: Results From A Randomized Controlled Trial, Michael E. Levin, Jack Haeger, Rick A. Cruz Jan 2018

Tailoring Acceptance And Commitment Therapy Skill Coaching In-The-Moment Through Smartphones: Results From A Randomized Controlled Trial, Michael E. Levin, Jack Haeger, Rick A. Cruz

Psychology Faculty Publications

There is growing evidence for the efficacy of acceptance and commitment therapy (ACT) interventions delivered through smartphones, but research has not yet focused on how to optimize such interventions. One benefit of mobile interventions is the ability to adapt content based on in-the-moment variables. The current randomized controlled trial evaluated whether an ACT app that tailored skill coaching based on in-the-moment ecological momentary assessments (EMAs) would be more efficacious than the same app where skill coaching was random or an EMA-only condition. A sample of 69 adults interested in using a self-help app were randomized to one of three app ...


Effects Of Acceptance And Commitment Therapy On Impulsive Decision Making, Kate L. Morrison, Brooke M. Smith, Clarissa W. Ong, Eric B. Lee, Jonathan E. Friedel, Amy Odum, Gregory J. Madden, Thomas Ledermann, Jillian Rung, Michael P. Twohig Jan 2018

Effects Of Acceptance And Commitment Therapy On Impulsive Decision Making, Kate L. Morrison, Brooke M. Smith, Clarissa W. Ong, Eric B. Lee, Jonathan E. Friedel, Amy Odum, Gregory J. Madden, Thomas Ledermann, Jillian Rung, Michael P. Twohig

Psychology Faculty Publications

This study examined the transdiagnostic effect of acceptance and commitment therapy (ACT) on impulsive decision making in a community sample. Forty adults were randomized to eight individual sessions of ACT or an inactive control. Participants completed pre-, mid-, and post-assessments for psychological symptoms, overall behavior change, valued living, delay discounting, psychological flexibility, and distress tolerance. Data were analyzed with multilevel modeling of growth curves. Significant interaction effects of time and condition were observed for psychological flexibility, distress tolerance, psychological symptoms, and the obstruction subscale of valued living. No significant interaction effect was found for two delay discounting tasks nor the ...


Telepsychotherapy For Trichotillomania: A Randomized Controlled Trial Of Act-Enhanced Behavior Therapy, Eric B. Lee, Jack A. Haeger, Michael E. Levin, Clarissa W. Ong, Michael P. Twohig Jan 2018

Telepsychotherapy For Trichotillomania: A Randomized Controlled Trial Of Act-Enhanced Behavior Therapy, Eric B. Lee, Jack A. Haeger, Michael E. Levin, Clarissa W. Ong, Michael P. Twohig

Psychology Faculty Publications

Despite its prevalence, quality treatment for trichotillomania is often difficult to find. The use of telepsychology has been an effective method for disseminating treatment services for a variety of mental health conditions. However, no research has examined the use of telepsychology to treat trichotillomania. This randomized controlled trial used Acceptance and Commitment Therapy Enhanced Behavior Therapy delivered by way of telepsychology to treat trichotillomania in adults. The study compared an active treatment condition (n = 12) to a delayed treatment waitlist control condition (n = 10). Results showed significant reductions in hair pulling severity from pre- to post-treatment compared to the waitlist ...


Acceptance And Commitment Therapy For A Case Of Scrupulosity-Related Obsessive-Compulsive Disorder, Eric B. Lee, Clarissa W. Ong, Woolee An, Michael P. Twohig Jan 2018

Acceptance And Commitment Therapy For A Case Of Scrupulosity-Related Obsessive-Compulsive Disorder, Eric B. Lee, Clarissa W. Ong, Woolee An, Michael P. Twohig

Psychology Faculty Publications

Acceptance and Commitment Therapy (ACT) is a modern form of Cognitive Behavior Therapy (CBT) with growing support for treating obsessive-compulsive disorder (OCD). We present a case wherein a client presented with scrupulosity-related OCD. We briefly review scrupulosity, explain the theory behind ACT, and present a case, the treatment process, and desired outcomes. Exposure and response prevention (ERP) is described from an ACT perspective and discussed as an option for people with OCD who may be reluctant to engage in more traditional forms of ERP.


Psychological Inflexibility And Stigma: A Meta-Analytic Review, Jennifer Krafft, Jillian Ferrell, Michael E. Levin, Michael P. Twohig Nov 2017

Psychological Inflexibility And Stigma: A Meta-Analytic Review, Jennifer Krafft, Jillian Ferrell, Michael E. Levin, Michael P. Twohig

Psychology Faculty Publications

Stigma is known to have major impacts on the physical and psychological health of many groups. Psychological inflexibility is a psychological process that may help explain the impact of stigma on both self and others. Accordingly, acceptance and commitment therapy (ACT), which targets psychological inflexibility, has been researched as a potential treatment for stigma. In order to provide a comprehensive overview of these issues, this paper offers a systematic review and meta-analysis of the association between psychological inflexibility and stigma, as well as a systematic review of ACT interventions for stigma. The results of the meta-analysis showed a positive, medium-to-large ...


