Acceptance-based Approaches Research Articles

Social validity of acceptance-based workplace mental health training for use in a low resource setting. A qualitative study with Ugandan mental health providers

In low-resource settings, working age adults suffer a disproportionately higher mental health burden due to precarious work environments; yet access to evidence-based worksite mental health promotion programs remains severely limited due to the lack of professional service providers. Alternative mental wellness programs that are affordable, accessible and help build resilience to deal with the daily demands of work and life need to be introduced in workplaces of low-resource contexts. Such programs should however be acceptable and of social importance to the targeted contexts. Acceptance-based approaches meet these criteria but have mainly been implemented and evaluated in high-income countries. Gauging the appropriateness of such programs for low-resource workplace settings before wide-scale implementation is necessary. We engaged n = 14 mental health providers living and working in Kampala-Uganda in a one-day workshop focused on using acceptance and commitment training in the workplace. During in-depth interviews, these providers shared feedback on the social importance of the program’s goals and effects, and acceptability of the program’s procedures to Ugandan society. A deductive thematic approach was used to analyze data (codes organized according to a priori thematic categories that aligned with the Social Validity Framework). Findings showed that the program’s goals and effects were gauged as socially significant and the training process was acceptable. However, key adjustments were recommended, including introducing communal values into the program, reducing session load, integrating mental health awareness strategies, and adding contextually relevant metaphors. These adjustments are likely to enhance the appropriateness of this type of acceptance-based worksite mental health promotion program for use in Uganda.

A 6-Week Mindfulness-Acceptance-Commitment Intervention to Improve Professional Ballet Dancers' Psychological States Around Performance.

Background: Mindfulness and acceptance-based approaches have been trialled in professional sport. The present pilot study was a randomized controlled trial with professional ballet dancers investigating the effectiveness of the Mindfulness-Acceptance-Commitment (MAC) approach, developed for athletes, compared to an education program which included topics relevant to ballet and performance. Methods: Participants included 16 professional ballet dancers (2 men and 14 women) who were randomly assigned into either the MAC or education group for 1 session per week, for 6 weeks. Participants were assessed pre-and post-intervention using the Mindfulness Inventory for Sport (MIS) and the Acceptance Action Questionnaire (AAQ-II). Within 2 weeks of the final mindfulness session, all participants completed a semi-structured interview. Results: No differences were found when comparing the questionnaire responses between pre- and post- intervention, nor between the MAC group and the control group at post intervention for all subscales. Although dancers reported in the interviews that the sessions were valuable, they advised their ability to dedicate time to mindfulness ongoing would be challenging. Conclusions: Mindfulness interventions, as explored in this study, show promise to promote the well-being of professional ballet dancers. For consistent and ongoing mindfulness practice, future designs should seek to embed mindfulness practice into dancer and company schedules.

Family Caregivers' Progress Toward Values Moderates the Associations between Behavioral Symptoms of Dementia, Caregiver Burden, and Depressive Symptoms.

Increasingly, dementia caregiver interventions are informed by acceptance-based approaches such as Acceptance and Commitment Therapy. These interventions promote psychological skills like psychological flexibility and value-based living. Less is known how these constructs interact within well-established caregiver stress processes. We examined a moderated mediation model (N = 161 dementia caregivers; PROCESS Procedure; SPSS Release 4.1), with BPSD frequency (Revised Memory and Behavior Problems Checklist) predicting depressive symptoms (10-item CES-D), mediated via caregiver burden (short Burden inventory). The moderator was the Values Questionnaire, and we controlled for gender, caregiver duration, age, income, and education. Results: revealed that the indirect effect of BPSD on depressive symptoms through caregiver burden was weakened through higher progress toward values (moderated mediation significant at p < .05). Committed action toward values signify caregivers' success at balancing care-related stress with other priorities. Interventions that build skills in values-based living have promise for caregivers, offering healthier ways to adjust to being a caregiver.

