The Follies is a core feature of ACBS conferences. At the ACBS World Conference 15 it will take place on the Saturday night from around 21:00 – 23:00. Basically it’s a cabaret show, filled with funny songs, sketches, stand-up comedy routines, humorous PowerPoint presentations, pre-made videos, etc. And all of this funny and talented content is created by YOU: the conference delegates!

There will be a cash bar to facilitate you getting in touch with your values as a performer (yeah, right…), after the Follies there will be dancing.

There are very few rules regarding the content – Firstly it has to be short (around 3 minutes is perfect. Longer, and the shepherd’s crook will be sweeping you off the stage!) Secondly, any aspect of ACT, Mindfulness, Behaviourism, therapy, RFT, CBS or any of the people you know in the ACT / CBS Community is fair game to be (gently and kindly) mocked.

The Follies actually comes from an important tradition: in the past ‘The Truth’ was what an authority deemed to be true. Then science came along and people started to look to their direct observations to determine what was true. But of course, human beings being as we are and loving to categorise things in hierarchies, began to automatically create hierarchies of people who could directly observe what was true and hence we have scientific authorities. The purpose of the Follies is to ensure that no idea, and no person in this community who has an idea, is immune to question, playfulness, challenge.

So delegates: get your creative powers focused, anything you have seen in the ACT world that deserves to be made fun of is fair game. Produce your sketches, songs, PowerPoints, stand ups and either email sonjavbatten@gmail.com or daniel.moran@comcast.net  to ensure I have your name down for a place in the Follies or come and see me during the conference (Hurry you only have the first day to do it).

Our top tips are: if you have a funny song, produce a PowerPoint with the lyrics so people can see and sing along. If you are looking for a backing track to sing to, this is a good site: http://www.karaoke-version.com/

As a taster, and to inspire you to action here are some superbly talented videos that have been shown at previous ACBS World Conferences, courtesy of Daniel Ek:

https://www.youtube.com/watch?v=afnJYSvkqSA&feature=youtu.be

Here is one from our very own Joe Oliver: CBS Wars

https://contextualconsulting.co.uk/insights/cbs-wars-acbs-conference-follies-2015

And here is one from the Utah State and Nevada students from 2010:

https://www.youtube.com/watch?v=3cXb3rpU8M4

 

The fun doesn't stop when the Follies end! 

Immediately following the Follies we invite you to join us for a dance with "DJ CFunc", a.k.a Eric Morris.  See you on the dance floor!

Date:Saturday, 24 June 2017
Time: 09:45-12:45
Duration of tour: 3h 30m
Location: Seville historic centre
 

Description of activity:
The tour begins in front of the Melia Sevilla with an offical local English speaking guide and allows attendees to avoid waiting in all ticket lines (if tickets are still available... they can sell out). This walking tour takes place along two of the most important sites in Seville: the Royal Palace and the Santa Cruz Quarters. 

The Royal Palace of Seville, Alcazar, is one of the most visited monuments of Spain. The Alcazar was a luxurious and magnificent palace belonging to the Arabic Kings of Seville in Medieval times. It is considered the twin brother of the famous Alhambra palace of Granada. It is now the occasional residence of present kings whenever they stay in Seville.

Santa Cruz District is the name of the old Jewish sector of the city. It is located besides the Cathedral and Alcazar and it is now a quiet pedestrian area with plenty of narrow streets, flowers, chapels and taverns.

Guests should bring bottles of water, a hat, and wear sun cream.
 

Date: Friday, 23 June 2017 
Time: 09:30 to 17:30
Duration: 8h
Location: Córdoba is a 90m drive from Seville
 

Description of activity:

You will travel to the city of Córdoba, via motorcoach, with a local English speaking guide. This trip includes entrance into the Synagogue and the Mosque/Cathedral and allows attendees to avoid waiting in all ticket lines.

Córdoba is equally impressive today as it was in the past. Many don't know that in the 11th century, it was one of the most important capitals in Europe. People from many different cultural and religious backgrounds were living peacefully together. There were many important philosophers, scientists and artists who emerged from here. 

Learning about Córdoba's cultural background and visiting its great monuments, such as: the world famous Mezquita, the Moorish Mosque and museums, you will certainly find interesting aspects of each.  

Córdoba is a lively traditional Andalusian town with narrow streets of Moorish style houses, balconies and flowers everywhere, and Flamenco. This is certainly one of the most attractive destinations in southern Spain.

Once you arrive in Córdoba, you will visit one of the most well-known monuments in the city, the old Mosque. You will enjoy the beauty of the Mosque, with its artistic arches, columns, patios and treasures. This amazing building dates back to the early Medieval ages when Córdoba was the capital of the prosperous Moorish kingdom. At that time, Córdoba had one million inhabitants making it the most crowded city in the world. 

After, you will enter the Jewish quarters which is one of the most beautiful and popular parts of the town. Many centuries ago, Córdoba was a great example of how many different cultures could live peacefully together. At that time, Christians, Jews, and Moors were living together, sharing cultures and traditions. It was the most prosperous time in Córdoba history.

Schedule for Córdoba:

09:30 Meet & Greet with the guides in the lobby of the hotel Melia Sevilla
09:40 Coach transfer to Córdoba (optional comfort stop if necessary)
11:35 Estimated arrival in Córdoba (stop at the side of the Roman Bridge) / Walk to the Mosque
11:55 Guided tour of the Mosque/Cathedral
12:50 Guided tour of the Jewish quarter including the Synagogue
13:30 Lunch at leisure / Free time in the city center
15:30 Meet & Greet with your guides at the foot of the Mosque / Walking transfer back to the coaches
15:45 Coach transfer back to Seville
17:30 Estimated arrival in Seville / End of the tour 
 

Guests should bring bottles of water, a hat, money to purchase lunch, and wear sun cream.

Date: Thursday, 22 June 2017
Time: 10:00-13:00
Duration of tour: 3h
Location: Seville historic centre
 

Description of activity:

This tour will begin in front of the Melia Sevilla. (transportation by bus)

Your complete tour of the Cathedral and Giralda Tower will be guided by a private English speaking guide and allow you to avoid waiting in all ticket lines (if tickets are still available... they can sell out).

This tour will include a complete panoramic view tour of Seville, including: the Plaza de España, Golden Tower, Seville Bullring, Palace of San Telmo and Maria Luisa Park. 

The Cathedral of Seville is one of the most relevant historic buildings in Spain. It is the 3rd largest Christian temple in the world after St. Peter in the Vatican and St. Paul in London.

The building of this monument began as a large Muslim mosque during the 11th century. It was later partially destroyed by the Christian Reconquista of the city and turned into a gothic cathedral. However, it still kept parts of the beautiful Moorish architecture. 

Construction of the Cathedral took place over many centuries and today the Cathedral is a mix of Arabic, Gothic Renaissance, and Neo-Classic styles. 

Guests should bring bottles of water, a hat, and wear sun cream.

As a fun networking event, ACBS is organizing a wine and tapas event on 22 June, 2017 at the Restaurant La Raza

This event is complimentary for ACBS World Conference registrants, and included with your registration. 

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What: Wine and Tapas Social

When: 22 June, 2017 - 19:00-21:00

Where: Restaurant La Raza  (Restaurant La Raza is only a 10 minute walk from the Melia Sevilla Hotel, and on the way to the historic city center.)

 

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Dermot Barnes-Holmes, D.Phil.

Dr. Dermot Barnes-Holmes graduated from the University of Ulster in 1985 with a B.Sc. in Psychology and in 1990 with a D.Phil. in behavior analysis. His first tenured position was in the Department of Applied Psychology at University College Cork, where he founded and led the Behavior Analysis and Cognitive Science unit. In 1999 he accepted the foundation professorship in psychology and head-of-department position at the National University of Ireland Maynooth. In 2015 he accepted a life-time senior professorship at Ghent University in Belgium. Dr. Barnes-Holmes is known internationally for the analysis of human language and cognition through the development of Relational Frame Theory with Steven C. Hayes, and its application in various psychological settings. He was the world's most prolific author in the experimental analysis of human behavior between the years 1980 and 1999. He was awarded the Don Hake Translational Research Award in 2012 by the American Psychological Association, is a past president and fellow of the Association for Contextual Behavioral Science, is a fellow of the Association for Behavior Analysis, International, is a recipient of the Quad-L Lecture Award from the University of New Mexico and most recently became an Odysseus laureate when he received an Odysseus Type 1 award from the Flemish Science Foundation in Belgium.

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Lisa W. Coyne, Ph.D.

Dr. Coyne is the Founder and Director of the McLean OCD Institute for Children and Adolescents at McLean Hospital, and is on the Faculty of Harvard Medical School. She is a Research Associate Professor in the Clinical Psychology Doctoral Program at Suffolk University in Boston, Massachusetts, and is on the Faculty of the Behavior Therapy Training Institute (BTTI) of the International OCD Foundation (IOCDF). She is also a licensed psychologist and an internationally recognized ACT trainer with extensive experience using ACT with young people with OCD and their families.

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Paul Gilbert, Ph.D.

Psychology at the University of Derby and Consultant Clinical Psychologist at the Derbyshire Health Care Foundation Trust. He has researched evolutionary approaches to psychopathology over 40 years with a special focus on shame and the treatment of shame based difficulties - for which compassion focused therapy was developed. He was made a Fellow of the British Psychological Society in 1993. In 2003 Paul was president of the BABCP and a member of the first British Governments’ NICE guidelines for depression. He has written/edited 20 books and over 200 papers, and spoken on TV and radio In 2006 he established the Compassionate Mind Foundation as a charity with the mission statement To promote wellbeing through the scientific understanding and application of compassion (www.compassionatemind.co.uk). He was awarded an OBE by the Queen in March 2011.

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Steven C. Hayes, Ph.D.

Steven C. Hayes, Ph.D., is Nevada Foundation Professor in the Department of Psychology at the University of Nevada, Reno. He has served as president of multiple scientific and professional organizations, including the Association for Behavioral and Cognitive Therapies (ABCT) and the Association for Contextual Behavioral Science. His work has been recognized by the Award for Impact of Science on Application from the Society for the Advancement of Behavior Analysis and the Lifetime Achievement Award from the ABCT, among other awards. The author of 41 books and over 575 scientific articles, Dr. Hayes has focused on understanding human language and cognition and applying this understanding to the alleviation of human suffering and the promotion of human welfare.

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Maria Karekla, Ph.D.

Maria Karekla, Ph.D., licensed clinical psychologist and Assistant Professor, University of Cyprus is heading the “ACTHealthy: Anxiety disorders and Behavioral Medicine” laboratory. She received her doctorate degree in Clinical Psychology from the University at Albany, SUNY. She completed her residency at the University of Mississippi Medical Center and Veterans Administration Hospital. Currently holds the position of Assistant Professor of Clinical Psychology at the University of Cyprus and is the chair of the Clinical Psychology Doctorate committee. Her research focuses on areas of health promotion and the investigation of individual difference factors (especially experiential avoidance) as they relate to the development and maintenance of various behavioural difficulties (especially anxiety and health related problems). Additionally, she examines the treatment of these difficulties utilizing Acceptance and Commitment-based principles and innovative delivery methods (e.g. Internet delivered therapy, virtual reality). Her research received grants and awards by (among others) the European Council and Pompidou’s group, and the Association for the Advancement of Behavior Therapy. She is the chair of the Cyprus Bioethics Committee on Biomedical Research, a member of the Cyprus Psychologist Licensing Board, and a member of the European Federation of Psychology Associations’ Psychology and Health and e-health task forces. She is also presently serving as a member-at-large of the Association for Contextual Behavioral Science. A number of her research projects have received local (e.g., Cyprus Research Foundation grants), EU and other funding. 

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Carmen Luciano, Ph.D.

She received her PhD. in the Complutense University of Madrid in 1984. She is Professor of Psychology in the University of Almeria since 1994 – and in the University of Granada from 1979 to 1993. Her research dedication began on the experimental analysis of language. Her Postdoc Fulbright research stay in Boston University and the Cambridge Center for Behavioral Studies, in1985-86, was centered in studying problem-solving behavior, following Skinner’s last studies. This was a critical point in her career as basic researcher. She was involved in the equivalence research, rule-governed behavior and, shortly after, in research of RFT and ACT. Her research lab has been -and is- conducting basic creative experimental-applied RFT designs for the analysis of analogies, coherence, deictic and hierarchical framing in the context of identifying core components of metaphors, false memories, experiential avoidance, values, defusion, self and responding to the own behavior, as well as designing brief ACT protocols and learning ACT protocols.

She has published pivotal papers and books, connecting basic-applied domains. She is Director of the Experimental and Applied Analysis of Behavior Research Group since 1986, where she has directed over thirty doctoral theses - some of her students are running their own labs nowadays. She is also Director of the Functional Analysis in Clinical Contexts Doctoral Program in the University of Almeria, and of the Master Program in Contextual Therapies in Madrid Institute of Contextual Psychology – MICPSY. Her research has been funded for years by international, national and regional public fundings, and she has collaborated with different research groups at a global level.

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Gregory J. Madden, Ph.D.

Dr. Madden received his training from the University of North Texas, West Virginia University, and the University of Vermont. Dr. Madden’s research is focused on the behavioral economics of addiction and health decision-making. His early research documented extreme impulsivity in individuals addicted to illicit drugs and cigarettes. Later research revealed that impulsive decision-making predicted acquisition of cocaine self-administration in rats. His current research investigates methods for reducing impulsivity. Dr. Madden’s second, research line explores game-based behavioral-economic approaches to improving children’s health decision-making. These research lines have been supported by grants from the National Institute on Drug Abuse, the National Institute for Child Health and Development, and from the US Department of Agriculture. Dr. Madden frequently serves on NIH grant-review panels, he has published more than 90 papers in 30 different journals, and his peer-reviewed publications have been cited more than 5,500 times. From 2011 until 2015, he served as the Editor-in-Chief of the Journal of the Experimental Analysis of Behavior. He has edited two books including the two-volume APA Handbook of Behavior Analysis. He is currently co-writing an introductory Behavior Analysis textbook and, in his free time, he skis and hikes in the beautiful mountains of Northern Utah.

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D.J. Moran, Ph.D.

As a Board Certified Behavior Analyst, he has conducted safety improvement initiatives in a variety of industries including pulp & paper and petroleum with organizations such as the Kuwait Oil Company, Tennessee Valley Authority, and Boise Paper. D.J. also engaged in leadership training in Sierra Leone, and in several U. S. companies. His specialties include applied behavioral analysis, organizational behavior management, government consulting, Acceptance and Commitment Therapy (ACT), leadership consulting, behavior-based safety (BBS), innovation training, sales coaching, and executive coaching.

An interest in obsessive-compulsive disorder led him to work with individuals dealing with compulsive behavior. He has appeared on or been a part of several television projects including Hoarding: Buried Alive (The Learning Channel), Confessions: Animal Hoarding (Animal Planet); and Fox News broadcasts.

D. J. coauthored ACT in Practice, a professional book focused on complex, applied behavior analysis and is the author of numerous papers on behavior change and evidence-based education. He has spent the last several years combining ACTraining with behavior-based safety and executive coaching for leadership. He earned his doctorate in Clinical/School Psychology from Hofstra University. 

Hear more about D.J. and ACBS in the interview below

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Alicia E. Meuret, Ph.D.

Alicia E. Meuret, Ph.D. is the Director of the Anxiety and Depression Research Center (ARC) and an Associate Professor of Clinical Psychology at Southern Methodist University, in Texas, USA. Dr. Meuret received her Ph.D. in Clinical Psychology from the University of Hamburg based on her doctoral work conducted at the Department of Psychiatry and Behavioral Sciences at Stanford University. She completed postdoctoral fellowships at the Center for Anxiety and Related Disorders at Boston University and the Affective Neuroscience Laboratory in the Department of Psychology at Harvard University.

Her research program focuses on novel treatment approaches for anxiety and mood disorders, biomarkers in anxiety disorders and chronic disease (asthma), fear extinction mechanisms of exposure therapy, and mediators and moderators in individuals with affective dysregulations, including non-suicidal self-injury. Dr. Meuret is the founder of the Capnometry-Assisted Respiratory Training (CART), a FDA-approved biobehavioral intervention for normalizing hypocapnia.

 Dr. Meuret has published over 80 scientific publications, has received funding by federal grants for studying novel interventions for anxiety and asthma, and is currently the Principal Investigator on a NIH U-grant on developing a miniature asthma-trigger monitor. Dr. Meuret has served on a number of research panels, NIH review boards, and federal and scientific expert advisory boards. She is a past associated editor of Behavior Therapy, and past president of the International Society of the Advancement of Respiratory Psychophysiology. She has received awards by Anxiety and Depression Association of America, the Psychiatric Research Society, and the American Psychosomatic Society. Dr. Meuret is a board-certified clinical psychologist who maintains a small private practice.

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Niklas Törneke, M.D.

Niklas Törneke is a Swedish psychiatrist and licensed psychotherapist. He is a recognized ACT trainer and originally trained in cognitive therapy he has been working with ACT since 1998. He has been involved in training ACT in many different contexts both in his home country and internationally for over 15 years. His specializes in applying a behavior analytic approach to clinical work and he is the co-author of "The ABCs of human behavior" and has also authored "Learning RFT. An introduction to relational frame theory and it's clinical application". His forthcoming book "Metaphor in practice" (already available in Swedish) will be released in August 2017.

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Roger Vilardaga, Ph.D.

Roger Vilardaga is an Assistant Professor at the Center for Addiction Science and Technology at Duke University and Affiliate Professor at the Department of Human Centered Design and Engineering of the University of Washington. Roger is passionate about the potential of mobile technologies for the advancement of contextual behavioral science and the development of cost-effective and higher-reaching behavioral interventions. Roger studied psychology at the Universitat de Barcelona and in 2012 received his doctoral degree in Clinical Psychology from the University of Nevada, Reno under Steven C. Hayes' mentorship. He has published 42 papers addressing theoretical issues in CBS, the study of deictic relational responding in clinical populations, methodological innovation in CBS, and most recently translation of ACT interventions to digital media. From 2010 to 2015 he served as Associate Editor of the Journal of Contextual Behavioral Science. He has contributed to the study and development of several digital interventions, including Mindful Daily, SmartQuit, Tummy Trials, Eyes Free Yoga, Mindful Powers, and Pain Tracker Self Management. He created and designed Learn to Quit, the first NIH-funded mobile app to deliver smoking cessation treatment for individuals with serious mental illness. This app won the Gold W3 Award in 2016 by the Academy of Interactive and Visual Arts and the Silver Davey International Award in 2016 for best wellness and health app. His work has been featured in FastCompany, The Drum, Seattle K5 News and Psychiatric News. His lab has been funded by the National Institute on Drug Abuse, the University of Washington Innovation Award, Pfizer and Duke University.

Roger Vilardaga es Profesor Asistente en el CfAST (Center for Addiction Science and Technology) de la Universidad de Duke y Profesor Afiliado en el Departamento de Human Centered Design and Engineering de la Universidad de Washington. Roger tiene gran interés en el potencial de las tecnologías móviles para el avance de la ciencia conductual contextual y el desarrollo de tecnologías de bajo coste y gran alcance. Roger estudió psicología en la Universitat de Barcelona y en el año 2012 se graduó con un doctorado en Psicología Clínica por la University of Nevada, Reno bajo la supervisión de Steven C. Hayes. Ha publicado 42 trabajos cubriendo temas teóricos en CBS, el estudio de los marcos relacionales deícticos en poblaciones clínicas, innovación metodológica en CBS, y más recientemente la traducción de intervenciones ACT a formato digital. Desde el año 2010 hasta el 2015 sirvió como Editor Asociado para el Journal of Contextual Behavioral Science. Roger ha contribuido al estudio y desarrollo de varias intervenciones digitales: Mindful Daily, SmartQuit, Tummy Trials, Eyes Free Yoga, Mindful Powers, and Pain Tracker Self Management. También creó y diseñó Learn to Quit, la primera aplicación móvil financiada por el Instituto Nacional de Salud de los Estados Unidos (NIH) para tratar tabaquismo en individuos con trastornos mentales severos. Esta aplicación ganó el Premio Gold W3 otorgado por la Academia de las Artes Interactivas y Visuales y el Premio Internacional Silver Davey del 2016 en mejor aplicación para la salud y bienestar. Su trabajo se ha diseminado en diferentes medios de comunicación: FastCompany, The Drum, Seattle K5 News and Psychiatric News. Su laboratorio ha recibido financiación por parte del National Institute on Drug Abuse, la University of Washington Innovation Award, Pfizer y Duke University.

Hear Roger talk his contribution to this conference, his background, research interests, and a few tips to get the most out of a trip to Spain in the interview below. 

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Frans B. M. de Waal, Ph. D.

I am a biologist specialized in primate social behavior. After initial studies on aggression, dominance, and conflict resolution, I branched out to more socially positive domains of behavior (e.g. cooperation) and the interface between the cognition of monkeys, apes, and humans. My expertise in primate behavior is widely recognized and rather close to human social psychology. It is directly relevant to the project on cooperation in the operating room as we have refined data collection techniques on spontaneously interacting primates for ages. Apart from the verbal behavior of humans, which is unique and poses its special challenges, the nonverbal interactions, both positive and negative, take on similar forms and can be systematically documented from minute to minute in the same way, and analyzed for similar patterns of affiliation, dominance, conflict resolution, and so on.
 

Here are the folks who are putting it all together and make WC15 a success:

Program Committee Chairs:

Miguel Rodríguez Valverde
Francisco Ruiz
Yvonne Barnes-Holmes: RFT Track

Program Committee Members:

Adrián Barbero-Rubio
Dermot Barnes-Holmes
Mike Bordieri 
Nuno Bravo Ferreira
Francisco Cabello Luque
Juan Carmelo Visdómine Lozano
Aisling Curtin
Frederick Dionne 
Chad Drake
Martin Finn
David Gillanders
Bárbara Gil-Luciano
Andrew Gloster
Colin Harte
Louise Hayes
Mónica Hernández-López  
Maria Karekla
Deirdre Kavanagh
Valerie Kiel
Naoko Kishita
Russell Kolts
Andreas Larsson
Aileen Leech
Jenna LeJeune 
Miguel Ángel López Medina
Daniel Maitland
Staci Martin
Chris McCurry 
Ciara McEnteggart
Louise McHugh
Amy Murrell
Manuela O’Connell
Paula Odriozola González
Sarah Potts
Josh Pritchard
Graciela Rovner
Regan Slater 
Juan Carlos Suárez Falcón
Thomas Szabo
Christiene Terry
Miles Thompson
Niklas Törneke
Gloria Torres Fernández
Sonsoles Valdivia Salas
Roger Vilardaga
Jenn Villatte
Matthieu Villatte

 

Thursday, 22 June
12:45-14:00
Location: Prado

Session (21)

• Living our Values and Embracing Our Vulnerabilities in Graduate School and Beyond
Clare Kennedy Purvis, Psy.D., Lantern

Attendees at this conference are deeply committed to ACT and work to embrace psychological flexibility in our personal and professional lives. But how do we as a field and a community support graduate-level trainees and early career professionals in this same endeavor? Trainees face constant evaluation, competition and pressure in their graduate programs. As training progresses and we enter post-doc and first jobs, the race to the top often intensifies. If our community strives to build a culture of openness, authenticity, and flexibility, what steps can we take to support training environments where graduate students feel empowered to embrace their vulnerabilities and choose values-based actions? This talk will explore personal experiences of trainees and early career professionals who showed up in their professional contexts "warts and all," and will offer calls to action for this community to contribute to cultivating ACT-consistent cultures in our own professional and training environments.

• Lovism: A CBS-Based Life-stance
Alan Pogrebinschi, MSc., Private practice

Today, intolerance, hate and extremism are dangerously on the rise, especially in western societies where many thought those were ailments of the past. It may seem we're living an epidemic of psychological inflexibility! If that is so, how can we use CBS to steer our world towards a healthier course? Psychotherapy arguably doesn’t have the required bandwidth and traditional prevention programs usually depend on the very governments that are now falling into the hands of extremists. A bottom-up approach is warranted. We introduce Lovism, a CBS-based life-stance. Our aim is to develop an evolving self-sustaining and self-replicating social technology that consistently increases levels of psychological flexibility of those touched by it.

• The Words Don't Work
Jim Lucas, Private Practice & University of Birmingham, UK

Many of the words used to explain human suffering don't work, because they often do more harm than good. A tightly held biological view creates a context that has significant negative effects for research, service delivery and personal well-being. The biological explanation has been shown to increase stigma and prejudice.
When words are used to label experiences as illnesses and disorders, they function to incite responses based on attempts to fix, correct or cure. But what if there is nothing to fix? A response in this context looks very different and may provide some more workable alternatives.
The speaker will describe his own mistakes in using acts that don't work. He'll speak of how the acts, even when well-intentioned, function to create discord rather than harmony. I hope to support people to act mindfully so that we can remain curious about others and be courageous with our selves.

• Bridging the Gap Between Us and Them: About Stigmatization in Mental Health Practice
K L Helmus, Psychologist

In this short presentation you will be introduced into the subject of stigmatization and how act based interventions can be helpful in the process towards openness and understanding in clinical practice. It will be based on a tedX talk was held by the presenter (https://www.youtube.com/watch?v=GSdf53uz5Hw in Dutch, with English subtitles). This fresh and hopefully inspiring IGNITE talk will be held in English.
The theoretical base:
Stigmatization can have negative consequences for people with mental disorders. Studies in mental health care settings indicate that professionals frequently display stigmatizing attitudes and behaviour towards clients. Continuum beliefs about mental disorders, i.e. the belief that mental health problems are continuous with normal mentation, are associated with less stigmatizing attitudes. This is opposed to the belief that there is a dichotomous distinction between ‘us’ the healthy and ‘them’ the ill group. Training professionals in continuum beliefs about mental disorders is expected to reduce stigmatizing attitudes. The aim of this study was to examine the effect of a contact intervention on stigmatizing attitudes and continuum beliefs of mental health professionals working with people with (severe) mental disorders.

• Reducing Patients' Self-Stigma Through Their Mental Health Care Professionals
Marilon Van Doorn, University of Utrecht

Where the mental health care is aiming to be a place aimed at improvement or recovery, a significant percentage of mental health care professionals are suggested to have stigmatizing attitudes towards patients. More than 20% of reported patients stigmatization experiences take place in contact with mental health care professionals. When an individual considers a stigma as just, it can be internalised, so called self-stigmatization. Several meta-analyses on the effectiveness of interventions for diminishing self-stigmatization in psychiatric patients have been published, however results vary.The meta-analyses also address the intriguing issue whether interventions addressing self-stigmatization is not a form of stigmatization itself; suggesting that deviation of patients could be implicitly emphasized. If this is indeed the case, finding an effective direct intervention to reduce self-stigmatization would be challenging. A alternative approach, via mental health care professionals might reduce that risk.
A logical next step in diminishing self-stigmatization, mental health care professionals in this study were offered a workshop based on Acceptance and Commitment Therapy aimed at changing the ‘us’ versus ‘them’ thinking of the participating participants and via that influencing self-stigmatization of their patients.
The central question of the study is whether self-stigmatization of patients will decline through their mental health care professionals. In this study it is expected that self-stigmatization of patients will be reduced when their mental health care professional has participated in an ACT-based workshop. To our knowledge, this study will be the first randomized control trial to address self-stigmatization through ACT.

• Your Therapist Doesn't Feels Like a Fraud? You Should Look for Another Professional!
Giovanni Pergher, MS, Faculdades Integradas de Taquara

This presentation is based on a chronicle written by the author based on his experiences as a clinician, supervisor and human being. As implicit in the title, I suggest that a good therapist will invariable feels like a fraud. More specifically, I propose that the two main characteristics of a good therapist are the ones that will make the professional feels like a hoax. The two characteristics are 1) having an open mind for new knowledge relevant for improving his practice and 2) the capacity to put himself in the client's shoes in a deep sense. This features bring a sense of being a fraud because 1) with an open mind you'll get in touch with new interesting ideas that may contradict your previous convictions about the "right" way to help your clients and 2) the only way to connect with the client's pain in a real deep sense is by feeling pain yourself, which will raise the question "How can I help this person since I feel the same pain"?

• Designing a Digital ACT-Based Intervention: Things I have learned 

Orestis Kasinopoulos, Ph.D student, University of Cyprus
Maria Karekla, Ph.D., University of Cyprus

A growing body of evidence demonstrates that clinic-based, face-to-face interventions can be effectively used to treat sufferers of mental health and chronic health conditions. The increasing demands for cost reduction for services in the healthcare system and obstacles regarding physical access to treatment highlight the need for innovative, cost-reducing, self-management interventions. Digital interventions might present with feasible means to overcome many barriers and improve health care for persons with mental or health problems in the convenience of their space and time. Digital interventions, however, come with a few challenges. Firstly, a significantly higher proportion of participants often fail to adhere to online interventions. Secondly, effective planning and designing of a digital intervention involves numerous pitfalls and strategies to overcome them - from learning to speak the programmer's language to becoming an expert in audiovisual editing. This presentation aims to prepare and inform researchers aiming to explore the world of digital interventions through a personal journey of experience.

• TangOrient: Mindfulness and Therapeutic Innovation
Haneen Tamari,B.A, Dip., M. Sc., University of Toronto & Ryerson University

Some years ago, the presenter moved to Toronto, Canada. As a new Canadian, she strived to heal and recover from past displacement and ached to feel rooted in an unfamiliar city and country. While feeling disoriented, she discovered Argentinean Tango. The act of learning tango required commitment and mindfulness. Years later, she discovered by happenstance how much more she enjoyed the same dance when the music was from cultures closer to those of her own origins; an unconventional substitute for widely known tango music. Together with learning about ACT, she chose to develop an idea called TangOrient, or the dance of contextual music and re-ORIENTation. Would-be dancers can learn the rules of traditional Argentinian Tango while abiding to music to which one's heart connects. Today, in a world of ever-increasing forced displacement, the presenter believes it's important to explore cultivating therapeutic innovation, locally and sustainably. While the presenter is not an ACT therapist, she is willing to dig deeper to understand cultural layers in her local community. The presenter's proposed TangOrient philosophy calls on ACT to involve community members to support sustainable healing in local communities by connecting sensitively and contextually with sociocultural peers. In other words, the presentation makes the case that ACT practitioners might use the metaphor of “tango dancing to the client’s own music” as a way to assist clients with finding inspiration close to their source of well being even as time-honoured dance steps are learned and a fledgling acceptance of displacement is gained.

• Building Community Through Mindfulness and Committed Action
Annette Dufresne, PhD, CPsych., Private Practice

In this presentation, I will share my own journey in putting my values into action by starting to build community with individuals interested in practicing mindfulness. The journey began with offering group mindfulness practice, and expanded to include sharing a potluck meal and experiencing elements of mindful eating. The community broadened through word of mouth. Committed action became part of the culture of the community through free-will donations, with funds donated to local charitable organizations selected by the group. How similar activities can be used to help rebalance the negativity we are exposed to at a societal level on a daily basis will be explored.

• Just My Imagination: My Journey from OCD Patient to Therapist
Michael Blumberg, MA, LCPC, Glenview Counseling Group

I began my journey into madness at age 11 and had fully arrived there by 21. My Obsessive Compulsive Disorder spun it's web of lies into every empty second of my consciousness. Whether it was scrupulosity, harm obsessions, symmetry, contamination or any other false framework, I was overtaken by it. And then, just as it became completely debilitating, I asked for help. That is when the next chapter of my life began; the chapter whereby I crawled out from under OCD's crushing weight, lifted it above my head, and cast it into oblivion.
Now, as a clinician specializing in the treatment of OCD, I help other cast off the yoke of OCD and live the lives they want to live.

• ACT in Sex-therapy
Charlotte Makboul, Private Practice

The ignite will describe how to work with sexual issues such as erectal disorder or sexual desire disorders in an ACT- and mindfulnessbased psychotherapy. How to find values to follow, thougts to defuse and how to learn to expand uncomfortable feelings during sex to make the body more cooperative and functional.

• Four Paths to Wholeness
Marianela Medrano, Palabra Counseling Center

The main focus of this presentation is to demonstrate the effectiveness of writing based on mindfulness, to create a cognitive / experiential bridge or nexus that can clarify the usefulness or uselessness of our thoughts, feelings and actions in terms of whether they lead us or not to live a full and consistent life with our values. This presentation emphasizes how the use of writing has helped me to facilitate psychological flexibility in order to reduce human suffering.These are the four paths with which I facilitate an approach to the six main processes of ACT (psychological flexibility): First Path: Inhabit the House of the Self (The Here and Now, Acceptance, Values); Second Path: Cultivate and Preserve Goodness to the Self (Self-Compassion); Third Path: Use discernment to understand our history (Self as context, De-fusing); Fourth Path: Practice transformative thinking and write! (Commitment).
 

Thursday, 22 June
Friday, 23 June
Saturday, 24 June
Sunday, 25 June

Thursday, 22 June

11. Translational Research on Clinically Relevant Processes: Psychological Inflexibility, Hierarchical and Conditional Framing, Growth Mindset, and Self-Compassion
Symposium (11:00-12:30)
Components: Conceptual analysis, Original data
Categories: Clinical Interventions and Interests, Prevention and Community-Based Interventions, Behavioral medicine, Pattern of Psychological Inflexibility, Self-esteem, Growth mindset
Target Audience: Beg., Interm., Adv.
Location: Buhaira

This symposium presents a diversity of approaches to studying clinically relevant processes, ranging from analogue laboratory research to large-scale cross-sectional survey. The first paper in the symposium presents an analogue experimental study exploring the conditions that enhance avoidance behavior to the point of turning it into psychological inflexibility. The second study investigates whether different ways of framing task performance, either hierarchically (e.g., focusing on what you are doing is part of the task) or conditionally (e.g., focus on getting a good score), affects task persistence (motivation to persist in task), task performance, and self-efficacy and willingness to engage in the task. The third study presents a large-scale survey examining whether growth mindset can decouple the links between low self-esteem and outcomes such as poor academic achievement and low wellbeing. The fourth and last paper in the symposium presents research that has used the IRAP to explore the construct of self-compassion from the point of view of implicit verbal relations. Results show discrepancies between explicit and implicit measures of self-compassion. These different ways to assess self-compassion seem to capture different features of the construct itself.

• Conditions that Enhance Avoiding as Psychological Inflexibility
Adrián Barbero-Rubio, Ph.D., University of Almeria, Madrid Institute of Contextual Psychology
Carmen Luciano, University of Almeria

This study aimed to explore the conditions under which PI is enhanced through an experimental analogue of the elements involved in rigid dominance of avoidance psychological reactions. Firstly, 51 participants were randomly assigned to five experimental conditions to perform two experimental tasks. The tasks were designed to capture rigid psychological reactions. Secondly, four inflexibility protocols were designed with four different components of the learning process that might be involved in the natural developing a pattern of psychological inflexibility. The four inflexibility protocols and a control protocol were implemented to participants respectively in the five conditions. Finally, all participants repeated the experimental tasks. Results indicated significant lower performance in all the four conditions receiving the inflexibility protocol when compared to control participants. Results are discussed on the processes that enhance and disrupt the pattern of clinical inflexibility.

• Investigating the effect of Conditional vs Hierarchical Framing on Motivation
Varsha Eswara-Murthy, University College Dublin
Matthieu Villatte, Evidence-Based Practice Institute of Seattle
Louie McHugh, University College Dublin

Focusing on process not just outcome is often cited as an important part of living a meaningful life from a CBS point of view. The current study aimed to investigate whether task instructions that differed based on focusing on the process of completing a task, the outcome of completing a task, or both changed participants task performance and motivation. To that end, hierarchical (e.g., focusing on what you are doing is part of the task), conditional (e.g., focus on getting a good score) and a mixed condition (e.g., focus on engaging in the task and getting a good score) task instructions were compared. Participants completed an anagram task, followed by the presentation of scripts relating to the three separate framing conditions. Participants were subsequently exposed to a task persistence measure (i.e.,PASAT-C). Pre and post persistence task measures evaluating mood, self-efficacy and experiences of task participation were completed. A final anagram task was completed to evaluate the effect of framing condition on task performance and transfer of framing conditions across different tasks. Hierarchical and mixed groups outperformed the conditional group on measures of task performance and persistence. This effect was transferred to performance on the anagram task. Significantly increased self-efficacy, comfortableness and willingness was observed for both the hierarchical and mixed conditions over the conditional group with the hierarchical group outperforming the mixed group. This study highlights the potential differing effects framing tasks conditionally, hierarchically or both hierarchically and conditionally can have on motivation and task performance.

• The benefits of believing you can change: Growth mindset weakens the links between self-esteem and negative outcomes.
James Conigrave, Institute for Positive Psychology and Education
Professor Joseph Ciarrochi, Institute for Positive Psychology and Education
Assoc. Prof. Baljinder Sahdra, Institute for Positive Psychology and Education

Intervention-related research has suggested that there are two ways to combat the negative consequences of low self-esteem: improving the level of self-esteem, or decoupling or reducing the link between low self-esteem and negative outcomes. Prior evidence suggests that growth mindsets tend to prevent low-self-esteem from occurring in response to failure. However, little research has examined whether growth mindset can decouple the links between low self-esteem and outcomes such as poor academic achievement and low wellbeing. We sought to examine this possibility in female high school students (N = 489) and in a large sample of American adults (N = 7884). Moderation analyses in both samples showing that the links between low self-esteem and negative outcomes (wellbeing and achievement) were weaker for those with higher levels of growth mindset. People with low self-esteem may be especially likely to benefit from interventions boosting growth mindset.

• Using the IRAP to explore self-compassion and self-judgment
Andrea Compiani, Università IULM, Milano, Italy
Paolo Moderato, Università IULM, Milano, Italy
Giovambattista Presti, Kore University, Enna, Italy
Annalisa Oppo, Freud Universirty, Italy

Using the IRAP to explore self-compassion and self-judgment

12. Same Technology, Different Delivery: Varieties of Formats of ACT Interventions for Chronic Health Problems
Symposium (11:00-12:30)
Components: Conceptual analysis, Original data
Categories: Clinical Interventions and Interests, Behavioral medicine, ACT Delivery in Chronic Ill Health
Target Audience: Beg.
Location: San Bernardo

David Gillanders, University of Edinburgh
Ray Owen, Herefordshire NHS

One of the remarkable features of ACT is that the exact same technology can be used with relatively little adaptation across a very wide variety of problem areas. This has pragmatic benefits for clinicians (who don’t need to learn multiple protocols, specific to each problem area) and has benefits for the progress of clinical science as data can accumulate faster across a breadth of areas. A further remarkable feature is the flexibility with which the same technologies can be delivered. This has benefits to organisations in terms of using ACT technology across a variety of service delivery models. In this symposium, presentations from three different groups, with three different health problems, using both high and low intensity intervention formats will be presented. This symposium will show delegates the flexibility of ACT technology in addressing diverse health complaints and its adaptability to a range of service contexts.

• Low intensity psychological intervention for Irritable Bowel Syndrome
David Gillanders, University of Edinburgh
Nuno Ferreira, University of Edinburgh
Eugenia Angioni, University of Edinburgh
Maria Eugenicos, University of Edinburgh
Sergio Carvalho, University of Coimbra

IBS is a functional GI disorder characterised by bowel pain, diarrhoea and constipation. People with IBS also often fear having bowel accidents, and experience shame and embarrassment. People with IBS often use strategies to control or avoid these experiences, which have the unintended consequence of putting life on hold, at great cost to living. Anxiety, depression and reduced quality of life are common consequences. In this study, a sample of 45 people diagnosed with treatment resistant IBS were given an ACT based self-help book and audio CD, “Better Living with IBS”. They completed standardised measures prior to receiving the book, approximately two months and six months later. Results showed that participants improved significantly in terms of IBS acceptance, IBS related anxiety, and IBS symptom severity, but did not improve in relation to avoidance or quality of life Results are discussed in relation to social processes of exposure and commitment.

• ACT for obesity: Clinical techniques and research outcomes
Dayna Lee-Baggley, Ph.D., Nova Scotia Health Authority

Obesity has been called a global epidemic that threatens the health of individuals and the healthcare systems of nations (WHO, 2000). While there is evidence for the effectiveness of weight loss programs in the short-term, long-term, sustainable changes in obesity remain elusive. The authors will present techniques, clinical examples, and research data from their ACT-based, 52-week, multidisciplinary group intervention for obesity. The authors will review the ways in which ACT principles and techniques can be used in the management of health behaviours for people living with obesity. In addition, the authors will discuss the ways in which ACT may be better able to address the long-term management of obesity. Finally, preliminary data from the program will be presented.

