Acceptance And Commitment Therapy Research Articles

Co-Designing the MOSAIC mHealth App With Breast Cancer Survivors: User-Centered Design Approach.

Breast cancer is the world's most prevalent cancer. Although the 5-year survival rate for breast cancer in the United States is 91%, the stress and uncertainty of survivorship can often lead to symptoms of depression and anxiety. With nearly half of breast cancer survivors living with stress and symptoms of depression and anxiety, there are a significant number of unmet supportive care needs. New and potentially scalable approaches to meeting these supportive care needs are warranted. This study aimed to engage breast cancer survivors and acceptance and commitment therapy (ACT) content experts in user-centered design (UCD) to develop a mobile health app (MOSAIC [Mobile Acceptance and Commitment Therapy Stress Intervention]) using stress intervention strategies. We held 5 UCD sessions with 5 breast cancer survivors, 3 ACT content experts, 2 user experience design experts, and 1 stress expert facilitator over the course of 10 weeks. The sessions were developed to lead the 10 co-designers through the 5-step UCD process (eg, problem identification, solution generation, convergence, prototyping, and debriefing and evaluation). Following the fifth session, a prototype was generated and evaluated by the 5 breast cancer survivors and 3 ACT experts using the System Usability Scale, Acceptability E-scale, and a brief set of semistructured interview questions. The 10 co-designers were present for each of the 5 co-design sessions. Co-designers identified 5 design characteristics: simple entry with use reminders (behavioral nudges), a manageable number of intervention choices, highly visual content, skill-building exercises, and social support. A total of 4 features were also identified as critical to the use of the tool: an ACT and breast cancer-specific onboarding process, clean navigation tools, clear organization of the interventions, and once-per-week behavioral nudges. These requirements created the foundation for the app prototype. The 5 breast cancer survivors and 3 ACT co-designers evaluated the app prototype for 1 week, using an Android smartphone. They rated the app as usable (mean 79.29, SD 19.83) on the System Usability Scale (a priori mean cutoff score=68) and acceptable (mean 24.28, SD 2.77) on the Acceptability E-scale (a priori mean cutoff score=24). Through the UCD process, we created an ACT app prototype with 5 breast cancer survivors, 3 ACT experts, and 2 UCD designers. The next step in our research is to continue the assessment and refining of the prototype with additional breast cancer survivors. Future work will pilot-test the app to examine the feasibility of a large-scale, randomized control trial. Studies will enroll increasingly diverse breast cancer survivors to broaden the generalizability of findings.

Integrating Acceptance and Commitment Therapy with Selective Optimization with Compensation to Predict Wellbeing

ABSTRACT Objectives Selective Optimization with Compensation (SOC) is an empirically supported model of successful aging. Acceptance and Commitment Therapy (ACT) is an empirically supported intervention that has a theoretical model which is complementary to the SOC model. Combining the two models can provide a more comprehensive view of successful aging. The relationships between key SOC and ACT variables in relation to age-related wellbeing were explored among a sample of older American adults. Methods Older adult participants (n = 87) were recruited online from social media sites. This sample size provided sufficient power to test hypotheses. Participants completed measures of demographic characteristics, ACT constructs (acceptance, defusion, present-moment-awareness, self-as-context, values), SOC utilization, geriatric morale, purpose in life, and quality of life. Results Acceptance and defusion were significantly correlated with SOC variables and wellbeing. Acceptance and defusion mediated the relationship between SOC utilization and age-related wellbeing. Conclusions Acceptance and defusion were associated with better adjustment to the potential losses that co-occur with aging. Acceptance and defusion may also promote more openness to making changes in daily behaviors that can permit optimization and compensation of age-related losses. Clinical Implications Interventions that promote acceptance and defusion may be promising for older adults as they navigate the aging process.