Group-Based Acceptance and Commitment Therapy for PTSD in a HMO Psychiatry Clinic: An Open Trial

Mindfulness and acceptance-based approaches have shown promise as alternative interventions to trauma-focused therapies for PTSD. This open trial examined the potential effectiveness of an 8-session Acceptance and Commitment Therapy (ACT) group in reducing psychiatric symptoms and improving quality of life in outpatient adults (N = 86, 79% female) receiving treatment for PTSD in a health maintenance organization (HMO) psychiatry clinic. The group therapy was an adjunct to usual care and utilized the six core processes of ACT: acceptance, cognitive defusion, mindfulness, self-as-context, values, and committed action. Participants completed self-report measures of PTSD symptoms, depression, anxiety and quality of life; and self-report ACT-specific process measures of acceptance, cognitive defusion and mindfulness at pretreatment, posttreatment and 3-month follow-up. Repeated measures analyses of variance conducted with a completer sample (n = 55) demonstrated significant improvements on all variables with medium to large effect sizes at posttreatment and follow-up. The study findings support further investigation in a randomized controlled trial.

A clinical trial protocol of a single-session self-guided acceptance-based online intervention targeting food cravings as predictors of disordered eating in pregnant people

BackgroundPregnancy is a time of heightened risk for disordered eating behaviors, which are linked to adverse health outcomes in gestation, delivery, and the postpartum. These adverse outcomes may be partially mediated by greater rates of deviation from recommended weight gain trajectories, especially in those who engage in binge and loss of control (LOC) eating. Food cravings are powerful and highly modifiable triggers of binge and LOC eating in non-pregnant populations with preliminary evidence linking cravings to disordered eating behaviors in pregnancy as well. Acceptance-based approaches have been shown to be feasible and effective in reducing the adverse impact of cravings on behavior. PurposeTo test the feasibility, acceptability, and preliminary efficacy of a single-session, self-guided, acceptance-based online workshop targeting food cravings as predictors of binge and LOC eating in pregnancy. MethodsWe will conduct a pilot randomized controlled trial of a single-session, self-guided online acceptance-based workshop targeting food cravings in pregnancy. Pregnant individuals in the second trimester (n ≥ 74) endorsing current food cravings will be randomly assigned to the intervention or an untreated control group. The intervention group will participate in a one-hour workshop that imparts skills grounded in Acceptance and Commitment Therapy, including acceptance, defusion, and present-moment awareness. Both groups will complete comprehensive self-report assessments of primary outcomes and hypothesized mediators and moderators of intervention efficacy at baseline, one-month follow-up, and at full-term. ConclusionResults will inform integration of acceptance-based skills targeting food cravings into routine prenatal care to prevent adverse outcomes associated with disordered eating behaviors in pregnancy.Trial registration: ClinicalTrials.gov identifier NCT06129461; registered on November 10, 2023.

Shame and Emotion Dysregulation as Pathways to Posttraumatic Stress Symptoms Among Women With a History of Interpersonal Trauma.

Women who have survived interpersonal trauma are at elevated risk of developing posttraumatic stress disorder (PTSD), and potentially modifiable factors that may be targeted in treatment warrant further investigation. This study examined a pathway from interpersonal trauma to PTSD symptoms via emotion dysregulation and shame in a large non-clinical sample of women. The sample comprised 380 women, aged 18 to 59 years (M = 31.70, standard deviation = 10.06), all of whom had a history of interpersonal trauma. Participants completed the Experience of Shame Scale, the Difficulties in Emotion Regulation Scale-Short Form, and the Life Events Checklist for DSM-5. A serial and parallel process model with interpersonal trauma as a predictor of PTSD symptoms, emotional dysregulation and facets of shame as intermediary variables, was analyzed using Statistical Package for Social Sciences Statistics PROCESS Model 81with bias-corrected bootstrap tests of indirect effects. Non-interpersonal trauma was included as a covariate. Interpersonal trauma, emotion dysregulation, and characterological and bodily shame were significantly and directly associated with PTSD symptoms, together explaining 59% of the variation in PTSD symptoms. While emotion dysregulation was associated with behavioral shame, interpersonal trauma was not associated with behavioral shame, nor was behavioral shame associated with PTSD symptoms. Tests of indirect effects supported a pathway from interpersonal trauma to PTSD symptoms via emotion dysregulation and characterological and bodily shame. These findings suggest interventions that are particularly effective at reducing emotion dysregulation and characterological and bodily shame, such as compassion and acceptance-based approaches, may complement evidence-based PTSD interventions when working with women who have survived interpersonal trauma.

