Education Commons^™

Acceptability, Feasibility, And Efficacy Potential Of A Multimodal Acceptance And Commitment Therapy Intervention To Address Psychosocial And Advance Care Planning Needs Among Anxious And Depressed Adults With Metastatic Cancer, Joanna J. Arch, Joel N. Fishbein, Michelle C. Ferris, Jill L. Mitchell, Michael E. Levin, Elizabeth T. Slivjak, David J. Andorsky, Jean S. Kutner

Psychology Faculty Publications

Background: Adults with metastatic cancer frequently report anxiety and depression symptoms, which may impact health behaviors such as advance care planning (ACP).

Objective: The study leveraged acceptance and commitment therapy (ACT), an evidence-based approach for reducing distress and improving health behaviors, and adapted it into a multimodal intervention (M-ACT) designed to address the psychosocial and ACP needs of anxious and depressed adults with metastatic cancer. The study evaluated M-ACT's acceptability, feasibility, and efficacy potential.

Design: The study was designed as a single-arm intervention development and pilot trial.

Setting/Subjects: The trial enrolled 35 anxious or depressed adults with stage IV cancer …

A Randomized Dismantling Trial Of The Open And Engaged Components Of Acceptance And Commitment Therapy In An Online Intervention For Distressed College Students, Michael E. Levin, Jennifer Krafft, Elizabeth T. Hicks, Michael P. Twohig, Benjamin G. Pierce

Psychology Faculty Publications

This dismantling trial compared the effects of a full online Acceptance and Commitment Therapy (ACT) intervention to the isolated effects of the Open (i.e., acceptance, cognitive defusion) and Engaged (i.e., values, committed action) components of ACT. A sample of 181 distressed college students were randomized to one of four conditions: a 12-session full ACT website (Full), a version targeting the Open components (Open), a version targeting the Engaged components (Engaged), or waitlist. Participants in active conditions were also randomized to receive phone coaching or just email prompts to increase program adherence. All three ACT conditions significantly improved over time relative …

Beyond Acceptance And Commitment Therapy: Process-Based Therapy, Clarissa W. Ong, Michael E. Levin, Michael P. Twohig

Psychology Faculty Publications

This article describes process-based therapy (PBT) as a natural evolution toward more effective and efficient mental healthcare. Using acceptance and commitment therapy as an example of an early prototype of PBT, this paper explicates the broader features of PBT and the shift in mindset researchers and clinicians will need to take to fully embrace PBT with respect to assessment, conceptualization, and intervention. In addition, the paper enumerates challenges to implementing the PBT model and proposes recommendations for circumventing these challenges in the areas of theory development, research methodology, and clinical practice. Finally, we make the argument shifting to PBT is …

Moderators And Processes Of Change In Traditional Exposure And Response Prevention (Erp) Versus Acceptance And Commitment Therapy-Informed Erp For Obsessive-Compulsive Disorder, Clarissa W. Ong, Shannon M. Blakey, Brooke M. Smith, Kate L. Morrison, Ellen J. Bluett, Jonathan S. Abramowitz, Michael P. Twohig

Psychology Faculty Publications

The present study evaluated moderators and processes of change in a randomized controlled trial comparing exposure and response prevention (ERP) delivered from a traditional framework versus ERP from an acceptance and commitment therapy framework (ACT+ERP) for obsessive-compulsive disorder (OCD). This paper presents baseline, weekly session, posttreatment, and follow-up data from the study. We examined (a) moderation effects of anxiety, depression, psychological inflexibility, and interpretation of intrusions and (b) the role of psychological inflexibility and interpretation of intrusions respectively as processes of change. Participants with less dysfunctional appraisals at pretreatment performed consistently better in ERP relative to ACT+ERP. In process analyses, …

Evaluating Acceptance And Commitment Therapy And Mindfulness-Based Stress Reduction Self-Help Books For College Student Mental Health, Michael E. Levin, Woolee An, Carter H. Davis, Michael P. Twohig