• A Randomized Controlled Trial of a Guided Self-Help Bibliotherapy Among Community Adults Suffering from Chronic pain
Frederick Dionne, Ph.D., Université du Québec in Trois-Rivières
Josée Veillette, Université du Québec in Trois-Rivières
Marie-Claude Blais, Ph.D., psychologue, Université du Québec in Trois-Rivières

In Canada, one in five people suffers from chronic pain, triggering annual costs of nearly 60 billion dollars. While Acceptance and Commitment Therapy (ACT) has proven to be effective in reducing disability and suffering among chronic pain patients, unfortunately, very few people have access to these treatments. Self-help guided interventions can improve access to treatment, but further studies are necessary to evaluate their efficacy. This randomized controlled trial evaluated the efficacy of a 8-week ACT guided self-help bibliotherapy, with minimum therapeutic contact, among community adults suffering from chronic pain. 130 participants were randomly assigned to an ACT intervention or waiting list condition. Results from a two-way ANOVA show a reduction in pain-related disability, depressive symptoms and psychological inflexibility in favor of the ACT group (interaction effects were found between group and time for all variables). Benefits sustained at 3-month follow-up. Results are discussed in terms of future research.

13. Be More Contextual, Behavioral, and Scientific in Your Practice: Using Single-Case Designs (SCDs)
Symposium (11:00-12:30)
Components: Conceptual analysis, Original data, Case presentation
Categories: Evolution, Professional Development, Single-Case Designs (SCDs)
Target Audience: Beg.
Location: Lebrija

Niklas Törneke, MD, Private Practice
Carmen Luciano, Ph. D., University of Almeria

Using single case designs (SCDs) methodology in inherently suitable in philosophy of our Contextual Behavioral Science (CBS). However, we cannot see many SCDs-based researches and practices in our World Conference and Journal of Contextual Behavioral Science. It’s true that randomized controlled trials might be critically important, the “gold standard”, in the Empirically Supported Treatment (EST) or Evidence-based Practice in psychology (EBPP) era, but it is one of many standards in our CBS enterprise. Moreover, we also attach great importance to generating practice-based evidence, not only evidence-based practice, in order to build a progressive science. The purpose of this symposium is to promote using SCDs methodology through reconsidering some gaps between research and practice, and showing some technical, practical and analytic innovations in this methodology.

• Bridging the gap between research and practice using single case designs.
Michael Twohig, Ph. D., Utah State University

Conducing research in an applied setting or job is difficult. Single subject designs (SSD) are great ways to test predictions and participate in research when larger studies are not feasible. For example, someone who naturally has a waitlist may conduct a nonconcurrent multiple baseline design while testing a treatment. ABAB designs are useful in settings such as schools or residential settings. This presentation will cover the ways in which a person who works in an applied setting may participate in research using SSD. In addition to guidance on design selection and practical suggestions for completing the study, some guidance on publication of SSDs will be offered. Ethical considerations of collecting data in a clinic setting will also be discussed.

• How to implement “treatment-evaluation” through using single-case designs (SCDs): Some new technical and practical innovations.
Takashi Muto, Ph. D., Doshisha University

Hayes, Barlow and Nelson-Gray (1999) described the differing features between treatment-evaluation and treatment-research. Treatment-evaluation are designed and executed according to therapeutic criteria, giving priority to the resolution of client problems and the satisfaction of client needs over identifying control variables. The purpose of this paper is to present some new technical and practical innovations in implementing “treatment-evaluation” through using SCDs, for example, Muto (2012) and Muto & Mitamura (2015). These innovations are as follows; a) measuring the therapy processes with high-technological but low-cost devices, for example, a small-and-easy-operating activity meter, GPS logger, and action-camera, and b) making graph of client’s data, in particular, making new cumulative graph.

• Non-parametric approaches to planning and analyzing single case design data.
Roger Vilardaga, Ph. D., roger.vilardaga.duke.edu.

Single Case Design analysis has traditionally relied on visual interpretation of changes in trend and level of repeated observations over time across phases. This is a powerful approach to data interpretation, but it has limitations. For example, it doesn't inform us about how likely it is that we would have found the same result by chance. Randomization tests were conceived by Donald Fisher, the father of statistics, in the mid 1930's, but they were so computationally challenging that he invented parametric statistics, a shortcut to statistical inference. With current computational capabilities, we have now the opportunity to stiffen single case design data interpretation by combining both visual and statistical tools. This talk will briefly describe the rationale and practical use of these novel statistical techniques from a contextual behavioral perspective.

14. Examining the Role of Psychological Flexibility Within Distinct Lesbian, Gay, Bisexual, Transgender, Queer and Intersex (LGBTQI) Populations
Symposium (11:00-12:30)
Components: Conceptual analysis, Original data
Categories: Clinical Interventions and Interests, Prevention and Community-Based Interventions, Other, LGBTQI populations, Diversity, Coping, Mental and behavioural health
Target Audience: Beg., Interm.
Location: Utera

Jo Lloyd, Ph.D., Goldsmiths, University of London
Laura Silberstein, Psy.D., The Center for CFT

Research indicates that LGBTQ people experience minority stressors, in addition to the general life stressors experienced by everyone, which are salient to their mental health and wellbeing (Meyer, 2003; Testa et al, 2015). Whilst minority stressors have their origins in oppressive social and cultural structures, they are believed to take root in LGBTQ people via psychological processes. Specifically, there are subjective/proximal stressors (e.g., internalised transphobia) which are thought to result from the internalisation of negative social attitudes (Meyer, 2003). There are also objective/distal stressors (e.g., homophobic discrimination) which are thought to gain psychological importance when they manifest in the immediate context of people’s thoughts, feelings and actions (Meyer, 2003). Since psychological processes appear to underpin the experience of minority stressors, we suggest that the way in which people respond to their internal psychological events may be central to how they cope with such stressors. To this end, this symposium examines the role of psychological flexibility within three distinct LGBTQ populations: A heterogeneous sample of LGBTQ people, transgender and gender nonconforming (TGNC) people and LGBTQ employees. The latter paper also extends to an analysis of how the concept of psychological flexibility can be used to design teams and organisations in which LGBTQ employees can thrive.

• The Protective Role of Psychological Flexibility in the Relationship between Minority Stressors and Mental Health in Transgender and Gender Nonconforming (TGNC) People in England
Jo Lloyd, Ph.D., Goldsmiths, University of London

In this study we examined the protective role of psychological flexibility in the relationship between three widely examined minority stressors experienced by transgender and gender nonconforming (TGNC) people (i.e., transphobic discrimination, identity nondisclosure and internalised transphobia) and the mental health outcomes of anxiety and depression. We examined our hypotheses in a cross-sectional sample of 921 TGNC people in England (This is T1 data from a two-wave longitudinal panel study; T2 data is due to be collected in August 2017). Analyses revealed that TGNC people with higher levels of psychological flexibility had lower levels of anxiety and depression compared to those with lower levels of psychological flexibility. Furthermore, psychological flexibility showed a buffering/protective effect; specifically, harmful relationships between minority stressors and mental health outcomes were weaker for TGNC people with higher levels of psychological flexibility. Theoretical and practical implications for psychological flexibility theory and minority stress research are discussed.

• Stigma in context: Psychological distress and coping style of gender and sexual minorities.
Lauren Griffin, University of Louisiana at Lafayette
Rebecca Copell, MSc., University of Louisiana at Lafayette
Emily Sandoz, Ph.D, University of Louisiana at Lafayette

People within the LGBTQ community are at increased risk of psychological distress, mental health symptomatology, and risk-taking behaviors (Kirsch, Conley & Riley 2015). Some have suggested that LGBTQ individuals do statistically show worse mental health because of a lack of social resources, alienation, discrimination, victimization, and abuse (Kirsch et al. 2015). Past studies do not offer insight into what differentiates well functioning individuals from distressed ones (Herek & Garnets, 2007). Some seem to experience both psychological well-being and distress simultaneously. It may be that these minorities had to adapt to environmental difficulties related to orientation while also developing resilience in the face of life stressors (Kirsch et al., 2015). The purpose of this study is to determine whether or not (1) LGBTQ people experience psychological distress from enacted stigma, and (2) if they do experience distress, types of coping styles utilized to mitigate distress will be explored.

• Helping Lesbian, Gay, Bisexual, Transgender and Queer (LGBTQ) Employees Live Vital and Effective Lives: From Psychological Flexibility to Organisational Flexibility
Jo Lloyd, Goldsmiths, University of London

In this conceptual paper, we examine how psychological flexibility may help LGBTQ employees live vital and effective lives, even when they are experiencing difficult and/or challenging circumstances. Firstly, we inspect the manifestation of minority stressors in the workplace and the difficulties they may cause for LGBTQ employees. Secondly, we examine how individual-level training interventions that seek to enhance people’s psychological flexibility may be used to facilitate better mental health and performance in LGBTQ employees. Finally, we explore whether the concept of psychological flexibility can be used to design teams and organisations that are both mindful and committed to pursuing their values, such as supporting and developing the talents of their LGBTQ employees. To do so we draw upon the organisational flexibility model developed by Bond (2015) and use specific examples of how its key characteristics can be applied to create working environments in which LGBTQ employees can flourish whilst the organisation prospers.

19. Interfacing Conceptual and Experimental Analyses
Symposium (12:45-14:00)
Components: Conceptual analysis, Original data,
Categories: Relational Frame Theory, Clinical Interventions and Interests, Theoretical and philosophical foundations, Experimental Psychopathology, Anxiety, IRAP, Analogy, Coherence
Target Audience: Beg., Interm., Adv.
Location: Giralda V

Miguel Rodríguez-Valverde, Ph.D., University of Jaén, Spain

This tightly-packed 4-paper symposium examines the reticulation between RFT concepts and their experimental manipulation. Paper 1 summarizes multiple experiments in which the existing Relational Elaboration and Coherence (REC) model appears to fall short in explaining various IRAP performances. As an alternative, the authors propose the Differential-Arbitrarily-Applicable-Relational-Responding-Effects (DAARRE) model as a more dynamical conceptualization of the relational performances observed in the IRAP. Paper 2 seeks to enhance simple and complex repertoires of analogical reasoning as derived relational responding in undergraduates. The results show that the relational training protocol enhances both the fluency and the flexibility of participants’ ability to solve analogies. Paper 3 presents experimental manipulations of the nature and functions of relational coherence, by systematically comparing relationally coherent or incoherent networks of stimuli. In the Consistent Context, feedback was contingent on responding in accordance with the trained relations, while this did not apply in the Inconsistent Context (IC). The results suggest that coherence in and of itself may function as a powerful reinforcer. Paper 4 tackles the difficulties in experimentally manipulating the transfer of physiological fear. In an MTS study of equivalence relations, electric shock was differentially conditioned and eye blink was the main dependent variable. The paper explores the possible implications of the findings for our understanding of fear generalization as derived relational responding.

• The IRAP Has a Mid-Life Crisis: A Younger (and More Complex) Model is Needed
Martin Finn, Ghent University
Dermot Barnes-Holmes, Ghent University

The program of research reported in the current paper began with an attempt to replicate the instructional effects reported by Finn et al. (2016) when participants are exposed to relatively simple IRAPs. The initial attempt failed to replicate the original findings and produced results that were difficult to explain based on the Relational Elaboration and Coherence (REC) model. Across 5 experiments a number of key issues were explored in a largely inductive manner: (i) the role of pre-experimental history in completing latency-based measures; (ii) the impact of employing a “talk-aloud” procedure during the IRAP; (iii) the impact of different types of stimuli within the IRAP; and (iv) the extent to which structured post-IRAP self-reports predict REC model consistent effects. The results of these studies gave rise to a Differential-Arbitrarily-Applicable-Relational-Responding-Effects (DAARRE) model, which emphasizes the highly dynamic nature of the relational responding produced on even relatively simple IRAPs.

• Impact of a experimental protocol in fluency and flexibility of analogical reasoning
Asunta Utande, University of Almería
Carmen Luciano, University of Almería
Zaida Callejón, University of Almería

Analogical behavior is a key element in intelligence as good remains established in mainstream psychology. However, the processes involved in the analogy have recently begun to be isolated in an experimental way upon the basis on the Relational Frame Theory. Experimental studies have begun to go into the are of relating networks. However the processes involved are still needed to be isolated. In addition, the huge picture involves in this domains requieres experimental and applied studies going hand by hand to progress. The present study goes in this direction and tries to evaluate the impact of a protocol built of abstract and words analogies. 47 university students participants. Standard and non-standard analogical measures were taken before and after applying the protocol to 26 out of the 47 participants. In addition to pre-post measures, specific variables were measured during the implementation of the protocol. The results show an increase in fluency and flexibility of analogical reasoning in those participants who received the experimental protocol.

• The reinforcing function of Coherence
Zaida Callejón Ruiz, University of Almería
Carmen Luciano, University of Almería

The current study aimed to explore the reinforcing function of coherence. Twelve students participated in the following sequence: Firstly, conditional discrimination training was implemented for the formation of three 5-member (A to F) equivalence classes. In a second phase, they were exposed to a 54-trial block of mutual and combinatorial trials for stimuli A to D with the purpose of altering the previous network coherence. This was done by providing different feedback according to two contexts: Consistent Context (CC) in which the feedback was given contingent to participants’ responses in accordance with the relations trained. Inconsistent Context (IC) in which the feedback was randomly assigned but always joined with points. Test accuracy and latency as well as the level discomfort were recorded while testing on each context. Finally, in a third phase, participants were exposed to a test of derived relations with F stimuli while making choices of context preferences. Results showed that most of participants chose the consistent context and when having to choose between incoherent trials, response latency and discomfort increased. Findings suggest that coherence appears to function as a powerful reinforcer. Implications for further research and applied areas are discussed.

• An experimental analysis of the transfer of conditioned fear using blink-startle modulation as a measure.
Miguel Ángel López-Medina, M.Sc., University of Jaén, Spain
Miguel Rodríguez-Valverde, Ph.D., University of Jaén, Spain
Mónica Hernández-López, Ph.D., University of Jaén, Spain

From a contextual behavioral perspective, research on the transfer/transformation (also called symbolic generalization) of fear is key to understanding the genesis and maintenance of anxiety and its disorders. Although the basic working model (that conditioned physiological fear reactions may transfer amongst physically dissimilar but symbolically related, e.g., equivalent, stimuli) is taken for granted, the truth is that there is very limited empirical evidence proving this phenomenon under controlled laboratory conditions, and it has relied on skin conductance responses as the physiological measure of fear. Previous research from our lab failed to find transfer-of-fear effects with blink startle (a more adequate measure of fear conditioning, according to current psychophysiology standards). The present study attempts to overcome some methodological limitations of our previous research. Participants in this study underwent a matching-to-sample procedure for the formation of two equivalence classes. Then, one element from each class was used in a differential aversive conditioning procedure (CS+: B1; CS-: B2) with electric shock as the UCS. Eye-blink startle (measured as EMG activity of the orbicularis oculi muscle after a burst of white noise) was the main dependent variable. Results are discussed in terms of their applied implications and relevance.

24. ACT Interventions for Health Problems
Symposium (12:45-14:00)
Components: Conceptual analysis, Literature review, Original data, Experiential exercises, Didactic presentation, Case presentation
Categories: Clinical Interventions and Interests, Prevention and Community-Based Interventions, Behavioral medicine, Chronic Disease, Behavior Change, RFT, Cancer, Parents with children with chronic illness, Clinical Health Psychology, Neuropsychiatry, Neuropsychology
Target Audience: Beg., Interm.
Location: Buhaira

There is increasing evidence that acceptance and mindfulness-based treatments are useful in the areas of health psychology and behavioral medicine. Acceptance, mindfulness, and values have proven effective in improving the management of health and chronic illness. This symposium presents four papers that attest to the potential of acceptance-based interventions in a diversity of health problems. The first paper will present an overview of the literature relating ACT and chronic disease and will show the use of applied ways to use ACT interventions to change health behaviors through an RFT framework. The second paper presents a data-driven approach to intervention development. The aim of this study is to analyze the association of ACT components with patient-reported outcomes in order to develop a more patient-led, and clinically and cost-effective intervention for stressful psychological transitions after primary cancer treatment. The third study presents the results of a randomized controlled trial of a 4-session group-based ACT intervention for parents of children with asthma. The results of this study show that ACT is potentially more efficacious than an educational talk in helping parents to adjust in caring for their children with asthma. The last paper will present a detailed case series of routinely collected data from an UK National Health Service clinic offering ACT for functional neurological disorders (FND) like conversion disorder and other somatic symptom disorders. This novel and promising approach to the treatment of these disorders that are at the intersection of mental and physical health will be illustrated in a detailed case study.

• Health Behavior Change: How to use RFT principles and ACT interventions to change habits
Dayna Lee-Baggley, Ph.D., Nova Scotia Health Authority
Ray Owen, D. Clin Psychol, Wye Valley NHS Trust, Hereford, UK
Jason Lillis, Ph.D., Brown University

The purpose of this submission is to provide an overview of the literature relating ACT and chronic disease and to demonstrate the use of ACT techniques through an RFT framework. We will provide concrete, applied ways to use ACT interventions to change health behaviors (e.g., smoking, exercise, diet, medication use) as they relate to chronic conditions (e.g., chronic pain, obesity, diabetes). The theoretical and clinical applications will be framed through RFT. That is, participants will gain a better understanding of RFT principles and how to apply them to behaviour change. Health behaviors can be understood through relational frame networks, pliance, rule following and coherence. Participants will learn how to apply various relational frames (e.g., coordination, hierarchical) to “rules” that clients may present with in order to foster change. Participants will also learn how to use augmenting, tracking, functional coherence, and changing frames to create transformation of function to assist clients in behavior change.

• Psychological transition after primary cancer treatment: Component mapping using an Acceptance and Commitment Therapy (ACT) Framework for effective intervention development
Nick Hulbert-Williams, PhD, University of Chester
Brooke Swash, PhD, University of Chester
Pandora Patterson, PhD, CanTeen Australia and University of Sydney
Fiona McDonald, CanTeen Australia & University of Sydney
David Gillanders, DClinPsy, University of Edinburgh
Melissa Pilkington, MSc, University of Chester & Edge Hill University

Transitions between diagnosis, treatment and survivorship are psychologically stressful for cancer patients. As a values-based intervention, emphasising return to functional living, ACT may improve wellbeing in this population. This study investigates associations between ACT components and patient-reported outcomes in a cohort of cancer patients. Participants are being recruited in the UK, Canada and Australia using social media and through national cancer charities. Self-report questionnaires are completed at baseline, and three-monthly time intervals for two years thereafter. Questionnaires assess components of the ACT framework, fear of cancer recurrence, depression, anxiety, stress and quality of life. Recruitment is underway (n=47 to date). Baseline data analysis will be presented: these analyses yield novel data on comparative associations between ACT process measures and psychological outcomes. Using a ground-up, data-driven approach, we aim to use this study to develop more patient-led, and clinically and cost-effective interventions.

• The Efficacy of a Group-Based Acceptance and Commitment Therapy on the Psychological Flexibility and the Psychological Adjustment of Parents of Children with Asthma: A Randomized Controlled Trial
Yuen Yu CHONG, Ph.D student, School of Nursing, The Hong Kong Polytechnic University, Hong Kong
Yim Wah MAK, Ph.D, School of Nursing, The Hong Kong Polytechnic University, Hong Kong
Alice Yuen LOKE, Ph.D, School of Nursing, The Hong Kong Polytechnic University, Hong Kong

Enhancing the psychological flexibility (PF) of parents through Acceptance and Commitment Therapy (ACT) may help them to deal with their own psychological needs while managing the asthmatic condition of their children. A randomized controlled trial was employed to examine the efficacy of 4 weekly sessions of a group-based ACT intervention (ACT) in comparison with an asthma educational talk (Control), on the PF and the psychological adjustment of parents in raising their children with asthma. Assessments were conducted using the parental report before, immediately after and at 6 months after the intervention. One hundred and sixty-eight parents of children aged 3-12 years with asthma were consecutively recruited in a public hospital in Hong Kong. The results from generalized estimating equations showed that there were significant time-by-group interactions in the PF (p <.001) and in all the subscales assessing the psychological adjustment (ps ranged from <.001 to .026). The parents in the ACT group had a significant improvement in the PF when compared with those in the Control group at 6-month follow-up (d = 0.82). The study demonstrated that ACT is potentially more efficacious than an educational talk in helping parents to adjust in caring for their children with asthma.

• Using ACT to improve outcomes in functional neurological disorders (“conversion disorder”): A detailed case series.
Christopher D. Graham, University of Leeds

Functional Neurological Disorders (FND) include diagnoses such as non-epileptic attacks and functional movement disorders (limb weakness, paralysis etc). Aetiology and prognosis are unclear; yet, these conditions are presumed to have psychosocial causes. There are no treatments with high-quality empirical support. ACT has good face validity as at treatment approach, and has demonstrated efficacy in similar contexts. We present a case series of routinely collected data from an UK National Health Service clinic offering ACT for FND. Nine participants were included. Treatment comprised face-to-face tailored ACT, aiming to improve meaningful functioning. Participants attended six to 11 hour-long sessions. Outcomes (functioning [WSAS]; mood [CORE-10)) and psychological flexibility (AAQ-II) were recorded before each session. We will present data on session-to-session, and pre- to post- intervention (reliable change and clinically significant change), changes in variables. The treatment approach will be illustrated in one detailed case study. This is the first step in understanding whether ACT might prove useful in FND care.

25. Working with Values and Values-Consistent Behavior
Symposium (12:45-14:00)
Components: Conceptual analysis, Original data, Experiential exercises, Didactic presentation, Case presentation
Categories: Clinical Interventions and Interests, Prevention and Community-Based Interventions, Educational settings, Supervision, Training and Dissemination, Functional contextual neuroscience and pharmacology, Relational Frame Theory, Other, Psychological Flexibility in Students, PTSD, Substance use disorders, Military veterans, Values, Committed action, Intellectual Disabilities, Autism, Teenagers
Target Audience: Beg., Interm., Adv.
Location: San Bernardo

Values are a key component of the psychological flexibility (PF) model, and values clarification and work in promoting engagement with valued actions are fundamental elements of ACT. Engagement in valued daily life actions is what makes life meaningful, according to the ACT model. The four papers in this symposium present a diversity of ways of working with values and values-consistent behavior. The first paper presents research that tested the effect of an online gamified app-platform designed to enhance psychological flexibility in order to achieve valued goals. College students were randomly assigned to one of two conditions: a gamified ACT intervention or an active control condition (traditional online games such as tetris, pinball, etc.). The main results show that the gamified ACT intervention enhanced PF, reduced procrastination behaviors, increased the accomplishment of valued goals, and increased academic performance. The app-platform seems to be an easy and efficacious way to enhance PF in order to increase goal valued performance and academic achievement in college students. The second paper in this symposium examines the connection between values and behavioral assignments in therapy. Using case examples drawn from a treatment outcome study of ACT for co-morbid PTSD and alcohol use disorders in US veterans, the presentation will focus on how to collaboratively develop values-consistent behavioral assignments in therapy, a challenge for novice ACT therapists that requires a deep understanding of the connection between values and commited action. The third paper will present an adaptation of the procedure (Hayes and Carrochi, 2015) to conduct a Values Conversation as a part of Preference Assessment of verbally competent people with intellectual disabilities. This procedure systematically uses the value altering effects of verbal stimuli to establish a verbal context to help the individual with intellectual disability engage in behavior consistent with long-term reinforcers, quality of life and personal values. The fourth and last paper in this symposium will discuss original data from a study with a community sample aimed at assessing psychometric properties of measures of values and values-consistent behaviour with adolescent population.

• Increasing psychological flexibility, goal valued performance and academic achievement in university students through a gamified online platform
Sara de Rivas, Universidad Autónoma de Madrid
Oscar Lecuona, Universidad Autónoma de Madrid
Luz Vilte, Universidad Autónoma de Madrid
Jennifer Moreno, Universidad Autónoma de Madrid
Raquel Rodríguez-Carvajal, Universidad Autónoma de Madrid

Current society presents a landscape of increasing demands where intellectual talent as well as concrete knowledge and education are important for academic and work success. However, there are other individual aspects less considered that are of key importance, and not explicitly included neither in the academic curricula nor in organizations formative courses and so on. These aspects regard self-regulation process in a broad sense of the term. That is, not only these aspects involve the way people relate to external events implicated in their academic or job goals (as for example scheduling, planning, etc.), but how people relate to their own internal events or experiences such as feelings of fear, laziness, unwanted thoughts of failure, goal clarity and so on. There are many applications created to help users planning and organizing their time and their external context to achieve their valued goals. However there are few apps designed to deal with the internal events such as emotions, thoughts and feelings that are involved in those moments when you are actually trying to achieve a valued goal. Even less applications in this area (if any) had scientifically tested their efficacy to do what they claim. In the present research we tested the effect of an online app-platform designed precisely to enhance psychological flexibility in order to achieve valued goals. Considering acceptance and commitment therapy, as well as gamification principles, different audio-visual and interactive elements were created and integrated to conform the platform. To test the effects of the platform 178 university students were randomly assigned to one of the conditions: platform condition (gamified act intervention) or active control condition (traditional online games such as tetris, pinball, etc.). In the platform condition, participants completed thirteen platform missions until reaching the end of the platform during a four weeks period. Mission duration was estimated in approximately 10-15 minutes. They were encouraged to complete only one mission per day, but they could use the platform (or the control) any time they wanted. All participants filled in questionnaires right before they started the study, one month after it, and at the end of the academic semester to fill in their academic achievement. Main results showed positive differences for psychological flexibility in time within the platform condition (Pillai’s trace F (1, 155) = 43.147, p <.001, partial η2 = .22), but not for the control condition (ns), and we found differences between platform and control conditions (Pillai’s trace time x condition: F (1, 155) = 17.439, p <.001, partial η2 =.10). In addition participants in platform condition reported that they had reduced their procrastination behaviors in a very significant way, as we found highly significant differences in time within the platform condition (Pillai’s trace F (1, 155) = 64.044, p <.001, partial η2 = .29), but not for the control condition, and differences between platform and control conditions (Pillai’s trace time x condition: F (1, 155) = 18.094, p <.001, partial η2 =.10). We also found differences regarding the degree participants felt they had accomplished their main valued goal (F (2, 157) = 4.381, p = .014), as well as regarding the degree they stayed on track to their personal value regarding that goal (F (1, 157) = 10.842, p = .001). Even more, we found statistical differences in academic performance, concretely in the number of curses they actually got tested, participants in the platform condition got tested in more courses than participants in the control condition (F (1, 174) = 9.062, p = .003, partial η2 = .05), and they passed the curses with more excellent grades we found statistical differences between conditions (F (1, 174) = 4.794, p = .030, partial η2 = .03), participants in the platform condition got more excellent grades than participants in the control condition. Finally, a SEM approach with multi-group analysis was conducted in an attempt to create an explanatory model of the intervention process. In such model, changes in psychological flexibility across time powerfully predicted changes in most of the variables therefore playing a central explanatory role. The platform seems to be an easy and efficacious way to enhance psychological flexibility in order to increase goal valued performance and academic achievement in university students.

• Putting values into action: Examining the connection between values and behavioral assignments from a study of ACT for co-occurring posttraumatic stress disorder and alcohol use disorders
Eric Meyer, PhD, VA VISN 17 Center of Excellence for Research on Returning War Veterans
Robyn Walser, PhD, National Center for PTSD-Dissemination and Training Division

Increased engagement in valued action is the desired behavioral outcome in ACT. Guiding clients in developing values-consistent behavioral assignments requires rich understanding of the connections between values and committed action. Our experience suggests that developing values-consistent behavioral assignments is challenging for many novice ACT therapists. This presentation will use case examples drawn from a treatment outcome study of ACT for co-occurring posttraumatic stress disorder (PTSD) and alcohol use disorders (AUD) in U.S. military veterans. Data will be comprised of actual behavioral assignments developed during treatment and the values that clients identified as being connected with these assignments. Themes and life domains within which these assignments take place will be examined. Teaching will focus on how to collaboratively develop values-consistent behavioral assignments. Case illustrations will focus on how these assignments build sequentially over the course of treatment, supporting clients in developing progressively larger patterns of valued living.

• Altering the value of reinforcers: Values Conversations for Intellectual Disabilities
Giovanni Miselli, PhD BCBA, Fondazione Istituto Ospedaliero di Sospiro Onlus (CR) Italy
Roberto Cavagnola, Psy D., Fondazione Istituto Ospedaliero di Sospiro Onlus (CR)
Mauro Leoni, PhD, Fondazione Istituto Ospedaliero di Sospiro Onlus (CR), University of Pavia
Serafino Corti, PhD, Fondazione Istituto Ospedaliero di Sospiro Onlus (CR), Università Cattolica Brescia Italy
Francesco Fioriti Ed.D, Fondazione Istituto Ospedaliero di Sospiro Onlus (CR)
Giuseppe Chiodelli, MD; Laura Galli, MD; Michela Uberti, MD, Giovanni Michelini, PhD., Fondazione Istituto Ospedaliero di Sospiro Onlus (CR)

The motivational function exerted by verbal antecedents has been extensively approached from a theoretical perspective and within the direct conditioning paradigm (Valdivia, Luciano, Molina, 2006). Also the research concerning the alteration of the motivational function via verbal means are now increasing due to the impact of RFT. Following the work on Values (Wilson, K. G., Sandoz, E. K., Kitchens, J., & Roberts, M. E., 2010) we will present an adaptation of the procedure (Hayes and Carrochi, 2015) to conduct a Value Conversation as a part of Preference Assessment of verbally competent people with Intellectual Disabilities. The value altering effect of verbal stimuli will be systematically used to establish a verbal context to help the individual with Intellectual Disability engage in behavior consistent with long term Reinforcers, quality of Life and Personal Values. The procedure, video and result from the application of the Value Conversation will be presented.

• Values, values-consistent behaviour and wellbeing in adolescents
Davina Chauhan, NHS Lothian
Nuno Ferreira, University of Edinburgh
Paul M Morris, University of Edinburgh

This paper presentation will discuss original data from a community adolescent sample. The aims of the study were to assess a limited set of psychometric properties of measures of values and values-consistent behaviour with an adolescent population; (ii) to assess which values are endorsed by adolescents; and (iii) to explore whether values-consistent behaviour accounts for some of the variation in wellbeing scores beyond known correlates.

26. Reclaiming Health and Wellbeing for Populations Affected by War, Gender-Based Violence, and Other Adversity: CBS Strategies from Small to Large Scale
Symposium (12:45-14:00)
Components: Conceptual analysis, Original data
Categories: Clinical Interventions and Interests, Prevention and Community-Based Interventions, Supervision, Training and Dissemination, Functional contextual approaches in related disciplines, Relational Frame Theory, Humanitarian Emergencies, Implementation Science, Gender-based violence
Target Audience: Beg.
Location: Lebrija

Thomas Szabo, Florida Institute of Technology, Commit and ACT
Ross White, University of Liverpool

Armed conflicts have contributed to an estimated 65.3 million forcibly displaced people globally. Furthermore, many individuals live in contexts of ongoing adversity, poverty, and high rates of gender-based violence. These conditions have devastating and long-lasting impacts on health and wellbeing. Yet many individuals in these settings lack access to evidence-based care. It is essential that global efforts focus on rolling out effective interventions that can reach vast numbers of individuals, families, and communities. In such settings we need to develop innovative methods for implementation, training, and supervision, since there are often limited resources available. In this symposium, we will present recent developments from four organizations working to address these issues – Commit & Act, World Health Organization, Peter C Alderman Foundation, and War Child Holland. The interventions and implementation models discussed here range from small to large scale, from individual behavior to health-system building, and have both research and service focuses.

• Scalable psychological interventions in communities affected by conflict and other adversity: Case studies from the WHO Mental Health and Psychosocial Support in Emergencies programme
Felicity L. Brown, War Child Holland
Kenneth Carswell, World Health Organization
Mark van Ommeren, World Health Organization
Wietse A. Tol, Johns Hopkins Bloomberg School of Public Health, Peter C Alderman Foundation
Atif Rahman, University of Liverpool, Human Development Research Foundation
Jura Augustinavicius, Johns Hopkins Bloomberg School of Public Health
Marx Leku, Peter C Alderman Foundation

At a global scale, the number of individuals living with prolonged, disabling emotional distress is staggering, and this is even more the case in communities affected by humanitarian crises. In these settings there is a vast gap between psychological support required, and the available resources. In response, the WHO Mental Health and Psychosocial Support in Emergencies programme is focusing on systematically developing, culturally-adapting, and evaluating low-intensity psychological interventions that can be delivered by non-specialists and require few resources to reach larger numbers of individuals. As our first case study, we will report on the development, early piloting, and results of a pilot randomized controlled trial of an ACT-based guided self-help intervention conducted with the Peter C Alderman Foundation in northern Uganda with South Sudanese refugees. As our second case study we will report on a pilot randomized controlled trial of a transdiagnostic intervention incorporating problem-solving and behavioural techniques in Pakistan.

• A multi-level care-system for children affected by war: Feasibility data from War Child Holland’s work in Lebanon and Gaza
Kenneth E Miller, War Child Holland
Elise Griede, War Child Holland
Heba Ghalayini, War Child Holland OPT
Ali Jawad, War Child Holland Lebanon
Kate Roberts, War Child Holland OPT
May Aoun, War Child Holland Lebanon
Marx Leku, Peter C Alderman Foundation

Millions of children live in nations affected by war. Children exposed to war are vulnerable to increased rates internalizing and externalizing difficulties. There are a small but growing number of intervention studies conducted in an effort to improve child psychosocial outcomes after war. However, tremendous gaps exist in the ability to provide effective care that targets known risk factors at different ecological levels after war, including family environments, child protection risks, and poor quality education. We will present the vision and research and development agenda of War Child Holland to develop a multi-level care system, incorporating evidence-based interventions, alongside methods to improve access, acceptability, and quality. We will present feasibility data from Gaza and Lebanon for a parent-focused intervention that directly teaches parenting and mindfulness skills, with the aim of increasing parent psychological flexibility and overall wellbeing, and reducing reactive and harsh parenting. Future evaluation plans will be discussed.

• Microaggression, Intimate Partner Gender-Based Violence, and Behavioral Flexibility Training in Sierra Leonean Couples
Thomas G. Szabo, Florida Institute of Technology
Hannah Bockarie, Commit & Act, Sierra Leone
Jonathan Tarbox, University of Southern California
Ross White, University of Liverpool, UK
Corinna Stewart, National University of Ireland, Galway

Gender-based violence and microaggression are rarely studied by behavior analysts but likely entail a complex repertoire of physical, verbal and arbitrarily applied relational responding. Microaggression is particularly important to the reduction of gender-based violence because it often goes unnoticed and therefore unaddressed, but it predicts other more serious forms of aggression. Like most other operant behavior, it is reinforced without explicit awareness of its occurrence by the speaker or the listener. We conducted a multiple probe study across married couples in which microaggression and overtly aggressive behavior were recorded during and between sessions of a month-long, four-session behavioral flexibility training that was modeled on Acceptance and Commitment Therapy. The study was conducted in a small west African nation where gender-based violence is reported to be at pandemic levels. Microaggression, aggression, and collateral behavior (heavy drinking, drug use, and betrayal) decreased, whereas replacement behaviors increased. Implications and future research are discussed.

27. Avances en la Investigación con el IRAP: Aspectos de Relevancia Clínica y Metodológica
Symposium (12:45-14:00)
Components: Datos originales
Categories: Teoría de los Marcos Relacionales, Intervenciones y aspectos clínicos, Contextos educativos/escolares, , Otros, IRAP
Target Audience: Beg., Interm., Adv.
Location: Utera

Mónica Hernández-López, Ph.D., Universidad de Jaén
Giovambattista Presti, M.D., Kore University, Enna

El IRAP se ha convertido en un procedimiento popular dentro de la ciencia conductual contextual para la evaluación de repertorios verbales de carácter implícito. La investigación más reciente aborda dos cuestiones fundamentales. Por un lado la relevancia clínica de dichos repertorios y por otro las características metodológicas de la propia tarea. Este simposio incluye trabajos que abordan ambos aspectos. El primero de ellos es uno de las pocos trabajos que han utilizado el IRAP con población infantil y adolescente y está centrado en el estudio de respuestas relacionales implicadas en la evitación y aceptación de las propias emociones. El segundo aborda las creencias disfuncionales implícitas en cuidadores de personas mayores con demencia. El último trabajo se centra del estudio de los efectos de la inhibición de respuesta en la ejecución en el IRAP.

Evaluación de creencias disfuncionales implícitas en cuidadores informales de personas mayores con demencia a través de una tarea IRAP, La relación entre las creencias disfuncionales evaluadas de forma explícita (autoinformes) y el malestar emocional de los cuidadores no es consistente a través de los estudios. Este trabajo presenta una tarea computerizada basada en el Procedimiento de Ev
maria.marquez@uam.es, Sí

Andres Losada, PhD., Universidad Rey Juan Carlos
Un análisis de los efectos de la inhibición de respuesta sobre la ejecución en el IRAP, Una cuestión importante es en qué medida la ejecución en el IRAP se ve afectada por variables personales ajenas a la propia tarea. Una investigación previa de nuestro laboratorio exploró los posibles efectos que la inhibición de respuesta (medida a través)

34. New Data on Core RFT Concepts: Rules, Coherence, and Level of Derivation
Symposium (15:15-16:45)
Components: Conceptual analysis, Literature review, Original data
Categories: Relational Frame Theory, Theoretical and philosophical foundations, Rule Governed Behavior, Coherence, Derivation, Relational Responding
Target Audience: Interm., Adv.
Location: Prado

Ian Hussey, PhD, Ghent University
Ian Stewart, PhD, National University of Ireland, Galway

Relational Frame Theory aspires to provide a general framework for the prediction-and-influence of language and complex human behaviour in both laboratory and applied contexts. This symposium presents data from three lines of research on core RFT ideas. The first paper provides a conceptual outlines of relational coherence as an organizing and presents novel empirical data on affective and behavioural responses to coherent and incoherent networks. The second paper describes the RFT account of implicit attitudes. Data from three pre registered studies are presented which manipulate level of derivation and observes changes in effects on Implicit Association Test (IAT), providing initial but strong support for the influence of opportunities to derive on the strength of relational responding. The third paper describes Rule Governed Behaviour and presents novel data on derived insensitivity to changes in contingencies. Future directions for each line of work and implications for the study of the relational behaviours that constitute language will be discussed.

• Relational Coherence and Ambiguity: Behavioural and Affective Responses within a Novel Training Paradigm
Sam Ashcroft, University of Chester
Lee Hulbert-Williams, PhD, University of Chester
Kevin Hochard, PhD, University of Chester
Nick Hulbert-Williams, PhD, University of Chester

Relational coherence being a generalized operant is a fundamental assumption of Relational Frame Theory (RFT). Relational coherence is said to have reinforcing properties (Hayes, Barnes-Holmes & Roche, 2001). In other words, it is a driving and organising force within language and symbolic learning processes. In light of this importance, relational coherence plays a key role in the ‘multidimensional multilevel framework’, which currently steers many aspects of RFT research. Despite this centrality, behavioural responses to coherence have seldom been tested within CBS (Bordieri et al., 2016). We assessed and compared behavioural and affective responses to relational coherence and ambiguity using a novel training paradigm with 85 participants. Contrasting with Match-to-Sample, this paradigm trains unidirectional relationships using trial and error learning. We present results that answer and ask numerous questions regarding relational coherence. For instance, the impact of ambiguity and coherence on affective responses and response latencies.

• Testing the RFT account of implicit attitudes: Manipulating level of derivation of relational responding
Ian Hussey, PhD, Ghent University
Sean Hughes, PhD, Ghent University
Jan De Houwer, PhD, Ghent University

In the last decade, RFT researchers have taken an interest in the use of implicit measures such as the IRAP and IAT, and have provided a conceptual account of such behaviours (Hughes et al., 2012). However, little empirical work has tested this account to date. This paper examines one factor proposed to influence relational responding: the level of derivation of relational responding. Concepts will be outlined and data from three studies presented. These manipulate the level of derivation of relational responses and observe the impact on speed of relational responding. Studies employed open science principles, including pre-registration of hypotheses and making all materials and data available, therefore adding to the weight of evidence and providing large datasets for others. Results have direct relevant to an RFT account of the effects observed on implicit measures.