A meta-analytic review of acceptance-based interventions for migraine.

To determine the efficacy of acceptance and mindfulness-based interventions on migraine disability, medication use, and attack frequency. Acceptance-based approaches to headache management are those in which individuals learn to mitigate the influence of pain-related experiences on their general functioning without controlling pain itself. Treatment approaches include acceptance and commitment therapy (ACT) and mindfulness-based practices. Both have shown promise in improving broad functioning and disability among individuals with headache. Despite a growing body of research examining acceptance-based interventions for headache broadly and migraine specifically, no meta-analytic review of ACT interventions for headache exists, and two meta-analytic reviews of mindfulness-based practices yielded conflicting results. The present study aimed to systematically and quantitatively review the literature related to the efficacy of acceptance-based interventions among adults with migraine. A multi-database search (PubMed/MEDLINE, Scopus, PsycINFO, and the Cochrane Central Register of Controlled Trials) identified clinical trials among individuals with migraine that compared structured ACT or mindfulness-based interventions to control treatment. Random-effects meta-analyses were performed using RevMan 5.4 meta-analytic software, and standardized mean differences (SMD) with 95% confidence intervals (CIs) quantified effect sizes on outcomes of disability, medication use, and headache frequency. Heterogeneity was quantified via I2 index and explored via subgroup analyses. Acceptance-based interventions yielded significant improvements in disability (SMD = -0.38, 95% CI = -0.56 to -0.20; I2 = 25%, p = 0.20) but not in medication use (SMD = -0.25, 95% CI: -0.57 to 0.06; I2 = 0%, p = 0.82) or headache frequency (SMD = -0.16, 95% CI = -0.37 to 0.05; I2 = 0%, p = 0.73). Results suggest that acceptance-based interventions are effective in improving disability among adults with migraine and are a viable non-pharmacological treatment option, in addition to well-established behavioral migraine management approaches, for patients seeking functional improvement.

The effectiveness of a counseling program based on the Mindfulness and Acceptance-Based Approaches in reducing the level of smiling depression among a sample of working women at Al-hassan Industrial Zone

هدفت الدراسة إلى فحص فاعلية برنامج إرشاد جمعي يستند إلى العلاج باليقظة الذهنية والقبول في خفض مستوى الاكتئاب المبتسم لدى عينة من النساء العاملات في مدينة الحسن الصناعية في إربد، الأردن، وتكونت عينة الدراسة من (30) سيدة من النساء العاملات في مدينة الحسن الصناعية، وتم تعيينهم بشكل عشوائي لمجموعتين متساويتين: المجموعة التجريبية (ن=15) وشاركت في برنامج الإرشاد الجمعي والمجموعة الضابطة (ن=15) التي لم تشارك في أي برنامج تدخل، ولتحقيق أهداف الدراسة، تم استخدام قائمة بيك الثاني للاكتئاب (BDI-II)، ومقياس الاكتئاب المبتسم، لجمع بيانات الدراسة في الاختبارات القبلية والبعدية لمجموعتي الدراسة، وفي الاختبار التتبعي لأفرادِ المجموعة التجريبية فقط، بالإضافة إلى برنامج إرشادي جماعي مستند إلى النهج القائم على اليقظة الذهنية والقبول. أظهرت نتائج تحليل التباين المصاحب (ANCOVA) وتحليل التباين المتعدد (MANCOVA) وجود فروق دالة إحصائيًا عند مستوى الدلالة (0.05=α) بين الوسطين الحسابيين للقياس القبلي والبعدي لمستوى الاكتئاب المبتسم وفقاً للمجموعة في الاختبار البعدي لصالح المجموعة التجريبية، مما يشير إلى فعالية البرنامج الإرشادي. أيضاً، أشارت نتائج المقارنات البعدية والتتبعية لدى أفراد المجموعة التجريبية الى عدم وجود فروق ذات دلالة إحصائية لاختبار (ت) للعينات المترابطة لمقياس الاكتئاب المبتسم وبعديه. ويعني ذلك استمرار أثر البرنامج رغم مرور فتره زمنية على انتهائه. &nbsp