The effect of Acceptance and Commitment Therapy on perceived stress, rumination, and distress tolerance in women with Bulimia Nervosa

ABSTRACT This study aimed to evaluate the efficacy of Acceptance and Commitment Therapy (ACT) in mitigating perceived stress, rumination, and distress tolerance among women diagnosed with Bulimia Nervosa (BN) in Ahvaz, Iran. A quasi-experimental pre-test-post-test design with a control group was employed. The target population consisted of all female BN patients referred to the Ahvaz Binge Eaters Association between February and May 2022. Patients were definitively diagnosed with BN by a clinical specialist using a structured clinical interview adhering to DSM-5 criteria. From an initial pool of 91 patients, 50 were randomly selected for participation and subsequently assigned to either the experimental or control group, with each group comprising 25 individuals. Pre-test analysis revealed no significant group differences in perceived stress, rumination, or distress tolerance among women with BN. However, post-test scores indicated a significant decrease in both perceived stress and rumination within the experimental group compared to the control group (p < .01). Furthermore, the post-test analysis demonstrated that ACT intervention significantly improved distress tolerance in women with BN (p < .01). These findings suggest that ACT may be a promising therapeutic approach for alleviating psychological distress and enhancing emotional regulation in individuals grappling with BN.

Exploring the Mediating Influence of Psychological Flexibility and Self-Compassion on the Relationship Between Adverse Childhood Experiences and Post-Traumatic Growth among Young Adults in India.

Through the course of the last few decades researchers have observed that Adverse Childhood Experiences (ACE) can act as a breeding ground for transformative positive changes to develop in the face of adversity. This process of enhanced growth is systematically studied as 'Post Traumatic Growth' (PTG). Though there is an existing association between ACE and PTG, yet there is a paucity of studies that explores the mediating variables in this relationship. The current study aims to explore the role of self-compassion (SC) and psychological flexibility (PF) between ACE and PTG among Indian young adults. The study was conducted on 298 Indian participants who were in the age bracket of 18-25years. The study variables were assessed using self-administered rating scales. Participants were screened for ACE using Adverse Childhood Experiences (ACEs) Questionnaire. Additionally, Self-Compassion Scale (SCS-SF), Acceptance and Action Questionnaire-II (AAQ-II), Posttraumatic Growth Inventory- Short Form were other tools used. The results have indicated that both Psychological Flexibility and Self-Compassion mediate the relationship of ACE with PTG. The current findings have emphasized on the role of Psychological Flexibility and Self-Compassion in moving towards Post Traumatic Growth. These findings reassert that Psychological Flexibility and Self-Compassion are foundational to Acceptance Commitment Therapy and highly useful especially while working with trauma affected populations.

The Effectiveness of Treatment Based on Acceptance and Commitment Therapy on Psychological Capital, Weight and Fat Mass in Obese Women

Introduction: The present study was conducted with the aim of investigating the effectiveness of acceptance and commitment therapy (ACT) on psychological capital, weight and fat mass of obese women. Method: This study is a semi-experimental, involving a pre-test and post-test design with a control group. The research population comprised all overweight and obese women living in Yazd in 2021. According to the inclusion criteria, 30 people were selected and randomly replaced in two experimental and control groups (15 people in each group). The research instruments included a demographic information questionnaire, the psychological capital questionnaire, and the ACT treatment protocol. Following the pre-test, subjects in the control group underwent ACT treatment training sessions as the independent variable. The intervention consisted of nine group therapy sessions, each lasting 1.5 hours. Analysis of covariance (ANCOVA) was used to analyze the data. Results: At the beginning of the research, the average weight in the experimental group was 73.85 kg and in the control group was 74.01 kg. The findings of the research showed that the treatment based on ACT was able to play an effective role in increasing the psychological capital of overweight and obese women in Yazd city (p=0/001). This treatment was also effective in reducing the fat mass and weight of the participants (p=0/001). Conclusion: According to the results of the present study, it seems that ACT can play an effective role in solving the problems of overweight women and increase their psychological capital and reduce their weight and fat mass.

Effectiveness of Acceptance and Commitment Therapy on Reducing Depression and Anxiety in Older Adults: A Systematic Review and Meta-Analysis.

