Education Commons^™

Acceptance And Commitment Therapy For Obsessive Compulsive Disorder In A Brazilian Context: Treatment Of Three Cases, Luana D. Laurito, Carla Pereira Loureiro, Livi Faro, Rafaela Venâncio Dias, Bianca Torres, Maria Eduarda Moreira-De-Oliveira, Samara Dos Santos-Ribeiro, Gabriela B. De Menezes, Leonardo F. Fontenelle, Carter H. Davis, Michael P. Twohig

Psychology Faculty Publications

Previous research indicates that a combination of Acceptance and Commitment Therapy (ACT) and Exposure and Response Prevention (ERP) is an effective treatment for obsessive-compulsive disorder (OCD). However, there are no studies to date of ACT for OCD in Latin American populations. Because socio-cultural context influences OCD symptomatology, it is worth adapting and testing ACT for OCD in such cultures. Three patients seeking treatment for OCD at a public health center in Rio De Janeiro, Brazil were treated with 16 sessions of ACT and ERP. All participants showed decreased OCD scores from baseline to post-treatment that remained lower at follow-up, suggesting …

Tracking Valued And Avoidant Functions With Health Behaviors: A Randomized Controlled Trial Of The Acceptance And Commitment Therapy Matrix Mobile App, Michael E. Levin, Jennifer Krafft, Seth Seifert, Jason Lillis

Psychology Faculty Publications

This randomized controlled trial evaluated the acceptability and additive effects of self- monitoring avoidant and valued functions of behavior, in the context of self-monitoring physical activity and dietary behavior in a mobile app. The self-monitoring approach was based on the Acceptance and Commitment Therapy (ACT) Matrix. A sample of 102 adults interested in improving their diet and physical activity were randomized to a Health Behavior Tracking app (HBT), HBT plus ACT matrix app (HBT+ACT), or waitlist condition. Online self-report assessments were completed at baseline, mid (2 weeks), and post-intervention (4 weeks). Participants reported high usability, but mixed satisfaction with both …

The Empirical Status Of Acceptance And Commitment Therapy: A Review Of Meta-Analyses, Andrew T. Gloster, Noemi Walder, Michael E. Levin, Michael P. Twohig, Maria Karekla

Psychology Faculty Publications

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 …

An Iranian Study Of Group Acceptance And Commitment Therapy Versus Group Cognitive Behavioral Therapy For Adolescents With Obsessive-Compulsive Disorder On An Optimal Dose Of Selective Serotonin Reuptake Inhibitors, Mohammad Javad Shabani, Hamid Mohsenabadi, Abdollah Omidi, Eric B. Lee, Michael P. Twohig, Afshin Ahmadvand, Zahra Zanjani

Psychology Faculty Publications

Conducted in Iran, participants included 69 adolescents with obsessive-compulsive disorder (OCD) who were on a stable selective serotonin reuptake inhibitor (SSRI) dose and were randomly assigned to one of three conditions: group acceptance and commitment therapy (ACT)+SSRI, group cognitive behavioral therapy (CBT)+SSRI, or continued SSRI treatment. Assessment occurred at pre-, post-treatment, and three-month follow-up and included the Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS), Children’s Depression Inventory (CDI), Avoidance and Fusion Questionnaire for Youth (AFQ-8), Valued Living Questionnaire (VLQ), and Child and Adolescent Mindfulness Measure (CAMM). ACT+SSRI and CBT+SSRI conditions demonstrated significant reductions in OCD severity that were maintained at follow-up …

Evaluating The Open And Engaged Components Of Acceptance And Commitment Therapy In An Online Self-Guided Website: Results From A Pilot Trial, Julie M. Petersen, Jennifer Krafft, Michael P. Twohig, Michael E. Levin

Psychology Faculty Publications

Online acceptance and commitment therapy (ACT) is promising for treating a range of psychological problems. Component research can further clarify which components are needed for optimal outcomes in what contexts. Online platforms provide a highly controlled format for such research. In this pilot trial, 55 adults were randomized to: ACT-Open (i.e., acceptance, defusion components), ACT-Engaged (i.e., values, committed action), or ACT-Combined (i.e., acceptance, defusion, values, committed action). Each condition was 12 sessions over six weeks, with assessments at baseline, posttreatment, and four-week follow-up. ACT-Open, ACT-Engaged, and ACT-Combined all significantly improved from pre- to post-treatment on mental health, psychosocial functioning, and …

Starting Off On The Right Foot In Acceptance And Commitment Therapy, Michael P. Twohig, Clarissa W. Ong, Jennifer Krafft, Jennifer L. Barney, Michael E. Levin

Psychology Faculty Publications

This paper describes the initial phase of acceptance and commitment therapy (ACT). The paper begins with a review of ACT’s theoretical orientation. Basic empirical support for ACT and its model is covered. A case description follows that highlights the initial phases of ACT. The paper concludes with practical recommendations for starting therapy using ACT.