A look at intercultural sensitivity from the perspective of mindfulness and acceptance of diversity

Although the concept of mindfulness is gradually increasing its use in the intercultural literature, it is seen that there has not been enough empirical research on the role of mindfulness in intercultural relations and the variables related to intercultural relations. One of the intercultural variables is intercultural sensitivity. In today's world, which is getting richer with increasing diversity, it can be said that approaching intercultural sensitivity from the framework of mindfulness will provide a more comprehensive understanding. Acceptance of diversity is one of the variables that are emphasized in the culturally sensitive approach processes. Therefore, it is thought that mindfulness and acceptance-based approaches will positively affect intercultural sensitivity. In this study, it was aimed to reveal the roles of mindfulness and acceptance of diversity variables in predicting the intercultural sensitivity levels of university students. The study is a descriptive research in which the correlational survey model was used and the data were collected with the convenience sampling method. 336 university students participated voluntarily in the study. Acceptance of Diversity Scale (ADS), Adolescent and Adult Mindfulness Scale (AAMS), Intercultural Sensitivity Scale (ISS), participant information form were used as data collection tools. Multiple Linear Regression Analysis and Pearson Product Moment Correlation techniques were used in the analyses. The findings revealed that the sub-dimensions of Adolescent and Adult Mindfulness Scale -focus on the present moment, being non-reactive, non-judgmental, self-accepting- and acceptance of diversity explained 33% of intercultural sensitivity level. As a result, it is a necessity to provide an inclusive and supportive environment free from discrimination for every individual of society and to protect their well-being. In order to foster intercultural sensitivity; it is of great importance to promote mindfulness and acceptance of diversity.

Acceptance and Commitment Training for Ice Hockey Players: A Randomized Controlled Trial.

Recent systematic reviews on the topic of mindfulness- and acceptance-based approaches in sport psychology conclude that there is a need for further trials using a more robust research methodology with direct performance as outcome. Acceptance and Commitment Training (ACT) is a contextual behavioral change method that focuses on facilitating psychological processes such as values, committed action, acceptance and mindfulness. In the present study designed as a randomized controlled trial, 34 junior elite ice hockey players were allocated into either an ACT group intervention or a wait list control group. Results showed significant effects on both objective performance outcomes (goals, assists, and taken shots) and blinded coach ratings of players’ performance, focus and commitment to their development in favor of the ACT group. Effects lasted at 3-month follow-up for the coach ratings, but not for the objective performance measures. All ACT trained players recommended ACT to other players and considered the training as important for their development as ice hockey players. The results add to the growing body of evidence on ACT interventions for athletes and its effect on performance. Future studies should investigate the maintenance of effects from the psychological training over time, using robust research methodology and investigate theoretical coherent potential mediating variables.

Effects of mindfulness- and acceptance-based interventions on diabetes distress and glycaemic level in people with type 2 diabetes: Systematic review and meta-analysis.