• Rule-Based Insensitivity Propagation through Equivalence
James Greville, PhD, Aberystwyth University
Jean-Louis Monestès, PhD, University of Grenoble Alpes
Nic Hooper, PhD, University of the West of England

Research on rule-governed behavior (RGB) suggests that rules can result in insensitivity to changes in environmental contingencies. Here, we assessed whether insensitivity to contingencies may propagate to novel stimuli via derived relational responding. Firstly, participants completed a task where they could score points by following simple rules (reinforcement schedules) in the presence of specific stimuli. Following equivalence training, participants exhibited rule-following in the presence of stimuli with no direct prior association with that rule, demonstrating derived generalization of RGB. Participants who were explicitly given this rule took longer to adapt their behavior to the new schedule thus demonstrating derived insensitivity to contingencies. These findings contribute to our understanding of perseverative behavior and psychological flexibility.

35. Using Technology to Better Assess and Enhance Psychological Flexibility Among College and University Students
Symposium (15:15-16:45)
Components: Original data
Categories: Educational settings, Clinical Interventions and Interests, College/University
Target Audience: Beg., Interm., Adv.
Location: Nervión Arenal I

Frederick Dionne, Ph.D. and Simon Grégoire, Ph.D., Université du Québec à Trois-Rivières
Jacqueline Pistorello, University of Nevada, Reno

Many college and university students struggle with mental health problems that undermine both their quality of life and academic success. Recently, different mindfulness and acceptance-based interventions have been implemented throughout college and university campus to promote mental health among post-secondary students (Pistorello, 2013). Although encouraging, these interventions currently face two major challenges: 1) how can they be offered so they are easily accessible and cost-effective and 2) how can they be assessed with ecological validity? The symposium explores new ways of promoting and assessing psychological flexibility among students suffering from either stress, distress or procrastination using new technologies. Haeger and colleagues present the results from a Web-based online ACT therapy intervention (LifeToolbox) for distressed college students. Dionne and colleagues present a Web-based ACT program to reduce procrastination among university students. Grégoire and colleagues use a single-subject time-series design and the ecological momentary assessment method to examine day-to-day fluctuations in stress and psychological flexibility among students enrolled in a ACT intervention. These studies are discussed by Jacqueline Pistorello, Ph.D., and they will be space for questions from the audience.

• Initial findings from a randomized dismantling trial of the LifeToolbox website: A transdiagnostic online acceptance and commitment therapy intervention for distressed college students
Jack Haeger, M.S., Utah State University, Logan, Utah
Jennifer Krafft, B.A., Utah State University, Logan, Utah
Michael Levin, Ph.D., Utah State University, Logan, Utah

Mental health issues are common in U.S. college populations, impacting roughly 50% of students per year (Blanco et al., 2008). College counseling centers struggle to fully address this issue given funding and staffing limitations. Online self-help interventions offer a promising, cost-effective method for providing services to distressed college students, including those who may not otherwise seek help due to perceived stigma and logistical concerns. This study evaluated a web-based, transdiagnostic ACT intervention (LifeToolbox). By implementing a randomized dismantling trial, this study compared the efficacy of distressed students randomized to the following conditions: ACT-full (program including all ACT processes), ACT-mindful (limited to mindfulness components), ACT-Values (limited to values components), or waitlist. Key findings will be presented regarding the efficacy of comprehensive vs. targeted web-based interventions and their impact on specific processes of change, the effects of prompting methodology (email vs. phone coaching) on adherence and outcomes, and potential mediators and moderators of treatment outcomes.

• A Web-Based ACT Program to Reduce Procrastination Among University Students : The Results From a Pilot Study
Frederick Dionne, Ph.D., Université du Québec à Trois-Rivières
Guillaume Raymond, Ph.D. (c), Université du Québec à Trois-Rivières
Joel Gagnon, Ph.D (c), Université du Québec à Trois-Rivières
Simon Grégoire, Ph.D., Université du Québec à Montréal

Procrastination is typically defined as an irrational tendency to delay the beginning and/or end of an academic task. Almost 50% of students procrastinate consistently and problematically which leads to lower grade point average, longer task completion time, course withdrawals, stress and increased health risks. Effective interventions to help students overcome procrastination are still lacking. Studies on ACT and procrastination have shown empirical support from a theoretical and clinical standpoint. The purpose of this paper is twofold. Firstly, to present the content of an eight-week Web-based ACT program to reduce academic procrastination. Secondly, to summary preliminary results on its feasibility and efficacy. The sample is comprised of 35 university students (78% female) studying at Université du Québec à Trois-Rivières (UQTR) in Canada. Results showed that the program reduced self-reported procrastination with a small effect size. Overall, analyses showed that participants were satisfied with the program. Implications and future developments are discussed.

• Ecological Momentary Assessment of Stress and Psychological Flexibility Among College and University Students Taking Part in an ACT intervention
Simon Grégoire, Ph.D., Université du Québec à Montréal
Lise Lachance, Ph.D., Université du Québec à Montréal
Christophe Chénier, Université du Québec à Montréal

The aim of this intensive longitudinal study was to assess the sequence of daily changes taking place within College and University students who took part in an ACT intervention (http://www.korsa.uqam.ca/en/). Using a single-subject time-series design, we examined the within-person day-to-day fluctuations in stress and psychological flexibility and looked at the temporal associations between these variables over the course of the intervention. Students (N=30) were recruited in six Colleges and six Universities in Canada during fall 2016. They were asked to use a smartphone application five times per week during the intervention (five weeks) to report their momentary level of stress and psychological flexibility using a six items questionnaire. Results showed that about 43% of participants reported a decrease in their level of stress and an increase in their level of psychological flexibility throughout the intervention. About 30% of them reported that these variables neither increased nor decreased.

38. ACT Processes in the Workplace and in Organizational Settings
Symposium (15:15-16:45)
Components: Literature review, Original data,
Categories: Prevention and Community-Based Interventions, Organizational behavior management, Burnout, Forensic, Leadership, Sustainability, Work-related stress, Forensic, Intellectual Disabilities, Staff Burnout
Target Audience: Beg., Interm., Adv.
Location: Buhaira

This symposium focuses on the role of psychological flexibility and other ACT-relevant processes in employee wellbeing and employee performance in different work settings. The first and last papers explore the role of psychological flexibility in predicting employee well-being and its influence in burnout and job demands and satisfaction for employees working in highly demanding secure mental health settings. The second paper presents an RFT-based analysis of how to improve the effectiveness of leader communication in enhancing employee performance as related to individual employee values aligned with corporate social responsibility. The third paper in the symposium presents a data-driven intervention development study aimed at identifying the ACT components/processes that correlate better with work-related wellbeing in a population under high risk of work-related stress (oncology nurses), so as to tailor a specific ACT intervention targeted to this population. All in all, these four papers provide a broad overview of the application and great potential impact of ACT in the workplace and organizational settings.

• Working in a demanding environment: employee wellbeing in secure forensic settings
Nuno Ferreira, PhD, University of Edinburgh
Amelia Cooper, DClin, University of Edinburgh, The State Hospital

Introduction: Care professionals suffering with poor wellbeing is a phenomenon that has been found to have a damaging effect upon individual employees, service users and organisations. Employees working in forensic settings are believed to be at increased risk of poor wellbeing due to the unique demands of their working environment, including exposure to violence and aggression. Aims: To examine the ability of demands related to violence and aggression, and resources of two types (cognitive and contextual behavioural) to predict the wellbeing of employees in a high secure forensic mental health (FMH) hospital. Method: 142 employees at a high secure FMH hospital completed self-report questionnaires which examined their wellbeing (Burnout, psychological distress, turnover intention), perceptions of the prevalence of aggression, beliefs about safety, attitudes towards aggression, and psychological flexibility. Results: The results suggested that exposure to violence and aggression was not a good predictor of wellbeing. However, the beliefs staff held about safety and staff’s level of psychological flexibility were predictive of wellbeing (all outcomes excet turnover intention). Conclusions:Job demands related to staff’s cognitive appraisal of safety, and the contextual behavioural resource, psychological flexibility, were predictive of staff wellbeing. Further research using contextual behavioural interventions within forensic settings is recommended in order to develop the limited research on forensic professionals’ workplace wellbeing.

• Leader Communication and Employee Values: The Motivative Augmental in Leader Communication on Employee Performance of Environmentally Relevant Behaviors
Julia H. Fiebig, PhD, BCBA-D, Ball State University & ABA Global Initiatives

The importance of effective leadership practices in context of anthropogenic climate change is well established by policy negotiators and there has been an increasing trend of organizations creating leadership roles to address environmental issues (Karlsson et al., 2011). Organizational change efforts focused on corporate social responsibility (CSR) initiatives often generate significant costs for organizations without contributing to desired results, and messages from leaders to stakeholders in organizations do not frequently align with performance related to those messages (Peloza et al., 2012). There has been limited research that systematically addresses how leader communication influences employee performance related to CSR goals (Brammer, Millington, & Rayton, 2007). Relational frame theory, a behavior analytic account of language, allows for analysis of verbal stimuli as motivating operations in context of leader antecedent communication to employee behavior. This study examined the relationship between a leader�s verbal behavior and employee performance as related to individual employee values. In an analysis of employee reported values as related to human-caused climate change and effects of leader email communication on energy consumption based on those individual values, results provided compelling information about the potential utility of tailoring leader communication to employee values and provided findings that informed future research directions.

• The relationship between Acceptance and Commitment Therapy (ACT) processes and work-related wellbeing in UK nurses: an intervention development study.
William Kent, University of Chester
Dr Kevin Hochard, University of Chester
Professor Nick Hulbert-Williams, University of Chester

Oncology nurses are at especially high risk of work-related stress. This study aims to explore which components of the ACT intervention framework may be especially pertinent correlates of work-related wellbeing in this population to inform the development of an ACT-based intervention. Nurses from various specialties (including oncology) are being recruited from four NHS sites in England, UK. Data will be collected using an online self-report survey assessing ACT components, and stress, burnout, and compassion fatigue/satisfaction. Recruitment for this study launched in February and is expected to take 2-3 months (target sample size based on power calculation: n=103). Statistical analyses will provide empirical evidence for the applicability of ACT for this population in the context of managing stress, burnout and compassion fatigue. Using a data-driven approach to intervention development, this study will identify components especially important in an effective, population-targeted ACT intervention for oncology nurses.

• Burnout and Job Satisfaction in Secure Mental Health Settings; exploring the effects of Social Support, Psychological Mindedness and Psychological Flexibility
Nuno Ferreira, PhD, University of Edinburgh
Joanna Chabinska, University of Edinburgh, NHS Tayside

BACKGROUND: For staff working in Secure Mental Health Services, there is limited research on the indirect effects of internal processes (psychological flexibility, psychological mindedness) and external resources (social support) on the demands, burnout and satisfaction with work. OBJECTIVE: This study aimed to explore any direct relationships of subjectively perceived understanding, predictability, control (job demands) with burnout and job satisfaction, and in-direct effects of social support, psychological mindedness and psychological inflexibility on these relationships. METHODS: A cross-sectional design with quantitative measures was used Data gathered from 141 nursing staff working in secure mental health services (forensic - 58.65%; intellectual disability - 41.35%) was analysed using t-tests, bi-variate correlations, hierarchical regressions and a series of mediation, moderation and moderated-mediation analyses. RESULTS: Perceived understanding, predictability and control were relevant to job satisfaction but not all the burnout dimensions. Psychological inflexibility was a mediator and social support- an independent predictor in these relationships. Psychological mindedness was shown to be a relevant variables to the dimension of personal accomplishment. CONCLUSION: Job demands are likely to follow individualised pathways through which they contribute to job satisfaction and burnout. Social support and psychological flexibility are of significant value and must not be understated.

39. Perspective Taking and the Self: Measurement and Application
Symposium (15:15-16:45)
Components: Original data
Categories: Clinical Interventions and Interests, Relational Frame Theory, Perspective Taking and the Self
Target Audience: Beg.
Location: San Bernardo

Lin Yu, Kings College London
Priscilla Almada, University of Wollongong

The current symposium comprises three papers the unifying concern of which is selfing and perspective taking from a Contextual Behavioural Science (CBS) point of view. Paper 1 looks at the development of a measure of selfing that differentiates two distinct patterns of selfing behavior (i.e., self as distinction and self as observer). The second paper reports on a qualitative analysis of self-discriminations in adolescent responses to questions about their own and others perspectives. The final paper in the symposium looks at whether Antipsychotics impact on perspective taking (i.e., deictic relational responding) in patients with schizophrenia. Taken together the symposium offers new insights into a CBS account of selfing and perspective taking.

• The Self Experiences Questionnaire (SEQ): Preliminary analyses for a measure of self in people with chronic pain
Lin Yu, King’s College London
Sam Norton, King’s College London
Lance McCracken, King's College London

The purpose of the study was to develop a measure based on the three-facet conceptualization of self rooted in the Psychological Flexibility model. Participants included 528 adults referrals who completed twenty-nine items intended as the basis for a measure called the Self Experiences Questionnaire (SEQ). Factor analyses were conducted to reduce the item pool and explore underlying dimensions. Following item and scale analyses fifteen items were selected forming a preliminary two-dimensional scale (Self as distinction, Self as observer), overall α=.90. Adequate construct validity for the total score was supported through correlations with pain acceptance, r=.34, decentering, r=.66, and committed action, r=.36, all p<.001, as well as correlations with measures of patient functioning, after controlling for pain and process from the PF model, including: depression, β=−.15, p<.01, work and social adjustment, β=−.10, p<.05, and pain interference, β=−.11, p<.05. A preliminary measure of contextual self with adequate reliability and validity emerged here.

• Measuring occurrences of Self and Other in relation to mental health in adolescent speech
Orla Moran, University College Dublin
Priscilla Almada, University of Wollongong
Louise McHugh, University College Dublin

The importance of a healthy sense of self for adolescent mental health is well documented. According to CBS, there are three distinct self-discriminations, as well as three corresponding senses of other. Recent evidence suggests that these discriminations in naturally occurring speech are predictive of lower distress, as well as increased well-being, and psychological flexibility. This present study investigates these self discriminations in an adolescent sample, using a mixed methods design with opened-ended questions and quantitative measures of mental health, well-being, and experiential avoidance (N= 97; M= 15.66; SD = .518; 28 male). Participants were asked to respond to eight opened-ended questions regarding experiences involving a number of specified emotions. Participant responses were coded for occurrences of the three senses of self, and other as conceptualized by CBS using the coding frame developed by Atkins and Styles (2015). Study findings are discussed in relation to the benefits of using a behavioral measure of self-relating in adolescents.

• Do Antipsychotics Have Any Effect on Perspective Taking in Schizophrenia?
Ahmet Nalbant, Bakirkoy Research and Training Hospital for Mental Health and Neurological Diseases, Istanbul

Schizophrenia is a complex disorder with multidimensional symptom clusters that include positive, negative, affective, cognitive and sensory-motor symptoms. Beyond these symptom clusters, there are widely reported areas of disrupted functioning and among them; low social functioning is one of the most disabling. Other than well-defined symptom clusters, it seems social functioning in schizophrenia is partly due to low perspective taking performance between self and others. This study examines whether different antipsychotics have any effect on perspective taking (i.e., deictic relational framing) in people with schizophrenia and to investigate its processes along with psychotic symptoms from acute state to remission. Understanding the processes of the change between deictic framing and the symptomatology of schizophrenia might lead us developing better interventional models to improve social functioning in schizophrenia.

40. Análisis de los procesos terapéuticos y aplicaciones de la Terapia de Aceptación y Compromiso
Symposium (15:15-16:45)
Components: Conceptual analysis, Literature review, Original data, Didactic presentation, Case presentation
Categories: Clinical Interventions and Interests, Prevention and Community-Based Interventions, Performance-enhancing interventions, Supervision, Training and Dissemination, Grief, Postvention, Suicide, ACT, Autoestigma Trastorno Mental Grave, Depression, Relación Terapéutica
Target Audience: Beg., Interm., Adv.
Location: Lebrija

El análisis de los procesos terapéuticos es un área de investigación de fundamental importancia para el avance de las terapias contextuales como la Terapia de Aceptación y Compromiso (ACT) y la Psicoterapia Analítico Funcional (FAP). El avance en este análisis puede permitir, entre otras cosas, avanzar en el diseño de aplicaciones novedosas de estas terapias. En este symposium se presentan cuatro trabajos que abordan ambas perspectivas. El primer trabajo está dedicado al análisis de los procesos comunes en las terapias contextuales y su efecto en el éxito de la intervención. El segundo estudio analizar los procesos verbales que acaecen en FAP. La tercera presentación explora la aplicación de ACT para los casos de duelo complicado debido a suicido. Finalmente, compara la aplicación de ACT versus terapia cognitivo conductual en la disminución del autoestigma de pacientes con trastorno mental grave.

• terapia de aceptación y compromiso para duelo complicado por suicidio
Jose I. Cruz Gaitán, Universidad de Guadalajara
Ivonne Corona Chavez, Universidad de Guadalajara

Este paper tiene el objetivo de servir como guía para los clínicos que desean trabajar con clientes que presenten problemas en el manejo del duelo por suicidio, siendo útil tanto de forma preventiva para disminuir el riesgo de presencia de un duelo complicado, así como para la intervención si ya está presente el duelo complicado en el cliente. La primera parte incluye su fundamentación teórica, explicando las características teóricas, etiológicas y sintomáticas del duelo, la segunda parte incluye la descripción, sesión por sesión, de las actividades que se realizarán en cada una de ellas para finalmente mostrar los hallazgos encontrados en la clínica de duelo por suicidio de la Universidad de Guadalajara en México.

• “Comparación del efecto de ACT versus terapia cognitivo-conductual en el afrontamiento del autoestigma en personas con Trastorno Mental Grave”
José Luís Arroyo Cifuentes, Línea de Rehabilitación Psicosocial Hospitalarias. Instituto ACT
Marisa Páez Blarrina, Instituto ACT

Cada vez existe más evidencia sobre el efecto negativo que el estigma social tiene sobre el funcionamiento psicosocial y calidad de vida de personas diagnosticadas de Trastorno Mental Grave (TMG). Por ello es preciso desarrollar estrategias de intervención eficaces. El presente estudio es un ensayo controlado aleatorio multicéntrico que tiene como objetivo obtener evidencia sobre la comparación entre los efectos de una intervención cognitivo-conductual y otra intervención ACT para abordar problemas relacionados con el autoestigma en una muestra de personas atendidas en dispositivos comunitarios. Se describirá la metodología empleada y el protocolo de intervención utilizado. Se analizarán resultados comparando el efecto que tienen las dos intervenciones en variables clínicas, autoestigma, funcionamiento e integración social, calidad de vida y adherencia al tratamiento. Finalmente se discutirán estos resultados, así como la importancia que estas intervenciones pueden tener a la hora de promover la calidad de vida y recuperación de personas con TMG.

• Análisis del proceso terapéutico en las Terapias Contextuales
Francisca López Ríos, Universidad de Almería
José Manuel García Montes, Universidad de Almería

Desde las terapias contextuales, en especial, ACT y FAP, se proponen procesos psicológica implicados en el desarrollo y mantenimiento de patrones de comportamiento problemáticos. Dichos procesos se han descrito en el hexaflex. En el presente estudio se registra sistemáticamente el comportamiento de terapeutas en 10 casos atendidos en la Unidad de Atención Psicológica de la Universidad de Almería. Las variables registradas se incluyen en una escala de 10 elementos terapéuticos tales como: validación de la experiencia, reconocimiento de la singularidad del paciente, escucha activa, técnica específica aplicada,... Al tiempo se registra el comportameinto del paciente: indicadores de fusión cognitiva, apatía o comportamiento no orientado, indicadores de apertura y disposición, indicadores de comporamiento comprometido. Los resultados permiten mostrar si elementos genéricos del comportamiento terapéutico debilitan la defusión cognitiva y potencian el comportamiento orientado a valores.

• Análisis de los procesos verbales en la relación terapéutica. Presentación de metodología y de caso tratado con terapias contextuales.
José Manuel Sánchez Olid, Universidad de Málaga
Luis Valero Aguayo, Universidad de Málaga

La evidencia muestra que la psicoterapia es eficaz, y que varios modelos que usan metodología diferente son igual de eficaces (Wampold, 1997).Estos factores comunes que parecen mostrarse en todas las terapias, independientemente del modelo y de la técnica empleada, son: apoyo, aprendizaje y acción según Grencavage (1990) y apoyo, persuasión y efecto placebo según Natan (2000). Aquí arrojaron luz Kohlenberg y Tsai (1991) con la presentación de la Psicoterapia Analítico Funcional y el concepto de Conducta Clínicamente Relevante (CCR): todo aquel comportamiento que ocurre en sesión y está relacionado con el problema que trae al paciente en consulta; establecen tres tipos: CCR1 representa el comportamiento del paciente en sesión que resulta problemático y por tanto se supone que debe desaparecer si la terapia avanza, CCR2 representa el comportamiento del paciente en sesión que resulta deseable y esperamos que aumente conforme avanza la sesión, y por último CCR3 que representa toda aquella interpretación que el paciente hace sobre su comportamiento y le resulta útil y funcional como regla a seguir para su propio avance. Los autores de PAF muestran que, en una buena relación terapéutica, el profesional es capaz de observar las CCR y comportarse en sesión de manera contingente a los resultados que se quieren conseguir. Estos antecedentes nos llevan al estudio de la relación entre Conducta Clínicamente Relevante, reglas verbales y contingencias realizadas por el terapeuta, y funcionalidad del comportamiento de ambos participantes en la terapia. Se relaciona con el resultado mismo de la terapia (éxito terapéutico en el caso de que así sea). Las conclusiones muestran el proceso de moldeamiento verbal y su relación con el éxito terapeutico. Se presenta la aplicación de la metodología de estudio en un caso clínico llevado a cabo.

41. Understanding Processes of Change Responsible for Successful Outcomes in Brief ACT Interventions
Symposium (15:15-16:45)
Components: Original data
Categories: Clinical Interventions and Interests, Supervision, Training and Dissemination, Mediational Analyses
Target Audience: Interm.
Location: Utera

Raimo Lappalainen, Ph.D., University of Jyväskylä, Finland
Arto Hiltunen, Ph.D., University of Karlstad, Sweden

Psychological flexibility has shown to be associated with psychological wellbeing. Also, the change in psychological flexibility during the intervention is connected to changes in psychological wellbeing. From the clinical point of view it would be important to know more closely the specific skills associated with psychological flexibility that lead to successful outcomes in psychological interventions. One way to increase our knowledge of the key processes of change is meditational analysis. The aim of the symposium is give a short introduction to the main idea in a meditational analysis, and present data from three interventions based on an ACT model that have applied meditational analyses. The first study will describe the role of psychological flexibility in weight management. The second study will show data from a web-based ACT intervention for sleeping difficulties and the third study will present observations from a web-based intervention for increasing wellbeing of university students.

• From aims to actions – The role of psychological flexibility in eating regulation
Essi Sairanen, Ph.D., University of Karlstad, Sweden

Acceptance and Commitment Therapy offers new solutions for the long-term weight management. This paper investigates the psychological mechanisms through which ACT is supposed to lead to adaptive eating regulation, that is, eating regulation based on personal values and weight-related psychological flexibility. Participants (N = 148) were adults with overweight who participated in an ACT-intervention (group or mobile). ACT aims to strengthen the connection between values and behavior, and identifies psychological inflexibility as a key barrier to engaging in values-consistent behaviour. Thus, it was hypothesized that psychological flexibility is a process that mediates the effect of value-based reasons (also called autonomous motivation vs. controlled motivation or tracking vs. pliance) on eating regulation and weight management. The present results indicated that improving participants’ autonomous motivation (tracking) and weight-related psychological flexibility can support weight management and encourage eating for physical reasons guided by hunger and satiety cues, and decrease using food as a reward or to emotionally comfort oneself. Weight-related psychological flexibility mediated the relationship between changes in autonomous motivation and eating behaviors as well as weight.

• Suppression of thoughts as a mediator of change in sleeping difficulties: Results from a non-guided online ACT-based program for adults
Raimo Lappalainen, Ph.D., University of Jyväskylä, Finland
Päivi Lappalainen, Ph.D., University of Jyväskylä, Finland

The purpose of this study was to examine the impact of web-based Acceptance and Commitment Therapy (ACT) program for sleeping difficulties among middle aged participants (n = 82). Participants filling the inclusions criteria (defined by Insomnia Severity Index, ISI), were randomized either to an iACT –group (n=42) or to a waiting list –control group (n=40). The iACT group received an ACT-based web-intervention that they were instructed to use over a period of 6-weeks. During this period they were sent reminders to use the program, but no personal support was offered. According to the Basic Nordic Sleep Questionnaire (BNSQ), the iACT had a significant impact on the frequency of sleeping difficulties and to the quality of sleep. However, the between group difference to the no-treatment control group was small (d=0.32). The iACT had also a significant impact on suppression of unpleasant thoughts as measured by White Bear Suppression Inventory (WBSI). The meditational analysis indicated that the changes in suppression of unpleasant thoughts (WBSI) mediated the chances in sleeping difficulties (BNSQ) during the intervention. This study suggests that suppression of unpleasant thoughts might be one of the variables that could be observed more closely when treating sleeping difficulties and insomnia, at least in ACT interventions applying web-based programs.

• Mindfulness skills as mediators of change in wellbeing and psychological symptoms? Results from a guided, online ACT-based program for university students.
Panajiota Räsänen, MSc., University of Jyväskylä, Finland
Raimo Lappalainen, Ph.D., University of Jyväskylä, Finland

A web-based, coach-guided ACT intervention, aiming at enhancing the wellbeing of university students while also focusing on transdiagnostic processes that might both prevent and alleviate a wide range of mental health issues has been previously found to be an effective alternative in reaching the needs of the university population (Räsänen et. al, 2016). The present study explored the possible mediators of change accounting for outcomes in that previously reported randomized trial. Our primary goal was to examine whether changes in mindfulness skills would mediate changes in psychological wellbeing, perceived stress and symptoms of depression in the participants (N = 68; 85% female; 19-32 years old). Results showed that non-reactivity was the primary mediator that partly explained changes in all outcome measures. This study is a first step toward understanding the potential mechanisms of change taking place in online, guided ACT-based programs. The implications and limitations of the findings are discussed.

42. Using Different Methods to Study Clinical Applications I
Symposium (15:15-16:45)
Components: Literature review, Original data
Categories: Relational Frame Theory, Clinical Interventions and Interests, Educational settings, Causal Efficacy, Inattention, Impulsivity,Children and Adolescent, IRAP, Psychological Inflexibility
Target Audience: Beg., Interm., Adv.
Location: Estepa

Benjamin M. Ramos, M.Sc., University of Edinburgh

This tightly-packed 4-paper symposium is the first of two to explore and discuss different methodologies for studying clinical applications of RFT, covering ADHD, psychological flexibility in children and adolescents, psychological inflexibility in police conflict, and Alzheimer’s Disease. Paper 1 conceptualizes the positive illusory bias in terms of derived causal efficacy and explores this behavior in the context of a series of Go/NoGo tasks. The results highlight the experimental and applied benefits of operationalizing this established effect in this functional-analytic way, and may speak directly to our understanding of impulsive behavior. Paper 2 uses the IRAP to explore psychological flexibility in children and adolescents, and its potential as an assessment tool. The results highlight the potential value of the procedure in this regard, as well as detecting inflexibility in adolescence that does not appear present in middle childhood. Paper 3 also examines psychological flexibility using the IRAP, but does so in the context of police conflict. Not only does the IRAP capture strong relations between inflexible reactions and feelings, but also produces interesting differential trial-type effects. There were also correlations among these effects and other standardized measures of flexibility. Paper 4 returns to trusted and traditional methods for exploring the impact of exemplar training of coordination, distinction, and comparison relations on participants diagnosed with Alzheimer’s Disease. The aim of this extended study, that includes a follow-up, is to determine the potential benefits on cognitive and executive functioning. The results point to the possibility of decelerating cognitive decline with relational training, with effects retained at follow-up.

• Feels Good to Be Among the Worst: A RFT Account of the Positive Illusory Bias
Benjamin M. Ramos, M.Sc., University of Edinburgh
Emily K. Sandoz, Ph.D., University of Louisiana at Lafayette
Caleb S. Fogle, University of Louisiana at Lafayette

Despite a history of academic and social failures, many individuals with ADHD maintain a self-protective bias in which they maintain high self-evaluations of causal efficacy termed the positive illusory bias (PIB; Owens et al., 2007). While in the normal population positive self-evaluations are not only the norm but also adaptive, the benefits are only maintained if the difference between the self-evaluation of performance and actual performance are slight. This may contribute to greater levels of inattention, impulsivity, and resulting dysfunction, as self-evaluation is rule-governed rather than a result of self-awareness. This study aimed to model the positive illusory bias using the principles of derived relational responding. Participants completed a series of Go/NoGo tasks with contextual cues that had derived causal efficacy functions through their relations with discriminative stimuli for high or low rates of responding. Simultaneously participants rated their experience of causal efficacy with each contextual cue before, during, and after each of the Go/NoGo tasks. The impact of derived causal efficacy was then examined in terms of errors of omission (inattention) and errors of commission (impulsivity) and compared to self-reported ratings of causal efficacy. We will then discuss this study as a potential Relational Frame Theory model of the PIB.

• The IRAP as an implicit measure of Psychological Flexibility in children and adolescents.
Gloria Torres-Fernández, M.Sc., University of Jaén, Spain
Mónica Hernández-López, Ph.D., University of Jaén, Spain
Miguel Rodríguez-Valverde, Ph.D., University of Jaén, Spain

Recent research has explored the use of the IRAP for the assessment of aspects related to Psychological Flexibility (PF) (Drake et al., 2016; Hooper et al., 2010; Kishita, et al., 2014). However, to date no published study has attempted to use the IRAP to explore PF in children or adolescents. The purpose of this study is to explore the applicability of the IRAP as a complementary tool for the assessment of PF during late childhood and adolescence. Our study is a cross-sectional study comparing one group of 5th grade primary school students (10-11 years old), one group of 1st grade secondary school students (12-13 years old) and one group of 3rd grade secondary school students (14-15 years old) amounting a total of 139 participants. Preliminary findings appear to show a small implicit inflexibility bias in secondary school participants, but not in primary school ones. These findings point to the IRAP as a potentially useful tool to investigate the development of psychological flexibility.

• The IRAP to measure Psychological Inflexibility in Police Conflicting Situations
Evangelina Ruiz García,
Carmen Luciano, University of Almería
Adrián Barbero-Rubio, Ph.D., University of Almeria, Madrid Institute of Contextual Psychology

The current study aimed to assess psychological inflexibility (PI) in police conflicting situations using the Implicit Relational Assessment Procedure (IRAP). Local policemen (N = 16) from a City Council in Spain completed several questionnaires (AAQ-II, CFQ and VQ) and a self-report measure of PI adjusted to police contexts. Then, participants were asked to complete an IRAP designed to measure PI feelings-reactions in conflict situations. Results showed that the IRAP captured strong relations between inflexible reactions to feelings in the whole sample: time-reactions were different when responding: (a) affirmatively to relations between inflexible reactions to feelings and negatively to relations between flexible reactions to feelings (consistent block) than when responding (b) affirmatively to relations between flexible reactions to feelings and negatively to relations between inflexible reactions to feelings (inconsistent block). Correlations among IRAP effect and other Psychological (In)Flexibility measures are discussed. These findings show that the IRAP can be a preliminary tool to measure PI.

• RFT based intervention for cognitive decline in Alzheimer’s patients: 3 month follow-up results of a clinical trial
Giovambattista Presti, Department of Human and Social Sciences, Kore University Enna Italy
Salvatore Torregrossa, Alzheimer and Dementia Unit – Neurodegenerative Disorders O.U.,A.S.P. 2 Caltanissetta Italy
Edoardo Cumbo, Alzheimer and Dementia Unit – Neurodegenerative Disorders O.U.,A.S.P. 2 Caltanissetta Italy
Bryan Roche, Maynooth University

Twenty-seven patients (15 (55,5%) female and 12 (44,5%) male) with a diagnosis of mild-to-moderate Alzheimer’s disease (AD) were enrolled in a prospective, randomized, 3 month, parallel-group trial to evaluate the efficacy of a computer assisted multiple-exemplar relational training (RFT), as add-on non-pharmacological therapy to cholinesterase inhibitors (ChEIs). Participants were exposed to SMART (Strengthening Mental Abilities with Relational Training) a multiple exemplar training in the relational frames of SAME, OPPOSITE, MORE THAN, and LESS THAN. Cognitive and executive functions were assessed at baseline, and at the end of training (3 months) and after 3 month follow-up (FU) using respectively MODA (Milan Overall Dementia Assessment), Coloured Progressive (CPM) and attentive matrices. Patients treated with RFT as add-on intervention (n=14) scored significantly better (p>0.05 vs baseline; p>0.05 vs ChEIs) on MODA, CPM and attentive matrices. Results were maintained at FU. Overall these data seem to suggest that an RFT-based training may slow down cognitive decline and improve general cognitive functioning in AD subjects treated with ChEI

Friday, 23 June

57. Experimental Analysis of Brief Defusion and Self-as-Context Interventions
Symposium (11:00-12:30)
Components: Original data
Categories: Clinical Interventions and Interests, Performance-enhancing interventions, Relational Frame Theory, Mindfulness, Perspective Taking, Defusion, Self-as-context
Target Audience: Beg., Interm.
Location: Buhaira

Martin O'Connor, MSc., Ph.D Candidate, University College Dublin
Nic Hooper, Ph.D, University of West England

The unifying concern of this symposium is the effectiveness of defusion, self-based and perspective taking interventions in coping with internal experiences. Particularly looking at their effect on the renewal of fear, negative and angry thoughts, as well as comparing their efficacy to common alternative interventions; exposure, focused breathing and restructuring exercises. The first study explores how self-based mindfulness techniques can specifically enhance therapeutic outcomes, by comparing a ‘self-as-context’ intervention to a focused breathing intervention. Findings highlight the efficacy of self-based mindfulness interventions as a superior strategy for managing negative self-referential thought over interventions that utilise present moment awareness alone. The second study compared the effectiveness of brief cognitive defusion and perspective taking interventions with a CBT based cognitive restructuring task for coping with angry thoughts and elevated state anger. Findings indicate that both cognitive restructuring and defusion are effective brief anger reduction techniques. The third study explores the use of perspective taking techniques to alter the contextual renewal of fear. It is proposed that self-as-context interventions may provide an experiential extinction context which is less subject to variability and can extend the generalisation of learning beyond the effects of just exposure.

• Comparing Self-as-Context and Focused Breathing Techniques for Coping with Negative Self-Referential Thoughts
Varsha Eswara Murthy, MPsychSc., Ph.D Candidate, University College Dublin
Louise McHugh, Ph.D, University College Dublin

The current study aimed to compare whether the effects of a self-as-context intervention differed from those of a focused breathing intervention for coping with a negative self-referential thought. Participants were asked to identify a personally relevant negative thought and given either a self-as-context, focused breathing or no-instruction control strategy to manage the negative thought over a five-day period. The self-as-context intervention involved the completion of the ‘observer you’ exercise daily, as well as utilising hierarchical metaphors as a coping strategy. The focused breathing group completed a focused breathing exercise daily and were given brief focused breathing exercises as a coping strategy. Findings indicate that the self-as-context intervention lowered believability, increased comfort, increased willingness and decreased negativity associated with the target thought significantly more than the focused breathing or control strategy. The focused breathing strategy also made significant gains in the same direction, however the control group did not. Frequency of target thought occurrence was reduced for both the self-as-context and focused breathing intervention and increased for the control group. Findings provide evidence for the efficacy of self-as-context interventions for managing negative self-referential thoughts.

• A Comparison of Brief Cognitive Intervention Methods for Anger Reduction
Tracey McDonagh, MPsychSc., Ph.D Candidate, University of Southern Denmark
Louise McHugh, University College Dublin

This exploratory study aimed to assess the potential effectiveness of three brief cognitive techniques when managing angry thoughts (i.e., defusion, restructuring and perspective taking). While cognitive restructuring is a common technique used in anger treatment, recent research has shown promising results in the effectiveness of using cognitive defusion with negative thoughts (Larsson et al., 2015). We hypothesised that this may generalise to negative thoughts generated by affective processes. Preliminary findings (N=55) suggest trait anger, state anger, ‘anger expression in’ and ‘anger expression out’, were predicted by effortful control. Self-compassion approached significance as a predictor of state anger. Interestingly, psychological flexibility was highly predictive of ‘anger expression in’. The findings also suggest that cognitive defusion and cognitive restructuring appeared to be effective brief anger reduction techniques. Perspective taking approached significance but appeared to be less effective; this may require further investigation.

• 'Self-as-context' perspective-taking and the contextual renewal of fear
Donal Campbell, University College Dublin
Marc Bennett, Ph.D, Trinity College Dublin
Louise McHugh, University College Dublin

Exposure therapy is considered an effective means of treating anxiety disorders and phobias, but its successful application is sometimes compromised by a mechanism of patient relapse called contextual renewal (CR). Research has indicated that the efficacy of exposure therapy is predicated upon the extinction of fear associated with a conditioned stimulus (CS). It is understood that extinction does not replace the fear association but rather represents new learning, and that the context in which the CS is subsequently encountered can determine which association is recalled. Thus a patient who encounters the problematic CS outside of the extinction context may experience a renewal of fear. While various methods of mitigating this effect have been investigated, findings are frequently inconsistent or clinically impractical. It is for this reason that the present research proposes a novel approach to preventing CR using the concept of the ‘self as context’. This perspective-taking manipulation may provide an experiential extinction context which is less subject to variability and can extend the generalisation of learning.

58. WorkACTive: ACTing on Sickness Absence and Return to Work
Symposium (11:00-12:30)
Components: Original data
Categories: Clinical Interventions and Interests, Performance-enhancing interventions, Behavioral medicine, Sick-leave, Return to work, Musculoskeletal disorders, Common Mental Disorder
Target Audience: Beg., Interm., Adv.
Location: San Bernardo

Jenny Thorsell Cederberg, Uppsala University

In 2004 JoAnn Dahl published a pilot study indicating that a brief ACT intervention reduced sick-leave and utilization of medical treatment resources in a Swedish sample. This study sparked several randomised clinical trials in both Norway and Sweden utilizing ACT in different return to work interventions for individuals on sick leave due to musculoskeletal- and common mental disorders. In the Nordic countries, there are unique opportunities to measure sickness absence and return to work due to the national registries and the public insurance systems where all legal residents are registered. This symposium presents results from three separate randomised clinical trials reporting on return to work and effects on sick-leave using registry data in Norway and Sweden as outcome measures. Welcome!

• Effects of multicomponent occupational rehabilitation on sickness absence and health outcomes: results of a randomized clinical trial.
Lene Aasdahl, Norwegian University of Science and Technology, Trondheim, Norway
Marius Fimland, Norwegian University of Science and Technology and Trondheim University Hospital, Norway

Aim: To evaluate effects of a multicomponent inpatient occupational rehabilitation program compared to a less comprehensive outpatient program for individuals on sick leave with musculoskeletal complaints or mental health disorders. Methods: In this randomized clinical trial a 4+4 days inpatient program offering Acceptance and Commitment Therapy (ACT), physical training and work related problem solving, was compared to an outpatient program offering six weekly group based ACT sessions. Results: 168 individuals were randomized to the inpatient program (n=92) or the outpatient program (n=76). The programs did not statistically differ in median number sickness absence days at 6 and 12 months follow-up or time to sustainable RTW (HR 0.74, 95% CI 0.48-1.32, p=0.165). Except slightly less pain reduction after the inpatient program, the health outcomes neither differed statistically significant. Conclusions: A 4+4 days multicomponent inpatient rehabilitation program was not superior to a less comprehensive outpatient program in improving RTW or health outcomes.

• Inpatient occupational rehabilitation based on Acceptance and Commitment Therapy (ACT) vs standalone outpatient ACT for patients sick listed with musculoskeletal or common mental disorders: A randomized clinical trial reporting on return to work, self-rep
Sigmund Ø. Gismervik, Norwegian University of Science and Technology, Trondheim, Norway
Marius Fimland, Norwegian University of Science and Technology and Trondheim University Hospital, Norway

Aim: To compare work and health related outcomes of two different ACT based interventions for patients on sick leave. Methods: Patients were randomised between a 3½ week inpatient rehabilitation program consisting of ACT sessions, physical exercise and work-related problem solving (n=86) or outpatient ACT with weekly 2½ hour group sessions over 6 weeks plus three individual sessions (n=80). Results: The hazard ratio for return to work was 1.9 (95% CI 1.2- 3.0) in favour of inpatient rehabilitation, and the median number of sickness days at 12 months was 85 (IQR 33-149) and 117 (IQR 59-189), respectively (p=0.034). Except for average pain (a minor reduction in favour of standalone ACT) there were no differences in self-reported anxiety, depression or health related quality of life. Conclusion: Inpatient rehabilitation was superior to standalone ACT in returning to work and reducing sick leave. Health outcomes were similar. Cost effectiveness needs to be assessed.