To assess the effectiveness of acceptance and commitment therapy (ACT) in reducing depressive and anxiety symptoms in older adults. A systematic review and meta-analysis. Nine databases were searched for publications up to 2 April 2024, using combinations of search terms related to depression, anxiety, ACT, older adults and randomised controlled trials (RCTs). Two researchers were selected according to inclusion and exclusion criteria, data extraction and methodological quality evaluation, and Stata 16.0 software was used for meta-analysis. Seven articles were included in a systematic review and six were in a meta-analysis. The results indicated that, compared to the control group, ACT had a small but significant effect in reducing depressive symptom (SMD = -0.22, 95% CI, -0.38 to -0.06, p < 0.001; 576 older adults; low-quality evidence), while it showed a small, non-significant effect on reducing anxiety symptoms (SMD = -0.29, 95% CI, -0.73 to 0.15, p = 0.194; 576 older adults; very low-quality evidence). Subgroup analysis based on the different control conditions may have some enlightenment on the sources of heterogeneity. ACT can be an important component of future psychotherapy for older adults, as it may alleviate depressive symptoms. However, high-quality studies with large samples, multiple centres and long follow-up durations should be performed to further reliably assess the treatment effects of depressive symptoms and explore potential benefits for anxiety symptoms.

Efficacy of Acceptance and Commitment Therapy in Social Anxiety Disorder: A Systematic Review and Meta-analysis

Background: Acceptance and commitment therapy (ACT) is a novel third-wave therapy becoming popular in the management of various anxiety disorders. In this systematic review, we wish to gather the data that have been studied to determine the effectiveness of ACT in treating social anxiety disorder (SAD). Methods: This study followed standard systematic review guidelines and was registered with PROSPERO prior to undertaking the review. Databases, namely PubMed, PsycINFO, Ovid MEDLINE, and gray literature (ClinicalTrials.gov, BASE) with relevant keywords, were searched from inception to February 2024. Randomized controlled trials encompassing both clinical and nonclinical populations aged more than 10 years diagnosed with SAD were included. These trials compared ACT with wait list controls (n = 6) and cognitive behavioral therapy (n = 3). The primary outcome focused on the reduction of symptoms associated with social anxiety, while quality of life served as a secondary outcome. Measures of effect were determined through pre-test and post-test mean values, alongside their respective standard deviations. The random effect model was used to calculate pooled effect size. The quality of the included papers was assessed using Cochrane RoB-1. Covidence software was used for the initial selection of studies, and meta-analyses were performed using RevMan software. Results: From the initial 442 study records that were searched, finally 9 studies were included for the systematic review, of which 6 studies were found suitable for meta-analysis. The pooled estimate for studies comparing ACT with wait list found that the overall effect size for social anxiety symptoms was g = −1.28 (95% confidence interval of -1.88, -0.69) favoring ACT intervention significantly. Conclusion: This review found that ACT is efficacious in treating SAD. Most of the studies included were conducted in adolescent females. Varying ACT intervention modalities were incorporated, with the primary outcome assessed using a range of scales. The results of our meta-analysis should be interpreted with caution because of heterogeneity and smaller number of studies being included. ACT can be considered a psychotherapeutic option for the management of SAD.

Combined Habit Reversal Therapy and Acceptance and Commitment Therapy for Treatment of Tics in Tourette Syndrome: A Pilot Study of Effectiveness and Response Duration

AbstractBackgroundFew studies have examined the effectiveness and duration of mindfulness‐based therapies for tics in Tourette's syndrome. This study combined habit reversal therapy (HRT) with acceptance and commitment therapy (ACT).ObjectivesTo evaluate the efficacy and response duration of HRT + ACT in reducing tic severity in adults with Tourette's Syndrome.MethodsTic severity was assessed at baseline, post‐intervention, and at 6‐ and 12‐month follow‐ups using the Yale Global Tic Severity Scale (YGTSS) and video assessments. The intervention included eight weekly 1‐h sessions.ResultsMixed‐effects regression showed significant reductions in tic severity post‐treatment (b = −10.36, P = 0.002), maintained at 6 months (b = −8.19, P = 0.012) and 12 months (b = −8.82, P = 0.009). Video assessments confirmed these findings.ConclusionThe HRT + ACT protocol effectively reduced tic severity, with benefits lasting 12 months. These results support further trials to compare HRT + ACT with HRT alone.

Acceptance and commitment therapy as a transdiagnostic approach to adolescents with different anxiety disorders: study protocol.