Psychology Faculty Publications

Objectives: Self-help has the potential to improve access to mental health resources for college students. However, solutions are needed to improve sustainable delivery, cost- effectiveness, and to know which resources are most useful. Methods: A sample of 109 college students were randomly assigned to read either an Acceptance and Commitment Therapy (ACT) or Mindfulness-Based Stress Reduction (MBSR) self-help book through the University library website over 8 weeks with assessments at baseline, midtreatment (4-weeks), and posttreatment (8-weeks). Results: The majority of participants reported reading over half of their assigned book and high satisfaction ratings were given for both books. Both conditions …

Utilizing Act Daily As A Self-Guided App For Clients Waiting For Services At A College Counseling Center: A Pilot Study, Jack Haegar, Carter H. Davis, Michael E. Levin

Psychology Faculty Publications

Objective: Considering increasing demands for mental health services at college counseling centers (CCCs), there is a need for cost-effective solutions that avoid depleting stressed CCC resources. This study examined if ACT Daily, a mobile application based on acceptance and commitment therapy (ACT), could serve as an effective self-guided intervention.

Participants: 11 individuals on a CCC waitlist suffering from anxiety/depression participated in the study over 2 weeks.

Methods: This study implemented a pre-post, open trial design of ACT Daily. Assessments were completed at baseline and 2-week post assessment.

Results: Results indicated that ACT Daily was acceptable and that participants improved on …

Examining Processes Of Change In An Online Acceptance And Commitment Therapy Dismantling Trial With Distressed College Students, Michael E. Levin, Jennifer Krafft, Michael P. Twohig

Psychology Faculty Publications

This secondary analysis examined the processes of change from a randomized dismantling trial evaluating the Open (i.e., cognitive defusion, acceptance) and Engaged (i.e., values, committed action) components of acceptance and commitment therapy (ACT). Analyses were conducted with 161 distressed college students randomly assigned to a full online ACT program (Full n=40), online ACT targeting the Open components (Open n=41) or targeting the Engaged components (Engaged n=39), or a waitlist condition (Waitlist n=41). The intervention occurred over six weeks followed by a post-treatment assessment with mental health symptoms as the primary outcome. Consistent with predictions, pre- to …

An Examination Of The Relationship Between Perfectionism And Neurological Functioning, Julie M. Petersen, Clarissa W. Ong, Allison S. Hancock, Ronald B. Gillam, Michael E. Levin, Michael P. Twohig

Psychology Faculty Publications

Clinical perfectionism is the rigid pursuit of high standards, interfering with functioning. Little research has explored neural patterns in clinical perfectionism. The present study explores neural correlates of clinical perfectionism, before and after receiving ten 50-minute, weekly sessions of acceptance and commitment therapy (ACT), as compared to low-perfectionist controls, in specific cortical structures: the dorsolateral prefrontal cortex (DLPFC), medial prefrontal cortex (MPFC), right inferior parietal lobule (IPL). Participants in the perfectionist condition (n = 43) were from a randomized controlled trial evaluating ACT for clinical perfectionism and low-perfectionist controls were undergraduate students (n = 12). Participants completed three tasks (editing …

A Preliminary Investigation Of The Effect Of Acceptance And Commitment Therapy On Neural Activation In Clinical Perfectionism, Clarissa W. Ong, Allison S. Hancock, Tyson S. Barrett, Eric B. Lee, Nicholas Wan, Ronald B. Gillam, Michael E. Levin, Michael P. Twohig

Psychology Faculty Publications

Clinical perfectionism is associated with various cognitive processes including performance monitoring and emotion regulation. This exploratory study analyzed neurological data from a randomized controlled trial for clinical perfectionism that compared acceptance and commitment therapy (ACT) to a waitlist control. The objective was to assess the effect of ACT on neural activation. Twenty-nine participants underwent a functional near-infrared spectroscopy assessment during which they completed behavioral tasks designed to elicit error detection and error generation at pre- and posttreatment. The hemodynamic response function (HRF) in the dorsolateral prefrontal cortex, dorsomedial prefrontal cortex, and right inferior parietal lobe was analyzed using mixed effects …