• Efficacy and cost-effectiveness of Acceptance and Commitment Therapy and Workplace Dialogue Intervention for workers on sickness absence.
Anna Finnes, Karolinska Institutet, Stockholm, Sweden
JoAnne Dahl, Uppsala University, Sweden

Aim: The aim of this trial was to determine the efficacy and cost-utility of Acceptance and Commitment Therapy (ACT) and the Workplace Dialogue Intervention (WDI), as stand-alone interventions and combined. Methods: We designed a randomized controlled trial with four treatment groups: ACT, WDI, ACT+WDI, and Treatment as Usual. Participants were in working age (n=352, 78.4% females) and on sickness absence from work due to depression, anxiety or stress. A cost-utility analysis was conducted alongside the RCT. Results: There were no differences between groups over time for sickness absence. For health outcomes, ACT and ACT+WDI were superior in comparison to TAU at post-measurement but not during the follow-up period. ACT was a cost-effective treatment alternative from a health-care perspective. Conclusions: Neither ACT, WDI or ACT+WDI were superior to TAU on improving RTW or for health outcomes during follow-up. ACT may be a cost-effective treatment alternative for common mental disorders.

59. Compassion at the Core: Providing Care for Sexual Minorities, Muslim Immigrants, and Families of Children with Autism
Symposium (11:00-12:30)
Components: Conceptual analysis, Literature review, Original data, Didactic presentation, Case presentation
Categories: Prevention and Community-Based Interventions, Clinical Interventions and Interests, LGBT, GSM, Muslim Immigrants, Autism, Compassion, Mindfulness
Target Audience: Beg., Interm.
Location: Lebrija

Kayla Sargent, M.A., Children's Healthcare of Atlanta
Kayla Sargent, M.A., Children's Healthcare of Atlanta

Whereas the embracement of diversity is a shared value among many of us, relatively little attention is directed to how the intersections of multiple sociocultural identities (e.g., gender, race, sexual orientation, etc.) and their social consequences unfold within the self as well as in relationships with others. The purpose of the present symposia is to shed light on the intersections of human identities and to promote humanization in broad contexts, from neurocognitive illnesses in medical settings to adjustment and acculturation in community settings. The symposia is both didactic and empirical; it starts with a brief introduction on intersectionality, including how it unfolds in our daily lives and for unique populations of interest: sexual and gender minority clients, Muslim immigrants, and families of children with Autism Spectrum Disorder. Experiences of these patients will be discussed from a perspective of various meaningful identities. The presenters aim to enhance perspective taking, increase awareness, and harvest inclusiveness by illuminating the ways in which all people hold various and multiple identities, how to cope with and integrate those identities in our lives and communities in accordance with our values, highlighting the impact that these experiences and cultural blueprints have in our lives. Subsequently, we present a CBS approach to working with three communities, using theory and applied science that can be broadly applied to working with broad groups of people.

• A compassion-based approach to working with sexual minority clients and their intersecting identities
Kayla N. Sargent, M.A., Children's Healthcare of Atlanta

The present talk will focus on providing compassion-based approaches to case conceptualization within a CBS framework. Whereas the field of behavioral health care has begun to pay greater attention to the impact of a minority status on health, behavioral health professionals may not adequately approach subgroups of minorities and their health, particularly multiple-minority individuals, such as ethnic minorities within the LGBT community. Multiple-minority status is found to be linked to greater emotional distress and hardship (Berdahl & Moore, 2006; Pak, Dion, & Dion, 1991), but professionals tend to focus exclusively on a single aspect of a person’s identity, such as gender, and its impact on the person’s health, while overlooking intersecting identities. One way to contribute to this field is to offer a potential working model that allows professionals to understand and promote the behavioral health of multiple-minority individuals. We think an acceptance- and compassion-based approach serves as such a model.

• Compassionate Alliance: Working with Muslim Immigrants through a Compassionate lens
Khashayar Farhadi Langroudi, Psy.D., Kaiser Permanente

Human beings have migrated since their early appearance in Africa. The origin of work migration is rooted in the Latin word migrātus (past participle of migrāre), which means to move from place to place, change position or abode. In today's world, more than 175 million people live outside of their country of birth (Stilwell, et al., 2003). Due to the recent world events, many Muslim immigrants have found their new home in the Western world such as Europe and the U.S. The purpose of this presentation is to employ the CBS approach to shed a pragmatic light on common challenges that the migrant might face. The presenters will provide some recommendations on how to navigate Muslim clients’ migration-related challenges in psychotherapy and foster a place for resilience and growth.

• Mindfulness and Compassion Training for Parents and Therapists of Children with Autism
Samuel Fernandez-Carriba, Ph.D., Emory University

CBCT is a mindfulness and compassion meditation protocol developed at Emory University. Recent research on the impact of six to eight weeks of CBCT practice on undergraduate students without prior experience in meditation shows reduced immune inflammatory and emotional distress responses to psychosocial stressors as well as enhancement of empathic accuracy when assigning emotions to other people’s faces with changes in the neurobiology supporting it. In addition, CBCT has shown benefits with typical children, at-risk adolescents in foster care, breast cancer survivors, medical students, veterans and prison inmates. We offer evidence from several pilot studies conducted with families and therapists of children with Autism Spectrum Disorder (ASD) at the Marcus Autism Center. Like traditional mindfulness programs, CBCT fosters self-regulation by bringing attention to the present moment experience. The compassion aspect of CBCT helps promotes “others-regulation” by helping practitioners develop affection for, positive connection with, and acceptance and understanding of others. Promising results from a series of quasi-experimental studies (without a control group) with parents of children with ASD suggest CBCT has the potential to help families accept their experience and become more aware of and utilize better the available social support. Preliminary findings on 9 caregivers included a significant decrease in perceived severity of the child’s symptoms (ABC) and in parent stress (PSI) as well as significant increase in acceptance (AAQ) and parenting sense of competence (PSOC). Mixed models were utilized to evaluate pre-post changes in scores at the 0.05 significance level. In addition, as CBCT promotes awareness of self and others and skills to relate to others, it has the potential to become an effective training on cultural/relational competence for providers. Data obtained from 22 therapists in another experimental study (with a control group) showed a significant decrease in stress (PSS) and increase in acceptance (AAQ) and cultural competence (CCC) for those who attended the CBCT program. Paired t-tests compared pre-post changes in experimental and control groups at the 0.05 significance level.

61. ACT in the Oncology Setting: Better Understanding How ACT Can be Used to Improve the Wellbeing of those Affected by Cancer
Symposium (11:00-12:30)
Components: Conceptual analysis, Original data
Categories: Behavioral medicine, Clinical Interventions and Interests, Cancer
Target Audience: Interm.
Location: Estepa

Lee Hulbert-Williams, PhD, University of Chester
David Gillanders, DClinPsy, University of Edinburgh

Psychological distress is common in those affected by cancer and is associated with poor quality of life, and possibly even premature mortality (Batty et al, 2017). Family members are not exempt from the adverse impact of cancer on psychological wellbeing: adolescent and young adult offspring of cancer patients are often overlooked (Patterson et al, 2013). Current evidence for the psychological intervention benefits for those affected by cancer is inconsistent and often time-limiting. ACT is more conceptually suitable to the nature of cancer-related distress (Hulbert-Williams et al 2016), and is gaining traction as pilot studies are published. This symposium presents data from three studies which inform how ACT can be integrated into cancer care. We explore the moderating role of psychological flexibility between unmet psychosocial and supportive care needs and distress; a group-based intervention for offspring of cancer patients; and, an ACT-enhanced communication skills training programme for oncology healthcare professionals.

• Psychological flexibility as a moderator of unmet psychosocial needs and psychological wellbeing in haematological cancer survivors.
Brooke Swash, PhD, University of Chester
Nick Hulbert-Williams, PhD, University of Chester
Ros Bramwell, PhD, University of Chester

Haematological cancers are noteworthy for high levels of associated psychological distress. The relationship between unmet psychosocial needs and patient-reported outcome is recognised, but process variables affecting this relationship are not well understood. We investigated the moderating effects of psychological flexibility in 91 haematological cancer survivors (53% female, mean age=62yrs). Participants completed questionnaires assessing unmet needs, anxiety, depression, quality of life, and psychological flexibility. Results indicate high prevalence of unmet needs, psychological distress, and poor quality of life in all sub-types of disease group. Significant correlations were found between all variables (r=2.98-8.20; all p<.05). Psychological flexibility significantly moderated the relationship between four unmet need domains with anxiety and quality of life (all p<.02), but not depression: need-outcome correlations were significant only where psychological flexibility was higher. Further research is needed to explore the nature of this moderation relationship further, and to develop interventions that target flexibility to improve psychological wellbeing in cancer survivors.

• TRUCE: The development and evaluation of an Acceptance and Commitment Therapy program for young people who have a parent with cancer.
Pandora Patterson, PhD, CanTeen Australia & University of Sydney
Fiona McDonald, PhD, CanTeen Australia & University of Sydney
Jospeh Ciarrochi, PhD, Australia Catholic University
Louise Hayes, The University of Melbourne
Danielle Tracey, Western Sydney University

Young people who have a parent with cancer experience significant unmet needs and elevated distress, however support to this vulnerable group is significantly lacking. An ACT-based manualised 7-session group program called Truce was developed for adolescents and young adults impacted by parental cancer. ACT was considered to be appropriate given its focus on helping create a full and meaningful life while accepting the pain that life invariably brings. Truce is currently being evaluated at 3-time-points (pre-, post-, 2-month follow-up questionnaires). Program fidelity and satisfaction is also assessed. Results indicate very high satisfaction (mean session interest=8.7/10) and there are promising preliminary outcome results focusing on core ACT processes such as psychological flexibility and mindfulness which are maintained at follow-up. Truce is showing promise as an intervention that is acceptable and effective for AYAs impacted by parental cancer, providing clinicians with a much needed program to assist these young people.

• ACT-enhanced communication skills training: development and evaluation of a training programme to improve psychosocial care in the cancer setting
Nick Hulbert-Williams, PhD, University of Chester
Lee Hulbert-Williams, PhD, University of Chester

Psychological suffering is ubiquitous with cancer and yet psychological support is often difficult to access. Healthcare workers in this setting are often driven—despite high stress and compassion fatigue—by work-related personal meaning. Medical training often instills a drive to ‘fix’ patients’ psychological suffering; we aimed to change the nature of clinical communication towards an ACT-consistent approach. Part self-development, our brief experiential communications skills workshop is underlined by applied RFT and ACT. Across three settings (two UK-based; one in Australia) including health service and charity sectors, we have trained over 150 people to date. Evaluation data is positive and shows a promising intention to use the skills learnt: 78% of participants from one of our recent trainings agreed that it had clear relevance to their work and 46% had already implemented the skills by follow-up. This training programme could bring benefit for both staff and patient wellbeing in the cancer setting.

68. Can ACT Help People with a Visible Difference?
Symposium (12:45-14:00)
Components: Original data, Didactic presentation, Case presentation,
Categories: Clinical Interventions and Interests, Other, Visible Difference
Target Audience: Beg., Interm., Adv.
Location: Buhaira

Dr. Nic Hooper, University of the West of England (UWE), UK.
Dr. Ray Owen, Consultant Clinical Psychologist, Wye Valley NHS Trust, UK.

As people with disfigurement often report psychological issues and as current interventions report little success with this population, some have suggested that the development of novel evidence-based interventions is essential. ACT is one such intervention, however, it has received very little empirical attention in this domain. In this symposium, three presenters on the cutting edge of the research area, will argue that ACT is well placed to help those with a visible difference. Joanna Dudek, who will present cross-sectional questionnaire data, will provide a rationale for using ACT with this population. Staci Martin will present what an ACT intervention might look like with the help of case examples. And Fabio Zuchelli will present a qualitative analysis that gives an insight into patients experience of ACT. Finally, Ray Owen will use his expertise to offer thoughts on ways to move the work forward in this area.

• Psychological flexibility and appearance-related distress in women with lipedema
Joanna E. Dudek, SWPS University of Social Sciences and Humanities
Wojciech Bialaszek, Ph.D., SWPS University of Social Sciences and Humanities
Pawel Ostaszewski, Ph.D., SWPS University of Social Sciences and Humanities

Visible differences can have a significant impact on the quality of life and wellbeing of individuals subject to stigmatization and self-stigmatization. However, psychological flexibility may prove to be an ability, which can be trained and developed, that promotes better adjustment to unpleasant external and internal experiences related to visible changes in the appearance. We conducted a cross-sectional study of 328 women with lipedema, a relatively common but still insufficiently known condition that can lead to disfigurement through uncontrollable accumulation of adipose tissue in the extremities. Women with greater psychological flexibility showed lower appearance-related distress. In the talk we discuss potential benefits of ACT-based interventions for people who are struggling with visible differences, entailed by our results.

• How to Use ACT when treating someone suffering as a result of a visible difference
Staci Martin, PhD, Clinical Consultant: Department of Psychology, George Washington University, Washington, DC.

Individuals with medical conditions sometimes have diseases or treatments that radically impact their appearance, such as disfiguring tumors, hair loss from chemotherapy, or swelling/weight gain from steroids. These physical aspects of disease can negatively impact quality of life (Wolkenstein et al., 2001). Mental health professionals can employ ACT techniques to target the anxiety, depression, and low self-esteem that often accompany these visible signs of illness. In this presentation, we will explore how medical patients with visible differences can practice acceptance of their condition hand in hand with self-compassion related to their anxious thoughts and self-criticism. Examples of how patients can use defusion to target thoughts about how people “should” react to their appearance will be presented. Finally, connecting with values is of pivotal importance, such as in the case of a person going through a treatment with appearance-altering side effects.

• The perspective of adults with psychosocial difficulties arising from a visible difference: Findings from a qualitative interview study.
Fabio Zucchelli, University of the West of England (UWE), UK.
Dr Olivia Donnelly, North Bristol NHS Trust
Dr Elisabeth Baker, Royal Free Hospital
Dr Nic Hooper Ph.D, University of the West of England (UWE), UK.
Dr Heidi Williamson Ph.D, University of the West of England (UWE), UK.

The aim of this presentation is to summarise qualitative interview findings from adults with a visible difference and related psychosocial difficulties, who have received individual Acceptance and Commitment Therapy. Visible difference refers to any congenital or acquired condition that creates an altered appearance. Some of those affected experience challenges such as social anxiety and body dissatisfaction (Norman & Moss, 2015). Evidence for ACT’s efficacy for both issues is burgeoning (e.g. Craske et al., 2014; Pearson et al., 2012). Psychologists at two specialist UK-based NHS psychological services for this client group primarily deliver ACT, based on a process-driven guide protocol. Researchers from the Centre for Appearance Research, UWE Bristol, are in the process of interviewing up to eight patients post-intervention from these sites to gain insights into their experience of ACT, with a view to identifying key components, exercises and other lessons for content development and also to inform a feasibility trial.

69. Cognitive Fusion in the Laboratory
Symposium (12:45-14:00)
Components: Original data
Categories: Clinical Interventions and Interests, Cognitive Fusion, Measurement, Virtual Reality, IRAP
Target Audience: Beg., Interm., Adv.
Location: San Bernardo

Helen Bolderston, Bournemouth University
Andrew Gloster, University of Basel

Cognitive fusion is a key process in the Psychological Flexibility Model of psychopathology. As such, it is important to investigate the role of fusion, under controlled laboratory conditions, as well as in the clinic. Greater variety in the methodologies used in such research will increase confidence in the conclusions drawn about fusion and defusion. This symposium therefore brings together three papers, each using innovative methods in laboratory-based studies, to investigate fusion and increase defusion. Helen Bolderston will introduce the State Cognitive Fusion Questionnaire, a self-report measure which may have particular utility in laboratory-based studies involving brief defusion interventions. Arianna Prudenzi will then present the findings of two studies testing the impact of a virtual reality task on defusion, in relation to negative self-referential thoughts. In the final paper, David Gillanders will discuss an IRAP study that examined relationships between cognitive fusion, implicit and explicit measures of worry, anxiety, mindfulness, engaged living and experiential avoidance. Andrew Gloster will then discuss the papers and their implications.

• The initial development of a state version of the Cognitive Fusion Questionnaire
Helen Bolderston, Bournemouth University
Georgia Turner, Bournemouth University
Holly Taylor, King's College, London
David T. Gillanders, University of Edinburgh
Alister Coleman, Bournemouth University

Cognitive fusion is hypothesised to play a significant role in the development and maintenance of mental health problems. The development of a psychometrically sound measure, the Cognitive Fusion Questionnaire (CFQ; Gillanders et al., 2014) has successfully facilitated research examining the role of fusion. However, the CFQ operationalises fusion as being trait-like. It is therefore possible it might not be sufficiently sensitive over short periods of time to detect change following the kinds of brief defusion interventions used in analogue studies. A state version of the CFQ has therefore been developed. This paper presents this new, state version of the CFQ, along with preliminary data indicating it is a reliable, valid measure of cognitive fusion. Data on its sensitivity to change compared to that of the original CFQ, will also be presented. Future research required to further validate the state CFQ will be discussed.

• Studying Cognitive defusion Through Virtual Reality: Two Exploratory Studies In The Management Of Negative Thoughts
Arianna Prudenzi, School of Psychology, University College Dublin
Louise McHugh, School of Psychology, University College Dublin
Brandan Rooney, School of Psychology, University College Dublin
Nanni Presti, Department of Human and Social Sciences, Kore University, Enna, Italy
Marco Lombardo, Behaviour Labs, Catania, Italy
Daniele Lombardo, Behaviour Labs, Catania, Italy

Virtual reality (VR) is of increasing interest to applied psychologists due to its potential for exposure learning. The current study comprises two experiments that aimed to examine the effect of a VR task on participants’ relationship with negative self referential thoughts (e.g., 'I am not good enough'). To that end, participants were instructed to select a thought that they were 'fused with' and to interact with this thought in a VR environment. In Study 1, 30 participants (age range: 18-65) across three groups (Cognitive Defusion, Distraction & Control) were tested pre and post VR task on trait fusion and their overall relationship with the negative thought. In Study 2, a further control group of VR only and a state measure of fusion were introduced. Overall the results indicate that VR, not only facilitates the management of negative thoughts, but that it generalises to a reduction in both trait (Study 1) and state (Study 2) fusion levels. The findings are discussed in terms of the utility of VR in applied settings.

• Implicit beliefs about worry, cognitive fusion and their relationships with anxiety and other aspects of psychological flexibility
David T. Gillanders, University of Edinburgh
Julie Dwyer, University of Edinburgh

Objective: Relationships between cognitive fusion, implicit and explicit measures of worry, mindfulness, engaged living, experiential avoidance and anxiety were explored. Method: 113 adults completed clinical interview, standardized questionnaires of the above constructs, and an IRAP operationalizing the functions of worry. Results: Cognitive fusion was associated with implicit relations about worry as both harmful and helpful. Fusion was also strongly associated with reduced valued living, reduced life fulfillment, and reduced mindfulness. Fusion was also associated with higher experiential avoidance, and psychological inflexibility. Fusion was not associated with an explicit measure of worrying, though surprisingly explicit worry was also not associated with anxiety. By contrast, implicit measures of worry and cognitive fusion were both associated with anxiety. Conclusions: Data provide further support for cognitive fusion as a process associated with undesirable outcomes. The pattern of associations is supportive of contextual behavioural theory at both the mid-level constructs and implicit relations.

71. Components that Maximize the Metaphor Effect I: Hierarchy, Perspective Taking, Relational Elaboration and Physicalization
Symposium (12:45-14:00)
Components: Conceptual analysis, Original data
Categories: Relational Frame Theory, Clinical Interventions and Interests, Metaphors
Target Audience: Beg., Interm., Adv.
Location: Utera

Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz
Carmen Luciano, Universidad de Almería

Acceptance and commitment therapy (ACT; Hayes, Strosahl, & Wilson, 1999) is a contextual model of psychological intervention that aims to promote psychological flexibility. To accomplish this aim, metaphors are profusely used in ACT. One of the areas of human cognition most studied by relational frame theory (RFT; Hayes, Barnes-Holmes, & Roche, 2001) is analogical reasoning. The link between ACT and RFT is becoming closer as a theoretical and empirical line of research is emerging that analyzes the components of metaphors that maximize the promotion of psychological flexibility (e.g., Foody et al., 2014; Ruiz & Luciano, 2015; Sierra, Ruiz, Flórez, Riaño-Hernández, & Luciano, 2016; Villatte, Villatte, & Hayes, 2015; Törneke, 2017). This symposium presents three empirical studies that extends previous research in this regard by analyzing the effect of hierarchical relations, cues to prompt perspective taking, the presentation of the metaphor in first or third person, and the metaphor physicalization.

• The effect of hierarchical and perspective taking cues in metaphor effect
Andrés Peña-Vargas, Fundación Universitaria Konrad Lorenz
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz
Eduar Ramírez, Fundación Universitaria Konrad Lorenz
Paola Bernal, Fundación Universitaria Konrad Lorenz
Nikol Pardo, Fundación Universitaria Konrad Lorenz
Alejandra Orozco, Fundación Universitaria Konrad Lorenz
Bárara Gil-Luciano, Madrid Institute of Contextual Psychology

The role of hierarchical framing has been found to be especially relevant in promoting psychological flexibility in typical defusion exercises (e.g., Foody et al., 2014; Luciano et al., 2011; Gil-Luciano et al., 2017). However, the effect of including hierarchical relations between the person and her private events in metaphors has not been demonstrated. Additionally, the effect of cues that prompt temporal perspective taking has not been analyzed. Accordingly, this study analyzed the effect of both variables by conducting a factorial 2x2 design. Eighty participants provided informed consent and were exposed to the cold-pressor task (CPT). After that, participants were randomly allocated to one of the four experimental conditions and listened to an audio that presented a metaphor in which the independent variables were manipulated. Lastly, participants were exposed again to the CPT. Results are discussed in terms of the interactive effect of both independent variables.

• The role of deictic framing and relational elaboration in metaphor effect
Eduar Ramírez, Fundación Universitaria Konrad Lorenz
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz
Paola Bernal, Fundación Universitaria Konrad Lorenz
Andrés Peña-Vargas, Fundación Universitaria Konrad Lorenz
María B. García-Martín, Fundación Universitaria Konrad Lorenz
Bárara Gil-Luciano, Madrid Institute of Contextual Psychology

This experiment analyzes the effect of two independent variables in the metaphor effect: (a) presenting the metaphor by asking the individual to imagine herself as the protagonist of the story or by imagine that the protagonist is a third person, and (b) the inclusion of relational cues that prompt for the relational elaboration of the rules that might be derived according to the metaphor content. Eighty undergraduates participated in this 2x2 factorial design. After signing the informed consent, participants were exposed to the cold-pressor task (CPT). Then, participants were randomly assigned to one of the four experimental condition and listened to an audio that presented a metaphor in which the independent variables were manipulated. Subsequently, participants were exposed to the CPT again. Lastly, participants responded to tests of empathy and imagination. Results are discussed in terms of the participant’s tolerance to the CPT and the variables that moderate the effect of the independent variables.

• The effect of physicalizing metaphors in promoting behavioral change
Paola Bernal, Fundación Universitaria Konrad Lorenz
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz
Andrés Peña-Vargas, Fundación Universitaria Konrad Lorenz
Eduar Ramírez, Fundación Universitaria Konrad Lorenz
Daniela Salazar, Fundación Universitaria Konrad Lorenz

One guideline that is often provided in ACT books and workshops is that to physicalize metaphors can improve their effect. This study aims to analyze this point by conducting an experimental analogue. Sixty participants were randomly assigned to the two experimental conditions: Physicalization vs. No Physicalization. After signing the informed consent, participants responded to several self-report measuring experiential avoidance and the tendency to engage in ruminative thinking. Subsequently, participants were exposed to a 3-minute rumination induction task and a working memory test. Participants then received one of two protocols that consisted of one metaphor that aimed to promote defusion from ruminative thinking. The only difference between conditions was that in one condition the metaphor was physicalized while in the other not. Lastly, participants were exposed again to the rumination induction task and the working memory test.

82. Advances in the Application of Acceptance and Commitment Therapy in Autism
Symposium (15:15-16:45)
Components: Conceptual analysis, Original data
Categories: Clinical Interventions and Interests, Relational Frame Theory, Autism, ACT
Target Audience: Beg., Interm., Adv.
Location: Buhaira

Thomas G. Szabo, Florida Institute of Technology
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz

The application of acceptance and commitment therapy (ACT) in autism is increasing during the last years. ACT has been shown to be useful in the counseling of parents of children with autism, but there is less evidence of the applicability of ACT in the treatment of children with autism. This symposium presents cutting-edge research in this topic using single-case experimental designs. The first paper presents the effect of a brief ACT-based intervention to change the pattern of behavior displayed by children with autism when playing games. The second paper describes the effect of a two-day ACT training with parents of children with autism. The training was directed to disrupt parents’ session avoidance. Lastly, the third paper shows the effect of ACT training as an approach to parents’ private events. Specifically, the study describes an intervention focused on values-directed behaviors in parents of children with autism.

• Benefits of Acceptance and Commitment Training for children with autism
Thomas G. Szabo, Florida Institute of Technology
Madison Wood, Florida Institute of Technology
Gina Hansen, Florida Institute of Technology
Jessica Bentley, Florida Institute of Technology

Children with autism often display inflexible behavior when playing games. This behavior is often negatively reinforced in that it results in decreased time spent in aversive social settings. To the child, short term benefits of this avoidance are coupled with log term problems, such as removal from social milieus and constrained repertoires under tight aversive control. In the current study, we asked to what extent will inflexible behavior decrease and manding-for-rule-changes increase after a two-hour training in behavioral flexibility (ACT) conducted in a home setting with a function-based treatment and specific, measurable replacement behaviors. Results and implications for future research are discussed.

• Acceptance and Commitment Training for parents of children with autism
Thomas G. Szabo, Florida Institute of Technology
Jana Gleason, Florida Institute of Technology
Asia Murdy, Florida Institute of Technology
Deena Garman, Florida Institute of Technology
Cassie Rushford, Florida Institute of Technology
David Scribner, Florida Institute of Technology

Parents want ABA treatment to improve their children's lives, but parent session avoidance is negatively reinforced. This is a significant challenge for behavior therapists, because the window in which verbal skills can be taught to a child with autism closes by the time the child is twelve years old. Additionally, behavior analysts do not have access to reinforcers for parent engagement in ABA work outside of session and limited access to reinforcers for their participation during sessions. Negative reinforcement traps are coupled with positive reinforcement traps and these are overlaid with rule insensitivity that further cements parent avoidance of the private events that accompany their participation in ABA work. In this study, we evaluated a method of addressing both indirect-acting (verbal) and direct-acting contingencies in a two-day Acceptance and Commitment Training. Results and implications for future research are discussed.

• Acceptance and Commitment Training for parents of children with autism
Evelyn Gould, FirstSteps for Kids, Inc.

Behavioral parent training is a critical component of effective treatment for children with autism, however, engaging parents effectively can be extremely challenging. Despite evidence that private events can strongly influence parent behavior and training outcomes, the topic has received minimal attention in the behavioral literature thus far. Acceptance and Commitment Training (ACT) is a contemporary behavioral approach to increasing adaptive, flexible repertoires of behavior, by reducing control by problematic rule-deriving and rule-following. This study is one of the first to examine the effects of ACT on values-directed behavior in parents of children with ASD. A nonconcurrent multiple baseline across participants indicated that ACT resulted in increased parent engagement in values-directed behavior. Gains were maintained post-training, with training effects most prominent at follow-up, more than 6 months post-training. Exploratory data suggested that ACT may also have resulted in substantial decreases in parental experiential avoidance and notable increases in self-compassion

83. Addressing Mental Health Stigma
Symposium (15:15-16:45)
Components: Conceptual analysis, Literature review, Original data, Didactic presentation
Categories: Prevention and Community-Based Interventions, Educational settings, Stigma
Target Audience: Beg., Interm., Adv.
Location: San Bernardo

Kenneth Fung, University of Toronto
Josephine Pui-Hing Wong, Ryerson University

Mental health stigma remains one of the major barriers towards people seeking timely assessment or receiving appropriate care. Further, psychosocial and cultural factors interact, intersect, and exacerbate stigma. In this symposium, we will explore mental health stigma in several diverse populations, including undergraduate university students in North Texas US, East Asian women in Montreal Canada, and Asian men in Toronto Canada. Psychosocial interventions will be discussed, including the use of ACT in particular to address stigma.

• Preventing progress: Barriers to seeking psychological treatment
Teresa Hulsey, B.A., University of North Texas
Danielle N. Moyer, MS, University of North Texas
Amy R. Murrell, PhD, University of North Texas

Although most college campuses provide affordable mental health resources for students (Reetz, Krylowicz, & Mistler, 2014), many emerging adults in need of help appear not to utilize these services (American College Health Association, 2014). Therefore, a better understanding of the underlying processes that prevent college students from seeking psychological treatment is needed. This paper examines barriers to seeking mental health treatment in an undergraduate population. Participants (n = 965) completed online measures of self-stigma and perceived public stigma of seeking treatment, intentions to seek treatment, attitudes and beliefs toward seeking treatment, experiential avoidance, and psychological distress. Data is being analyzed now. A binomial logistic regression will be used to identify significant barriers to seeking treatment. The role of each barrier to seeking treatment in the context of a college campus will be discussed.

• Improving attitudes toward mental illness among East Asian women: A mixed-methods study
Sumin Na, Department of Educational and Counselling Psychology, McGill University
Momoka Watanabe, Department of Psychology, Concordia University
Andrew G. Ryder, Department of Psychology, Concordia University
Kenneth Fung, Department of Psychiatry, University of Toronto
Josephine Wong, Daphne Cockwell School of Nursing, Ryerson University
Laurence J. Kirmayer, Division of Social & Transcultural Psychiatry, McGill University

The present study examined the effectiveness of acceptance and commitment therapy (ACT) and mental health literacy (MHL) group interventions among East Asian Canadian women. East Asian Canadian women (N = 91) were randomly assigned to ACT, MHL or a no intervention control. The authors assessed for stigma toward mental illness and attitudes toward help-seeking pre-intervention, post-intervention and at 3-month follow-up. Participants also took part in focus groups following the interventions for a more nuanced understanding of potential effects of the interventions. The quantitative results indicated that ACT and MHL reduced mental illness stigma and improved attitudes toward help-seeking compared to the control group, and some of the effects were retained at 3-months. Qualitative findings captured the process mechanisms of change and differences between the two interventions that could not be captured through the quantitative measures. The authors discuss implications for mental health promotion initiatives in diverse communities and program evaluation.

• Use of ACT in Reducing Stigma and Training Mental Health Ambassadors Among Asian Men – The Toronto Site Results
Kenneth Fung, MD FRCPC MSc, University of Toronto
Rick Sin, MSW, PhD (ABD), Ryerson University
Amy Bender, RN, PhD, University of Toronto
Yogendra Shakya, PhD, Access Alliance
Sepali Guruge, RN, PhD, Ryerson University
Souraya Sidani, RN, PhD, Ryerson University
Naila Butt, MD, MPH, Amplify Change
Josephine Pui-Hing Wong, RN PhD, Ryerson University

Strength In Unity is a multi-site community-based research that engages Asian Canadian men to examine the effectiveness of Acceptance and Commitment Therapy (ACT) and Contact-Based Empowerment Education (CEE) in reducing mental health stigma and mobilizing participants as Mental Health Ambassadors. Asian men, aged 17 and older, community leaders (CL) and those living with or affected by mental illness (LWA) are randomized to receive ACT, CEE, both, or psychoeducation. Scales are administered pre-, immediate-post, 3-month, and 6-month post-intervention. Over 500 Asian men completed the intervention in Toronto. ACT and the combo groups had increased psychological flexibility. All groups had decreased stigma in the Authoritarianism Subscale, with the CEE group having reductions in other subscales. Internalized stigma was reduced in the Combo group. Over 2500 activity logs captured health promotion activities. Focus groups elucidated the psychosocial and cultural factors affecting the mental health of Asian men.

84. Psychological Flexibility Model in Severe Psychological Problems
Symposium (15:15-16:45)
Components: Literature review, Original data, Didactic presentation
Categories: Functional contextual approaches in related disciplines, Other, Psychological Flexibility Model in Chronic Severe Psychological Problems
Target Audience: Beg., Interm., Adv.
Location: Lebrija

Dr Eric Morris, La Trobe University Psychology Clinic,Melbourne, Australia
Joe Oliver, University College London

Investigations about psychological flexibility (PF) in severe psychological problems (like schizophrenia and bipolar disorder) remains as an empty field at contextual behavior science arena. What about the PF level in people who diagnosed bipolar disorder and schizophrenia? Which processes of PF differs at people who suffers from these severe psychological problems when compare with control group? Which processes of PF are more relevant with the functionality of patients? How about perception of situation in bipolar disorder group when experiencing stressful life events? Does the usage of avoidance strategies vary from people that diagnosed bipolar disorder from control group? These three study try to serves a humble contribution to all these questions.

• Investigation of psychological flexibility model in patients with schizophrenia
Alparslan Cansiz, MD, Siverek State Hospital, Sanliurfa, Turkey
K. Fatih Yavuz, MD, Istanbul Bakirkoy Research and Training Hospital for Psychiatry and Neurology,Istanbul, Turkey
Ahmet Nalbant,MD, Istanbul Bakirkoy Research and Training Hospital for Psychiatry and Neurology,Istanbul, Turkey
Merve Terzioğlu,MD, Istanbul Bakirkoy Research and Training Hospital for Psychiatry and Neurology,Istanbul, Turkey

Current research aims to provide a contribution to psychological flexibility model’s view to schizophrenia. The study, included 110 patients who had been diagnosed with schizophrenia and 110 healthy volunteers. Participants in both groups filled Sociodemographic Data Form (SDF), Cognitive Fusion Questionnaire (CFQ), Valued Living Questionnaire (VLQ), Self-as-Context Scale (SACS), Freiburg Mindfulness Inventory (FMI) and Acceptance and Action Questionnaire-II (AAQ-II), in addition, to schizophrenia group, Positive and Negative Syndrome Scale (PANSS) and Quality of Life Scale (QoLS) were applied by clinicians. In the schizophrenia group scores of AAQ-II and CFQ were higher; and SACS, FMI and VLQ were found lower. Furthermore, the PANSS positive subscale, SACS and AAQ-II scores on the schizophrenia group; PANNS negative subscale, SACS, VLQ, FMI and AAQ-II scores were found associated. The scores of the functionality of the patients are determined to be associated with SACS and VLQ points. Our findings are indicating that schizophrenia patients were more inflexible than psychologically healthy individuals.

• Response Styles And Avoidance Strategies In Manic Episode and Remission Period of Bipolar Disorder
Sevinc Ulusoy,MD, Istanbul Bakirkoy Research and Training Hospital for Psychiatry and Neurology,Istanbul, Turkey
Okan Ufuk İpek, MD, Igdir State Hospital, Igdir, Turkey
K. Fatih Yavuz, MD, Istanbul Bakirkoy Research and Training Hospital for Psychiatry and Neurology,Istanbul, Turkey

This study aims to investigate relations between stress, cognitive and emotional maladaptive processes in bipolar disorder from the psychological flexibility model perspective. The study consists of 74 participants who diagnosed Bipolar I Disorder (BD 1)-Manic Episode, 67 participants in remission period and 70 healthy controls. Sociodemographic Data Form, Leahy Emotional Schema Questionnaire (LESQ), Ruminative Thinking Style Questionnaire (RTSQ), Penn State Worry Questionnaire (PSWQ), Stress Appraisal Measure Dispositional (SAM-DF) and State Form (SAM-SF) and Acceptance and Action Questionnaire II(AAQ-II) were applied to both of the groups. Participants with BD 1, both of the remission and manic episode group, have higher scores in ‘treat’ and ‘uncontrolled’ subscales of SAM- DF/SAM-SF. ‘Lower ruminative response style and higher worry was found in manic episode group than healthy controls . Also BD 1 group has higher scores at AAQ- II than the control group. Our results indicate that BD 1 patients have lower psychological flexibility and use more avoidance strategies in the presence of difficult thoughts and emotions than psychologically healthy individuals.

• PSYCHOLOGICAL FLEXIBILITY IN BIPOLAR DISORDER
Hasan T. Karatepe, Asst.Prof., Medeniyet University, Psychiatry Department, İstanbul, Turkey
Murat Aktepe, MD, Arnavutköy State Hospital, İstanbul, Turkey
K. Fatih Yavuz, MD, Istanbul Bakirkoy Research and Training Hospital for Psychiatry and Neurology,Istanbul, Turkey

The goal of this study is to invertigate all processes of psychological flexibility in individuals with bipolar disorder. Our hypothesis is the level of psychological flexibility is less in people who diagnosed bipolar disorder than control groups. 101 euthymic participants of bipolar I disorder being treated in outpatient clinic and 100 volunteers who had no psychiatric complaints between age of 18-65 were included into the study. Cognitive Fusion Questionnaire (CFQ), Values Living Questionnaire (VLQ), Self-as-Context Scale (SACS), Freiburg Mindfulness Inventory (FMI) and Acceptance and Action Questionnaire (AAQ-2) were applied to both of the groups. It has been detected that bipolar disorder group has higher scores at AAQ-2 and CFQ with lower scores at SACS, FMI and VLQ-part II than the control group. VLQ-part I didn't show significant statistical difference between two groups. Data obtained from our research indicates that individuals with bipolar disorder are psychologically more inflexible than control group.

85. Recent Innovations in Applying Acceptance and Commitment Therapy and the Psychological Flexibility Model to Chronic Pain
Symposium (15:15-16:45)
Components: Original data,
Categories: Clinical Interventions and Interests, Behavioral medicine, ACT, Chronic Pain, Psychological Flexibility, Online Treatments, Self-as-Context, Assessment
Target Audience: Beg.
Location: Utera

Lance M. McCracken, Ph.D., King's College London
Lance M. McCracken, Ph.D., King's College London

Acceptance and Commitment Therapy (ACT) is considered an empirically supported treatment with “strong research support” for chronic pain, and there is growing evidence that improvements in facets of psychological flexibility account for improvements in chronic pain outcomes. At the same time, more research is needed to understand how to maximize the effectiveness of ACT for chronic pain, with a particular focus on mechanisms underlying treatment. To this end, the development and refinement of assessment measures of psychological flexibility is an important line of investigation. Research and treatment development is also needed to increase the accessibility of ACT for people with chronic pain. This symposium will present recent innovations in the application of ACT and the psychological flexibility model for chronic pain. In particular, the symposium will focus on recent validation studies of novel assessment measures of psychological flexibility, and data linking changes on these new measures to improved chronic pain outcomes. The symposium will also provide data supporting a novel low-intensity treatment delivery approach for increasing the accessibility of ACT for chronic pain.

• Validation of an efficient 3-item measure to assess “open, aware, and engaged” in people with chronic pain
Whitney Scott, Ph.D., King's College London
Lance M. McCracken, Ph.D., King's College London

The originally proposed six facets of the psychological flexibility model have more recently been described in terms of behaviour that is “open, aware, and engaged”. This condensed three-part process has the advantage of being easy to communicate to patients and potentially efficient to track in the course of treatment delivery. Therefore, we sought to validate a brief, three item assessment measure with one item each reflecting qualities of open, aware, and engaged behaviour. This three item measure was completed by 250 patients with chronic pain receiving ACT-based treatment provided by a multidisciplinary group of clinicians. This measure was completed before and after treatment, along with full-length process measures of acceptance, cognitive defusion, and committed action, and outcome measures of pain-related disability and depression symptoms. This presentation will discuss data regarding the reliability, validity, and predictive utility of the three item “open, aware, and engaged” measure with respect to the full-length process measures.