Adolescence increases vulnerability to mental ill-health, particularly anxiety disorders like Social Anxiety Disorder (SAD) and Generalized Anxiety Disorder (GAD). Still, the understanding of Psychological Flexibility/Inflexibility (PF/PI) as a transdiagnostic framework relevant to explaining these difficulties and the efficacy of Acceptance and Commitment Therapy (ACT) in addressing adolescent SAD and GAD remains limited. Hence, this study has two aims: examining the role of PI/PF on adolescents' mental health and assessing ACT's efficacy for adolescent SAD and GAD. We will collect data from 400 community adolescents and employ network analysis to explore connections between PI/PF processes, anxiety, and flourishing. We will also investigate pathways linking PI/PF processes with flourishing and anxiety across samples (clinical SAD, clinical GAD, and mentally healthy groups), expecting to find similar patterns. Furthermore, a Randomized Controlled Trial with three groups (control, SAD experimental and GAD experimental), each comprising 29 participants, and four assessment moments (pre- and post-intervention and 3- and 6-months follow-up) will be conducted. Similar improvements are anticipated in both experimental groups, driven by changes in PI/PF processes. Findings from this work will provide valuable evidence to PI/PF as accurate conceptualizations of human suffering and expand the transdiagnostic application of ACT to adolescents with anxiety disorders.

Internet-based treatment for provoked vulvodynia: factors associated with treatment outcomes

Abstract Introduction Previous research has indicated that internet-based Acceptance and Commitment Therapy (ACT) can reduce pain during intercourse and increase pain acceptance in individuals with provoked vulvodynia, but the factors associated with treatment outcomes remain unknown. Aim This study aimed to investigate factors associated with changes in pain acceptance following an internet treatment based on ACT. Methods This exploratory study used data from the EMBLA study, a multicenter randomized controlled trial that investigated the effects of internet-based ACT for provoked vulvodynia. The examined factors included sociodemographics, medical history, pain and sexual behavior, and psychosocial characteristics. Linear regression analysis was employed to assess the association of these factors with pain acceptance, including interaction effects. Results were adjusted for multiple testing using Bonferroni correction. Outcomes The outcome measure was pain acceptance assessed on the scale Chronic Pain Questionnaire–Revised, which comprises two sub-scales: activity engagement and pain willingness. Results Before adjustment, greater improvement in overall pain acceptance and the subscale activity engagement was seen participants in the intervention group who had a history of physical violence or sexual assault. Increased time spent on the treatment platform per week was also associated with greater improvement in pain acceptance. Participants who reported gastrointestinal problems before the internet-based treatment showed better treatment outcomes in activity engagement. Previous contact with a psychologist or counselor was associated with less improvement in activity engagement. The intervention was less effective on the subscale pain willingness with increased age and for those reporting urinary problems. No associations remained statistically significant after adjustment for multiple testing. Clinical implications Previous exposure to violence and sexual assault, concomitant gastrointestinal or urinary problems, and adherence to treatment should be further investigated in larger studies on factors associated with treatment outcomes after internet treatment based on ACT, especially regarding pain. Strengths and limitations This was a novel and exploratory study and provides information for researchers in future investigations of how individual characteristics may influence treatment outcomes. A range of variables were explored in the models, underscoring the importance of future studies to strengthen the findings. One limitation concerns the sample size, which was fairly small considering the nature of the study. Conclusion After correcting for multiple testing, no factors were found to be statistically associated with changes in pain acceptance after the treatment.

Effectiveness of Acceptance and Commitment Therapy (ACT) on disease acceptance for breast cancer patients: Study protocol of a randomized controlled trial.