Examining The Feasibility Of Acceptance And Commitment Therapy Self-Help For Problematic Pornography Viewing: Results From A Pilot Open Trial, Michael Levin, Scott T. Heninger, Benjamin G. Pierce, Michael P. Twohig Sep 2017

Examining The Feasibility Of Acceptance And Commitment Therapy Self-Help For Problematic Pornography Viewing: Results From A Pilot Open Trial, Michael Levin, Scott T. Heninger, Benjamin G. Pierce, Michael P. Twohig

Psychology Faculty Publications

This pilot study evaluated the feasibility of an acceptance and commitment therapy (ACT) self-help program for problematic pornography viewing (PV). A sample of 19 adults seeking help for problematic PV was recruited in an open trial. Participants reported adequate program acceptability, although only 45% of those completing post-assessment read at least half of the self-help book. Significant improvements on problematic PV and cognitive fusion were found over the 8-week intervention period, with effects sustaining at 8-week follow-up. Participants who read more improved more on PV problems and psychological inflexibility. Overall, an ACT self-help approach appears feasible and potentially efficacious for ...


Examining The Feasibility Of Acceptance And Commitment Therapy Self-Help For Problematic Pornography Viewing: Results From A Pilot Open Trial, Michael E. Levin, Scott T. Heninger, Benjamin G. Pierce, Michael P. Twohig Sep 2017

Examining The Feasibility Of Acceptance And Commitment Therapy Self-Help For Problematic Pornography Viewing: Results From A Pilot Open Trial, Michael E. Levin, Scott T. Heninger, Benjamin G. Pierce, Michael P. Twohig

Psychology Faculty Publications

This pilot study evaluated the feasibility of an acceptance and commitment therapy (ACT) self-help program for problematic pornography viewing (PV). A sample of 19 adults seeking help for problematic PV were recruited in an open trial. Participants reported adequate program acceptability, although only 45% of those completing post-assessment read at least half of the self-help book. Significant improvements on problematic PV and cognitive fusion were found over the 8-week intervention period, with effects sustaining at 8-week follow-up. Participants who read more improved more on PV problems and psychological inflexibility. Overall, an ACT self-help approach appears feasible and potentially efficacious for ...


Evaluating An Adjunctive Mobile App To Enhance Psychological Flexibility In Acceptance And Commitment Therapy, Michael E. Levin, Jack Haeger, Benjamin Pierce, Rick Cruz Jul 2017

Evaluating An Adjunctive Mobile App To Enhance Psychological Flexibility In Acceptance And Commitment Therapy, Michael E. Levin, Jack Haeger, Benjamin Pierce, Rick Cruz

Psychology Faculty Publications

The primary aims of this study were to evaluate the feasibility and potential efficacy of a novel adjunctive mobile app designed to enhance the acquisition, strengthening, and generalization of acceptance and commitment therapy (ACT) skills being taught in therapy. A sample of 14 depressed/anxious clients receiving ACT used the ACT Daily app for two weeks in a pre-post, open trial design. Participants reported a high degree of program satisfaction. Clients significantly improved over the two-week period on depression and anxiety symptoms as well as a range of psychological inflexibility measures. Analyses of mobile app data indicated effects of ACT ...


The Acceptance And Commitment Therapy Matrix Mobile App: A Pilot Randomized Trial On Health Behaviors, Michael Levin, Benjamin Pierce, Benjamin Schoendorff Jan 2017

The Acceptance And Commitment Therapy Matrix Mobile App: A Pilot Randomized Trial On Health Behaviors, Michael Levin, Benjamin Pierce, Benjamin Schoendorff

Psychology Faculty Publications

Mobile apps provide a promising format for delivering acceptance and commitment therapy (ACT) to improve diet/exercise. This pilot trial evaluated a novel ACT-based app for health behaviors based on the matrix approach. A sample of 23 community adults were randomly assigned to use the app for two weeks or to a waitlist condition. Findings indicated a high degree of satisfaction with the app and acceptable adherence. Although the intent-to-treat sample indicated few intervention effects, when focusing on program engagers only, health behaviors significantly improved in the app condition relative to waitlist. There were no differences between conditions on valued ...


Acceptance And Commitment Therapy As A Treatment For Anxiety And Depression: A Review., Michael P. Twohig, Michael P. Levin Jan 2017

Acceptance And Commitment Therapy As A Treatment For Anxiety And Depression: A Review., Michael P. Twohig, Michael P. Levin

Psychology Faculty Publications

Acceptance and commitment therapy (ACT) is a modern form of cognitive behavioral therapy based on a distinct philosophy (functional contextualism) and basic science of cognition (relational frame theory). This article reviews the core features of ACT’s theoretical model of psychopathology and treatment as well as its therapeutic approach. It then provides a systematic review of randomized controlled trials (RCTs) evaluating ACT for depression and anxiety disorders. Summarizing across a total of 36 RCTs, ACT appears to be more efficacious than waitlist conditions and treatment-as-usual, with largely equivalent effects relative to traditional cognitive behavioral therapy. Evidence from several trials also ...


Examining The Role Of Implicit Emotional Judgements In Social Anxiety And Experiential Avoidance, Michael Levin, Jack Haeger, Gregory S. Smith Jan 2016

Examining The Role Of Implicit Emotional Judgements In Social Anxiety And Experiential Avoidance, Michael Levin, Jack Haeger, Gregory S. Smith

Psychology Faculty Publications

This study sought to examine the relationship of implicit emotional judgments with experiential avoidance (EA) and social anxiety. A sample of 61 college students completed the Emotional Judgment – Implicit Relational Assessment Procedure (EJ-IRAP) as well as a public speaking challenge. Implicit judgments were related to greater self-reported EA, anxiety sensitivity, emotional judgments and social anxiety as well as lower performance ratings and willingness in the public speaking challenge. Effects differed by trial type with “Anxiety is bad” biases related to greater EA/anxiety, while “calm is bad” biases related to lower EA/anxiety (“Good” biases were generally unrelated to outcomes ...