• Change in “Self-as-Context” (“Perspective-taking”) Occurs in Acceptance and Commitment Therapy for People with Chronic Pain and is Associated with Improved Functioning
Lin Yu, King’s College London
Dr. Sam Norton, King's College London
Prof. Lance M. McCracken, King's College London

Research on the psychological flexibility (PF) model in the context of chronic pain has largely neglected the process of self-as-context, until recently. This study investigates whether ACT is associated with an effect on self-as-context (SAC) and whether this effect is linked to treatment outcomes in people with chronic pain. Participants included 412 adult patients with chronic pain. Participants completed measures of treatment processes (SAC, pain acceptance) and outcomes (pain-related interference, work and social adjustment, depression) before treatment, post-treatment, and at nine-month follow-up. Results from paired sample t-tests suggested participants significantly improved on all process and outcome variables at post-treatment (d=.38 to .98) and nine-month follow-up (d=.24 to .75). 42.0% to 67.5% participants showed meaningful improvements on each outcome at post-treatment and follow-up. Regression analyses with residualized change scores from process and outcome variables, and bivariate growth curve modeling suggested that change in SAC was associated with change in outcomes (β=-.21 to -.31; r=-.16 to -.46). Results support a role for change in SAC in treatment as the PF model suggests.

• ACT Psychological Flexibility Processes and Traditional CBT Variables Involved in a Mixed Self-Help/Online Treatment for Chronic Pain
Marie-Eve Martel, M.A., Psy.D.(c), Université du Québec à Trois-Rivières
Whitney Scott, Ph.D., King's College London
Frédérick Dionne, Ph.D., Université du Québec à Trois-Rivières
Josée Veillette, Psy.D.(c), Université du Québec à Trois-Rivières
Joseph Chilcot, Ph.D., King's College London
Lance M. McCracken, Ph.D., King's College London

Acceptance and Commitment Therapy (ACT; Hayes et al., 2012) is considered an empirically supported treatment with “strong research support” for chronic pain (APA, 2013), but accessibility of this type of treatment remains an important challenge. Therefore, self-help books or internet-delivered versions of ACT for chronic pain are promising because they offer a potentially cost-effective treatment option that requires little support from a therapist, and can be widely accessible. This presentation will discuss data from a randomized control trial using a mixed self-help/online treatment for chronic pain compared to a waitlist control. The study was conducted in Quebec (Canada) and the sample consists of 130 French-speaking individuals recruited from the community with various types of chronic pain. The treatment was given over a period of eight weeks and included minimal therapist contact. In addition to measures of distress and disability, psychological flexibility processes and traditional CBT variables such as pain self-efficacy and kinesiophobia were assessed at pre-treatment and post-treatment for both groups, and at a twelve-week follow-up for the group receiving the treatment. Treatment outcome data will be presented, along with the results of mediation analyses to determine the relative contribution of changes in psychological flexibility and traditional CBT processes to changes in treatment outcomes.

86. ACT and Mindfulness-Based Interventions for Youth
Symposium (15:15-16:45)
Components: Original data, Experiential exercises, Didactic presentation, Case presentation
Categories: Clinical Interventions and Interests, Prevention and Community-Based Interventions, Performance-enhancing interventions, Educational settings, Relational Frame Theory, Other, Children, Adolescents, OCD, RFT, Educational settings
Target Audience: Beg., Interm.
Location: Estepa

Lisa W. Coyne, Ph.D., McLean Hospital/ Harvard Medical School
Louise Hayes, Ph.D., University of Melbourne

Acceptance and Commitment Therapy (ACT) and mindfulness-based approaches with adults have received great research and clinical interest in recent years. Evidence suggesting that these approaches are effective in promoting psychological health and well-being has been expanding. As such, these approaches have started to be applied for children and youth with beneficial results, however this research is still in an embryonic state. This symposium will explore the adaptation and application of ACT and mindfulness-based interventions and processes in children and adolescents in different settings. Topics examined will include the use of ACT, mindfulness, and values to enhance exposures for adolescents with OCD, helping young children to tact their private experiences, and the use of a two-session ACT workshop for cultivating emotional health in elementary school children.

• A Case Study Exploring ACT and Mindfulness Interventions for a 16-Year Old Latino Male with Severe OCD
Carlos E. Rivera, M.S., Suffolk University; Child & Adolescent OCD Institute at McLean Hospital/ Harvard Medical School
Maria G. Fraire, Ph.D., McLean Hospital/ Harvard Medical School
Lisa W. Coyne, Ph.D., Child & Adolescent OCD Institute at McLean Hospital/ Harvard Medical School

While exposure and response prevention (ERP) is considered the gold standard behavioral intervention for obsessive-compulsive disorder (OCD), a number barriers limit ERP’s efficacy including drop-out rates of 25% (Abramowitz et al., 2009) and treatment refusal. Existing research on acceptance and commitment therapy (ACT) and other acceptance- and mindfulness-based interventions for OCD suggests these interventions are effective in treatment progress and outcome, and may facilitate ERP. The aim of the present case study is to explore an adolescent’s experience with severe OCD while receiving acceptance- and mindfulness-based treatment at an inpatient residential unit for youth with OCD. We will discuss how mindfulness, acceptance, and values could facilitate the use of ERP, the youth’s personal direct report of his experiences with acceptance and mindfulness, previous interventions, symptom remission, and treatment maintenance plan.

• Teaching Children and Adolescents to Tact and Discriminate with ACT for Better Emotion Regulation and Valued Behaviour
Timothy Gordon, MSW, RSW, The Zen Social Worker, Independent Practice

ACT has been demonstrated to work in clinical settings with children (Swain, Hancock, Dixon, Bowman, 2015) and adolescents (Hayes & Sewell, 2011) however little has been demonstrated in ACT’s clinical literature to assist young client populations with deficits in their ability to tact to private experiences, specifically to identify painful private stimulus events such as thoughts, feelings, sensations, and memories. The current case study presents original data and case examples of young client populations practicing an adaptation of McHugh, Bobarnac, Reed’s (2011) teaching situation-based emotions to improve their ability to tact to painful private experiences. Discussion will include producing improvements for working with difficult emotions in clinical settings with young populations, examples of techniques and specifics methods will be demonstrated, methodological caveats, and further research implications for research will also be discussed.

• ACTmind: A mindfulness and Acceptance and Commitment Therapy program for cultivating emotional health in elementary school children
Maria Karekla, Ph.D., University of Cyprus
Anthoula Papageorgiou, B.A., University of Cyprus

The purpose of the present study was to examine the feasibility, acceptability and preliminary effectiveness of a mindfulness and ACT two-session workshop for cultivating emotional health in elementary school children. Sessions comprised of teaching mindfulness and present moment awareness skills, acceptance of all internal experiences, and how to act based on what is important for them even in the presence of fearful thoughts and emotions via the use of experiential exercises and metaphors. Results suggest that the program is feasible and well accepted by elementary school children. Students’ avoidance and unwillingness to experience scary and worrisome thoughts decreased from pre to post during session one and overall from session one to two, suggesting that learning occurred and students started to become more open to experiencing negative thoughts. It was also indicated that students found the program to be very helpful and that they would participate in such a program again in the future.

Saturday, 24 June

97. Self-Compassion and Compassion in Clinical Intervention: Testing New Models, Processes, and Methods
Symposium (11:00-12:30)
Components: Original data
Categories: Clinical Interventions and Interests, Other, Compassion
Target Audience: Beg., Interm.
Location: Nervión Arenal I

Jason Luoma, Ph.D., Portland Psychotherapy Clinic, Research, & Training Center
Paul Gilbert, Ph.D., University of Derby

This symposium brings together three data-based presentation relating to data on compassion and self-compassion in clinical contexts. The first paper presents data from two studies examining the relationships between self-compassion and psychological flexibility measures, with an aim to clarify the conceptualization of and operationalization of these related constructs. The second paper presents data from two studies involving a very brief intervention involving participants practicing the Compassionate Self meditation, using an online audio guided exercise. The first study examines the effect of cognitive restructuring as opposed to Compassionate Self imagery in affecting dehumanized perceptions and avoidance of images of homelessness under experimental conditions. The second study examines the effect of a brief Compassionate Self intervention on body shame and anxiety among a sample of undergraduate students. The third paper presents pilot data on a novel group intervention for highly self-critical and shame prone people that focuses on using perspective taking interventions to help participants develop greater self-compassion and a sense of belongingness.

• A closer look at The Compassionate Self imagery meditation: initial research validating the utility of a foundational CFT component
Dennis Tirch, Ph.D., The Center for Compassion Focused Therapy

Every mental health intervention and contemplative tradition that targets the training of mindful compassion uses imagery exercises to evoke an experience of our compassionate minds. CFT, The Mindful Self Compassion Program, and Compassion Focused ACT all deploy functionally similar meditations and imaginal exercises as a part of their interventions. Foundational to CFT, The Compassionate Self Imagery meditation is a brief and frequently used practice that guides a person through a process of experiencing themselves as a compassionate being. Previous outcome research has demonstrated the effectiveness of interventions using this imagery practice. This presentation looks at two studies involving a very brief intervention involving participants practicing the Compassionate Self meditation, using an online audio guided exercise. The first study examines the effect of cognitive restructuring as opposed to Compassionate Self imagery in affecting dehumanized perceptions and avoidance of images of homelessness under experimental conditions. The second study examines the effect of a brief Compassionate Self intervention on body shame and anxiety among a sample of undergraduate students. These studies will be compared to an earlier study using a very similar intervention to address body shaming in a clinical population. Potential applications of this imagery practice, including clinical implications, possible counter-indications, and limitations will be discussed.

• Psychological flexibility and self-compassion: two processes or two conceptualizations?
Stanislaw Malicki, Akershus University Hospital

There is robust evidence of the impact of both self-compassion and experiential avoidance on mental health. Research has also shown strong correlation between measures of both transdiagnostic processes. However, the question of how they are interrelated needs further investigation, as it may bear significant clinical implications. Both constructs were proposed and operationalized within various scientific traditions and paradigms. Thus, instead of translating one in terms of another, the paper approaches the question of their interrelationship by presenting a set of correlational data and statistical analyses linking them to variables that may be used in building cross-theoretical models. The first, completed study, investigates interrelations between self-compassion, experiential avoidance, adult attachment and early childhood experiences. The second, still running study investigates the link between self-compassion, different measures of experiential avoidance, self-criticism, social safeness and measures of anxiety and depression. As the second study is to be completed by the end of 2017, the paper presents partial data.

• Big Heart, Open Wide: Overview and Pilot Data on a Novel Group Therapy for People who are Highly Self-Critical and Shame Prone
Jason Luoma, Ph.D., Portland Psychotherapy Clinic, Research, & Training Center
Jenna LeJeune, Ph.D., Portland Psychotherapy Clinic, Research, & Training Center
Melissa Platt, Ph.D., Private Practice

Self-criticism and shame are transdiagnostic factors that contribute to a variety of psychological problems. As an extremely social species, humans function best when having they have a sense of belonging. Shame threatens this sense of belonging, especially when chronic and repeated. Thus, the central target of the 9-session group treatment is decreasing the sense of isolation and other-ness associated with chronic shame and self-criticism. The intervention is guided primarily by insights from affective science and contextual behavioral science, particularly work on flexible perspective taking. We will provide an overview of the treatment approach and present pilot data from pre-treatment, post-treatment, and one-month follow up for the initial cohort of participants (n=8). Initial data show comparable effect sizes to other treatments targeting this population and preliminary support for the idea that belongingness and a sense of “common humanity” are important mechanisms of action.

100. Understanding the Effects of Psychological Flexibility and Improving ACT Specific Skills Using Smartphone Technologies
Symposium (11:00-12:30)
Components: Original data
Categories: Clinical Interventions and Interests, Clinical Interventions and Interests, Performance-enhancing interventions, Depression, Social Phobia, Smartphones, Ecological Momentary Assessment, Coaching, Patients, College Students, RCT
Target Audience: Beg., Interm.
Location: Buhaira

Charles Benoy, MSc, Psychiatric Hospital of the University of Basel, Switzerland
Andrew T. Gloster, Prof. Dr., University of Basel, Department of Psychology, Division of Clinical Psychology and Intervention Science, Basel, Switzerland

Smartphone technologies represent an essential part of our daily life and their importance is increasing each year. By 2020 the number of smartphone users worldwide is predicted to have roughly doubled compared to 2014 . Smartphones allow new ways of analyzing psychological processes, including ACT specific aspects. In this symposium, three papers will be presented that use smartphones in clinical and analogue research. The first two focus on how Ecological Momentary Assessment (EMA) can be implemented in a clinical sample. The first paper thus examines the association between different types of social interactions and psychological flexibility, while the second paper explores how memory of events is associated with psychological flexibility. The third paper focuses on how skills can be delivered via smartphone, and provides input on future app development and face-to-face therapy by examining which ACT skills are most effective in-the-moment based on individual and contextual variables.

• “I’d like to see you – except when I don’t”: Types of Social Interaction and Psychological Flexibility – Preliminary Results
Jeanette Villanueva, MSc, University of Basel, Department of Psychology, Division of Clinical Psychology and Intervention Science, Basel, Switzerland
Andrea H. Meyer, PhD, Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland
Thorsten Mikoteit, Dr. med., University of Basel, Psychiatric Hospital, Centre for Affective, Stress and Sleep Disorders, Basel, Switzerland
Jürgen Hoyer, Prof. Dr., Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany
Martin Hatzinger, Prof. Dr. med., Psychiatric Services Solothurn and University of Basel, Switzerland
Roselind Lieb, Prof. Dr., University of Basel, Department of Psychology, Division of Clinical Psychology and Epidemiology, Basel, Switzerland
Andrew T. Gloster, Prof. Dr., University of Basel, Department of Psychology, Division of Clinical Psychology and Intervention Science, Basel, Switzerland

Social interactions (SIs) are an integral part of human beings. Nevertheless, for some people, SIs cause discomfort and fear. As a result, some people avoid interactions or choose interactions perceived as less threatening (for example, those that do not involve face-to-face interactions). In this study participants’ choice of interaction type (face-to-face, phone, Internet/chat or other) and whether psychological flexibility (PF) facilitates such choices, is examined. This study investigated 284 individuals (Major Depressive Disorder, Social Phobia, Controls) via smartphones in an Ecological Momentary Assessment (EMA) for one week. We captured 5616 social interactions in participants’ naturally selected environments. Preliminary results indicate that the probability of choosing face-to-face and phone interactions differ with the level of PF. Given that PF is relatively low in many forms of psychopathology, models will further examine differences across groups with a diagnosis of Major Depression Disorder or Social Anxiety Disorder, in comparison to healthy controls.

• Remember, remember: Evaluating the Memory-Experience Gap for Psychological Flexibility using Ecological Momentary Assessment — Preliminary Results
Marcia T. B. Rinner, MSc, University of Basel, Department of Psychology, Division of Clinical Psychology and Intervention Science, Basel, Switzerland
Andrea H. Meyer, PhD, Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland
Thorsten Mikoteit, Dr. med., University of Basel, Psychiatric Hospital, Centre for Affective, Stress and Sleep Disorders, Basel, Switzerland
Jürgen Hoyer, Prof. Dr., Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany
Martin Hatzinger, Prof. Dr. med., Psychiatric Services Solothurn and University of Basel, Switzerland
Roselind Lieb, Prof. Dr., Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland
Andrew T. Gloster, Prof. Dr., University of Basel, Department of Psychology, Division of Clinical Psychology and Intervention Science, Basel, Switzerland

People have difficulty accurately recalling their experiences – a phenomenon referred to as the Memory-Experience Gap (MeG). Nevertheless, clinical assessments overwhelmingly rely on retrospective recall. The aim of this paper is to investigate the effect of psychological flexibility (PF) on the MeG. Ecological Momentary Assessment (EMA) collects data in participants’ own chosen environment close to the time of experiences of interest. Thus, EMA as administered by smartphones, is considered the method of choice to examine the MeG. Data stem from 118 patients with Major Depression, 47 patients with Social Phobia and 119 healthy controls. We compared >10,000 EMA assessments to retrospectively recalled PF levels from the previous week. Preliminary results showed that participants inaccurately recall their level of PF. These data contribute to the understanding of the relation between PF and the MeG, and underline the importance of the MeG to understand research using retrospective recall of PF.

• Evaluating methods for teaching psychological skills through smartphones: A randomized control trial of the revised ACT Daily mobile app
Jack Haeger, M.S., Utah State University, Logan, Utah
Michael Levin, Ph.D., Utah State University, Logan, Utah
Benjamin Pierce, M.S., Utah State University, Logan, Utah

Mobile apps are a promising technology for improving mental health services. These programs are readily available throughout the day, provide a convenient system to monitor and prompt skill use, and can tailor skills based on clients’ responses. ACT Daily integrates these strengths with an ecological momentary intervention approach that prompts users to check-in with distress levels and ACT processes, followed by a recommended ACT skill tailored to check-in data. Pilot studies displayed improvements on depression/anxiety symptoms, ACT processes, and effective skill use in-the-moment. This study extends this research with a RCT design, applying an updated version of ACT Daily within an undergraduate sample across three conditions: assessment-only, random-skills, and tailored-skills. Results will be presented regarding app efficacy, methodology, and conditions leading to effective use of specific skills. Findings may inform app development and face-to-face therapy by examining which ACT skills are most effective in-the-moment based on individual and contextual variables.

102. Developing and Adapting ACT for Group Work: Lessons from the Inpatient Ward, and the Community
Symposium (11:00-12:30)
Components: Original data, Experiential exercises, Didactic presentation
Categories: Clinical Interventions and Interests, Other, Psychosis, Extreme states, Inpatient, Community Mental Health, Compassion, University Clinic
Target Audience: Beg., Interm., Adv.
Location: Lebrija

Angus Maxwell, Waitemata District Health Board, Auckland New Zealand
Eric Morris, La Trobe University

Group ACT provides opportunities to learn from others’ experiences, act out metaphors and exercises, and provide a small community context for developing psychological flexibility. In this symposium teams from three countries will present on their development and implementation of ACT groups for inpatient and community mental health settings. Participants in these groups have had experience of psychosis and/or extreme psychological distress. The symposium will offer an opportunity to understand the nature of working with this population, the challenges of setting up such groups and the differing formats they can take. The presenters will cover structure, content and outcomes from their groups. Initial outcome data, qualitative feedback and experiences from individual cases will be described.

• ACT in acute settings: using multidisciplinary Group work
Joris Corthouts, Psychiatric Hospital Sint Hiëronymus, Sint Niklaas, Belgium

In 2010 PC St Hiëronymus chose to implement ACT (together with recovery) as the main therapeutic approach for working with psychosis at an in-patient ward. Next to individual work, open and closed group-sessions are delivered by a multidisciplinary team. Different group-formats of delivering ACT have been developed since the start. This part of the symposium will focus on the methodology that was used for integrating ACT in a multidisciplinary team and how the group-formats got their current practice. As an example there will be summary of a client’s progress highlighting the different aspects of treatment.

• The Recovery ACT: evaluation of a group program for people with psychosis in the community
Eric Morris, La Trobe University, Melbourne, Australia
Jesse Gates, NorthWest Mental Health, Melbourne Australia
Jacinta Clemente, NorthWest Mental Health, Melbourne Australia
Eliot Goldstone, NorthWest Mental Health, Melbourne Australia
Alana Cross, NorthWest Mental Health, Melbourne Australia
John Farhall, NorthWest Mental Health, Melbourne Australia

The Recovery ACT is an 8-session group program for people with psychosis adapted from the UK to an Australia outpatient community team context. The group focuses on developing key ACT processes of mindfulness, willingness and valued action through the use of experiential exercises, with ‘Passengers on the Bus’ used as a central metaphor. We have completed three rounds of groups across three community teams, with 5 to 12 participants in each group. We evaluated the feasibility, acceptability and core ACT processes using a pre-post mixed methods group design. Questionnaires included a qualitative examination of participant’s experience, and quantitative measures of acceptance/action, values, cognitive fusion, mindfulness, recovery, and clinical and symptom changes. Participants reported the groups have been helpful at normalising experiences, developing valued action and increasing understanding of individual experience. Initial data indicates participants experienced positive changes in values/action, clinical outcomes and process of recovery.

• ACT for recovery – An Acceptance and Commitment Therapy Group for community mental health clients
Angus Maxwell, Waitemata District Health Board, Auckland, New Zealand
Nic Hughes, Waitemata District Health Board, Auckland, New Zealand
Claire Turner, University of Auckland

Development of an open two hour Acceptance and Commitment Therapy Group in a community mental health setting. The 12 week group is divided into three, four week modules. Each module has a different focus; the first being a general ACT model, the second with a focus on psychotic phenomena experiences, and the third integrating self-compassion . The group is both experiential and didactic in nature. There are up to twelve participants and three facilitators; one of whom is an experienced based expert and graduate of earlier groups, adding an important element of service user perspective and bringing validity to the process. The group utilises pre and post measures including the CORE-34, the CORE-10, the AAQ-II and the FSCRS. Qualitative feedback is also collected from group participants and from clinicians whose clients access the group.

103. Using the IRAP to Explore Emotions and Deictics
Symposium (11:00-12:30)
Components: Didactic presentation
Categories: Relational Frame Theory, Clinical Interventions and Interests, Theoretical and philosophical foundations, Relational Frame Theory, Other, IRAP, Perspective-taking, Emotions
Target Audience: Beg., Interm., Adv.
Location: Utera

Louise McHugh, University College Dublin

This tightly-packed 4-paper symposium explores various ways in which the IRAP can be used to study emotions (Papers 1 and 2) and self (Papers 3 and 4). Paper 1 uses the IRAP to explore the transformation of emotional functions, following a multiple exemplar training procedure, and highlights concordance of effects on the two procedures. Paper 2 is also concerned with studying emotions using the IRAP. A large sample of participants are presented with an IRAP involving male and female faces with 6 standard emotions. Comparing the IRAP with the explicit measure highlights a lower emotional threshold and no differences between males and females. Paper 3 is among the first to use the IRAP to study the self as deictic relational responding, and is particularly novel in incorporating all three types of deictic relations. The results highlight the IRAP’s ability to target these relations successfully, and concord with existing distinctions in terms of levels of relational complexity. Paper 4 again tests the utility of the IRAP as a measure of interpersonal deictic relations and attempts to replicate the only published study in this area. In a novel development, Paper 4 separates I and YOU into two IRAPs, presented in a natural language format. The differential performances in the two IRAPs supports the view that participants respond differently to I than YOU.

• An RFT analysis of deictic relational responding using the Implicit Relational Assessment Procedure (IRAP)
Deirdre Kavanagh, Ghent University
Yvonne Barnes-Holmes, Ghent University
Dermot Barnes-Holmes, Ghent University
Ciara McEnteggart, Ghent University

Perspective-taking appears to be a key process in the development of “self”. Under the rubric of Relational Frame Theory (RFT), researchers have investigated the role of deictic relational responding in the analysis of self in relation to others, place, and time, primarily through the use of an extended developmental protocol (Barnes-Holmes, 2001). In a move towards extending methodologies for studying deictic relational responding, Study 1 here employed the Implicit Relational Assessment Procedure (IRAP) to measure deictic flexibility regarding I versus OTHER. In short, participants were required to coordinate their own physical characteristics with I (i.e., I-I), and the physical characteristics of others with OTHER (Other-Other). The results showed strong, significant effects on both the I-I and Other-other trial-types, suggesting inflexible deictic relational responding. However, responding on the other trial-types (I-Other and Other-I) showed some flexibility in responding. Nonetheless, it could be argued that these IRAP trial-types did not require participants to actually take the perspective of another. In Study 2, we presented two Natural Language IRAPs (one that was I-focused and one that was Others-focused) that required participants to respond to both positive and negative statements about themselves and others. Initial data from this study suggests that this methodology is moving us a step closer toward the development of an IRAP that requires an individual to respond on the basis of the perspective of another. Hence, we are beginning to move towards a more precise analysis of the role of deictic relational responding in perspective-taking.

• Perspective-Taking through the IRAP.
Juan C. López, Ph.D., Universidad de Almería
Adrián Barbero-Rubio, Universidad de Almería & MICPSY
Carmen Luciano, Universidad de Almería & MICPSY
Zaida Callejón, Universidad de Almería

The current study aimed to advance into the analysis of relational flexibility through an innovative IRAP application to measure perspective-taking (PT) framing. For this, undergraduate students (N = 50) completed several explicit measures such as a self-reported questionnaire (IRI) and a behavioural task (DRT), which were included to explore the validity of the IRAP to measure the relational framing involved in PT. Subsequently, the participants were asked to complete a PT-IRAP, which included not only interpersonal deictic (I-You) or spatial (here-there) as previously done (Barbero et al., 2015) but temporal (then-now) framings. The findings showed that the DIRAP trial-types were a precise indicator of relational flexibility in PT. In addition, the analysis pointed out to the differential relational complexity per type of deictic involved: interpersonal, spatial or temporal; being the latter those in which higher latency were obtained. These data are in line with previous attempting to create a PT-IRAP and might be a cutting point moving forward a more precise analysis of perspective-taking.

• Woman and man face to face: implicit recognition of varying threshold of facial emotions
Annalisa Oppo, SFU, Milano (ITALY)
Valeria Squatrito, Kore, Enna (ITALY)
Enrica Basile, Kore, Enna (ITALY)
Giovambattista Presti, Kore, Enna (ITALY)

In a social context, having a successful social interaction may be due to recognition of a particular stimulus as an “emotional stimuli” and, maybe, emotional facial expressions are the most salient stimuli. Literature mainly focused on recognition of facial expressions used only intense exemplars and the role of soft expression remain unclear at the explicit level and mainly unstudied at the implicit level. The aim of this study was to assess an “emotional threshold” both at explicit and implicit level, using implicit relational assessment procedure (IRAP) for the latter one. One hundred and thirty six participants were enrolled in this study, and 104 (76.5%) participants achieved established criteria for accuracy. Assessment included explicit measures that evaluated self-compassion skills and depressive symptoms. A standardized set of graded, from full expression to neutral, emotional faces adapted by Gao & Maurer, D. (2009) were used. Specifically, photographs of one female model and one male model showing intense facial expressions of the six basic emotions (happiness, sadness, fear, anger, disgust, and surprise) and photographs of one female model and one male model showing graded facial expression (25%). Results showed that the “emotional threshold” is higher at the explicit level than at the implicit level (IRAP d-score for 25% trial type= 0.27; p<.001). Furthermore the threshold is similar for man and women and it is unrelated to the model (male or female).

• Transformation of emotional functions in comparison relations evaluated by Likert scales and IRAP.
João Henrique de Almeida, Universidade Federal de São Carlos
William Ferreira Perez, Paradigma centro de ciências do comportamento
Júlio César de Rose, Universidade Federal de São Carlos

Transformation of emotional functions have been considered, by some researchers, difficult to be observed in abstract stimuli with no topographical characteristic that facilitate this process (e.g. it was observed for head silhouettes but not for meaningless words or pictures). The present experiment employed a complex multiple exemplar training containing a variety of comparison relations among stimuli (non-arbitrary: size and amount; and arbitrary: numbers and words) for teaching undergraduates two contextual cues of comparison. Later, eleven undergraduates were trained to establish comparison relations between meaningless stimuli (grey spheres with nonsense words labels). One of this spheres were paired to faces expressing happiness. The transformation of functions to derived stimuli was evaluated by explicit (Likert) and implicit measures (IRAP). Nine of the eleven participants transformed the emotional function and responded in the Likert scales consistently with the relational training. A T-test show that D-IRAP scores had statistically significant negative effects for sphere A (“smallest”) related to “more happy” and for statistically significant effect for sphere D (“biggest”) related to “more happy”, both consistent with the training realized. These results permit to infer that many difficulties reported in the literature could be due the characteristics of the multiple exemplar training realized. A multiple exemplar training that presents a huge variety of stimuli with different properties may enable the adequate transformation of functions.

104. The Measure(s) of Our Commitment to Science: A Review of How Contextual Scientists Measure Behavior
Symposium (11:00-12:30)
Components: Conceptual analysis, Literature review, Original data
Categories: Theoretical and philosophical foundations, Performance-enhancing interventions, Measurement
Target Audience: Beg., Interm., Adv.
Location: Estepa

Kendra Newsome, Fit Learning
Ian Stewart, National University of Ireland Galway

Both the basic and applied wings of contextual behavior science share an interest in the prediction and influence of human behavior as it occurs in the natural environment. They also share a strong conceptual adherence to the tenants of natural science, with carefully vetted investigative and explanatory constructs. A review of the Journal of Contextual Behavior Science, however, reveals a division between how the basic and applied domains measure behavior, as well as the conspicuous shortage of analyses of ‘free-operant’ behavior. In this symposium we will review the tenants of a natural science and discuss their implications for how we ought to measure free-operant behavior. Additionally, we will demonstrate how adherence to natural science measures can provide a common analytic lens across both basic and applied domains. A common way of measuring our subject matter affords a more coherent and comprehensive science of behavior, better able to achieve our shared analytic goals.

• The “Stuff” of Science: What being committed to science means for science itself.
Timothy C. Fuller, University of Nevada, Reno
Donny Newsome, Fit Learning
Kendra Newsome, Fit Learning

A commitment to science requires that we declare what science we want to be committed to. Science, as an enterprise, sets out to provide a context from which its workers can produce statements about what is observed. Contextual behavior science (CBS) has done a laudable job outlining the values its workers need to bring to their scientific work, but what about science itself? If we want to commit to a thing called science, it is useful then to consider several basic tenets of science and thereby establish a foundation from which we can evaluate the behaviors of CBS workers. This presentation sets out to review what we think the basic tenets of a natural science are, where they have come from, and the implications these tenets have on the analytic activities of CBS scientists.

• A commitment to science means zero percent correct.
Donny Newsome, Fit Learning
Kendra Newsome, Fit Learning
Timothy C. Fuller, University of Nevada, Reno

The focus of this presentation will be a review of measurement practices in the Journal of Contextual Behavior Science as they pertain to both free and discrete operant paradigms. In the context of that analysis, we will discuss the merits of various measurement tactics relative to the standards of a thoroughgoing natural science of behavior. Specifically, we will orient to the problems with non-dimensional measures of behavior (percent correct) and self-report (surveys, questionnaires) and advocate for an increasing focus on free-operant behavior and the natural dimensions thereof (count, rate, latency, duration, magnitude, etc.).

• How contextual behavior science ‘measures up’ to the natural sciences.
Kendra Newsome, Fit Learning
Donny Newsome, Fit Learning
Timothy C. Fuller, University of Nevada, Reno

The solving of applied problems does not require new measures. Skinner put forth the use of rate of response as his biggest contribution to behavior science. This orientation to measuring our subject matter yielded a science of behavior aligned with other natural sciences. The closer our measures are to our subject matter of interest, the better we are positioned for discoveries that can readily traverse the basic and applied domains. This presentation will discuss the continuity afforded when natural sciences employ the approach to measurement across all areas of scientific activity. This alignment, present in other natural sciences, allows for basic research to directly inform applied research and for applied research to directly inform clinical practice.

111. New Directions in Learning Research
Symposium (12:45-14:00)
Components: Conceptual analysis, Literature review, Original data
Categories: Theoretical and philosophical foundations, Performance-enhancing interventions, Theoretical and philosophical foundations, Relational Frame Theory, Learning
Target Audience: Interm.
Location: Nervión Arenal I

Jan De Houwer, Ghent University
Jan De Houwer, jan.dehouwer@ugent.be

Learning research focusses on ways in which organisms adapt to their environment during their lifetime. It thus provides a cornerstone for any science of behavior, including contextual behavioral science. Moreover, Relational Frame Theory (RFT) not only has its origins in learning research but also has important implications for learning research. In this symposium, we explore new directions in learning research that were inspired by RFT. Hayes reminds us that RFT provides a radical new perspective on traditional forms of learning such as operant conditioning and provides new evidence from applied work that supports this view. In line with RFT's emphasis on relational processes, Hussey and Stewart present new evidence on relational learning, more specifically behavior change that results from relations between relations. During the discussion, De Houwer analyzes the conceptual implications of this work, including the way it relates to learning research in general.

• Is Derived Relational Responding Learned?
Steven C. Hayes, University of Nevada
Mark Dixon, PEAK
Jordan Belisle
Anne Blevins

The core conception of Relational Frame Theory is that derived relational responding is itself learned, and that once learned it in turn alters much more ancient learning processes. This talk will outline available evidence on these points, and will present new data using the PEAK curriculum showing that direct training of traditional verbal operants (PEAK-DT) and their generalization (PEAK-G) does not increase derived relational responding, but that application of the PEAK module for equivalence (PEAK-E), does do so. These results provide additional support for view that derived relational responding is acquired as an operant.The implications of this idea for behavioral and cognitive accounts of language and cognition will be briefly explored.

• The Implicit Association Test as an analogical learning task
Ian Hussey, Ghent University
Jan De Houwer, Ghent University

The Implicit Association Test (IAT) is a popular tool for measuring attitudes. We suggest that performing an IAT could, however, also change attitudes via analogical learning. For instance, when performing an IAT in which participants categorize (previously unknown) Chinese characters, flowers, positive words, and negative words, participants could infer that Chinese characters relate to flowers as negative words relate to positive words. This analogy would imply that Chinese characters are opposite to flowers in terms of valence and thus that they are negative. Results confirmed that learning via analogy can take place when performing an IAT. We discuss the implications of our findings for research on analogy and research on the IAT as a measure of attitudes.

• Empirical advances in studying relational networks
Shane McLoughlin, University of Chichester
Ian Stewart, National University of Ireland Galway

The relating of relations is a key feature of the development of complex relational networks. Despite this, thus far there has been little empirical study of this phenomenon, outside of analogy. The latter, which involves coordination of relational networks, is indeed an important example of the relating of relations but there are other examples that can also be involved in complex relational framing. Experiment 1 extended previous research by exploring non-coordinate relating of relations in adult participants. First, Crel functions of YES, NO, SAME, DIFFERENT, and OPPOSITE were established in arbitrary stimuli using a multi-stage Relational Evaluation Procedure (REP). Then participants were tested for the evaluation of various forms of relating of relations including deriving coordination, distinction and opposition relations between relations. Three out of four participants showed predicted patterns of behavior. In Experiment 2, these same three participants showed transformation of contextual control functions via the relation of relational networks. Implications and future research directions are discussed.

112. Experimental and Clinical Analyses of Rumination and Repetitive Negative Thinking
Symposium (12:45-14:00)
Components: Conceptual analysis, Original data
Categories: Relational Frame Theory, Clinical Interventions and Interests, ACT, Emotional disorders
Target Audience: Beg., Interm., Adv.
Location: Buhaira

Ángel Alonso, Madrid Institute of Contextual Psychology
Carmen Luciano, Universidad de Almería

The current symposium presents RFT and ACT research on rumination and repetitive negative thinking (RNT). The first study investigates mood-congruent memory as one of the relational processes involved in rumination. The study aimed to explore the extent in which negative-mood induction produces mood-congruent bias for stimuli with aversive rather than appetitive functions during a free recall task. The second study analyzed the relations between thoughts that trigger rumination by conducting an analog study involving rumination induction procedures. Furthermore, the study also analyzed the effect of defusion protocols involving different degrees of hierarchical framing in the context of rumination. Lastly, the third study presents a summary of three clinical studies with brief and preliminary RNT-focused ACT protocols applied to emotional disorders. In conclusion, this symposium is a good representation of the reticular model of scientific research supported by contextual behavioral science.

• A Relational Frame Theory Account of Mood-Congruent Memory
L. Jorge Ruiz-Sánchez, Universidad de Almería
Carmen Luciano, Universidad de Almería

Mood-Congruent Memory refers to when people’s memories match how they feel, such that when they are in a negative mood, they have more unpleasant than pleasant memories. We aimed to explore the extent in which negative-mood induction produces mood-congruent bias for stimuli with aversive rather than appetitive functions during a free recall task. Three 6-member equivalence classes were established under contextual control using pseudo-words. A1 and B1 were trained to participate in an equivalence class with C1, D1, E1 and F1 (Class 1) in one context (Context 1), and with C2, D2, E2 and F2 (Class 2) in another context (Context 2). A third class (A3-F3) was established in both contexts. B1 and C1 were conditioned negatively using shocks in Context 1 while B1 and C2 were positively conditioned using earning points in Context 2. Finally, participants were asked to recall the pseudo-words related to B1 in a new context (Context 3) after the implementation of neutral and negative-mood induction protocols.

• The hierarchical organization of triggers for rumination
Bárbara Gil-Luciano, Madrid Institute of Contextual Psychology
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz

Problematic rumination and worry are common denominators to many psychological disorders. These strategies are based on going around private events that seem to be organized at different levels as might be a hierarchical organization. The present study is exploring this with two ruminative induction protocols and its impact of ulterior intervention protocols. Forty participants were recruited in a Spanish University and randomly distributed in two conditions. All them went to phase 1: pre-test measures (questionnaires and in-live task). All them were evaluated in regard to discomfort and strength of own thoughts and emotions. Then, in phase 2, part of the participants went to one of two ruminative induction protocols. In phase 3, post-test measures were taken. Phase 4 consisted in all of them receiving a protocol in order to establish a hierarchical relation with their own's emotions and thoughts. Finally, all them went to phase 5 for additional post-test II measures. Results are discussed in terms of the relations involved in trigger for worry and rumination and the effect of the protocols to disrupt them.

• Effect of RNT-focused ACT protocols for emotional disorders.
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz
Cindy L. Flórez, Fundación Universitaria Konrad Lorenz
María B. García-Martín, Fundación Universitaria Konrad Lorenz
Diana García-Beltrán, Fundación Universitaria Konrad Lorenz
Andrea Monroy-Cifuentes, Fundación Universitaria Konrad Lorenz
Diana Riaño-Hernández, Fundación Universitaria Konrad Lorenz
Marco A. Sierra, Fundación Universitaria Konrad Lorenz

This paper summarizes the results obtained in several studies that tested the effect of brief protocols of ACT focused on reducing repetitive negative thinking (RNT) in the form of worry and rumination. All studies were preliminary and used single-case experimental designs. In the first study, the effect of a 2-session RNT-focused ACT protocol was implemented in 10 participants with moderate to severe emotional symptoms. In the second study, a 3-session protocol was applied with 6 individuals showing comorbid and severe levels of depression and generalized anxiety disorder (GAD). Lastly, in the third study, the same 3-session protocol was applied to 3 individuals showing GAD with the main domain of worry being the couple relationship. The results of the three studies showed very large effect sizes in symptoms reduction, measures of RNT, and ACT processes, with all participants showing clinically significant changes.

113. A New Measure of Psychological Flexibility Based (more) on RFT
Symposium (12:45-14:00)
Components: Conceptual analysis, Literature review, Original data, Didactic presentation
Categories: Clinical Interventions and Interests, Theoretical and philosophical foundations, Psychometrics, Measuring Psychological Flexibility
Target Audience: Interm.
Location: San Bernardo

Frank W. Bond, Ph.D, Goldsmiths, University of London
Dermot Barnes-Holmes, Ph.D., Ghent University

ACT and RFT theories are complex webs of ideas and constructs that researchers and clinicians constantly explore, and these efforts reveal new insights that, together with basic research, suggest new ways of understanding and measuring processes such as psychological flexibility (PF). This symposium discusses both the theoretical (Torneke et al., 2016) and empirical (Luciano et al., 2009) work that has led to the development and then testing of a new measure of PF, the Psychological Flexibility Indicator (PFI). In addition, research into this new measure reveals not only its psychometric properties, but it also critically suggests core issues concerning how we understand psychological flexibility, how we can enhance it clinically, and how we can begin to develop methodologies to better understand this construct.

• Why do we need a new measure of psychological flexibility?
Yvonne Barnes-Holmes, Ph.D., Ghent University

Early in the development of relational framing, relations of coordination are established between “I”, “me”, my own name, my own thoughts, feelings and my own behaviour. Similarly, relations of distinction are established between “I” and “you”, “others”, "other names"; temporal relations are also established between "now" and "then". Furthermore, research has shown that a hierarchical relation with my own behaviour is likely to be relatively effective and beneficial (e.g., Luciano et al., 2009). Such theory and recent research has led to a new exploration of RFT concepts, such as perspective taking and hierarchical framing (Torneke et al., 2016), to see how they can inform our understanding and measurement of psychological flexibility. This paper discusses these empirically based theoretical advances to show how they can inform clinical practice and how such advances may provide an opportunity for us not only to better understand and improve psychological flexibility but to measure it.

• Psychometric properties of the Psychological Flexibility Indicator (PFI)
Frank W. Bond, Ph.D, Goldsmiths, University of London
Joda Lloyd, Ph.D., Goldsmiths, University of London

This paper discusses why theoretical and empirical advances, in conjunction with limitations of the AAQ-II, warranted a new measure of psychological flexibility. It presents studies that tested the the initial item pool of this new measure of psychological flexibility, the Psychological Flexibility Indicator (PFI) (Bond, Lloyd, Barnes-Holmes, Torneke, Luciano, Barnes-Holmes, Guenole, in prep), its item reduction procedures, and its eventual factor structure that reveals insights into both to RFT and ACT theory and practice. Data from at least four studies will identify the measure's psychometric properties, including its factor structure, reliabilities, concurrent and predictive validates, and its performance in relation to the AAQ-II. Discussion will focus on psychometric, clinical and theoretical implications of these findings for both RFT and ACT.