Breast cancer patients face significant psychological challenges, including difficulties in accepting the diagnosis, treatment, and long-term impact of the disease. Acceptance and Commitment Therapy (ACT) has shown promise in enhancing acceptance and psychological flexibility in various populations. This study aims to investigate the effectiveness of ACT in promoting disease acceptance among breast cancer patients through a randomized controlled trial. This study will recruit 90 breast cancer patients and randomly allocate them to an ACT intervention or control group. The ACT intervention, focusing on acceptance, mindfulness, value clarification, and committed action, will be delivered over 4 weeks. Meanwhile, the control group will receive standard care with non-therapeutic intervention. The study's primary outcome is disease acceptance, while secondary outcomes include depression, anxiety, social support, quality of life (QoL), and psychological inflexibility. Data will be collected at three points: baseline, post-intervention, and three-month follow-up. Statistical analysis will compare outcomes between groups to evaluate the effectiveness and mechanism of this intervention using covariance and mediation analysis. This study evaluates the effectiveness of ACT in promoting disease acceptance among breast cancer patients. It hypothesizes that the ACT group will show higher disease acceptance and improvements in social support, QoL, and psychological flexibility compared to the control group. The findings will contribute to research on psychological interventions and demonstrate ACT's effectiveness in enhancing disease acceptance. The research project is registered in the ClinicalTrials (NCT05327153).

Psychological Flexibility and Compassion Training for Equality in Organizations: A Randomized Controlled Trial of a Diversity and Inclusion Intervention

Abstract Objectives Discrimination and prejudice are prevalent in workplaces worldwide, but there are few empirically validated interventions for combating racial bias in organizational settings. This study aims to evaluate an intervention consisting of experiential exercises derived from Acceptance and Commitment Therapy (ACT) and Compassion-Focused Therapy (CFT). The objective is to address psychological processes influential in promoting inclusive and equal workplaces in relation to race/ethnicity. Method A sample of 123 employees was randomized to an intervention or a comparison condition. The intervention involved exercises designed to increase compassion and empathic perspective-taking, decrease psychological inflexibility related to prejudiced thoughts and racial attitudes, and enhance participants’ commitment to organizational values. Participants in the intervention group were compared to those participating in traditional diversity and inclusion lectures, which served as the comparison condition. Results The study found that participants in the flexibility and compassion condition showed a significant increase in self-reported compassion. The results also showed a significant decrease in the participants’ inflexibility in relation to prejudiced and stigmatizing thoughts. However, no significant differences between the conditions were found regarding the endorsement of racist attitudes or empathic perspective-taking. Conclusions This study adds to the important but limited literature on effective diversity training in organizations. It suggests that methods derived from ACT and CFT may improve workplace diversity and inclusion interventions by increasing compassion and reducing the impact of prejudiced and stigmatizing thoughts on behavior. Preregistration The study was not preregistered.

Virtual Coach-Guided Online Acceptance and Commitment Therapy for Chronic Pain: Pilot Feasibility Randomized Controlled Trial.

Veterans are disproportionately affected by chronic pain, with high rates of pain diagnoses (47%-56%) and a 40% higher rate of prevalence of severe pain than nonveterans. This is often accompanied by negative functional outcomes and higher mortality. Combined with research suggesting medical treatments for chronic pain are often insufficient, there is an urgent need for nonmedical pain self-management programs. An interactive online platform to deliver an efficacious treatment for chronic pain such as acceptance and commitment therapy (ACT) could be a valuable option to assist veterans with pain care at home. This study aims to evaluate the virtual coach-guided Veteran ACT for Chronic Pain (VACT-CP) online program compared to a waitlist and treatment as usual (WL+TAU) control group through a small pilot feasibility randomized controlled trial. The primary aim was to evaluate the feasibility and acceptability of VACT-CP and study procedures, such as ease of recruitment, treatment receptivity, attrition and retention, sustained participation, system usability, and assessment of trial procedures. Secondary aims explored differences in the VACT-CP and WL+TAU groups on pre- and posttest (week 7) outcome measures for pain, mental health, functioning, and ACT processes. Veterans with chronic pain were recruited and randomized to either the VACT-CP (n=20) or the WL+TAU (n=22) group in a parallel group trial design. Self-report surveys were administered to participants at baseline (week 0), at the intervention midpoint (week 3), immediately after the intervention (week 7), and at the 1-month follow-up (week 11). We used Wilcoxon signed rank tests with the intention-to-treat sample to describe changes in secondary outcomes from pre- to postintervention within each group. Study procedures showed good feasibility related to recruitment, enrollment, randomization, and study completion rates. Participants reported that VACT-CP was easy to use (System Usability Scale: mean 79.6, SD 12.8; median 82.5, IQR 70-87.5); they completed an average of 5 of the 7 total VACT-CP modules with high postintervention satisfaction rates. Qualitative feedback suggested a positive response to program usability, content tailoring, veteran centeredness, and perceived impact on pain management. Although the pilot feasibility trial was not powered to detect differences in clinical outcomes and significant findings should be interpreted with caution, the VACT-CP group experienced significant increases in chronic pain acceptance (P<.001) and decreases in depressive symptoms (P=.03). VACT-CP showed encouraging evidence of feasibility, usability, and acceptance, while also providing promising initial results in improving a key process in ACT for chronic pain-chronic pain acceptance-after online program use. A full-scale efficacy trial is needed to assess changes in clinical outcomes. ClinicalTrials.gov NCT03655132; http://clinicaltrials.gov/ct2/show/NCT03655132. RR2-10.2196/45887.