For people with type 2 diabetes, self management and fear of disease complication often cause psychological distress. Mindfulness and acceptance might be beneficial for reducing diabetes-related distress and glycaemic level. We systematically review the effects of mindfulness- and acceptance-based interventions on diabetes distress and glycaemic level in community-dwelling adults with type 2 diabetes. Seven electronic databases (English and Chinese) were searched comprehensively from inception to June 2020. Data extraction and methodological quality assessment were independently performed by two reviewers using Grading of Recommendations, Assessment, Development and Evaluations criteria. Nine RCTs (801 participants) examining the effects of acceptance and commitment therapy, mindfulness-based cognitive therapy, mindfulness-based stress reduction and self-directed mindfulness practice were included. In the reviewed RCTs, the majority of participants (mean age: 50-66years, average disease duration: 4-10years) had suboptimal diabetes control (HbA1c >7.0%, 53mmol/mol). Compared with controls, the interventions significantly reduced diabetes distress (standardised mean difference, SMD=-0.37, 95% confidence intervals, CI: -0.63, -0.12; p<0.01) and HbA1c (mean difference, MD=-0.35, 95% CI: -0.67, -0.04; p=0.03) up to 1-month post-intervention. However, the underpowered studies may have led to overestimation, the interventions for diabetes distress and HbA1c were heterogeneous. Within evidenced-based diabetes education programmes, mindfulness- and acceptance-based approaches may reduce distress and HbA1c levels and promote self care in people with type 2 diabetes. Further controlled trials are recommended to examine the clinical effectiveness of such programmes for people with type 2 diabetes of diverse clinical, cultural and socio-demographic backgrounds.

Feasibility and acceptability of a single-session, videoconference-delivered group intervention for pain in multiple sclerosis.

Chronic pain is one of the most common and interfering symptoms experienced by people with MS. There is an opportunity to shift the paradigm from interventions delivered after pain has become chronic to early, proactive interventions to alter the impact of MS-related pain. The purpose of this study was to develop and test a remotely delivered single-session group intervention to modify the pain trajectory for individuals with early MS. Research Method/Design: This was a single-center 2-group pilot randomized (1:1) controlled trial comparing a novel videoconference-delivered single-session pain intervention to a waitlist control. Participants were N = 27 adults who were diagnosed with MS in the preceding 36 months and who had moderate or worse pain. The study team developed the intervention to introduce pain coping and commonly used cognitive, behavioral, and acceptance-based approaches for adaptive coping. Participants completed outcome assessments on pain intensity, interference, and coping at pretreatment, posttreatment, and 3-months posttreatment. Among participants in the treatment arm, the majority (54%) indicated satisfaction with treatment and all (100%) indicated continued use of strategies learned in the intervention. The 2 groups did not differ on any of the outcomes at any time point, and large standard deviations were found on most of the measures for both groups at all timepoints. This brief, highly accessible intervention targeting pain coping in individuals with early MS is feasible and acceptable. Further research is needed to better understand the effectiveness of the intervention both immediately and in positively impacting future coping in this population. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Helping athletes flourish using mindfulness and acceptance approaches – an introduction and mini review

Mindfulness and acceptance are core concepts of the third wave of cognitive and behavioral psychotherapies. Their aim is not to overpower thoughts and emotions by suppression and using control techniques but to change the relationships with them. This article focuses on mindfulness- and acceptance-based approaches in sports. It briefly outlines these approaches and concludes that they are characterized by promoting three processes, which are present-moment attention, metacognitive awareness, and acceptance. Subsequently, the paper describes one approach particularly suitable for sports in detail – Acceptance and Commitment Therapy – with a special focus on how athletes can promote psychological flexibility and thrive in their effort to perform. This paper further addresses the question of whether mindfulness- and acceptance-based approaches are effective in sports by summarizing research from the past five years in the form of a mini-review. Findings from 19 reviewed studies, including 15 controlled or randomized controlled studies, suggest that different athlete populations can benefit from mindfulness- and acceptance-based approaches in terms of athletic performance and well-being. Positive effects on performance and well-being could be mediated by other psychological processes, e.g., enhanced emotion regulation. Further research is needed, especially regarding the mechanisms that impact mindfulness- and acceptance-based interventions in sports.