• Measuring psychological flexibility is needed but how? Implications for basic and clinician domains
Carmen Luciano, Ph.D., University of Almeria

As discussed in this symposium, measuring psychological flexibility is a complex process that requires extensive knowledge of the theory underlying its definition. As has been noted in other papers, perspective and hierarchical framing are at the core according the experimental data (e.g., Luciano et al., 2011, Gil-Luciano et al., 2016; López, 2016), however, the way to measure those processes is not an easy endeavour, and further research is still needed to understand them more. Based on experimental research, this paper discusses different methodologies to measure it and its difficulties.

115. Acceptance, Mindfulness and Compassion-Based Interventions for Problem Eating Behaviors
Symposium (12:45-14:00)
Components: Literature review, Original data
Categories: Clinical Interventions and Interests, Functional contextual approaches in related disciplines, Binge Eating Disorder, Overweight and Obesity, ACT, Mindfulness
Target Audience: Beg., Interm., Adv.
Location: Utera

Increasing evidence points to the relevant potential impact of acceptance, mindfulness, and compassion-based interventions on health problems related to eating behaviors. This symposium presents four papers that focus on the application of such interventions to problems ranging from binge eating to obesity and overweightness. The first paper presents data on the efficacy of a low intensity pilot intervention for binge eating disorder aimed at promoting the development of compassion, mindfulness and psychological flexibility, with results showing a significant decrease in binge eating symptomatology and increases in body image-related psychological flexibility. The second paper presents follow-up results (up to 6 months) of an acceptance, mindfulness and compassion-based group intervention (Kg-Free) for obese and overweight women without binge eating disorder. Results show reductions in weight self-stigma, unhealthy eating patterns, and an improvement in quality-of-life. The third paper presents an innovative integration of ACT and wearable technologies (activity tracker and mHealth tools) for the development of an effective intervention in fostering healthy lifestyles for obese individuals. Finally, the fourth paper presents a review of the literature on the application of broadly defined mindfulness procedures (comprising MBSR, ACT, meditation, and mindful eating) as an agent for change in eating behaviors (weight reduction and prevention and treatment of eating disorders).

• The efficacy of a low intensity compassion, mindfulness and acceptance-based intervention for binge eating
Cristiana Duarte, Msc, Ph.D. Candidate, Cognitive and Behavioural Centre for Research and Intervention (CINEICC), Faculty of Psychology and Educational Sciences, UC
José Pinto-Gouveia, MD, Ph.D., Cognitive and Behavioural Centre for Research and Intervention (CINEICC), Faculty of Psychology and Educational Sciences, UC
James Stubbs, Ph.D., Appetite Control and Energy Balance Research Group, School of Psychology, University of Leeds

Evidence shows that shame, self-criticism and psychological inflexibility play a significant role in the development and maintenance of Binge Eating Disorder (BED). Interventions that target these processes and promote the development of compassion, mindfulness and psychological flexibility may be particularly suitable to treat this clinical condition. A recent pilot study tested the efficacy of a low intensity 4-week compassion, mindfulness and acceptance-based intervention – CARE (Compassionate Attention and Regulation of Eating Behaviour) – in women from the general community diagnosed with BED. Results revealed significant reductions in binge eating symptomatology, body shape and weight overvaluation, self-criticism and indicators of psychopathology; there were significant increases in body image-related psychological flexibility and in the ability to engage in compassionate actions. Most effects were stable at 1-month follow-up. Results suggest that innovative interventions focused on developing mindfulness, compassion and acceptance competencies may have beneficial impacts in eating behaviour and psychological adjustment in individuals with BED.

• Follow-up results from an acceptance, mindfulness and compassion-based group intervention (Kg-Free): Exploring who benefited the most from the intervention?
Lara Palmeira, CINEICC, Cognitive and Behavioral Research Centre, University of Coimbra
Marina Cunha, CINEICC, Cognitive and Behavioral Research Centre, University of Coimbra; Miguel Torga Superior Institute (ISMT), Coimbra, Portu
José Pinto-Gouveia, CINEICC, Cognitive and Behavioral Research Centre, University of Coimbra

Kg-Free is a 12-session group intervention that includes mindfulness, ACT and (self)compassion components for women with overweight and obesity without binge eating disorder. Results from the randomized controlled trial revealed that the intervention was effective in reducing weight self-stigma, unhealthy eating patterns and improving quality-of-life. This study aims to explore changes in outcomes at 3 and 6-months follow-up and to examine whether changes in main outcomes at follow-up were significantly different depending on baseline differences. Overall, 53 women with a mean of 42.55 years old (SD=9.05) and a mean BMI (Kg/h2) of 34.09 (SD= 5.30) participated. Results suggest significant improvements from baseline to 3-and 6-months follow-up in all outcomes. We also explored if changes in weight self-stigma, unhealthy eating behaviors, and quality-of-life at follow-up were significantly different depending on participants’ baseline levels of self-criticism and external shame. Clinical implications will be discussed.

• ACTonHEALTH study: promoting Psychological Flexibility with Activity Tracker and mHealth tools to foster healthy lifestyles for Obese Individuals
Giorgia Adelaide Varallo Del Signore, Istituto Auxologico Italiano - Clinical Psychological Lab
Roberto Cattivelli, Istituto Auxologico Italiano IRCCS, Department of Psychology, Catholic University of Milan, Milan, Italy
Margherita Novelli, Istituto Auxologico Italiano IRCCS
Alessandro Musetti, Department of Literature, Arts, History and Society, University of Parma, Parma, Italy
Chiara Spatola, Istituto Auxologico Italiano IRCCS, Department of Psychology, Catholic University of Milan, Milan, Italy
Emanuele Cappella, Department of Psychology, Catholic University of Milan, Milan, Italy

Obesity and overweight are growing steadily and becoming a global epidemic. Recent researches report a 64% of the adult population as overweight. The social and economical impact is increasing and the most of the rehabilitation programs, while effective in the short term, do not produce long lasting results. From a behavioral perspective an explanatory model can describe the phenomena with the lack of sources of reinforcement related to healthy habits in the daily-life context. The goal of this work, combining Acceptance and Commitment Therapy and Wearable Technology, is to develop an effective intervention, efficient and sustainable, which continues after ending of structured rehabilitation programs, providing adequate contingencies of reinforcement in the natural environment, integrating systematic measurements, continuous feedbacks and individualized, values-based objectives. Related goal-setting show a shift from results linked with weight loss towards action connected with healthy life-style.

• Mindfulness, Acceptance and Commitment Therapy, and Nutrition
Vivian Costa Resende Cunha, MSc, Pontifícia Universidade de Goiás, Brasil
Sônia Maria Mello Neves, PhD, Pontifícia Universidade Católica de Goiás, Brasil

The concept of mindfulness originates from oriental meditation practices and, since the early 90s, this practice has been used in psychology by contextualist behavior therapies and other public health disciplines. Using the PubMed database, 60 papers were found in the last 8 years that addressed mindfulness techniques for weight loss, for prevention and treatment of diseases or eating disorders, and as an agent for change in eating behaviors. Papers that related mindfulness for weight control had an n of 22, of which 4 used Acceptance and Commitment Therapy (ACT), 5 used meditation practices as a protocol, 8 used mindful eating practices, 2 used the Mindfulness Based Stress Reduction (MSBR) protocol, and 3 were systematic reviews and meta-analyses on mindfulness and weight loss. The mindfulness techniques has mostly been used by Nutrition professionals as an end in itself and not as part of psychotherapeutic treatment.

122. A Functional Direction: Understanding the Symptoms of Psychosis Using Relational Frame Theory
Symposium (15:15-16:45)
Components: Conceptual analysis, Original data, Didactic presentation, Case presentation
Categories: Relational Frame Theory, Clinical Interventions and Interests, , Theoretical and philosophical foundations, Functional contextual approaches in related disciplines, Psychosis
Target Audience: Interm.
Location: Prado

Corinna Stewart, School of Psychology, National University of Ireland, Galway
Dr. Eric Morris, La Trobe Psychology Clinic, School of Psychology and Public Health, La Trobe University, Melbourne, Australia

While the positive symptoms of psychosis have long garnered attention in clinical, cognitive, and neuropsychology, these phenomena have yet to be systematically explored within CBS. Recently however, there has been a “call to arms” for systematic, inductive and empirically informed functional analyses of delusions (Stewart, Stewart, & Hughes, 2016), dissociation and auditory hallucinations (McEnteggart et al., 2016). This symposium comprises researchers and clinicians working together to bring an Relational Frame Theory (RFT) approach to understanding, researching and supporting individuals with unusual experiences and psychosis. Drawing upon recent developments in “clinical RFT”, we present an overview of how persecutory delusions may be conceptualized in RFT terms and present data from preliminary research investigating threat anticipation and avoidance generalization. We then demonstrate how RFT can be used to inform case conceptualization and therapeutic intervention via a case study on persecutory delusions. Finally, we reflect on promising research directions, challenges, and the clinical implications of adopting an RFT approach to delusions and psychosis more generally. It will be argued that a contextual approach to understanding the experiences of psychosis has the potential to identify environmental influences that may lead to better-informed psychological interventions to help those distressed and disabled by these experiences.

• An RFT approach to the study of persecutory delusions
Corinna Stewart, School of Psychology, National University of Ireland, Galway
Dr. Sean Hughes, Department of Experimental Clinical and Health Psychology, Ghent University, Belgium
Dr. Ian Stewart, School of Psychology, National University of Ireland, Galway

Persecutory delusions are the most prevalent sub-type of delusional beliefs and are associated with a range of clinical phenomenon, including poor social functioning, anxiety, and depression. There has been a dearth of research investigating persecutory delusions from the functional-analytic perspective. This paper provides a starting point for functionally-oriented researchers and clinicians interested in this phenomenon. Drawing on RFT research, we provide a substantially bottom-up, functional interpretation of persecutory delusions. Specifically, we define delusional beliefs as behaviors (i.e., derived relational responding; DRR) and attempt to identify the learning histories and environmental factors supporting this behavior. DRR may be responsible for formation and generalization of fear, threat-beliefs, avoidance, and other psychological properties characteristic of persecutory delusions, especially for stimuli and events never previously contacted. Data is presented investigating generalization of threat anticipation and avoidance functions to stimuli not directly paired with interpersonal threat. Educational objective: To conceptualize persecutory delusions from an RFT perspective.

• A functional analytic perspective on paranoia: A case study
Dr. Joe Oliver, University College London & Camden and Islington NHS Foundation Trust
Dr. Yvonne Barnes-Holmes, Department of Experimental Clinical and Health Psychology, Ghent University, Belgium

There is an increasing interest among members of the CBS community in how therapies, especially Acceptance and Commitment Therapy (ACT), can be more directly informed by RFT. The current paper presents an on-going case summary in which ‘verbal functional analysis’ and the ‘drill-down’ featured strongly in case formulation and clinical focus. The case involved an adult woman with paranoia, who had been diagnosed with psychosis, and had an extended history of familial and other abuse. The paper highlights the importance of the deictic relations and how disturbances in the development of these relations may contribute to experiences of paranoia. This complex case illustrates the broad utility, and functional-analytic focus, of using conceptual developments in RFT to guide clinical work. Educational objective: To understand how RFT can be used to provide a functional analytic account of paranoia.

• Using ‘verbal functional analysis’ and the ‘drill down’ in complex clinical cases
Dr. Yvonne Barnes-Holmes, Department of Experimental Clinical and Health Psychology, Ghent University, Belgium
Dr. Ciara McEnteggart, Department of Experimental Clinical and Health Psychology, Ghent University, Belgium
Dr. Joe Oliver, University College London & Camden and Islington NHS Foundation Trust

The current paper is part of an ongoing effort to better connect or stretch RFT to the complexities of clinical phenomena. Drawing upon the case study presented in Paper 2, the current paper illustrates the way in which verbal functional analysis and the drill-down featured strongly in the case formulation and clinical focus. First, verbal functional analysis is an approach to identifying and targeting the relational networks that seem to be clinically relevant, to create broad and flexible repertoires of relational responding. Second, the drill-down aims to provide a bottom-up approach to the relational processes (with specific focus on the deictic relations) of the therapeutic alliance. The paper attempts to illustrate how therapeutic work can remain closely connected to basic theory and argues that it will be important in future work to further expand these connections with ongoing developments in RFT. Educational objective: The paper aims to illustrate how therapeutic work can remain closely connected to the basic concepts of RFT.

123. Shifting the Focus from Feeling Good to Doing Well: Empirical Studies on Valued Aspirations and Behaviors, and Their Implications for Clinical Practice
Symposium (15:15-16:45)
Components: Conceptual analysis, Literature review, Original data, Didactic presentation
Categories: Clinical Interventions and Interests, Theoretical and philosophical foundations, Functional contextual approaches in related disciplines, Measurement
Target Audience: Beg., Interm.
Location: Nervión Arenal I

Professor Joseph Ciarrochi, Institute for Positive Psychology and Education, Australian Catholic University, Strathfield, NSW, Australia
Dr. Baljinder Sahdra, Institute for Positive Psychology and Education, Australian Catholic University, Strathfield, NSW, Australia

Acceptance and Commitment Therapy (ACT) focuses on altering the environment to activate value consistent behavior rather than altering internal mental states. In support of this conceptual and clinical orientation towards valued action, this symposium includes three presentations providing evidence for the importance of values and behavior in promoting positive functioning. Using diverse samples and methodologies, we will demonstrate that the intention to behave in line with one's values, as well as the behaviors themselves, reduce suffering and promote well-being. What you want to do, what you say you do, and what you actually do, all play a role in enhancing well-being. Furthermore, it is crucial to know the function of valued behaviors, not just those behaviors in isolation. The symposium will reinforce key principles of ACT through a holistic lens and empirically demonstrate that the contextual and functional details are key in identifying and encouraging valued action.

• Expanding the circle of aspirations: Intrinsic value patterns relate to positive functioning when they centre on community giving
Emma Bradshaw, Institute for Positive Psychology and Education, Australian Catholic University, Strathfield, NSW, Australia
Dr. Baljinder Sahdra, Institute for Positive Psychology and Education, Australian Catholic University, Strathfield, NSW, Australia
Professor Joseph Ciarrochi, Institute for Positive Psychology and Education, Australian Catholic University, Strathfield, NSW, Australia
Dr. Philip Parker, Institute for Positive Psychology and Education, Australian Catholic University, Strathfield, NSW, Australia
Tamás Martos, Department of Personality, Clinical and Health Psychology, University of Szeged, Szeged, Hungary
Professor Richard Ryan, Institute for Positive Psychology and Education, Australian Catholic University, Strathfield, NSW, Australia

Aspirations can be extrinsic (wealth, fame and attractiveness) or intrinsic (personal growth, relationships, community giving and health). It is often assumed that intrinsic is “good” and extrinsic is “bad” for well-being. However, typically observed small correlations between intrinsic and extrinsic values suggest that they are not universally divergent and may even be convergent in some people. Bifactor structural equation modelling and latent profile analysis of two independent samples from Australia (N=1632) and Hungary (N=3370) yielded three replicable latent profiles: Disengaged from relationships and health (P1); Aspiring for interpersonal relationship and health (P2); and aspiring for community relationship and giving (P3). P1 reported the lowest levels of positive functioning and P3 the highest, even after controlling for the individual aspirations. These results suggest that extrinsic aspirations may not be inherently negative if the aspiration profile favors intrinsic values, and that community involvement is important for well-being.

• The Six Ways to Well-Being (6WWeb): A new measure of behaviors that reduce mental ill-health and promote well-being
Geetanjali Basarkod, Institute for Positive Psychology and Education, Australian Catholic University, Strathfield, NSW, Australia
Professor Joseph Ciarrochi, Institute for Positive Psychology and Education, Australian Catholic University, Strathfield, NSW, Australia
Dr. Baljinder Sahdra, Institute for Positive Psychology and Education, Australian Catholic University, Strathfield, NSW, Australia

CBS-based interventions limit direct attempts to change emotional states like anxiety, and focus on activating value-consistent behaviors. However, most CBS outcome studies focus on emotional states. The Six Ways to Well-being (6WWeB) measures behaviors that are theorized to promote well-being: connecting with others, challenging oneself, giving, engaging in physical activity, embracing the moment, and caring for oneself. The measure also assesses motivation for each behavior (autonomous versus controlled). American (N = 1800) and Australian (N = 1563) participants completed the 6WWeb and related measures. Structural equation models including factors of autonomy and pressure in general and specific to each of the six domains fit the data well. The 6WWeb predicted substantial variance in mental–ill health and well-being, and related in theoretically expected ways to personality. The 6WWeb may be a useful outcome measure that orients clients towards activating value-consistent behavior rather than reducing symptoms.

• Increasing valued behaviors precedes reduction in suffering
Professor Andrew Gloster, University of Basel, Department of Psychology, Division of Clinical Psychology and Intervention Science, Basel, Switzerland
Dr. Jens Klotsche, German Rheumatism Research Centre Berlin, Leibniz Institute, Epidemiology Unit, Berlin, Germany
Professor Joseph Ciarrochi, Institute for Positive Psychology and Education, Australian Catholic University, Strathfield, NSW, Australia
Prof. Georg Eifert, Chapman University, Orange, CA, USA
Dr. Rainer Sonntag, Private Practice, Olpe, Germany
Prof. Hans-Ulrich Wittchen, Technische Universität Dresden, Department of Psychology, Institute for Clinical Psychology and Psychotherapy, Dresden, Germany
Prof. Jürgen Hoyer, Technische Universität Dresden, Department of Psychology, Institute for Clinical Psychology and Psychotherapy, Dresden, Germany

Psychological flexibility theory suggests three key processes of change: increases in value-directed behaviors, reduction in struggle with symptoms, and reduction in suffering. We hypothesized that ACT would 1) increase valued behaviors and 2) exact change such that increases in valued action and decreases in struggle would precede change in suffering. Data were derived from a randomized clinical trial testing ACT for treatment-resistant patients with primary panic disorder (n= 41). Valued behavior, struggle, and suffering were assessed at each of eight sessions. Valued actions increased during therapy such that the discrepancy between what one said is important and what they actually did decreased. Struggle with symptoms and suffering also changed throughout therapy. Levels of valued behaviors influenced subsequent suffering, but the other two variables did not influence subsequent levels of valued action. These finding supports a central tenet of ACT that increased (re-)engagement in valued behaviors precedes reductions in suffering.

126. Development and Validation of Measures of Processes of Contextual Therapies
Symposium (15:15-16:45)
Components: Conceptual analysis, Original data
Categories: Clinical Interventions and Interests, Prevention and Community-Based Interventions, Theoretical and philosophical foundations, Adolescents, ACT Assessment, Measurement, Emotion Regulation
Target Audience: Beg., Interm., Adv.
Location: Buhaira

The development of psychometrically sound scales that measure the most relevant processes of contextual therapies is an important endeavor. A good number of scales have been designed in the last years; however, more research is still needed on adapting these scale to different languages and to design new and enhanced scales. This symposium presents advancements in this direction. The first presentation will present psychometric data of the Italian adaptation of the Child and Adolescent Mindfulness Measure (CAMM) and the Avoidance and Fusion Questionnaire for Youth (AFQ-Y). The second presentation will present data that supports the use of a new scale, the Comprehensive assessment of Acceptance and Commitment Therapy processes (CompACT). Lastly, the third paper will present a new scale that measures regulation difficulties associated with emotional overcontrol.

• Mindfulness Skills, Psychological Flexibility and Internalizing problems in adolescents: ACT-oriented measures for clinical assessment
Marta Schweiger, IULM University, Milan - Italy
Arianna Ristallo, IESCUM, Italy
Annalisa Oppo, Sigmund Freud University , Milan - Italy
Francesca Pergolizzi, IESCUM, Italy
Nanni Presti, Kore University, Enna - Italy
Paolo Moderato, IULM University, Milan - Italy

Providing psychometrically sound instruments is necessary in order to guide treatment decisions consistent with ACT processes. There are only few ACT-oriented self-reports tailored on young people: Child and Adolescent Mindfulness Measure (CAMM) and Avoidance and Fusion Questionnaire for Youth (AFQ-Y). Italian version of those measures (I-CAMM and I-AFQ-Y) had been validated and they showed good psychometric properties. 1336 participants, aged between 11 and 18, were enrolled in twelve schools all over Italy. The first aim of the study is to identify cut-offs that optimize sensitivity and specificity of I-CAMM an I-AFQ-Y in order to detect adolescents with internalizing problems assessed by Youth Self-Report (YSR): cut-offs are 24 for the I-CAMM and 11 for the I-AFQ-Y. Furthermore using a Classification Tree Analysis (CTA), groups of adolescents with specific characteristics are identified: in anxious-depressed adolescents, Withdrawn/Depressed symptoms are associated with low mindfulness skills, while Somatic/Complaints symptoms are associated with psychological inflexibility. Finally, correlation of ACT questionnaire with anxiety and depression measures (RCMAS-2 and CDI) are presented. The detection of homogeneous groups with specific behavioral patterns can help clinicians in decision making process about treatment. The potential uses of the I-CAMM and I-AFQ-Y in research and clinical practice are discussed.

• Development and continuing validation of the Comprehensive assessment of Acceptance and Commitment Therapy processes (CompACT)
David L. Dawson, DClinPsy, University of Lincoln
Nima Golijani-Moghaddam, University of Lincoln

Extant ACT process measures are typically circumscribed in their focus and have been subject to critique in terms of validity and conflation with distress measurement. In this presentation, we describe the development and ongoing validation of a new general measure of ACT processes (the CompACT). In phase one, ACT experts rated the face and content validity of 106 items using a Delphi consensus methodology, producing an initial 37-item measure. In phase two, a general population sample (N=377) completed this measure; exploratory factor analysis suggested a theoretically-coherent three-factor structure for a 23-item version of the CompACT. Work from these phases was recently published in JCBS. During this presentation, phase-three results (confirmatory factor analysis and assessment of test-retest reliability, using an independent sample [N~440]) will be reported for the first time. Results from previous phases indicate that the CompACT holds promise as a valid measure of general ACT processes.

• A transdiagnostic approach to emotion regulation: The development and validation of two scales of emotion regulation
Lauren Borges, Ph.D., Rocky Mountain Mental Illness Research, Education, and Clinical Center
Amy Naugle, Ph.D., Western Michigan University

Recent research suggests the transdiagnostic role of emotion regulation in the development and maintenance of psychopathology. Extant scales of emotion regulation, however, do not capture the transdiagnostic scope of this construct. These measures neglect the emotion regulation difficulties associated with emotion overcontrol. To address these gaps in the literature, a scale of emotion undercontrol and a scale of emotion overcontrol were developed from 305 undergraduates who completed preexisting measures of emotion regulation and personality. The emotion regulation strategies most predictive of personality disorders and traits associated with emotion overcontrol (e.g., Obsessive Compulsive Personality Disorder; propriety) and emotion undercontrol (e.g., Borderline Personality Disorder; disinhibition) formed item pools for exploratory factory analyses. Resulting from these analyses, two scales were formed which shared dimensions of emotional avoidance, emotion identification, emotional control, and emotional interference. The undercontrol scale included three unique factors of emotional tolerance, emotional reactivity, and emotional expressivity whereas emotional judgment and emotional reappraisal represented two unique facets to emotional overcontrol. These scales were found to be reliable and valid in the current sample. Implications for assessing emotion regulation and future directions for research are discussed.

• The Development of the Flexibility of Responses to Self-Critical Thoughts Scale (FoReST)
Ross White Ph.D, DClinPsy, University of Liverpool
Peter Larkin, NHS Greater Glasgow and Clyde
Annette Lloyd, NHS Greater Glasgow and Clyde

Background: This paper reports on the development of ‘The Flexibility of Responses to Self-Critical Thoughts Scale’ (FoReST); a measure specifically designed to assess psychological flexibility in relation to self-critical thoughts. Method: In Study 1, a convenience sample of 253 adults was recruited to investigate the factor structure and construct validity of the FoReST in a non-clinical sample. In Study 2, a total of 132 individuals attending Primary Care and Community Mental Health Teams in two health trusts in the UK participated in an investigation of the factor structure, construct validity and internal consistency in a clinical sample. Results: In both studies a two-factor (unworkable action and avoidance) structure for the FoReST was identified. The measure demonstrated good internal consistency, concurrent validity and predictive validity in both studies. Conclusions: The FoReST appears to be a valid assessment measure for administering to individuals with and without mental health difficulties. This measure could have important application for evaluating third wave therapies such as Acceptance and Commitment Therapy (ACT) and Compassion Focused therapy (CFT).

127. Research on the Negative Effects of Experiential Avoidance
Symposium (15:15-16:45)
Components: Original data
Categories: Clinical Interventions and Interests, Prevention and Community-Based Interventions, Behavioral medicine, Theoretical and philosophical foundations, Experiential avoidance, Aggression, Borderline Personality Disorder, Military Sexual Trauma, Smoking cessation
Target Audience: Interm.
Location: San Bernardo

The analysis of the negative effects of experiential avoidance in mental health and quality of life variables has been one the most productive areas of research within the Contextual Behavioral Science. However, experiential avoidance is so pervasive that many relations with other processes and outcomes remain uninvestigated. This symposium will present research that advances in this direction. The first presentation will show the attentional correlates of experiential avoidance in dementia caregivers. The second paper examines the role of experiential avoidance in the relationship between Borderline Personality features and aggression. The third presentation will discuss psychological flexibility in reference to professional mental health staff, personally and professionally. Overall, these presentations show the pervasive and counterproductive nature of experiential avoidance.

• Attentional correlates of Experiential avoidance in dementia caregivers
Isabel Cabrera, Ph.D, Universidad Autónoma de Madrid
María Márquez-González, Ph.D, Universidad Autónoma de Madrid
Andrés Losada, Universidad Rey Juan Carlos de Madrid
Carlos Vara, Universidad Autónoma de Madrid
Laura Gallego-Alberto, Universidad Autónoma de Madrid

Cabrera, I., Márquez-González, M., Losada, A., Vara, C., & Gallego-Alberto, L. Background: Experiential avoidance in caregiving (EAC) has been related to dementia family caregivers´ distress. This study aims to explore EAC-related attentional biases. Method: Ninety-one caregivers completed: a) a dot-probe task with emotional pictures varying in content and time of exposure; and b) the Experiential Avoidance in Caregiving Questionnaire. Results: A mixed design ANOVA was carried out with one between-subjects factor (EAC: high, low) and three within-subjects factors (picture valence: distressing, positive; picture content: general, caregiving-related; and time: 100 and 500 ms). A significant four-way interaction was found. High-EAC participants showed avoidant attentional biases or not attention to emotional pictures. Low-EAC participants showed an attentional bias for positive general information and an avoidant bias for distressing general information, and the opposite pattern for caregiving-related stimuli. Conclusion: High EAC levels were associated with general avoidant attentional biases, whereas low EAC levels were related to a more selective and adaptive attentional pattern.

• A Prospective Examination of Processes Influencing the Relationship between Borderline Personality Features and Aggression: Experiential Avoidance and Anger Rumination as Mediators
John J. Donahue, Psy.D., University of Baltimore
Rebecca Thompson, Ph.D., University of Baltimore

Borderline Personality Disorder (BPD) features have been associated with increased aggression toward others. Under the Emotional Cascade Model (ECM; Selby & Joiner, 2009), rumination is proposed to intensify negative emotionality and attention toward emotional stimuli, resulting in behavioral dysregulation such as aggression. While not explicitly included within the ECM, experiential avoidance (EA) is a process that is considered to play a key role in BPD (Iverson et al., 2012), is a proxy risk factor for rumination (Spinhoven et al., 2016), and is associated with aggression (Reddy et al., 2011). The present study therefore seeks to longitudinally examine the role of EA and anger rumination in explaining the relationship between BPD features and aggression in a community sample of participants high in emotion dysregulation. One hundred and seven participants (51% women, mean age = 30.94, SD = 7.33) were recruited to participate in a six-month prospective study with three assessment points. Data collection is ongoing and the second assessment point has recently completed. Preliminary results support a serial mediation model with a significant indirect effect of time 1 BPD features on time 2 aggression through EA and anger rumination. Specifically, a bias-corrected bootstrap confidence interval for the indirect effect (B = .07) based on 5,000 bootstrap samples did not include zero (.01, .20). The final presentation will report analyses based on all three time points and discussion will emphasize the interplay between EA and rumination on aggression among those with BPD features.

• Psychological flexibility: an investigation in mental health staff at the individual, leadership, and team level, and its impact on service user outcomes
Danielle Lamb, University College London
Professor Sonia Johnson, University College London

This research investigates one of the key elements of Acceptance and Commitment Therapy (ACT), psychological flexibility. This paper reports the findings of a longitudinal study with NHS staff (n=445) working in Crisis Resolution Teams (24/7 mental health teams in the UK providing care at home to those in mental health crisis, with the aim of avoiding hospital admission). Psychological flexibility has been investigated at three levels: 1) the individual level, where results support previous research, that higher levels of psychological flexibility predict better wellbeing outcomes (measured via burnout, work engagement, and general psychological health); 2) the leadership level, where results indicate some support for the hypothesis that higher manager psychological flexibility is associated with better wellbeing outcomes in their staff; and 3) the team level, where data will be presented on whether higher team-level psychological flexibility is associated with better service user outcomes. This research aims to provide both guidance to service planners and managers, and a conceptual account of complex psychological constructs and their impact in an occupational context.

• Could experiential avoidance mediate the relationship between stress and tobacco smoking?
Vasiliki Christodoulou, Mental Health Services, Cyprus
Maria Karekla, University of Cyprus
Georgia Frangou, University of Cyprus

Notable scholarly attention has been given to the existence of a significant association between stress and tobacco smoking. However, few studies have investigated the mechanisms underpinning this relation. The present study aims to reinforce current evidence indicating that experiential avoidance may be a viable underlying mechanism underpinning the relation between stress and smoking, as well as being a predictor of low motivation to quit and poor quit outcomes. Participants will complete demographics and smoking history questionnaires, a motivation to quit assessment, a Carbon Monoxide measurement, a Fagerström Test for Nicotine Dependence (FTND), a stress scale and an Avoidance and Inflexibility Scale (AIS). We predict that experiential avoidance will act as a mediating mechanism between stress and level of nicotine dependence. In addition, it is expected that a higher level of experiential avoidance will be predictive of lower motivation to quit smoking as well as of a history of failed quit attempts. The role of experiential avoidance as a mechanism affecting smoking behavior may be an important variable in terms of designing more effective smoking cessation programs.

128. Applying and Adapting ACT with Adults with Intellectual Disabilities
Symposium (15:15-16:45)
Components: Original data, Didactic presentation, Case presentation
Categories: Clinical Interventions and Interests, Professional Development, Intellectual Disabilities
Target Audience: Beg.
Location: Lebrija

Nick Gore, DClinPsy, Tizard Centre, University of Kent
Nick Gore, DClinPsy, Tizard Centre, University of Kent

This symposium presents some recent work applying ACT with an intellectual disabilities population, a population that traditionally requires careful adaptation to talking therapies. The first paper defines this client group and covers some of the lessons learned when working with ACT; including the need to consider deficits in relational framing ability when trying to work with thoughts and feelings, and the need to develop an appropriately accessible measure of psychological flexibility. The second paper presents the work of a mindfulness group delivered to people with intellectual disability and features videotaped testimony of the participants’ reactions. The final paper reports on a six-session ACT group intervention for adults with intellectual disabilities. It presents data showing symptom reduction despite its brief duration, and even though symptom reduction was not pursued. Adaptations made and lessons learned will be discussed throughout the symposium.

• Working with ACT with people with intellectual disabilities - Lessons learned and areas for development.
Mark Oliver, DClinPsy, Northumberland, Tyne and Wear NHS Foundation Trust

There is every reason to expect that the same verbal processes that contribute to psychological distress in the typically developing population also apply to people with intellectual disability (PWID). Unfortunately, the cognitive and developmental deficits presented by this population present a challenge to many ACT interventions, particularly those that use verbally sophisticated metaphors, orienting to metacognitions, and the targeting of deictic frames. In addition, the freedom to engage in value-guided activities is frequently constrained by the lived experience of being supported by paid and unpaid carers. The challenge for clinicians is to identify ways of adapting ACT to meet the needs of PWID while remaining true to the processes considered to be responsible for therapeutic change. This paper outlines examples of lessons learned through adapting ACT for an ID population, highlighting a number of directions where more clinical development is needed to mediate the cognitive limitations of this client group.

• Using ACT to enhance a mindfulness based intervention for adults with intellectual disabilities
Steve Noone, Ph.D, Northumberland, Tyne and Wear NHS Foundation Trust

Given the vulnerability of people with intellectual disabilities, it is important to help promote resilience to anxiety and depression. Mindfulness Based Interventions, delivered in groups, have a strong evidence base. Some studies have shown that these approaches can be adapted for this population. It remains unclear how best to do this. This paper describes adaptations that include using core ACT principles and collaborating with a self-advocacy group to promote practice and values clarification

• The Resilience Group: An Acceptance and Commitment Therapy based Group for People with Intellectual Disabilities
Matthew Selman, DClinPsy, Northumberland, Tyne and Wear NHS Foundation Trust
Kay Rooney, Northumberland, Tyne and Wear NHS Foundation Trust
Kelly Cocallis, Tees, Esk and Wear Valley NHS Foundation Trust
Mark Oliver, DClinPsy

This presentation reports on the use of an ACT group intervention for people with mild intellectual disabilities who were experiencing mild/moderate levels of psychological distress (anxiety and depression). This is the first reported use of a group ACT intervention for this client population. Two groups were run parallel to each other over six sessions – each session focussing on an element of the Hexaflex. Pre and post measures of psychological distress were administered along with measures of values. A focus group was held to gain the participants experience and ideas for improvement. Feedback was positive about the group experience and engaging in values. While not the aim, significant symptom reduction was experienced across both groups. Participants described wanting more sessions. Discussion around adaptations and the need for a measure of psychological flexibility are included. Difficulties in conveying some of the concepts used within ACT for this client group are also noted.

129. Gender and Acceptance-Based Treatment Approaches in Punishing Contexts
Symposium (15:15-16:45)
Components: Conceptual analysis, Literature review, Original data
Categories: Clinical Interventions and Interests, Prevention and Community-Based Interventions, Gender Differences, Treatment Outcomes, Acceptance-Based Treatments, Aggression
Target Audience: Beg., Interm., Adv.
Location: Utera

Robyn L. Gobin, Ph.D., University of Illinois at Urbana Champaign
Thomas Szabo, Ph.D., Florida Institute of Technology

Gender influences how people understand themselves and their risk for certain experiences (e.g., aggression in intimate relationships). Iverson et al., (2013) found gender differences in risk for several forms of interpersonal aggression. The negative consequences of physical and nonphysical forms of aggression have been documented (Arriaga & Schkeryantz, 2015; Iverson et al., 2013), yet little research has examined the impact of gender and contextual factors on one’s experience of aggression and treatment outcomes. Acceptance-based treatment approaches differ from traditional therapies in their focus on functional processes that maintain ineffective behaviors rather than symptom characteristics (McClean & Follette, 2016). Featuring conceptual and research-based talks, the proposed symposium will explore associations between gender and aggression and gender differences in response to acceptance-based treatment approaches. Context will be emphasized with specific attention to the contexts of the military, chronic pain, and intimate partner violence. Future research directions and clinical implications will be discussed.

• Gender Differences in Response to Acceptance and Commitment Therapy among U.S. military veterans
Robyn L. Gobin, Ph.D., University of Illinois at Urbana Champaign
Ariel J. Lang, Ph.D., MPH, VA San Diego Healthcare System, Center of Excellence for Stress and Mental Health
Shahrokh Golshan, Ph.D., VA San Diego Healthcare System
Carolyn Allard, Ph.D., VA San Diego Healthcare System, Center of Excellence for Stress and Mental Health
Jessica Bomyea, Ph.D., VA San Diego Healthcare System, Center of Excellence for Stress and Mental Health
Paula P. Schnurr, Ph.D., National Center for PTSD, White River Junction
Jennifer L. Strauss, Ph.D., Duke University Medical Center; Department of Veterans Affairs, Washington, DC

Little is known about the impact of gender on treatment response. The majority of our knowledge base regarding treatment response among veterans comes from predominantly male samples. However, the extant literature suggests that women and men use different coping strategies, which may impact how effective specific treatments are across genders. The purpose of this investigation was to examine gender differences in response to Acceptance and Commitment Therapy (ACT), an empirically-supported transdiagnostic psychotherapy. A secondary data analysis of a multi-site randomized controlled trial of ACT as compared to a psychotherapy control, Present Centered Therapy (PCT), was used. One hundred sixty Veterans (32 women and 128 men) of OEF/OIF/OND participated. In the larger trial, no significant differences were found between treatment conditions in reducing the primary outcome, general distress, or most secondary outcomes (Lang et al., 2016). In this study of gender differences, women who received ACT reported greater reductions in PTSD and anxiety symptoms relative to those who received PCT, p<.01. There were no differences between ACT and PCT among men. These preliminary results suggest that ACT may be a promising treatment for psychologically-distressed women veterans. Clinical implications with be discussed.

• Women and Intimate Partner Violence: A Contextual Behavioural Science Perspective
Lene Forrester, Ph.D., BMI Healthcare
Jennifer L. Strauss, Ph.D., Duke University Medical Center; Department of Veterans Affairs, Washington, DC

Intimate Partner Violence (IPV) is recognised as a significant societal problem, in terms of its high frequency and the detrimental impact upon the predominantly female survivors (World Health Organisation 2012). Despite this knowledge, there is a relative paucity in the Contextual Behavioural Science (CBS) literature attempting to: (1) enhance our understanding of the complex gender and cultural dynamics underlying IPV, and (2) develop evidence-based interventions aimed at empowering women to leave these destructive relationships (Larson 2011). This paper will present a comprehensive review of the literature on this topic within the perspective of Relational Frame Theory (RFT). The impact of current and historical context will be addressed, and the relevance of gender as a factor in the aetiology, maintenance and impact of IPV will be emphasized. A targeted Acceptance and Commitment Therapy (ACT) intervention for women subjected to IPV contacting Women’s Aid, currently under development, will be presented for discussion.

• Punishing responses from significant others - important to address in acceptance-based pain management programs?
Marie Blom, M.S., Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
Björn Gerdle, PhD, Pain and Rehabilitation Centre, and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden

Social context is widely known to influence the experience of longstanding pain (Edwards et al, 2016). Diary studies have shown pain ratings to increase after being criticized by a significant other (Burns et al, 2013). The aim of this ongoing project, is to apply a contextual behavioral perspective in studying the effects of self-reported punishing responses from significant others on pain expressions (e.g., anger, irritation). Respondents (n~300) participated in an 8-10 week acceptance-based multiprofessional pain management program (PMP) for longstanding pain at a Swedish outpatient pain clinic, between January 2014 and September 2016. Relationship issues are addressed only to some degree in the PMP. The main aim of this study is to investigate whether an increased focus on such issues would be likely to benefit patients. Results will be presented on Multidimensional Pain Inventory (MPI-S), pain characteristics, Chronic Pain Acceptance Questionnaire (CPAQ), Hospital Anxiety and Depression Scale (HADS) and Life Satisfaction questionnaire (LiSat-11); before, after and at 1-year follow up after the PMP. Possibilities and difficulties of involving significant others in pain rehabilitation will be discussed.

130. Analyses of Deictic Relations
Symposium (15:15-16:45)
Components: Original data
Categories: Relational Frame Theory, Clinical Interventions and Interests, New Evidence in Hierarchical Framing- RFT, RFT, Performance
Target Audience: Beg., Interm., Adv.
Location: Estepa

Deirdre Kavanagh, Ghent University
Dermot Barnes-Holmes, Ghent University

This second symposium that focuses on experimental analyses of the deitic relations highlights the view that this is critically important verbal behavior, with developmental and clinical significance. Paper 1 explores the relationship between what is traditionally defined as empathy and deictic relational responding. The study explores the use of a relational empathy training protocol delivered to 8 typically-developing children, as measured against standardized assessments of emotional responding and perspective-taking. The findings show positive benefits associated with the training protocol in terms of perspective-taking and related behaviors. In the study decsribed in Paper 2, undergraduates are introduced to a stress induction procedure that, accompanied by various analog interventions that manipulate deictic relational responding (Deictic; Deictic+Hierarchical1; Deictic+Hierarchical1+Augmental; and Deictic+Hierarchical1+Augmental+Hierarchical2). The results show the superiority of the latter two interventions that each contain an augmental function. This study and its outcomes shed further light on the potential processes involved when deictic relations are manipulated for clinical purposes. In another study of hierarchical relations, Paper 3 explores the transformation of functions in accordance with these relations. In two contrasting conditions, contextual cues for hierarchy are manipulated and the results highlight the importance of previous learning in this regard.