Web-based interventions for fear of cancer recurrence: A scoping review with a focus on suggestions for the development and evaluation of future interventions.

The objective of this scoping review is to provide an overview of the available evidence on the effectiveness of web-based interventions for fear of cancer recurrence (FCR) and a discussion of drawbacks and possible improvements for web-based interventions identified in the reviewed studies. These steps fulfil the aim of this review, which is to offer suggestions for developing future web-based interventions based on the reviewed studies. Five databases (PubMed, MEDLINE, EMBASE, SCOPUS and Web of Science) were searched. Original peer-reviewed articles, written in English, on web-based interventions for FCR were included for review. The data from the included studies was synthesised thematically. We included 34 papers reporting on 28 interventions. Most of the studies in the papers were quantitative and mixed quantitative studies with a qualitative element, e.g. an interview post-intervention. Interventions were most commonly trialled with women breast cancer patients. Top three countries where studies were conducted were USA, Australia and the Netherlands. The most common theoretical framework for interventions is cognitive behavioural therapy (CBT), followed by mindfulness-based and mixed CBT, mindfulness, acceptance and commitment therapy (ACT), relaxation approaches. FCR was the primary focus/measure in 19 Studies, in 9 studies FCR was a secondary/related outcome/measure. Overall, the evidence of efficacy of web-based interventions on FCR is mixed. The existing research suggests several key points for producing more robust evidence about the effectiveness of web-based interventions for FCR. First, the studies suggest that it is a priority to better define eligibility criteria to proactively include people with higher levels of FCR. Second, there is a need for longer-term follow-up and outcome measuring period. Third, research examining the reasons for dropout from web-based interventions for FCR is critical to improve the effectiveness of web-based interventions. Fourth, while web-based interventions do not involve the costs of transportation, traveling time, space, equipment, cleaning, and other expenses, further cost utility analyses should be performed. Finally, future studies should assess how intervention accessibility, adherence, and effectiveness can be improved across different intervention designs, varying from intensive synchronous individual therapist-assisted web-based programme to blended designs combining the advantages of face-to-face and internet-based elements, to entirely self-managed programmes. Developing and evaluating more accessible FCR treatments have been identified among top international FCR research priorities (Shaw et al. 2021). While there is some evidence that web-based interventions can be as effective as face-to-face interventions, currently there is a dearth of systematic data about the ways in which the web-based modality specifically can enhance supportive care for FCR. Developing knowledge about effective web-based interventions has implications for cancer survivors as they can be presented with more accessible, low-cost and low-burden options for managing fear of cancer recurrence.

A cultural adaptation of acceptance and commitment therapy with exercise for older Chinese with chronic pain and depressive symptoms: A mixed-methods study.