Perceptions of wellness recovery action plan (WRAP) training: a systematic review and metasynthesis

Purpose The purpose of this systematic review was to address two questions: what is the qualitative evidence for the effects of the Wellness Recovery Action Plan (WRAP) training, as perceived by adults with mental health difficulties using it? What is the quality of qualitative literature evaluating WRAP? Design/methodology/approach Five electronic reference databases and the EThOS database for unpublished research were systematically searched, as well as two pertinent journals. Study quality was assessed using Critical Appraisal Skills Programme criteria and results analysed using thematic synthesis. Findings Of 73 studies, 12 qualitative papers met inclusion criteria and were generally good quality. Analyses demonstrated expected findings, such as increased understanding and active management of mental health in the context of group processes. Results also highlighted that WRAP training promoted acceptance and improved communication with professionals. Peer delivery of WRAP was highly valued, with contrasting perceptions of peers and professionals evident. Some cultural considerations were raised by participants from ethnic minorities. Research limitations/implications WRAP training participation has positive self-perceived effects beyond those captured by measures of recovery. Broader implications are suggested regarding earlier access to WRAP, professional support and communication between professionals and service users. Recommendations for further research include the relationship between social support and illness self-management and peer-delivered acceptance-based approaches. Multiple time-point qualitative studies could offer insights into WRAP training processes and whether changes are sustained. Originality/value As the first review of qualitative evidence regarding WRAP training, value is offered both through increased understanding of outcomes and also guidance for future research.

Improvements in well-being and cardiac metrics of stress following a yogic breathing workshop: Randomized controlled trial with active comparison

Objective Compare two distinct psychosocial stress-management workshops. Participants Undergraduate and graduate students (n = 69 for analysis, completed April 2017). Methods Participants were randomized to one of two workshops (Sudarshan Kriya Yoga, SKY; Wisdom On Wellness, WOW), matched in terms of duration, group size, etc. Outcomes were questionnaires and psychophysiological response to laboratory stress induction at pre, post, and 3-month follow-up. Results SKY and WOW participants demonstrated similar workshop ratings and retention rates. SKY demonstrated greater improvements on a number of self-report measures relative to WOW, including perceived stress, sleep, social connectedness, distress, anxiety, depression, conscientiousness, self-esteem, and life satisfaction. Both groups improved in terms of heart rate measures of stress reactivity, however, these outcomes were partially related to changes in resting values at post-workshop and follow-up. Conclusions These findings offer insight into unique patterns of change between yogic breathing, acceptance-based approaches to stress management versus cognitively based approaches.

Mindfulness profiles in a sample of self-reported sleep disturbance individuals

There is some evidence that insomnia seems to constitute a heterogeneous sleep disorder in which different psychological and neurophysiological variables may have differential roles. Mindfulness and acceptance-based approaches suggest new constructs for psychopathology and health sciences which can be useful to investigate in insomnia. In this paper, our aim was to explore eventual homogenous subgroups pertaining to mindfulness within a selected sample of self-reported sleep disturbance individuals drawn from general population. Data from 483 individuals were collected via an online survey. From these, 74 were selected according to a cut-off point given by the European Portuguese version of the Insomnia Severity Index [ISI > 15]. Overall, 2 clusters were generated: A “low mindfulness” and a “high mindfulness” clusters within the subsample of sleep-disturbed individuals identified by the ISI cut-off point. According to our data, it seems feasible to differentiate subgroups of self-reported “insomnia” individuals according to their mindfulness profile. Further studies comprising larger samples and clinical groups are needed in order to validate these findings and verify whether other groups may also emerge. Implications for research and clinical practice are discussed.

Modern cognitive behavior therapy of psychotic disorders

The current treatment guidelines recommend several effective psychotherapeutic approaches for different indications or aims in the therapy of patients with psychotic disorders. In particular, cognitive behavior therapy (CBTp) is recommended for the treatment of positive and general symptoms in all phases of the disorder without any restriction. Although CBTp could be easily implemented in routine care, very few of the affected patients have access to this evidence-based procedure in inpatient or outpatient settings. The interventions in CBTp directly address the psychotic symptoms themselves as well as the factors involved in the development and maintenance of symptoms. The core features of CBTp are anormalizing attitude of the therapist towards symptoms, an individualized approach and cognitive interventions. Recent developments include symptom-specific, metacognitive as well as mindfulness and acceptance-based approaches. Moreover, the reduction of comorbid symptoms can add to the benefit of the treatment. This article provides an overview of the basic CBTp techniques and of some of the latest developments in this field. It is hoped that this will contribute to the training of therapists and to the better implementation of evidence-based and guideline-based psychotherapy in the care of patients with psychotic disorders.