• Establishing empathy: An exploratory study
Beatriz Harana, Ph.D. Student, University of Almeria
Carmen Luciano, Ph.D., University of Almeria
Adrián Barbero-Rubio, Ph.D., University of Almeria

Empathy has been addressed mainly from a cognitive standpoint but the numerous efforts still have not isolated the conditions under which it is produced. There is some agreement that empathy involves perspective taking and, accordingly, it might be studied as relational behavior (Relational Frame Theory (RFT). The main aim of this study is to develop a training protocol to establish empathy and evaluate its influence in traditional measures of emotions and perspective taking. A n=1 design is used with eight typical developing children and the protocol was implemented successively across participants. Results show an increase in the degree the child used perspective taking and behaved accordingly.

• An experimental analysis of the components involved in framing the own behaviour.
Juan C. López, Ph.D., Universidad de Almería
Carmen Luciano, Ph.D., Universidad de Almería & MICPSY

The current study aimed to thoroughly investigate the transformation of function involved in interacting with the own behaviour, typically known as defusion interactions. Deictic and hierarchical framing with augmental function have previously been identified in such interactions however the present paper is a somehow molecular analysis of the elements involved in such framings. 52 undergraduated completed two high-demand tasks at pre-test (PASAT-C and IRAP-Stroop). Next, they were randomly distributed and received one of four experimental protocols: Deictic Framing (D), whose interactions were built of only deictic framings on the ongoing discomfort and thoughts; D+Hierarchical framing (D+H), whose interactions were built adding to D the hierarchical function; D+H+Augmental (D+H+A) which explicitly added the augmental function; and the final condition which added the hierarchical discrimination of the whole ongoing process (D+H+A+H). They completed the two high-demand tasks as did as pre-test. Data showed the superiority of the D+H+A and D+H+A+H (those which included the explicit augmental function). These findings are discussed to make more explicit the processes or transformation involved in promoting effecive behaviors when discomfort is experimentally induced.

• One more step in analyzing hierarchical framing
Lidia Budziszewska, MS, Universidad Europea de Madrid, Spain
Carmen Luciano, University of Almeria,Spain
Enrique Gil, University of Almeria,Spain
Zaida Callejón, University of Almeria, Spain

The published evidence concerning transformation of functions in accordance with the relational frame of hierarchy is still very scarce; Gil, Luciano, Ruiz and Valdivia (2011) Gil, Luciano, Ruiz, Valdivia (2014) and Slattery & Stewart (2014).The aim of this study is to advance in such a track to provide more precise learning procedures. Participants were given two types of experimental histories prior to testing transformation of function according to hierarchical framing. The two conditions differed in the way the relational hierarchical cues were trained. In one case, participants received instructions to improve learning. In the other conditions, they did not. Participants followed several steps to learn to respond to arbitrary stimuli as coordination and relational hierarchical cues. Results show that participants reorganized stimuli according the previous learning especially when they received some specific instructions. Further research is discussed.

Sunday, 25 June

140. Investigación en Ciencia Conductual Contextual: Aportaciones Básicas y Aplicadas
Symposium (9:30-11:00)
Components: Datos originales
Categories: Intervenciones para mejorar el rendimiento
Target Audience: Beg., Interm., Adv.
Location: Buhaira

Este simposio presenta cuatro trabajos de diferentes procedencias que son una buena muestra del amplio abanico de posibilidades de investigación que permite abordar una perspectiva basada en la ciencia conductual contextual (contextual behavioral science: CBS), desde los aspectos más básicos al ámbito aplicado. El primer estudio se centra en la evaluación y el entrenamiento de la toma de perspectiva en niños desde la perspectiva de la RFT, esto es, como un tipo de comportamiento relacional deíctico. Este trabajo presenta una serie de modificaciones respecto a protocolos ya existentes de entrenamiento en marcos deícticos que parecen favorecer el desarrollo de este tipo de desempeño. El segundo trabajo presenta los resultados de un tratamiento ACT grupal para promover la adhesión al tratamiento antirretroviral (TAR) en pacientes infectados con VIH. La adhesión estricta al TAR es fundamental para que este tratamiento médico sea efectivo, y la intervención basada en ACT se muestra eficaz en la mejora de dicha adhesión. El tercer y cuarto trabajos que se incluyen en este simposio son estudios que han empleado el procedimiento de evaluación relacional implícita (IRAP) para explorar dos ámbitos de interés social. El tercer trabajo se centra en el análisis de las actitudes implícitas y explícitas hacia los alumnos con necesidades educativas especiales por parte de especialistas y profesores. El último trabajo presentado utiliza el IRAP para explorar las actitudes hacias las identidades catalana y española por parte de participantes catalanes y de otras partes de España. Ambos estudios muestran la utilidad del IRAP para detectar discrepancias entre actitudes implícitas y explícitas en sus respectivos ámbitos.

• Evaluación y entrenamiento de toma de perspectiva en niños: Reflexiones a partir de tres trabajos experimentales.
Luis Alberto Quiroga-Baquero, Fundación Universitaria Konrad Lorenz
María Isabel Rendón-Arango, Universidad Santo Tomás
Daniel Camilo Salas-Cuervo, Fundación Universitaria Konrad-Lorenz

Desde una perspectiva contextual-funcional, la Teoría de los Marcos Relacionales ha abordado teórica y empíricamente los fenómenos psicológicos relacionados con la toma de perspectiva, asumiéndolos como un tipo de responder relacional deíctico. La investigación empírica se ha centrado principalmente en el diseño de protocolos de evaluación y entrenamiento de marcos deícticos, así como en la replicación sistemática con el fin de aumentar su aplicabilidad y validez. El objetivo de esta serie experimental, fue implementar tres modificaciones a los protocolos formulados por McHugh, Barnes-Holmes y Barnes-Holmes (2004) y Davlin, Rehfeldt y Lovett (2011): (a) Entrenamiento previo en marcos de condicionalidad; (b) entrenamiento y evaluación de marcos deícticos en situaciones de interacción y manipulación directa; y (c) reducción de ensayos por fase e implementación de un diseño de líneas de base y pruebas múltiples a través de participantes y condiciones. Los resultados muestran que: (a) un entrenamiento previo en marcos de condicionalidad, promueve ejecuciones efectivas en las fases de evaluación y entrenamiento; (b) la evaluación y entrenamiento de relaciones deícticas en situaciones de interacción y manipulación directa de objetos favorece el desempeño en todas las fases del protocolo, en comparación con la utilización de situaciones hipotéticas; y (c) el uso de diseños de líneas de base y pruebas múltiples, permite identificar de forma más detallada los cambios en el responder relacional y promueve porcentajes de aciertos altos en cada fase. Estos hallazgos se discuten en términos de las dinámicas conductuales implicadas en el responder relacional deíctico, los supuestos de la investigación traslacional y los criterios de aplicabilidad, validez y eficiencia en la utilización de este tipo de protocolos.

• Efectos de la Terapia de Aceptación y Compromiso en la Adherencia al Tratamiento de Pacientes VIH de Bucaramanga
Cristian Leonardo Santamaria Galeano, Candidato a Magister, Universidad Pontificia Bolivariana, Seccional Bucaramanga
Ana Fernanda Uribe Rodriguez, Universidad Pontificia Bolivariana, Seccional Bucaramanga

El VIH es considerado una enfermedad crónica que implica mínimo un 95% de adherencia para garantizar el control viral y fortalecimiento inmunológico. Sólo una tercera parte de quienes acceden al tratamiento antirretroviral se adhieren a éste. Se aplicaron 8 sesiones de intervención a grupal a 17 pacientes VIH otros 28 fueron control, entre 18 y 50 años, en una institución de salud especializada en VIH. Se tomaron mediciones post-intervención y seguimiento con el cuestionario de adherencia al tratamiento (CAT-VIH), la escala de ansiedad y depresión (HAD) y el cuestionario de aceptación y acción (AAQ). Se encontraron diferencias estadísticamente significativas entre grupos en la medición del CAT-VIH en la post-intervención (p=.000) y el seguimiento p=.000. Al realizar el análisis de correlación, esta es negativa entre el CAT-VIH y el AAQ en la post-intervención (r=-.4) y el seguimiento (r=-.593). Se encontró correlación negativa entre la sintomatología depresiva y la adherencia al TAR en la post intervención (r=-.403); en el seguimiento se evidencia relación negativa entre la adherencia con la ansiedad (r=-.486) y la depresión (r=.510). Y correlación positiva entre el AAQ y la ansiedad (r=.542) y depresión (r=.372) en el seguimiento. Se evidencia la efectividad de un protocolo ACT en la adherencia al TAR. La relación inversamente proporcional entre las puntuaciones del AAQ y el CAT-VIH, ponen de manifiesto que a mayo evitación experiencial, los pacientes son menos adherentes al TAR.

• Usando el Procedimiento de Evaluación Relacional Implícita (IRAP) para Evaluar la Actitud del Profesorado hacia los Alumnos con Necesidades Educativas Especiales
Aurembiaix Llobera Cascalló, M. Sc., Universidad de Almería
Eduardo Miguel Blasco Delgado, Universidad de Almería

El presente estudio examina las actitudes implícitas y explícitas hacia el alumnado con Necesidades Educativas Especiales (NEE) en profesores de infantil-primaria (N= 11) y en profesores especializados en NEE (N= 12). Las actitudes implícitas se evaluaron a través de un Procedimiento de Evaluación Relacional Implícita (IRAP), mientras que las explícitas lo fueron a través de un cuestionario análogo al IRAP y el MBI-ED. Los resultados muestran diferencias entre las medidas implícitas y explícitas en ambos grupos. Así mismo, a nivel implícito, se ha encontrado un sesgo positivo hacia el alumnado con NEE en el grupo de especialistas y un sesgo negativo hacia el alumnado con NEE en el grupo de profesorado.

• Usando el Procedimiento de Evaluación Relacional Implícita (IRAP) para Evaluar las Actitudes hacia las Identidades Catalana y Española
Eduardo Miguel Blasco Delgado, M. Sc., Universidad Almería
Aurembiaix Llobera Cascalló, Universidad Almería

Un estudio basado en el Procedimiento de Evaluación Relacional Implícita (IRAP) fue diseñado para examinar las actitudes implícitas hacia la identidad catalana y hacia la identidad española en un grupo de catalanes (n = 17) y un grupo de personas del resto de España (n =16). Los participantes también completaron una medida explícita con ítems análogos al IRAP y el Cuestionario de Deseabilidad Social de Marlowe-Crowne. Los resultados muestran que ambos grupos presentan un sesgo más favorable hacia su grupo que hacia el otro grupo. También que el grupo Cataluña ha evaluado de forma menos favorable a los españoles que éstos a los catalanes. Finalmente, se ha confirmado que los participantes que han puntuado alto en la Escala Deseabilidad Social de Marlowe-Crowne, muestran discrepancias importantes entre lo contestado en el cuestionario explícito y el IRAP.

141. Assessing and Training Relational Framing in Children and Adults
Symposium (9:30-11:00)
Components: Original data
Categories: Relational Frame Theory, Educational settings, Children
Target Audience: Interm.
Location: San Bernardo

Ian Stewart, National University of Ireland Galway
Carmen Luciano, University of Almeria Spain

Relational frame theory (RFT) affords new insight into human language and cognition as arbitrarily applicable relational responding or relational framing. One key insight of RFT that derives directly from its operant roots is that relational framing can be targeted for training. This insight has most obvious application in the educational domain and this symposium presents a number of empirical studies centred on this theme and in particular on relational framing assessment and training with children. The first talk presents data showing the training of containment and hierarchical relational framing, the second provides data showing the training of same-difference relations, while the third discusses development of a tool for assessing operant fluency in relational framing in both children and adults and discusses measurement and training of relational operant behaviour in children and adults in light of their data.

• Facilitating Containment and Hierarchical Relational Responding Repertoires in Young Children
Teresa Mulhern, National University of Ireland Galway
Ian Stewart, National University of Ireland Galway

Relational Frame Theory (RFT) sees containment (A is in B; B contains A) and hierarchical (A is a type of B; B is a class containing A) relational responding as core repertoires for categorization. The current studies aimed to systematically train these repertoires including component skills of mutual and combinatorial entailment and transformation of function in young typically developing children. Study 1 focused on training arbitrary containment relational responding in three 5-year-olds using a combined multiple baseline (across both components and participants) design while Study 2 employed a combined multiple baseline design to facilitate arbitrary hierarchical relational responding in three 6-year-olds. In both cases, results showed the effectiveness of training for increasing responding in accordance with arbitrary containment and generalization was also observed. Results, including impact of training on standardized outcomes measures of intelligence broadly as well as categorization skill specifically, are discussed.

• Training children with autism in patterns of derived same and different relations
Siri Ming, National University of Ireland Galway
Ian Stewart, National University of Ireland Galway

The ability to identify similarities and differences between stimuli or concepts is a key skill in terms of development and academic success. In this study, two children with autism were trained to derive arbitrary relations of same/different using an iPad-based teaching protocol involving animals and their preferred foods. At baseline, neither child could derive arbitrary same/different relations either within the iPad game or based on a short text-based story. Following multiple exemplar training, both children could derive the relations with novel stimulus sets in both contexts. Implications for further research on same/different relations, curriculum development, and relevance for reading comprehension are discussed.

• Testing the predictive validity of an online relational responding fluency assessment
Shane McLoughlin, University of Chichester, UK
Sam Ashcroft, University of Chester, UK
Ian Tyndall, University of Chichester, UK
Antonina Pereira, University of Chichester, UK

This study aimed to develop an online tool for measurement of relational operant fluency. We administered a novel 72-trial derived relational responding (DRR) assessment to 50 people online (ages 8-59). This measured DRR accuracy and response latency for SAME / OPPOSITE and MORE / LESS relations at four levels of difficulty. From these accuracy / latency data, a fluency outcome variable was computed for each of four levels of both types of DRR. We then used correlation / regression analyses to investigate the relationship between relational operant behaviour (accuracy, latency, fluency) and several other outcome variables: (i) AAQ-2 performance, (ii) a novel response latency based measure of psychological flexibility, (iii) well-being (WHO Well-Being Index), (iv) self-efficacy in learning (e.g., Myself as a Learner Scale), (vi) attention and memory (immediate and delayed). Implications for measurement and training of relational framing in children and adults are discussed.

142. Using Different Methods to Study Clinical Applications II
Symposium (9:30-11:00)
Components: Didactic presentation
Categories: Relational Frame Theory, Clinical Interventions and Interests, Theoretical and philosophical foundations, Fear and Avoidance, Rule-governed Behavior
Target Audience: Beg., Interm., Adv.
Location: Lebrija

Dermot Barnes-Holmes, Ghent University

The current symposium is the second to explore and discuss different methodologies for studying clinical applications of RFT, covering fear of public speaking, spider phobia, and rule persistence. Paper 1 systematically compares analog interventions based on hierarchical-self and distinction-self in the context of public speaking as distress tolerance measured via self-report, skin conductance, and heart rate. The results show superiority of the hierarchical-self intervention and discusses the implications of this effect for clinical practice. Paper 2 compares two verbal rehearsal tasks (fear reduction vs. fear acceptance) on a spider-Fear IRAP and a spider-Avoid IRAP, as well as on a behavioral approach task with a live spider. Both IRAPs predict actual approach, with some evidence of differential moderating effects of the verbal rehearsal task similar to defusion. Paper 3 contains two studies that explore rule persistence in terms of levels of derivation (e.g., direct or derived rule) using an MTS task. The results show greater rule persistence with direct than derived rules, but only with extensive rule practice.

• Spider Fear and Avoidance: An Exploratory Study of the Impact of Two Verbal Rehearsal Tasks on a Behavior-Behavior Relation and its Implications for an Experimental Analysis of Defusion.
Aileen Leech, Ghent University
Dermot Barnes-Holmes, Ghent University

The current research sought to replicate and extend the findings reported by Leech, Barnes-Holmes, and Madden (2016) by examining the impact of a brief ‘verbal rehearsal’ task on performance on two Implicit Relational Assessment Procedures (IRAPs), actual approach behavior towards a live spider (a Behavioral Approach Task, BAT), and the relationship between the IRAPs and the BAT. The research comprised two verbal rehearsal conditions, one that focused on fear-acceptance, the other on fear-reduction, as ways of coping with fear. One IRAP targeted fear (Fear-IRAP), while the other targeted avoidance (Avoidance-IRAP). The Fear of Spider Questionnaire (FSQ) was also employed. The IRAP data broadly supported the previous findings where the Fear- and Avoidance- IRAPs predicted approach behaviors. There were no significant differences between the two verbal rehearsal conditions. However, correlations between performances on the IRAPs and the BAT were concentrated almost exclusively in the fear-reduction condition, rather than the fear-acceptance condition. This pattern suggests that the verbal rehearsal task impacted upon a behavior-behavior relation that may be relevant to the concept of defusion, as employed in the ACT literature.

• Persistent rule-following in the face of reversed reinforcement contingencies: Exploring the dynamics of levels of derivation, relational coherence, and relational flexibility
The importance of the effects of rules and instructions is well-established in the psychological literature. For Relational Frame Theory (RFT), analyses of levels of derivation may be critical to an understanding of rules. However, basic experimental research in this regard is extremely limited. Study1 comprised two experiments, in which participants received either a direct rule or a derived rule (i.e., involving a novel derived relational response). The results showed that the direct rule resulted in more persistent rule-following in the face of competing contingencies than the derived rule, but only when the opportunity to follow the reinforced rule beforehand was relatively protracted. This performance also showed significant correlations with stress. Study 2 explored different levels of derivation on rule-following, and preliminary findings already suggest differential patterns of rule-persistence. Overall, the findings have conceptual implications for an RFT-based account of rule-following., Ghent University
Yvonne Barnes-Holmes, Ghent University
Dermot Barnes-Holmes, Ghent University
Ciara McEnteggart, Ghent University

• An RFT analysis of self-based interventions for public speaking
Ana Belén Gallego Alonso, University of Jyväskylä. Finland
Raimo Lappalainen, University of Jyväskylä. Finland
Matthieu Villatte, Evidence-Based Practice Institute of Seattle

Research in the area of Relational Frame Theory has suggested the importance of emphasising the hierarchical dimension of self and not just the distinction between one's self and one's experiences in self as context exercises. The present study aimed to analyze the comparative effect of two self-based interventions (“Hierarchical Self” and “Distinction Self”). Using a between-subjects design, the participants were randomly assigned to one of the three groups: Group 1 (Hierarchical Self), Group 2 (Distinction Self), Group 3 (Control group). The primary outcome dependent variable was distress tolerance that was measured by the engagement in the behavioral task (i.e., giving a speech in front of a camera). An additional dependent variable was discomfort measured by self-reported questionnaires and physiological measures (skin conductance and heart beat). The independent variable was the intervention to which participants were assigned after the pre-experimental task. The findings indicated that participants´ assessments of their perceived speech performance, and also distress towards giving a speech were reduced in the Hierarchical Self condition compared to the Distinction Self condition. The implications of the findings for clinical practice are discussed.

143. Components that Maximize the Metaphor Effect II: Multiple Exemplars, Common Physical Properties and Nonarbitrary Causal Relations
Symposium (9:30-11:00)
Components: Conceptual analysis, Original data
Categories: Relational Frame Theory, Clinical Interventions and Interests, Metaphor
Target Audience: Beg., Interm., Adv.
Location: Utera

Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz
Carmen Luciano, Universidad de Almería

Acceptance and commitment therapy (ACT; Hayes, Strosahl, & Wilson, 1999) is a contextual model of psychological intervention that aims to promote psychological flexibility. To accomplish this aim, metaphors are profusely used in ACT. One of the areas of human cognition most studied by relational frame theory (RFT; Hayes, Barnes-Holmes, & Roche, 2001) is analogical reasoning. The link between ACT and RFT is becoming closer as a theoretical and empirical line of research is emerging that analyzes the components of metaphors that maximize the promotion of psychological flexibility. This symposium presents three empirical studies that extends previous research in this regard by analyzing the effect of common physical properties in the context of multiple examples of metaphors, the role of salience and hierarchical relations in the transformation of functions that occurs in metaphors, and the role of causal and hierarchical relations in metaphor effect.

• The effect of common physical properties and multiple exemplars in metaphor effect
José Simón, Fundación Universitaria Konrad Lorenz
Bibiana Criollo, Fundación Universitaria Konrad Lorenz
María B. García-Martín, Fundación Universitaria Konrad Lorenz
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz
Marco A. Sierra, Fundación Universitaria Konrad Lorenz
Diana Riaño-Hernández, Fundación Universitaria Konrad Lorenz

This experimental analogue study aimed to analyze the effect of two variables in the metaphor effect on promoting psychological flexibility according to RFT: (a) the presence of common physical properties between the individual’s experience and the metaphor, and (b) the proposal of one or multiple examples of similar metaphors. A 2x2 factorial design was implemented. Eighty participants first responded to measures of experiential avoidance. Subsequently, they were exposed to a cold-pressor task at pretest. Afterwards, participants were randomly assigned to four experimental protocols consisting of: (a) a metaphor with common physical properties, (b) a metaphor without common physical properties, (c) three metaphors with common physical properties, and (d) three metaphors without common physical properties. Then, participants were re-exposed to the cold-pressor task (posttest). The results showed the presence of common physical properties increased the effect independently of the number of metaphors proposed.

• Analyzing the salience component in metaphors and hierarchical framing
Carmen Luciano, Universidad de Almería
Adrián Barbero-Rubio, Madrid Institute of Contextual Psychology
Bárbara Gil-Luciano, Madrid Institute of Contextual Psychology
Ángel Alonso, Madrid Institute of Contextual Psychology
Zaida Callejón, Universidad de Almería
L. Jorge Ruiz-Sánchez, Universidad de Almería

Metaphor is a special type of analogical behavior that has been –and still is- difficult to analyze experimentally. Most of the conceptual analysis coincides in the more salient component in the source than in the target to explain how it works. According to RFT, metaphor is a type of relating networks, however experimental analyses are still undone in regard to the conditions under which metaphors work. The present study is one step forward in exploring such specific component on the basis of manipulating the non-arbitrary functions. Thirty participants were divided in four conditions that differ in the type of training series to establish different networks. Then, participants were tested for relating networks. Results were discussed taking into account the characteristics of each protocol.

• Analyzing causality in clinical metaphors and hierarchical framing.
Bárbara Gil-Luciano, Madrid Institute of Contextual Psychology
Ángel Alonso, Madrid Institute of Contextual Psychology
Adrián Barbero-Rubio, Madrid Institute of Contextual Psychology
Carmen Luciano, Universidad de Almería
Zaida Callejón, Universidad de Almería

The present study is focused on the relational analysis of the client`s interactions with his own behaviors on the basis of the analysis done by Törneke et al. (2016). The aim is to isolate the effect of the metaphors components that are used for establishing the client’s discrimination of his behavior and the natural consequences achieved in the short and long terms. Forty participants ran the experiment following several phases. Firstly, they were involved in tasks where discomfort and negative thoughts emerged. Then, a metaphor was incorporated with four different components that were differentiated per condition. Finally, they went into the experimental tasks. Results are discussed in terms of the transformation of functions involved in the different conditions.

144. Current Research on Effects of Psychological Flexibility
Symposium (9:30-11:00)
Components: Conceptual analysis, Original data
Categories: Clinical Interventions and Interests, Prevention and Community-Based Interventions, Professional Development, Occupational Psychology, Disordered Eating, Paediatrics, Diabetes, Psychological Flexibility
Target Audience: Beg., Interm., Adv.
Location: Estepa

Psychological (in)flexibility is the key concept of Acceptance and Commitment Therapy (ACT). The analysis of the role of psychological flexibility in a variety of mental health and quality of life outcomes has been a traditional research area for Contextual Behavioral Science. This symposium presents four papers that advance in this direction. The first paper will analyze the relationship between psychological flexibility and service user outcomes in mental health staff. The second paper will present a tripartite influence of psychological inflexibility in disordered eating in women. The third presentation will show a study in which the predictive ability of psychological flexibility, mindfulness and parenting in health outcomes in adolescents with diabetes was analyzed. Lastly, the fourth presentation will analyze the relationship between psychological flexibility and subjective wellbeing in people attending mental health services. Taken together, these papers will show the relevance of investigating the relationship of psychological flexibility with mental health and quality of life outcomes.

• Experiential Avoidance is Associated with Military Sexual Trauma Non-disclosure in Female Service Members/Veterans
Rebecca K. Blais, PhD, Utah State University
Emily Brignone, ABD, Utah State University
Michael E. Levin, PhD, Utah State University

Roughly 25% of female Veterans (FVs) do not disclose military sexual trauma (MST). Non-disclosure prevents the provision of mental health services that can reduce the sequelae of MST. Experiential avoidance, or actions that avoid reliving painful, traumatic memories, may be an important barrier to disclosure. This study sought to identify reasons for MST non-disclosure in 111 FVs. FVs provided reasons for non-disclosure using free text responses, which were analyzed using editing analysis style. Experiential avoidance was identified as a barrier to disclosure in 20% (n=22) of the sample. Sample responses included: “I didn’t want to relive it,” “brings up too many bad memories,” and “I just…wanted to forget and move on…” Other barriers included stigma (35%,n=39) and discomfort with screening setting (24%,n=27). Data collection is in progress to determine the association of experiential avoidance and MST non-disclosure in male veterans. ACT could help reduce experiential avoidance related to MST non-disclosure.

• The role of psychological inflexibility in the tripartite influence model for women: A single body image inflexibility pathway to disordered eating behaviours.
Catrin Griffiths, Doctorate in Health Psychology, University of the West of England, Bristol, UK
Tim Moss, PhD, University of the West of England, Bristol, UK
Nichola Rumsey, PhD, University of the West of England, Bristol, UK
Heidi Williamson, Doctorate in Health Psychology, University of the West of England, Bristol, UK
TracyTylka, Ohio State University

Sixty percent of women regularly engage in disordered eating, which is associated with the development of diagnosable eating disorders and obesity. In the current study latent structural equation modelling (SEM) tested an adapted version of the Tripartite Influence Model of body image and disordered eating with the inclusion of body image inflexibility, among 378 adult women. Body image inflexibility represented a single pathway which fully mediated the relationship between women’s body image and their engagement in disordered eating. Body image inflexibility also fully mediated the relationships between internalisation of the thin ideal and disordered eating, and between pressure from friends and disordered eating. Perceived pressure to be thin from friends, partners, family and the media also had distinct relationships within the model. The results highlight the importance of including body image inflexibility as a mediating variable in theoretical models of disordered eating and as a construct treatment interventions can target.

• An exploration of the role of psychological flexibility, mindfulness and parenting in predicting health outcomes in adolescents with type 1 diabetes
Lorraine Lockhart, DClin, University of Edinburgh, NHS Forth Valley
Nuno Ferreira, PhD, University of Edinburgh

Purpose: The current study was designed as an initial exploration of the associations between psychological flexibility and mindfulness, parenting behaviours and diabetes-related outcomes, specifically quality of life and treatment adherence. Methodology: A cross-sectional quantitative design was used. Forty five dyads of adolescents (aged 12-18) diagnosed with Type I diabetes and their parents responded to a survey comprised of the following measures - Adolescents: AAQ-Y , CAMM, DAAS, PBI , DQoLY , Self-Care inventory ; Parents: FFMQ , AAQ-II. Results: Higher levels of mindfulness and Psychological Flexibility in young people were associated with better self-care behaviours (r=.49; r=.54) and Quality of Life (r=.62; r=.42). Parental variables were not related to any of the outcomes. Higher levels of Psychological Flexibility in parents were associated with better self-care behaviours (r=.43) and QoL (r=.33), whilst parental mindfulness was only associated with better QoL (r=.35). Preliminary regression models seems to suggest that Adolescent diabetes acceptance and parental psychological flexibility are significant predictors of self-care whilst Adolescent mindfulness and type of Insulin administration are significant predictors of QoL. Conclusions: Psychological flexibility and mindfulness are useful constructs for understanding health outcomes in adolescents with type 1 diabetes suggesting acceptance and commitment and mindfulness-based therapies may be beneficial for improving outcomes in this population.

• Subjective Wellbeing and Psychological Flexibility in People Attending Mental Health Services
Ross White Ph.D, DClinPsy, University of Liverpool
Judith McCluskey, NHS Greater Glasgow and Clyde

Background: Subjective wellbeing has been recognised as an important outcome for those experiencing mental health difficulties. This study investigated associations between psychological flexibility and subjective wellbeing in people attending mental health services in the UK. Method: A total of 132 individuals attending mental health services in the UK participated in this study. Participants completed a battery of assessments including the Mental Health Continuum-Short Form (MHC-SF), Hospital Anxiety and Depression Scale (HADS), and Acceptance and Action Questionnaire (AAQ-II). A cross-sectional design was used. Results: Participants were divided into three groups according to their levels of subjective wellbeing assessed by the MHC-SF: "Languishing” (n=61), "Flourishing" (n=13) and "Moderately Mentally Healthy" (n=58). A statistically significant difference was found in the AAQ-II scores between the 3 groups (F (2, 129) = 28.80, p < .0001, η2=0.56) and this difference remained significant when depression (F (2, 128) = 4.26, p < .05) and anxiety (F (2, 128) = 14.45, p < .0001) scores were controlled for. Conclusion: The findings highlight the potentially important contribution that Acceptance and Commitment Therapy interventions may offer for improving levels of subjective wellbeing in people experiencing mental health difficulties.

152. Psychological Flexibility and Acceptance and Mindfulness-Based Treatments for Chronic Health Conditions
Symposium (11:15-12:30)
Components: Original data
Categories: Clinical Interventions and Interests, Behavioral medicine, ACT, Mindfulness, HIV, Health Psychology, Parents and Children with Chronic Illness
Target Audience: Beg., Interm., Adv.
Location: Buhaira

There is increasing evidence that psychological flexibility (PF) is a key variable in the adaptive adjustment to chronic health conditions. Also, acceptance and mindfulness-based treatments aimed at increasing PF have proven useful in improving the management of health and chronic illness. The present symposium includes four papers that address different aspects of the relationship between PF and health management in chronic disease. The first paper will present data on the efficacy and cost-effectiveness of a group-based ACT treatment for fibromyalgia from a randomized controlled trial conducted in Spain (EFFIGACT study). The group-ACT (GACT) treatment was more clinically effective than recommended pharmacological treatment (pregabalin + duloxetine) and a wait-list condition, with clinical improvements maintained at 6 months with medium effect sizes in most measures. Also, GACT was related to significantly less direct costs over the 6 months study period compared to both control arms. The second paper will present an analysis of the long-term outcomes of the Mindfulness Based Program for Infertility (MBPI) for a sample of 55 infertile women. Results show that in the seven-year period after treatment, there were sustained improvements in emotion regulation and psychopathological symptoms for participants in the program. The third paper in the symposium will present a randomized controlled trial conducted in Spain of a brief ACT intervention for newly diagnosed HIV patients. HIV diagnosis entails social stigma, fear of rejection, and chronicity, and is associated to impaired quality of life. The analysis will focus on identifying what patients may benefit most from the intervention and to which extent ACT could play a preventive role in comprehensive care for HIV patients. The last paper in this symposium explores the relationships between PF, asthma knowledge, and asthma management self-efficacy in parents of children with asthma and their children’s asthma morbidity. Parents of children aged 3-12 years with asthma completed a cross-sectional survey assessing their PF, asthma knowledge, asthma management self-efficacy, their children’s asthma symptoms and their use of inhaled bronchodilators. Results show that parental PF is positively associated to asthma knowledge, asthma management self-efficacy, and less asthma morbidity in children.

• Effectiveness and cost-utility of Group Acceptance and Commitment Therapy for Fibromyalgia versus recommended drugs: Results from a 6-month randomised controlled trial conducted in Spain (EFFIGACT study)
Albert Feliu-Soler, Ph.D, Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain
Francesco D’Amico, Ph.D, Personal Social Services Research Unit, London School of Economics and Political Science, London
Adrián Pérez-Aranda, MSc, Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain
Laura Andrés-Rodríguez, MSc, Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain
Javier García-Campayo, Ph.D, Miguel Servet University Hospital, University of Zaragoza, Spain
Juan V. Luciano, Ph.D, Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain

In the last decade, there has been burgeoning interest in the effectiveness of third-generation psychological therapies for managing fibromyalgia (FM) symptoms and there is also a need for studies evaluating the cost-effectiveness of pharmacological and non-pharmacological interventions in FM. The present work examined the clinical effectiveness and cost-utility of a group-based form of acceptance and commitment therapy (GACT) compared to recommended pharmacological treatment (RPT) or waiting list (WL). A total of 156 patients with FM were enrolled at primary health care centers in Zaragoza (Spain) and were randomly assigned to a group-based form of ACT (GACT; N=51), recommended pharmacological treatment (RPT = pregabalin + duloxetine; N=52), or wait list (WL; N=53). The primary clinical end point was functional status (measured with the Fibromyalgia Impact Questionnaire) and the secondary clinical end points included pain catastrophizing, pain acceptance, pain, anxiety, depression, and health-related quality of life. All clinical measures were assessed at baseline, after treatment and at 6-month follow-up. Health economic outcomes included health-related quality of life and healthcare use at baseline and at 6-month follow-up using the EuroQol (EQ-5D-3L) and the Client Service Receipt Inventory (CSRI), respectively. The differences between groups regarding clinical data were calculated by linear mixed-effects (intention-to-treat approach). Cost-utility analyses included Quality-Adjusted Life Years (QALYs), direct and indirect cost differences, and incremental costeffectiveness ratios (ICERs). Patients allocated to GACT showed superior improvement regarding functional impairment (d= 1.43), pain catastrophising (d= 0.69), pain (d= 0.47), anxiety (d= 0.39), depression (d= 0.37), pain acceptance (d= 1.01) and health-related quality of life (d= 0.66) compared to both RPT and WL immediately after treatment. Clinical improvements were maintained at 6 months with medium effect sizes in most cases. GACT was related to significantly less direct costs over the 6 months study period compared to both control arms (GACT €824.2 ± 1,062.7 vs. RPT €1,730.7 ± 1,656.8 vs WL €2,462.7 ± 2,822.0). Lower direct costs for GACT in comparison to RPT were due to lower costs from primary care visits and FM-related medications. The ICERs were dominant in the completers' analysis and remained robust in the sensitivity analyses. In conclusion, ACT appears to be an effective and cost-effective treatment in comparison to RPT in patients with FM.

• The Mindfulness Based Program for Infertility (MBPI): A seven-year follow-up study
Ana Galhardo, Ph.D., Instituto Superior Miguel Torga: CINEICC-Faculty of Psychology and Educational Sciences of the University of Coimbra
Marina Cunha, Ph.D., Instituto Superior Miguel Torga: CINEICC-Faculty of Psychology and Educational Sciences of the University of Coimbra
José Pinto-Gouveia, M.D., Ph.D., CINEICC-Faculty of Psychology and Educational Sciences of the University of Coimbra

This study examines whether there are long-term effects of the MBPI encompassing four moments: pre-MBPI (T1), post-MBPI (T2), six-months follow-up (T3) and seven-year follow-up (T4). Fifty-five women completed the MBPI and questionnaires assessing depressive and anxiety symptoms, experiential avoidance and mindfulness at T1, T2 and T3. Seven years later, participants completed the self-report measures online [response rate 73% (n = 40)]. Repeated measures ANOVAs showed significant direct effects of time with medium effect sizes in mindfulness (F = 7.16; p < .001; Ƞ2p = .24), experiential avoidance (F = 10.75; p < .001; Ƞ2p = .22), depressive symptoms (F = 11.68; p < .001; Ƞ2p = .23), and anxiety symptoms (F = 7.31; p < .001; Ƞ2p = .16). In the seven-year period there were sustained improvements in emotion regulation and psychopathological symptoms. Although further research is needed to replicate these findings, the MBPI gains seem to persist over time.

• Can ACT help patients to cope with HIV diagnosis? A randomized controlled trial in newly diagnosed HIV patients
Francisco Montesinos, Ph.D., European University of Madrid
Federico Pulido, Ph.D., Hospital Universitario 12 de Octubre, Madrid
Federico Pulido, Hospital Universitario 12 de Octubre, Madrid
M.Asunción Hernando, European University of Madrid
M.Asunción Hernando, European University of Madrid
Marisa Páez, Instituto ACT, Madrid
Alicia González , Hospital Universitario La Paz, Madrid
Ignacio Perez-Valero, Hospital Universitario La Paz, Madrid

Learning to live with uncertainty and risk of social rejection is not easy. Despite the medical advances, even today HIV diagnosis involves chronicity and stigma. This context can imply a noteworthy emotional impact and significant decrease in quality of life. 54 newly diagnosed HIV patients were recruited in two hospitals in Madrid and randomly assigned to control or ACT condition. The aim of our study was to determine the efficacy of an ACT-based abridged intervention. A protocol was designed and applied through 3 intensive individual sessions. Measures related with quality of life, anxiety, depression, psychological flexibility, cognitive fusion, CD4 and viral load levels at pre-intervention and 3, 6 and 12 months later were collected. Preliminary analysis comparing pre and post treatment measures will be presented. Analysis will be aimed at identifying which patients may benefit most from the intervention and what extent ACT could play a preventive role in in comprehensive care for HIV patients.

• The Relationships Between Psychological Flexibility, Asthma Knowledge, and Asthma Management Self-Efficacy Among Parents of Children with Asthma and Their Children’s Asthma Morbidity
Yuen Yu CHONG, PhD student, School of Nursing, The Hong Kong Polytechnic University, Hong Kong
Yim Wah MAK, Ph.D, School of Nursing, The Hong Kong Polytechnic University, Hong Kong
Alice Yuen LOKE, Ph.D., School of Nursing, The Hong Kong Polytechnic University, Hong Kong

Psychological flexibility (PF) refers to an individual’s capacity to draw on personal experiences to either persist in or change their behaviors for the purpose of valued living. Parental PF may have dual effects on parents in choosing appropriate strategies to manage childhood health problems and on their children’s health outcomes. This study was to examine the role of parental PF in the parental learning about childhood asthma management (such as parental knowledge and self-efficacy) and the asthma morbidity of their children (such as asthma symptoms or the use of symptom-relieving medications). Three hundred and twenty-four parents of children aged 3-12 years with asthma completed a cross-sectional survey assessing their PF, asthma knowledge, asthma management self-efficacy, their children’s asthma symptoms and their use of inhaled bronchodilators. The results from the structural equation modeling showed that more PF in parents was significantly associated with better asthma knowledge and asthma management self-efficacy. Furthermore, the parents’ PF was the only latent construct that was significantly associated with their children’s asthma morbidity (β = .34, p = .001). Fostering the PF of parents in the childhood asthma care might reduce their children’s asthma symptoms.

153. Exploring RFT Implications for Education
Symposium (11:15-12:30)
Components: Original data
Categories: Relational Frame Theory, Clinical Interventions and Interests, Educational settings, Children, Education
Target Audience: Beg., Interm., Adv.
Location: San Bernardo

Yvonne Barnes-Holmes, Ghent University
Dr. Ciara McEnteggart, Department of Experimental Clinical and Health Psychology, Ghent University, Belgium

ACBS has focused much of its energy and interest on clinical understanding, assessment, and application. While this is an important area of ongoing development for our community, educational focus significantly lags behind and yet remains an important area for futher exploration and expansion in a CBS field. This symposium on education contains two papers, thus leaves room for further discussion of why this area of our field stuggles to draw the enthisuaism of researchers and practitioners, relative to clinical interests. Paper 1 has two aims. 1. It contains data pertaining to a protocol of training repertoires of derived relational responding. 2. It explores the challenges commonly encountered in doing this type od developmental/educational research. Paper 2 is part of the same RFT-based educational research program underway in Poland. This paper focuses particularly on prerequisities to repertoires of, and competencies in, deictic relational responding. Consistent with previous research, the work also explores the potential relationship between deictic competence and traditional theory of mind tasks.