Chronic pain and depression are highly prevalent and correlated in older adults. Acceptance and commitment therapy (ACT) and exercise have been shown to be effective for both conditions, mostly in Western literature. Little is known about integrating two approaches, particularly in Asian cultures and among less well-educated people. This article describes the iterative process of developing a culturally adapted ACT with exercise intervention for older Chinese with chronic pain and depressive symptoms. A multidisciplinary expert panel codesigned a culturally adapted ACT with exercise intervention, comprising a weekly 2-hr ACT and a 1½-hr exercise program for 8 weeks, focusing on six ACT core components and low-to-moderate intensity circuit-based resistance exercise. Its feasibility was tested through a mixed-methods, pretest-posttest design with 22 older Chinese experiencing chronic pain and depressive symptoms (Mage = 71.5 years, SD = 7.5, 86% female). Participants showed significant improvements in pain intensity, pain interference, pain self-efficacy, physical performance, pain acceptance, and committed action (all p < .05). We identified five themes to inform protocol revision: (1) contextualizing values, (2) utilizing experiential learning, (3) using culturally appropriate metaphors, (4) establishing linkage between ACT concepts and pain, and (5) promoting application through repetition and prompts. Incorporating these findings, the final protocol emphasized three core ACT components and one set of physical exercises. This is the first study demonstrating the feasibility of a culturally adapted, person-centered tailoring ACT with exercise intervention for improving pain-related outcomes and mental wellness among older Chinese. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The effect and mechanism of acceptance and commitment therapy for young adults’ appearance-based rejection sensitivity and social comparison based on appearances : A randomized controlled trial

This study tested the effect and mechanism of acceptance and commitment therapy (ACT) on young adults’ appearance-based rejection sensitivity (ARS) and social comparison based on appearance (SCBA). A sample of 190 university students (Mage = 18.35, SD = 0.78; 56.62% female) was randomly assigned to either the ACT group (n = 94) or an active control group (n = 96), which focused on interpersonal discussions about experiences of appearance-based rejection. Participants completed six weekly group interventions, as well as three surveys: a baseline assessment before the intervention (T1), a post-test immediately after the intervention (T2), and a 3-month follow-up (T3). Clinically significant decreases in ARS and SCBA were observed in the ACT group from baseline to both the post-test and follow-up. Comparisons at each phase indicated that the ACT group outperformed the control group in reducing ARS and SCBA, as well as in improving psychological inflexibility and cognitive fusion. Furthermore, the parallel mediation models supported the mediating roles of psychological inflexibility and cognitive fusion between the ACT intervention and ARS/SCBA. These findings suggest that ACT is effective in reducing ARS and SCBA by improving psychological inflexibility and cognitive fusion. Future research should further explore the effects and mechanisms of ACT on ARS and its related constructs using diversified samples and multiple long-term follow-ups.

Sexual health counseling improves the sexual satisfaction of breast cancer survivors: a randomized controlled trial.

Breast cancer and its treatments can cause sexual problems both physically and psychologically by the changes it brings. This study aimed to investigate the effect of sexual health counseling based on acceptance and commitment therapy (ACT) on the sexual satisfaction of women with chemotherapy-induced menopause (CIM) in breast cancer survivors. Seventy women with CIM were randomly divided into two intervention (N = 34) and control (N = 36) groups. The intervention group attended eight sessions of 90-min sexual health counseling based on ACT. The control group received an educational booklet. The Sexual Satisfaction Scale for Women(SSS-W), the Sexual Quality of Life-Female questionnaire(SQOL-F), and the Menopause Rating Scale(MRS) were used to collect data before, after, and 1month after the intervention in both groups. The mean score of sexual satisfaction (F = 45.67, P < 0.001) and sexual quality of life (F = 33.39, P < 0.001) were significantly higher after the intervention and follow-up than before intervention in the intervention group. Also, the mean score of menopausal symptoms was significantly lower after the intervention and follow-up than before intervention in the intervention group (F = 11.80, P < 0.001). However, the mean score of sexual satisfaction (F = 0.02, P = 0.98), sexual quality of life (F = 0.05, P = 0.94), and menopausal symptoms (F = 0.08, P = 0.92) did not show significant differences before, after, and 1month after the intervention in the control group. Therefore, sexual health counseling based on ACT seems to have salutary effect on sexual satisfaction, sexual quality of life, and menopausal symptoms of women with breast cancer who experience CIM. This randomized control trial has been approved by Iranian Registry of Clinical Trials, IRCT20230105057055N1 at 2023-01-29.

Multidimensional Individualized Stuttering Therapy Outcomes At 24 Months Post Clinic: An Embodiment and Awareness Perspective.