Sexual Health Recovery For Prostate Cancer Survivors: The Proposed Role Of Acceptance And Mindfulness-Based Interventions.

1 in every 7 Canadian men is affected by prostate cancer. Given impressive advances in detection, treatment, and survival rates, there is a considerable focus on survivors' supportive care needs. Among the top unmet supportive care needs for prostate cancer survivors are concerns related to sexual health and intimacy. To provide a rationale for introducing mindfulness- and acceptance-based approaches into the role of psychosexual interventions aimed at improving sexual satisfaction among prostate cancer survivors (and their partners). A literature review was performed to examine the prevalence of sexual difficulties after prostate cancer treatment and the efficacy of current pharmacologic and psychological treatment approaches. The main outcome measure was focused on sexual satisfaction in prostate cancer survivors. Current pharmacologic interventions for sexual difficulties after prostate cancer treatment are not fully meeting the needs of prostate cancer survivors and their partners. Conclusions cannot be drawn from existing psychological interventions because of methodologic inconsistencies. Additionally, the focus on erectile function as a measure of treatment effectiveness is likely to instill a greater sense of hopelessness and loss for prostate cancer survivors, which may exacerbate issues around sexual intimacy and satisfaction. An impressive body of evidence supports the role of mindfulness in improving women's sexual functioning and there is preliminary evidence suggesting the efficacy of this approach for improving men's sexual functioning. We propose that psychosexual interventions that prioritize mindfulness and acceptance-based frameworks may help men to tune into sensations while challenging the foci on performance and erections, thereby increasing the potential for improvement to sexual satisfaction among prostate cancer survivors. Bossio JA, Miller F, O'Loughlin JI, etal. Sexual Health Recovery for Prostate Cancer Survivors: The Proposed Role of Acceptance and Mindfulness-Based Interventions. Sex Med Rev 2019;7:627-635.

Change in domain-specific but not general psychological flexibility relates to greater weight loss in acceptance-based behavioral treatment for obesity

Acceptance-based approaches have demonstrated promise for improving outcomes in behavioral treatments for obesity, but few studies have examined processes of change in these treatments. It is critical to identify mechanisms of action in treatment to further optimize this approach, refine theory, and inform future research. This study examined change in several domain-specific and general measures of psychological flexibility in a randomized controlled trial of an acceptance-based behavioral weight loss treatment. The relationships between change in these measures and weight loss outcomes were also examined. Adults (N = 283) were randomized to receive 12 months of acceptance-based (ABT) or non-acceptance-based (non-ABT) behavioral treatment and completed measures of general and weight control-specific psychological flexibility at months 0, 6, and 12. Participants in ABT demonstrated greater increases in psychological flexibility related to eating and physical activity experiences during treatment compared to participants in non-ABT, and changes in these processes were correlated with better weight loss. Parallel mediation analyses further revealed that psychological flexibility related to eating and physical activity experiences partially mediated the relationship between treatment condition and 12-month weight loss. Participants across conditions also experienced small increases in general psychological flexibility, but general psychological flexibility was not meaningfully related to weight loss outcomes. These findings indicate that domain-specific (versus general) psychological flexibility may be most impacted by ABT and most relevant to weight loss outcomes. Results also provide partial support for the theoretical model of ABT for weight management.

Mindfulness and acceptance-based training for Chinese athletes: The mindfulness-acceptance-insight-commitment (MAIC) program

Over the last decade, mindfulness and acceptance-based approaches to mental training have been widely applied in the field of sport psychology. In order to develop a context-sensitive mindfulness and acceptance-based training program for Chinese athletes, the Mindfulness-Acceptance-Insight-Commitment (MAIC) program was developed. The MAIC is based on the Mindfulness-Acceptance-Commitment approach (MAC) and includes integrated elements of indigenous Chinese culture such as the acceptance-based adversity coping, social-oriented values, and insight. The current article will briefly revisit and discuss the theoretical considerations, the main components, the applications and reflect on the MAIC program.