Clinical impact statement:

Question: The goal of this paper is to present the manner in which ACT is initiated. Findings: There are specific theoretical elements of ACT that suggest certain approaches be taken at the beginning of therapy. Meaning: Before starting ACT with a new client, …

Assessing Psychological Inflexibility In University Students: Development And Validation Of The Acceptance And Action Questionnaire For University Students (Aaq-Us), Michael E. Levin, Jennifer Krafft, Jacqueline Pistorello, John R. Seeley

Psychology Faculty Publications

This study sought to develop and validate a domain-specific measure of psychological inflexibility for university students, the acceptance and action questionnaire for university students (AAQ-US). Generic versions of the AAQ tend to not be as sensitive to changes in campus-specific functioning —a key outcome of interest in this population. An online survey was conducted with 425 undergraduate students. Psychometric analyses led to the refinement of a 12-item, single factor scale with strong internal consistency. Evidence for convergent validity was found with moderate to large correlations between the AAQ-US and measures of academic outcomes, mental health, and psychological inflexibility. The AAQ-US …

An Examination Of The Transdiagnostic Role Of Delay Discounting In Psychological Inflexibility And Mental Health Problems, Michael E. Levin, Jack Haegar, Clarissa W. Ong, Michael P. Twohig

Psychology Faculty Publications

Delay discounting is a basic behavioral process that has been found to predict addictive behaviors, and more recently, other mental health problems. Acceptance and Commitment Therapy (ACT), is a transdiagnostic treatment that appears to alter delay discounting, possibly through reducing psychological inflexibility. The current study sought to further bridge research on delay discounting and ACT by examining the relation of delay discounting to a broad range of selfreported mental health problems and measures of psychological inflexibility. A cross sectional online survey was conducted with 389 college students. Small negative correlations ranging between .09 and .15 were statistically significant between delay …

Delivering Acceptance And Commitment Therapy For Weight Self-Stigma Through Guided Self-Help: Results From An Open Pilot Trial, Michael E. Levin, Sarah Potts, Jack Haegar, Jason Lillis

Psychology Faculty Publications

Weight self-stigma is a promising target for innovative interventions seeking to improve outcomes among overweight/obese individuals. Preliminary research suggests acceptance and commitment therapy (ACT) may be an effective approach for reducing weight self-stigma, but a guided self-help version of this intervention may improve broad dissemination. This pilot open trial sought to evaluate the potential acceptability and efficacy of a guided self-help ACT intervention, included coaching and a self-help book, with a sample of 13 overweight/obese individuals high in weight self-stigma. Results indicated a high degree of program engagement (77% completed the intervention) and satisfaction. Participants improved on outcomes over time …

Web-Based Self-Help For Preventing Mental Health Problems In Universities: Comparing Acceptance And Commitment Training To Mental Health Education, Michael E. Levin, Steven C. Hayes, Jacqueline Pistorello, John R. Seeley

Psychology Faculty Publications

No abstract provided.

Perspectives On The Use Of Acceptance And Commitment Therapy Related Mobile Apps: Results From A Survey Of Students And Professionals, Benjamin G. Pierce, Michael P. Twohig, Michael E. Levin

Psychology Faculty Publications

Although mobile apps have proliferated as self-help or adjunctive therapy supports, scant research has explored their implementation among mental health practitioners. Little is known about uses and perceptions of mental health apps among applied practitioners, nor are agreed-upon criteria for evaluating and choosing apps available. The present survey study examined the uses and perceptions of mental health apps among 356 professionals and students familiar with Acceptance and Commitment Therapy (ACT), as indicated by being a member of the Association for Contextual Behavioral Science. The survey found that practitioners are interested in using ACT-related apps, but that use of and familiarity …

Web-Based Acceptance And Commitment Therapy For Mental Health Problems In College Students: A Randomized Controlled Trial, Michael E. Levin, Jack Haegar, Benjamin G. Pierce, Michael P. Twohig