Multidimensional Individualized Stuttering Therapy (MIST) is based on proactive collaborative work and shared decision making between client and clinician with the goal of identifying individual case-appropriate procedures and therapy elements in a manner that is meaningful and context-sensitive for each person. MIST combines value- and awareness-based elements from acceptance and commitment therapy (ACT) with stuttering and speech modification interventions. In keeping with the principles of ACT, we locate mindfulness as part of an embodied practice facilitated through a collaboration between the person who stutters and the speech-language therapist. The aim of this study was to see whether the positive results of MIST recorded at 12 months post-therapy remained stable at 24 months post-therapy and to consider the role of embodiment and awareness within MIST. Fifteen of 18 adults already enrolled in a treatment study (2015/FO12451) took part in a single-group repeated-measures design. They completed measures of stuttering severity, impact of stuttering, unhelpful thoughts and beliefs about stuttering, general anxiety symptoms, and fear of negative evaluation. There was a significant reduction of stuttering severity and negative impact of stuttering from pre-therapy to 24 months post-therapy. Unhelpful thoughts and beliefs about stuttering, symptoms of general anxiety, and fear of negative evaluation were reduced at 12 months post-therapy, and these values remained stable at 24 months post-therapy. MIST was associated with positive outcomes at 24 months post-therapy, suggesting a possible connection between the person-centered approach and longer-term benefit. Findings are discussed within the context of mindfulness and embodied adjustment, and shared client-clinician decision making. The absence of a control group is a limiting factor regarding certainty of interpretation. Future research is therefore needed on collaborative and individualized approaches to stuttering therapy that include embodiment and awareness perspectives.

Roles of Psychological Flexibility, Parenting Competence, and Asthma Management Self-Efficacy in the Functioning Outcomes of Parents of Children with Asthma Co-Occurring with Attention-Deficit/Hyperactivity Disorder.

Asthma and ADHD represent prevalent pediatric conditions, with the former being a physical disorder and the latter being a neurodevelopmental disorder. This study examined the influence of parental psychological flexibility (PF)-the ability to adapt to evolving situational demands, shift perspectives, and balance competing priorities-alongside parenting competence and asthma management self-efficacy on family functioning and parental psychological adjustment in families with children exhibiting concurrent asthma and ADHD symptoms. Baseline data were analyzed from 130 parents (mean age = 40.3 years, SD = 5.5; 88.9% mothers) of children diagnosed with both asthma and ADHD (mean age = 8.0 years, SD = 2.2; 74.6% boys), who were participating in a randomized controlled trial evaluating an Acceptance and Commitment Therapy (ACT)-based parenting intervention. An adjusted structural equation model revealed that greater parental psychological inflexibility was significantly associated with poorer family functioning (β = -0.61, 95% CI [-0.74, -0.33], p < 0.001) and increased psychological maladjustment (β = 0.48, 95% CI [0.32, 0.63], p < 0.001), accounting for intercorrelations with parenting competence and parental asthma management self-efficacy. Additionally, parental psychological flexibility was found to mediate the relationship between parenting competence and both family functioning and psychological adjustment. These findings underscore the importance of targeting parental psychological inflexibility and enhancing parenting competence in interventions to improve family dynamics and parental mental health and thereby suggest a shift from the traditional focus on self-efficacy in symptom management for pediatric asthma and ADHD.

Performance Mindfulness: Integrating ACT Matrix, Imagery and Mindfulness for Performance Enhancement

Mindfulness, imagery, and acceptance-based interventions have been widely applied within the sport and performance psychology domain. This paper presents a novel imagery method termed ‘Performance Mindfulness,’ which synthesizes insights from the Acceptance and Commitment Therapy (ACT) Matrix tool, the Physical, Environmental, Task, Timing, Learning, Emotion, Perspective (PETTLEP) imagery method, and principles of mindfulness. As existing imagery techniques are limited in effectively capturing the motivational and emotional dimensions of athletic performance, this integrated approach introduces a well-conceptualized, evidence-based framework rooted in Contextual Behavioral Science. This framework translates insights from the ACT Matrix into a practical tool within the imagery process and integrates principles of mindfulness to enhance the effectiveness of imagery. Performance Mindfulness is tailored for sport psychology practitioners who seek to incorporate acceptance and mindfulness principles into the mental preparation of athletes at various levels. The paper provides a detailed explanation of the technique, including concrete examples, and discusses its advantages and disadvantages comprehensively.