Psychology Faculty Publications

There are significant challenges in addressing the mental health needs of college students. The current study tested an acceptance and commitment therapy (ACT) web-based self-help program to treat a broad range of psychological problems students struggle with. A sample of 79 college students were randomized to web-based ACT or a waitlist condition, with assessments at baseline and posttreatment. Results indicated adequate acceptability and program engagement for the ACT website. Relative to waitlist, participants receiving ACT improved on overall distress, general anxiety, social anxiety, depression, academic concerns, and positive mental health. There were no between group effects on eating concerns, alcohol …

Examining The Role Of Psychological Inflexibility, Perspective Taking And Empathic Concern In Generalized Prejudice, Michael E. Levin, Jason B. Luoma, Roger Vilardaga, Jason Lillis, Richard Nobles, Steven C. Hayes

Psychology Faculty Publications

Research to-date on generalized prejudice has focused primarily on personality factors. Further work is needed identifying manipulable variables that directly inform anti-prejudice interventions. The current study examined three such variables: empathic concern, perspective taking, and psychological inflexibility/flexibility with prejudiced thoughts, as a test of the flexible connectedness model. A sample of 604 undergraduate students completed online surveys. A model indicated prejudice measures loaded onto a latent variable of generalized prejudice. In a second model, psychological inflexibility, flexibility, empathic concern and perspective taking were all significant, independent predictors of generalized prejudice. Psychological inflexibility also predicted prejudice above and beyond personality and …

An Initial Meta-Analysis Of Acceptance And Commitment Therapy For Treating Substance Use Disorders, Eric B. Lee, Woolee An, Michael E. Levin, Michael P. Twohig

Psychology Faculty Publications

Background: In the past decade, multiple studies have examined the effectiveness ofAcceptance and Commitment Therapy (ACT) for substance use disorders relative to other active treatments. The current meta-analysis examined the aggregate effect size when comparing ACT to other treatments (e.g., CBT, pharmacotherapy, 12-step,treatment as usual) specifically on substance use outcomes. Method: A total of 10 randomized controlled trials were identified through systematic searches. Results: A significant small to medium effect size was found favoring ACT relative to active treatment comparisons following treatment. Effect sizes were comparable across studies for smoking cessation (k = 5) and for other drug use disorders …

Feasibility Of An Acceptance And Commitment Therapy Adjunctive Web-Based Program For Counseling Centers, Michael E. Levin, Jacqueline Pistorello, Steven C. Hayes, John R. Seeley, Crissa Levin

Psychology Faculty Publications

Web-based adjunctive tools provide a promising method for addressing the challenges college counseling centers face in meeting the mental health needs of students. The current study tested an initial adjunctive prototype based on Acceptance and Commitment Therapy (ACT) in a pre-post open trial with 30 counselors and 82 student clients across 4 counseling centers. Results indicated high ratings of program satisfaction and usability with counselors and students. The majority of students completed at least part of the program. Significant improvements were found across almost all outcome and ACT process measures with student clients. Improvements in student outcomes were predicted by …

Decoupling As A Mechanism Of Change In Mindfulness And Acceptance: A Literature Review, Michael E. Levin, Jason B. Luoma, Jack Haegar

Psychology Faculty Publications

A growing body of research within the acceptance and mindfulness-based therapies suggests these treatments may function in part by reducing or eliminating (i.e., decoupling) the normative relationships between internal experiences and other internal/overt behavior. Examples of decoupling effects found in this review include reduced relationships between urges to smoke and smoking behavior, between dysphoric mood and depressive cognitions, and between pain intensity and persistence in a painful task. A literature review identified 44 studies on acceptance and mindfulness that demonstrated decoupling effects. Overall, preliminary evidence for decoupling effects were found across a broad range of problem areas including substance abuse, …

Examining Psychological Inflexibility As A Transdiagnostic Process Across Psychological Disorders, Michael E. Levin, Chelsea Maclane, Susan Daflos, John R. Seeley, Steven C. Hayes, Anthony Biglan, Jacqueline Pistorello

Psychology Faculty Publications

The current cross-sectional study examined psychological inflexibility, a process in which behavior is rigidly guided by psychological reactions rather than direct contingencies or personal values, as a transdiagnostic process relevant to a range of depressive, anxiety, substance use and eating disorders. A sample of 972 first-year college students between 17 and 20 years of age completed self-report measures of psychological inflexibility and psychological distress as well as a structured diagnostic interview. Psychological inflexibility was significantly higher across a range of current and lifetime depressive and anxiety disorders as well as lifetime history of eating disorders, relative to students with no …