• Exploring challenges in the assessment of relational responding in typically-developing children.
Krystyna Pomorska, MSc, University of Social Sciences and Humanities, Warsaw
Yvonne Barnes-Holmes Ph.D., University of Gent
prof. Paweł Ostaszewski, University of Social Sciences and Humanities, Warsaw

In spite of the substantive body of research on RFT, work on its potential application to education and remedial education lag behind other areas. Assessing relational repertoires in children is far from easy, given that these repertoires form the basis of language itself. Existing protocols for testing and training derivation are usually adopted from experimental protocols and seem odd and boring when presented even to typically-developing children. For children, referred to as atypical, it is often difficult to even determine what they are being asked, hence making it more difficult for assessors to determine whether the target skills are partially present. Finding the balance between presenting the task clearly (often requiring non-arbitrary examples), and at the same time assessing arbitrary applicable relational responding (AARR) is critical to the integration of RFT concepts into remedial education. The purpose of this presentation is to highlight obstacles we have recently observed in testing frames of coordination, distinction, comparison, opposition as well as deictic frames in typically-developing children aged 6-8 (N=30).

• Do we know everything about Theory of Mind? What a functional analysis of language brings to our understanding of perspective-taking skills in typical and atypical development.
Krystyna Pomorska, MSc, University of Social Sciences and Humanities, Warsaw
Yvonne Barnes-Holmes, Ph.D., University of Gent
prof. Paweł Ostaszewski, University of Social Sciences and Humanities, Warsaw

In mainstream psychology, perspective-taking skills have primarily been studied under the rubric of the Theory of Mind. While widely accepted, many questions remain to be answered by this approach and its potential application to remedial education. In contrast, behavioral researchers, working under the rubric of Relational Frame Theory, have defined perspective-taking in terms of repertoires of deictic relational responding. There is already a substantive body of evidence in support of this definition, as well as a number of studies to support its educational applicability. The purpose of this presentation is to illustrate the potential overlap and differences between deictic relational responding and theory of mind abilities (first- and second-order beliefs) at different stages of development (sample has N = 30) and different levels of verbal behavior. The data highlights the effectiveness of an intervention, based on training deictic relational responding, on theory of mind skills in typically-developing children and children with autism.

• Emergence of untrained verbal proficiency following an RFT based training on categories
Giovambattista Presti, Facoltà di Scienze dell’Uomo e della Società, Università “Kore” di Enna, Italy
Melissa Scagnelli, Istituto G. Fabris, Università IULM, Milano, Italy
Melissa Zecchin, Istituto scientifico “Eugenio Medea” Bosisio Parini, Lecco, Italy
Catia Rigoletto, Istituto scientifico “Eugenio Medea” Bosisio Parini, Lecco, Italy
Massimo Molteni, Istituto scientifico “Eugenio Medea” Bosisio Parini, Lecco, Italy
Paolo Moderato, Istituto G. Fabris, Università IULM, Milano, Italy

Much of our understanding of human cognition depends on our understanding of categorization. Behavior analysts have investigated taxonomical categorization for years without the need for relying on concepts as mental representations of categories. A categorical concept could be defined as a class stimuli (objects, actions, etc.) that control similar responses. Most of these concepts are acquired through formal or informal education, when the same response (e.g., saying ‘‘bird’’) is reinforced in the presence of several different stimuli (e.g., birds), but not in the presence of other animals or objects.Researchers in the field of Relational Frame Theory, a theory of language and human cognition have elaborate effective procedures to train categorization, however little is known on the more general effects of these training on special populations and on language skills in general. The aim of this study was to evaluate the efficacy of an RFT based procedure in teaching categories to children diagnosed with language disorders and its more general impact on language skills as measured with standardized testing. Twenty-two 3 to 7 years old children with a diagnosis of language disorder (F 80.1) according to ICD 10 criteria were first trained to respond to a “give me…” question (AB) and then to match groups of items (BC) and then tested in the derived relations over twelve categories. At the end of the testing phase an additional test was performed: Responding to “The X is a…?” and “Tell me the Y you know”, where X is an item in a category and Y are the categories. Data show a highly statistically significant increase not only with respect to the derived relational behaviors and in items spontaneously listed but also on standardized scoring with TVL (Test for assessment of the language) at baseline, after treatment and follow up in the following areas: Words comprehension (Wilcoxon test=2.748, p=0.006), Sentences comprehension (Wilcoxon test=3.080, p=0.002), Echoic of sentences (Wilcoxon test=3.348 p<0.001)labeling (Wilcoxon test=3,398, p<0.001).Preliminary data of a training based on a frane of coordination suggest that effects on language can go beyond the trained stimuli and categories.

154. Implementation and Empirical Support for Acceptance and Commitment-Therapy in Psychiatric Inpatient Settings
Symposium (11:15-12:30)
Components: Original data, Didactic presentation
Categories: Clinical Interventions and Interests, Clinical Interventions and Interests, Other, Clinical Psychiatric Inpatient Setting
Target Audience: Beg., Interm., Adv.
Location: Lebrija

Marcia Rinner, M.Sc., University of Basel, Switzerland
Andrew T. Gloster, Prof. Dr., University of Basel, Switzerland

To date, applications and research of ACT have concentrated predominantly on outpatient settings. However, ACT is increasingly applied in other clinical domains, such as inpatient settings. This symposium aims to present three different implementations of ACT in inpatient settings and the empirical testing of these settings via effectiveness studies.

• Influencing Factors of ACT compared to CBT in a naturalistic inpatient setting.
Mareike Pleger, M.Sc., Evangelisches Krankenhaus Königin Elisabeth Herzberge, Berlin, Germany
Prof. Albert Diefenbacher, Evangelisches Krankenhaus Königin Elisabeth Herzberge, Berlin, Germany
Dr. Christoph Schade, Evangelisches Krankenhaus Königin Elisabeth Herzberge, Berlin, Germany
Andrew T Gloster, Prof. Dr., Univeristät Basel, Switzerland
Prof. Thomas Fydrich, Humboldt-University, Berlin, Germany

The first talk presents data drawn from a quasi-randomized clinical trial, which conducts the effectiveness of ACT compared to CBT within a naturalistic setting. Results of our preliminary study indicate ACT and CBT to be equally effective treatments. In this symposium pilot results of our current study will be presented, which focuses on specific patient dispositions that might predict differing positive therapeutic outcomes according to each treatment approach. 170 transdiagnostic inpatients of a German psychiatric department were assigned to either ACT or CBT condition and assessed with respect to different symptom measures as well as ACT-specific outcomes.

• Implementing multi-professional ACT-treatment in a day-care setting
Inga-Marlen Pontow, M.Sc., Evangelisches Krankenhaus Königin Elisabeth Herzberge, Berlin, Germany
Ronald Burian, Dr. med., Evangelisches Krankenhaus Königin Elisabeth Herzberge, Berlin, Germany
Prof. Albert Diefenbacher, Evangelisches Krankenhaus Königin Elisabeth Herzberge, Berlin, Germany

The second talk will present the implementation of Acceptance and Committment Therapy (ACT) in a psychosomatic day-care clinic. It will emphasize the opportunities of working with ACT in a multi-professional team especially with patients that suffer not only from mental (such as somatization or other affective disorders) but comorbid from medical disorders (such as diabetes or coronary heart diseases). First pilot data will be presented that are based on pre to post-treatment assessments. Preliminary analyses indicate that patients benefit in terms of psychological flexibility and also in terms of symptom reduction even though this is not the core target of ACT.

• ACT –based inpatient setting for chronic and treatment resistant mental diseases
Charles Benoy, M.Sc., Psychiatric Hospital of the University of Basel, Switzerland
Isabell Schumann, lic. phil., Psychiatric Hospital of the University of Basel, Switzerland
Katrin Pinhard, med. pract., Psychiatric Hospital of the University of Basel, Switzerland
Veronika Kuhweide, Psychiatric Hospital of the University of Basel, Switzerland
Marc Walter, Prof. Dr. med., Psychiatric Hospital of the University of Basel, Switzerland
Andrew T. Gloster, Prof. Dr., Universität Basel, Switzerland

The third study presents pilot-data from a prospective effectiveness study analyzing an ACT-based inpatient setting for chronic and treatment resistant mental disorders. The analysis is based on a trans-diagnostic sample of N=79 patients and includes pre to post- treatment assessment battery and weekly process measures form three sources: patients, therapists, and nurses. Preliminary analyses show a moderate to large effect size in primary outcomes. Analyses will be presented that document change across numerous ACT and competing constructs as well as examining weekly-process patterns of change.

155. Contextual Behavioral Science Applications in Autism and Intellectual Disabilities
Symposium (11:15-12:30)
Components: Conceptual analysis, Literature review, Original data, Didactic Presentation,
Categories: Clinical Interventions and Interests, Behavioral medicine, Intellectual Disabilities, Autism
Target Audience: Interm., Adv.
Location: Utera

The most popular area of Applied Behavior Analysis is the intervention in autism and intellectual disabilities. As originated in Behavior Analysis, Contextual Behavioral Science (CBS) can contribute to improve these applications by providing a functional analysis of language and cognition. This symposium presents important advances in this direction. The first presentation will show the application of RFT-based training in a Child Psychiatry Unit conducted in Italy. The second presentation will address the possibilities of the Relational Evaluation Procedure (REP) for assessing and training children with autism. The third paper will show how to conduct a functional analysis and case conceptualization for people with intellectual disabilities. Lastly, the fourth paper will present the application of the Implicit Relational Assessment Procedure (IRAP) for measuring the effect of public messaging on attitudes towards autism. Overall, these presentations show the breadth of CBS applications to this applied area.

• Educational application of RFT based training in a Child Psychiatry Unit in the National Health System in Italy: A pilot study
Giovambattista Presti, IESCUM, Istituto Europeo per lo Studio del Comportamento Umano Università Kore
Antonella Costantino, Fondazione IRCCS Cà Granda – Ospedale Maggiore Policlinico
Melissa Scagnelli, IESCUM, Istituto Europeo per lo Studio del Comportamento Umano
Francesca Brasca, Fondazione IRCCS Cà Granda – Ospedale Maggiore Policlinico
Davide Carnevali, IESCUM, Istituto Europeo per lo Studio del Comportamento Umano
Martina Leuzzi, IESCUM, Istituto Europeo per lo Studio del Comportamento Umano
Concetta Messina, IESCUM, Istituto Europeo per lo Studio del Comportamento Umano
Paolo Moderato, IESCUM, Istituto Europeo per lo Studio del Comportamento Umano Libera Università di Lingue e Comunicazione IULM

A joint pilot project between IESCUM and UONPIA of Fondazione IRCCS Cà Granda – Ospedale Maggiore Policlinico addressed clinically relevant repertoires of 11 children with a diagnosis of Language Disorder and Dyslexia ranging from 3 to 11 years old. Research involved the application of clinical procedures based on Relational Frame Theory (RFT) to address language and reading issues. Categorization and reading are considered fundamental skills to promote development of thought, action and speech and to allow better adaptation to the natural and social environment. Trainings based on its principles showed efficacy in promoting the development of complex skills. Data show that procedures based on the frame of coordination promoted the emergence of skills beyond the specific responses taught in the categorization and reading trainings. There was a highly statistically significant increase, between baseline and end of intervention, in both trained and untrained behaviors. Significant differences in standardized test performance for language and reading were also found.

• Assessing and training children with autism spectrum disorder using the Relational Evaluation Procedure (REP)
Orla Corbett, National University of Ireland Galway
Jennifer Hayes, National University of Ireland Galway
Ian Stewart, National University of Ireland Galway
John McElwee, Private Practitioner
Concetta Messina, IESCUM, Istituto Europeo per lo Studio del Comportamento Umano
Paolo Moderato, IESCUM, Istituto Europeo per lo Studio del Comportamento Umano Libera Università di Lingue e Comunicazione IULM

The relational evaluation procedure (REP) is seen by proponents of relational frame theory (RFT) as a useful means by which to assess and train relational responding. Most REP work so far has been conducted with typically developing adults; however, given the importance of relational responding as a repertoire and of the potential utility of the REP for assessing and training this repertoire, researchers need to investigate its use with other populations including children with autism and other developmental delay. The current study presents relevant data. Nine children were initially assessed using a simple REP-based multi-level protocol (the NSD-REP) and on a measure of linguistic ability (Pre-school Language Scale, 4th Edition; PLS4). Three children found to pass Level 1 (same and different relations) but not Level 2 (affirmation and disconfirmation of same and different relations) were subsequently given a training intervention in the latter using a multiple baseline design. These findings supplement previous data suggesting the utility of the REP for training relational responding in children with autism.

• From ABA to ACT: functional analysis and case conceptualization for people with intellectual disabilities and psychopathology
Giovanni Miselli, PhD BCBA, Fondazione Istituto Ospedaliero di Sospiro Onlus (CR) Italy
Roberto Cavagnola, Psy D., Fondazione Istituto Ospedaliero di Sospiro Onlus (CR)
Mauro Leoni, PhD, Fondazione Istituto Ospedaliero di Sospiro Onlus (CR), University of Pavia
Serafino Corti, PhD, Fondazione Istituto Ospedaliero di Sospiro Onlus (CR), Università Cattolica Brescia Italy
Francesco Fioriti Ed.D, Fondazione Istituto Ospedaliero di Sospiro Onlus (CR)
Giuseppe Chiodelli, MD; Laura Galli, MD; Michela Uberti, MD, Fondazione Istituto Ospedaliero di Sospiro Onlus (CR)
Giovanni Michelini, PhD., Fondazione Istituto Ospedaliero di Sospiro Onlus (CR)

People diagnosed with intellectual disabilities and neurodevelopment disorders have a greater risk to develop a psychiatric disorder, despite this knowledge these conditions often and undiagnosed and untreated. The purpose of this talk is present a review on evidence -based intervention concerning the reduction of psychopatology and improvement of quality of life in people with intellectual disabilities and present procedure for functional analysis and case conceptualization field tested in a Department for Disabilities in Northern Italy. Theoretical models and literature are reviewed form ABA, Cognitive Behavior Therapy and Third Generation Cognitive Behavioral Therapies, with a specific focus on contextual behavioral science and ACT. Model and procedure for functional analysis and case conceptualization for this complex population will be presented theoretically and illustrated through single case intervention.

• Using the IRAP to investigate the effect of public messaging on attitudes towards autism
Diana Bast, PhD, National University of Ireland Galway
Christina Lyons, National University of Ireland Galway
Ian Stewart, PhD, National University of Ireland Galway

Although public awareness of autism has improved in recent times, there are still misunderstandings or judgmental attitudes based on misinformed stereotypes. This study investigated the effects on implicit (IRAP-based) and explicit (IRAP-analogue) attitudes of different types of messaging on autism. Undergraduates were randomly assigned such that Group 1 was shown a relatively negative video showing behavioral problems in autism, while Group 2 was shown an ostensibly positive video delivered by a successful adult diagnosed as autistic as a child. Analysis showed no between group difference on the explicit measure but a significant difference between the groups on the IRAP such that G2 (positive) showed significantly higher levels of anti-Autism/pro-Normal bias than G1 (negative) both within (d=.76, p<.001) and across IRAP (d=2.6, p=.0098) trial types. These apparently counter-intuitive data will be discussed in terms of subtleties of anti-prejudice messaging as well as issues of malleability and implicit-explicit divergence.

156. Contextual Behavioral Science and Mental Health
Symposium (11:15-12:30)
Components: Conceptual analysis, Literature review, Original data,
Categories: Clinical Interventions and Interests, Prevention and Community-Based Interventions, Crisis Intervention, Global Mental Health, Third Wave Cognitive Behavioural Therapies, Psychosis
Target Audience: Beg., Interm., Adv.
Location: Estepa

Contextual Behavioral Science (CBS) is providing a wide range of applications to enhance mental health in a variety of contexts. This symposium will present some reflections and applications of CBS in this area. The first presentation will review the evidence supporting brief applications of Acceptance and Commitment Therapy (ACT) and highlight the relevance of research in this area, which could lead to effective and low-cost applications of ACT in several socially-relevant domains. The second paper will reflect on the contribution that CBS can make to global mental health due to the cross-cultural utility of ACT and its focus on enhancing wellbeing instead of focusing on reducing symptoms. The third paper will present a systematic review of the cost-effectiveness of third wave therapies in the treatment of patients with physical or mental conditions. Lastly, the fourth paper will present the data from a multiple baseline design that analyze the effect of a 10-session individual protocol of a combination of ACT and behavioral activation with patients with psychosis.

• ACT in crisis intervention. A critical review.
Lidia Budziszewska, Universidad Europea de Madrid, Spain
Pablo Ruisoto, Universidad Europea de Madrid & University of Salamanca

In recent decades, the number of lab-controlled studies in ACT have multiplied supporting the validity of the core therapeutic processes of ACT (A-Tjak, Davis, Morina, Powers, Smits, & Emmelkamp, 2015), but more naturalistic approaches such as brief interventions in crisis remains a challenge, although successful experiences keep building up (Stroshal, Robinson, Gustavsson, 2012). For example, brief interventions working with former child soldiers, street children and victims of violence (Dahl, 2011, 2012). Two main reasons justify this study: first, dose/effect studies have found that most change in therapy happens before session (Strosahl, 2010); second, some context, such as currents interventions with refugees. The aim of this paper is twofold: 1) to critically review studies focused on brief interventions for high distress situations outlining key principles of brief ACT intervention in crisis, and 2) to review the available data about its efficacy and effectiveness. Key concepts, such as suffering and change, and the relevance of developing value-based brief interventions in multicultural contexts with limited funds, instead of expensive pathology centered long-term therapy will be further discussed underlying differences with biomedical model (DSM) approach. Hopefully, this study will foster new efforts to increase public investment to address crisis.

• The Contribution that Contextual Behavioural Science can make to Global Mental Health
Ross White, University of Liverpool

Global Mental Health initiatives aim to address inequities in mental health provision across the world, and place particular emphasis on building mental health service capacity in low- and middle-income countries (LMIC) where over 80% of the global population is living. Consistent with this approach, concerted efforts are being made to globally disseminate psychological therapies. These efforts will need to negotiate the tensions that exist between making therapies sufficiently scalable, whilst retaining features of the psychotherapy that maximize both the acceptability and efficacy of the intervention. This paper reflects on the important contribution that Contextual Behavioral Science (CBS) can make to Global Mental Health (GMH). This includes consideration of the cross-cultural utility and validity of Acceptance and Commitment Therapy (ACT), and the way in which CBS approaches can help ensure that GMH initiatives do not narrowly focusing on symptoms of mental disorders rather than enhancing wellbeing. Knowledge from ACT and Functional Analytical Psychotherapy can help build sophistication in efforts to develop and deliver programmatic/’therapist-free’ forms of psychotherapy that will need to retain sensitivity to even subtle forms of emotional expression from clients. In addition, the PROSOCIAL approach provides opportunities for groups of people to cooperate effectively to achieve shared aspirations and build ‘communities of support’ that can serve to optimize peoples’ mental health and wellbeing. Examples of CBS-related work being undertaken in LMIC will be used to illustrate these possibilities.

• Cost-effectiveness of 'Third Wave' Cognitive and Behavioral Therapies: A Systematic Review and Quality Assessment of Economic Evaluations Alongside Randomized Controlled Trials
Juan V. Luciano, Ph.D, Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain
Albert Feliu-Soler, Ph.D, Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain
Laura Andrés-Rodriguez, MSc, Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain
Adrián Pérez-Aranda, MSc, Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain
Francesco D’Amico, Ph.D, Personal Social Services Research Unit, London School of Economics and Political Science, London,
Lance M. McCracken, Ph.D, Institute of Psychiatry, Psychology & Neuroscience, King’s College London

The term “third wave” cognitive behavioural therapy (CBT) encompasses new forms of CBT that both extend and innovate within CBT. Most third-wave therapies have been subject to RCTs focused on clinical effectiveness, however the number and quality of economic evaluations alongside these RCTs has been unknown and may be few. Evidence about the cost-effectiveness of these therapies may help support decisions on efficient allocation of resources in health policies. The main aim of this study was to systematically review the cost-effectiveness of third wave therapies in the treatment of patients with physical or mental conditions. We conducted a systematic literature search in PubMed, PsycINFO, EMBASE, and CINALH to identify economic evaluations of third wave therapies. Quality and Risk of Bias (RoB) assessment of economic evaluations was also made using the Drummond 35-item checklist and the Cochrane Collaboration’s Risk of bias assessment tool, respectively. Ten RCTs were included in this systematic review. Mindfulness-Based Cognitive Therapy (MBCT), Mindfulness-Based Stress Reduction (MBSR), Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), and extended Behaviour Activation (eBA) showed acceptable cost-effectiveness and cost-utility ratios. No study employed a time horizon of more than 3 years. Quality and RoB assessments highlight some limitations that temper the findings. There is some economic evidence that MBCT, MBSR, ACT, DBT, and eBA are cost-effective from a societal or a third-party payer perspective. For many third wave interventions, no single economic evaluation alongside RCTs was identified. More economic evaluations with high methodological quality are needed.

• Psychological treatment for inpatients with psychosis
Cornelia Larsson, licensed psychologist adn psychotherapist, doctoral student, Centre for psychiatry research, Stockholm County Council & Dep.of Clinical Neuroscience Karolinska institutet, Stockholm, Sweden
Thomas Parling, PhD, Centre for psychiatry research, Stockholm County Council & Dep.of Clinical Neuroscience Karolinska institutet, Stockholm, Sweden
Tobias Lundgren, PhD, Centre for psychiatry research, Stockholm County Council & Dep.of Clinical Neuroscience Karolinska institutet, Stockholm, Sweden
Helena Fatouros-Bergman, PhD, Centre for psychiatry research, Stockholm County Council & Dep.of Clinical Neuroscience Karolinska institutet, Stockholm, Sweden

National guidelines in Sweden recommend individual cognitive behavior therapy as a prioritized intervetnion for those suffering from schizophrenia. However, a majority of inpatient wards lack psychological / psychotherapeutic competence to deliver these interventions. Recent studies have shown that acceptance based therapies are acceptable for patients with psychosis (Cramer et al., 2016), reduce positive symptoms (Shawyer et al., 2012), and reduce negative symptoms (White et al., 2011). The feasibility and effectiveness of behavioral activation for inpatients with psychosis have been shown in a preliminary study (Mairs et al., 2011). The study protocol includes one introductory session followed by three sessions each adressing; behavioural activation, acceptance of voices/thoughts and acceptance of affects/emotions. Aims: is an acceptance based therapy (10 daily individual sessions) acceptable, does it increase experienced health status, valued activities, and does it decrease psychotic symptoms in a Swedish inpatient context. Method: Participants from two inpatient wards are invited to 10 daily sessions. The study is a multiple baseline design with consecutive patients, the goal is to include n=12 participants. The study is ongoing and therefore no results are available at this timepoint. We will discuss the suitability of the intervention in a Swedish context parallell to the outcome.

Poster files will be added as we receive them. If you would like your poster file to be added to this list, please email it to Laura at acbsstaff@contextualscience.org.

Location: Melia Sevilla, Planta/Floors -1 & -2

Wednesday, 21 June, 2017, 18:30-19:30 - Poster Session #1 

Friday, 23 June, 2017, 18:15-19:15 - Poster Session #2

Friday, 23 June, 2017, 19:15-20:15 - Poster Session #3

Image denotes ACBS Junior Investigator Poster Award Recipients

Wednesday, 21 June, 18:30-19:30 - Poster Session #1

1. CareACT: Internet-Based ACT for Enhancing the Psychological Wellbeing of Elderly Caregivers
Primary Topic: Clinical Interventions and Interests
Subtopic: Elderly caregivers
Päivi Lappalainen. Ph.D., University of Jyväskylä & Gerocenter Foundation, Finland
Inka Pakkala, Ph.D., Gerocenter Foundation
Riku Nikander, Ph.D., University of Jyväskylä & Gerocenter Foundation

Background: It’s well known that stress, psychological burden, low quality of life and depression are relatively common problems among caregivers. The proportion of elderly caregivers is rapidly increasing, which emphasizes the need for new support systems for caregivers. However, the rehabilitation programmes targeted for caregivers seem to be more effective to promote their physical health but they rarely have long-lasting effects on psychosocial wellbeing of caregivers. Internet-delivered psychological interventions are one possible approach in the field of caregivers’ future support system, offering benefits as they are more easily to achieve for caregivers who often are home-bound with their relatives. Aim of the study: This study will examine whether a guided Acceptance and Commitment Therapy -based online psychological intervention aiming at enhancing wellbeing would be an effective alternative for promoting caregivers quality of life and alleviating depressive symptoms and psychosocial burden. Method: The effects of an ACT-based online intervention on caregivers’ burden, depressive symptoms, anxiety, quality of life, psychological flexibility, personality and physical performance will be studied by quasi-experimental study design comparing three groups of caregivers. Group 1 will receive the 12-week guided ACT-based online intervention (n=50), group 2 receive the standardized rehabilitation programme in the rehabilitation center (n=50); group 3 receive support given by voluntary caregiver organizations (TAU) (n=50). The caregivers’ experiences of web-based intervention will also be measured using open questions. Data collection will be conducted at three time points; baseline, 3 months and 10 months. Results: The first wave of the intervention and data collection is underway. We will present the preliminary results for the first two measurement points (pre and 3-month), and discuss the caregivers’ experiences of the web-based intervention. Conclusions: A challenge in aging societies is to develop effective strategies to promote health and well-being among caregivers who are at increased risk for psychosocial stress, burden and depressive symptoms. Results of this intervention can have impact on society when new rehabilitation strategies will be planned and guidelines for caregivers will be written.

2. Physiological and Experiential Responding During Exposure for Panic Disorder
Primary Topic: Clinical Interventions and Interests
Subtopic: Panic Disorder, Agoraphobia, Exposure
Natalie Tunnell, Southern Methodist University
David Rosenfield, Ph.D., Southern Methodist University
Anke Seidel, Ph.D.
Alicia E. Meuret, Ph.D., Southern Methodist University

Background: The activation of physiological and experiential variables during feared situations has been theorized to play an important role in exposure therapy. Previous research examined if physiological and experiential dimensions are related, but it remains unclear how these two dimensions are related. The goal of this study was to examine the degree to which physiological responding during in-vivo exposure to feared situations mediated experiential responding, and vice versa. Furthermore, we investigated the extent to which prior coping skill training (cognitive appraisal versus respiration regulation) would moderate physiological and emotional responding differently. Method: Participants were 34 individuals meeting DSM-IV diagnostic criteria for panic disorder and agoraphobia. Participants received 3 weekly in-vivo exposure sessions and a 4th session at 2-month follow-up, yielding 122 total sessions for analysis. Cardio-respiratory physiology (heart rate, PCO2, respiration rate) and experiential symptoms (cardio-respiratory symptoms, cognitive symptoms, and anxiety) were assessed throughout exposure sessions, in addition to weekly assessments of panic symptomatology. Multidimensional, longitudinal moderated mediation analyses were employed to assess relatedness and direction of the psychophysiological fear indices. Results. The treatment resulted in significant improvements in panic symptom severity, panic cognition, and functioning. Quadratic trends in cardiac, but not respiratory, responding mediated reductions in the experiential symptoms, and vice versa. Overall reductions in panic symptoms (linear trends), however, were unrelated to changes in cardio-respiratory symptoms, cognitive symptoms, and anxiety during exposure. This mediation pattern was stable across sessions and independent of treatment condition. Discussion. Overall, the results suggest physiological and experiential pathways of change to interact, thus supporting the important role of the physiological dimension in exposure-based treatments of panic disorder.

3. Acting Flexible, Acting Resistant: The Upsides of an ACT Choice. A Randomized Comparison of Acceptance and Commitment Therapy Group Intervention and Cognitive Behavioral Therapy Group for the Treatment of Obese Patients
Primary Topic: Clinical Interventions and Interests
Subtopic: Obesity, Eating Disorder
Roberto Cattivelli, Istituto Auxologico Italiano IRCCS, Department of Psychology, Catholic University of Milan, Milan, Italy
Alessandro Musetti, Department of Literature, Arts, History and Society, University of Parma, Parma, Italy
Margherita Novelli, Istituto Auxologico Italiano IRCCS
Giorgia Varallo, Istituto Auxologico Italiano IRCCS
Chiara Spatola, Istituto Auxologico Italiano IRCCS, Department of Psychology, Catholic University of Milan, Milan, Italy
Emanuele Cappella, Department of Psychology, Catholic University of Milan, Milan, Italy
Gianluca Castelnuovo, Istituto Auxologico Italiano IRCCS, Department of Psychology, Catholic University of Milan, Milan, Italy

Background: Effective weight-management programs often include a combination of physical activity, diet, and psychological intervention. The effects of these programs are frequently not stable, and usually the maintenance of achieved weight-loss lasts only for a short period of time. The purpose of the present study is to compare an Acceptance and Commitment Therapy (ACT) group intervention and a Cognitive Behavioral Therapy (CBT) group in a sample of obese individuals with respect to mid-term outcome. Method: The comparison between ACT and CBT has been assessed in a two arm randomized clinical trial. Both CBT and ACT groups followed an in-hospital intensive four-week treatment for weight reduction that includes dietarian, metabolical, psychological and physical rehabilitation. Participants were assessed before (t0), after in-hospital rehabilitation program (t1) and after six-month (t2). The CORE-OM (Clinical Outcome Routine Evaluation – Outcome Measure) and the AAQ (Acceptance and Action Questionnaire II) were administered to evaluate respectively the psychological functioning and the psychological flexibility. As a measure of weight-loss the weight was recorded. Results and Discussion: The evidence supports the hypothesis that ACT group intervention promotes a mid-term improvement more effectively than CBT group, specifically for Binge Eating Disorder patients. A further comparison of ACT and CBT intervention is required.

4. Adolescents with Type 1 Diabetes: Usefulness of the ACT-Model
Primary Topic: Clinical Interventions and Interests
Subtopic: Diabetes, Adolescents
Iina Alho, M.A. (psych.), Central Finland Health Distrinct & University of Jyväskylä, department of psychology
Raimo Lappalainen, professor, University of Jyväskylä, department of psychology
Mirka Joro, B.A. (psych.), University of Jyväskylä, department of psychology
Laura Juntunen, B.A. (psych.), University of Jyväskylä, department of psychology
Emmiina Ristolainen, B.A. (psych.), University of Jyväskylä, department of psychology
Emma Räihä, University of Jyväskylä, department of psychology

Background: Diabetes can be very challenging disorder to manage and needs a great amount of self-care and daily management. This management tends to deteriorate during adolescence due to both physiological and psychological factors. Poor adjustment to diabetes in adolescents tends to persist to young adulthood. This study aims to study the use of acceptance and value based methods for increasing well-being, psychological flexibility and motivation for treatment. Method: We developed an ACT-based group intervention consisting of five sessions, and invited 12-16 years old diabetics at pediatric policlinic to join the groups. The participants are randomized either to ACT+Treatment-as-usual (ACT+TAU) or TAU-group only. The HbA1c-level is monitored for both groups as well as the psychological flexibility, diabetes related acceptance, depression and quality of life. We have run four intervention groups so far and will continue the data collection until the year 2018. Results: The results suggest that the pre-measurement levels of HbA1c correlate significantly with the levels of psychological flexibility (DAAS, r = -0.52, p = 0.002, n=33; CAMM, r = -0.37, p = 0.032, n = 33). Thus, the lower level of flexibility is associated with higher level of blood glucose. The initial findings based on the first groups suggest that the intervention has positive impact on psychological flexibility as well as on the general quality of life. Discussion: Our results indicate that higher level of psychological flexibility is associated with better control of diabetes. This may suggest that by increasing psychological flexibility we could possible have a positive impact on how well diabetes is controlled. On the other hand, our first observations show that we are able to increase psychological flexibility by using a short 5-session group-based ACT intervention. Based on the initial findings, the ACT-model seems to be suitable for adolescents with type 1 diabetes having difficulties to control their diabetes.

5. An Acceptance-Based Intervention for Children and Adolescents Experiencing Pain During Cancer Treatment: A Single Subject Study
Primary Topic: Clinical Interventions and Interests
Subtopic: Pain in children with cancer
Jenny Thorsell Cederberg, MS, Uppsala University
JoAnne Dahl, Ph.D., Uppsala University
Louise von Essen, Ph.D., Uppsala University
Gustaf Ljungman, Uppsala University

Background and Aim: Children and adolescents with cancer report pain as one of the most frequent and burdensome symptoms during the cancer trajectory. Pain is often associated with psychological distress, which, in turn, increases the pain experience. Psychological acceptance has been shown to improve psychosocial and physical functioning for adults and children with chronic pain. In experimentally induced pain, acceptance-based interventions have been shown to predict decreased pain intensity and experienced unpleasantness of pain and increased pain tolerance. The aim of the study was to preliminarily evaluate an acceptance-based intervention for children and adolescents experiencing pain during cancer treatment, in a single-subject design study. Methods: Children, aged 4-18 years, who were being treated at the Pediatric Oncology Ward at Uppsala University Children’s Hospital and who were reporting pain were offered participation in the study. The children rated pain intensity and experienced unpleasantness of pain at five baseline measurements and at post intervention. The intervention consisted of a 10-15 minutes long acceptance-based pain exposure exercise. Results: Five children/adolescents participated in the study. All participants carried out the exercise. Three of the participants reported decreased pain intensity and all five participants reported decreased unpleasantness of pain after the intervention. Conclusions: An acceptance-based intervention is feasible to implement for children and adolescents with cancer and may be a helpful addition to their coping repertoire when experiencing pain during cancer treatment. Given the design of the study the results are highly tentative and the intervention must be further evaluated.

6. Experiential Avoidance: Comparing Measures from AAQ-II, IRAP and Behavioral Task
Primary Topic: Clinical Interventions and Interests
Subtopic: IRAP
William F. Perez, Ph.D., Paradigma - Center of Behavioral Sciences and Technology
Roberta Kovac, M.A., Paradigma - Center of Behavioral Sciences and Technology; USP - University of Sao Paulo
Ila Linares, Paradigma - Center of Behavioral Sciences and Technology
Sarah Fernandes, Paradigma - Center of Behavioral Sciences and Technology
Gabriela dos Santos, Paradigma - Center of Behavioral Sciences and Technology
Cainã Gomes, Paradigma - Center of Behavioral Sciences and Technology

Experiential avoidance (EA) is supposed to underlie a variety of psychological problems. Studies have frequently used explicit measures, like questionnaires (e.g., AAQ-II), in order to infer the occurrence of EA in participant's daily life. The present study aimed at developing an additional measure of EA using the Implicit Relational Assessment Procedure (IRAP). Adults responded the AAQ-II and were exposed to an IRAP procedure. On IRAP trials, sentences related to "Acceptance" (e.g., It is OK to think, I allow myself to feel...) or "Avoidance" (e.g., I avoid feeling, I can't stand thinking of...) were presented as sample and sentences related to "Positive" (e.g., happy things, pleasant things...) or "Negative" (e.g., things that scares me, things that makes me anxious...) psychological contents were presented as target stimuli along with the words "True" or "False" as response options. After finishing the IRAP, participants were exposed to an avoidance task with aversive images. Results suggest that participants who emitted avoidance responses during the behavioral task responded faster to “True” on Avoid-Negative IRAP trials compared to participants who did not emit any response during the avoidance task. No differences were observed between groups concerning the AAQ-II score.

7. Psychological Flexibility, Health and Wellbeing
Primary Topic: Clinical Interventions and Interests
Subtopic: Mental Health and Psychological Inflexibility
Lidia Budziszewska, MS, Universidad Europea de Madrid, Spain
Pablo Ruisoto, Ph.D., Universidad Europea de Madrid & University of Salamanca
Alberto Bellido, Universidad Europea de Madrid, Spain

Background: A high level of psychological infexibility is often associated with poorer status of mental health and psychological well-being in the population. However, studies in the Latin American context are scarce and cross cultural validation of previous results is needed. The aim of this study is to analyze the relationship between the psychological infexibility and different indicators of health (physical and psychological) in a sample of university students in Ecuador. Method: Measures of psychological infexibility or experiential avoidance Acceptance and Action Questionnaire II (AAQ-II) (Bond et al., 2011) Life Engagement Test (LET) (Scheier et al., 2006). Measures the extent of valued based behaviour Measures of alcohol consumption: Alcohol Use Disorders Identi cation Test (AUDIT) (Babor et al. 2001). Life Satisfaction Question (LSQ) “Overall, how satisfued are you with your current life” Answers ranged from 0 (totally unsatisfied) to 10 (totally satisfied) (Dolan et al., 2011) Measures of anxiety and depression syntoms: Patient Health Questionnaire (PHQ) (Kroenke, 2009) Measures perception of unpredictability, uncontrollability and overload: Perceived Stress Scale (PSS) (Cohen et al.,1983) Measures subjective availability of mainly emotional support: UCLA Loneliness Scale Revised-Short (Hughes et al., 2004) Measures tendency to competitiveness, hostility, aggressiveness, and urgency. Type A Behavior Scale (Haynes, Baker, 1982) variables (Mann-Whitney U). The statistical significance was p <0.05. Results and discussion: 1. Psychological infexibility and engagement in valued oriented behaviour were associated with problematic alcohol consumption. 2. Psychological infexibility was the best predictor of alcohol consumption, while more engagement with value oriented behaviour was the best predictor of life satisfaction. 3. Psychological infexibility was also the best predictor of other health indicators such as anxiety, depression, stress and loneliness. 4. Females reported higher psychological infexibility than males, but we failed to find gender diferences in life engagement.

8. Effectiveness of Acceptance and Commitment Therapy on Shyness in Male Adolescents
Primary Topic: Clinical Interventions and Interests
Subtopic: Acceptance and Commitment Therapy, Shyness, Male adolescents
Prof. Asghar Aghaei, Isfahan(Khorasgan) branch, Islamic Azad University, Isfahan, Iran
Parvin Tavakoli, M. A., Isfahan(Khorasgan) branch, Islamic Azad University, Isfahan, Iran

The purpose of this study was to investigate the effectiveness of Acceptance and Commitment Therapy on shyness of male adolescents. It was a quasi-experimental research with pretest- post test design and tow months follow up with the experimental and control groups. The statistical population consisted of all male students in second and 3rd grade of high schools in Isfahan city. From this population, sample of 30 students were selected by convenience sampling method, and were randomly assigned to experimental and control groups (15 per group). Subjects in both groups assessed by Stanford Shyness Inventory (1977) at pretest, post test and follow-up. The intervention involved 8 sessions of acceptance and commitment therapy, each last for 1.5 hours, which were administered only to the experimental group. Data were analyzed trough analysis of variance with repeated measures. Results showed that there was no significant difference between the mean scores of experimental and control groups in shyness in post-test and follow up stage. The finding of this study showed that acceptance and commitment therapy was not an effective therapy on this variable.

10. A Systematic Review of Third Wave Online Interventions for Depression
Primary Topic: Clinical Interventions and Interests
Subtopic: Online interventions
Marco A. Sierra, Fundación Universitaria Konrad Lorenz
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz
Cindy L. Flórez, Fundación Universitaria Konrad Lorenz

Online psychological intervention is an emerging field which primary objective is to deliver therapeutic assessment through information and communication technologies, being a legitimate therapeutic activity and a promising alternative to traditional psychotherapy. The third wave of behavioral and cognitive psychotherapies is a diverse group of empirically supported treatment approaches that comprehends acceptance and commitment therapy (ACT; Hayes, Strosahl, & Wilson, 1999), functional analytic psychotherapy (FAP; Kohlenberg & Tsai, 1991), behavioral activation (BA; Martell, Addis, & Jacobson, 2001), dialectical behavioral therapy (DBT; Linehan, 1993), metacognitive therapy (MCT; Wells, 2009), mindfulness-based cognitive therapy (MBCT; Segal, Teasdale, & Williams, 2004), and rumination-focused cognitive-behavioral therapy (RF-CBT; Watkins, 2016). There is little research on the efficacy of online psychological interventions developed under this approaches. The present study pretends to analyze the efficacy of online psychological interventions conceived from any of the third wave approaches to psychotherapy and explicitly designed for the treatment of depression.

11. Are Pain Acceptance and Willingness Stable Constructs or Psychological States Influenced by Pain Intensity?
Primary Topic: Clinical Interventions and Interests
Subtopic: Chronic pain
Carlos Suso-Ribera, University Jaume I. Castellon (Spain)
Diana Castilla-López, University Jaume I. Castellon (Spain)
Irene Zaragozá-Álvarez, CiberFisiopatologia Obesidad y Nutrición (CB06/03 Instituto Salud Carlos III)
María Victoria Ribera-Canudas, Pain Unit. Vall d'Hebron Hospital
Cristina Botella, University Jaume I. Castellon (Spain)
Azucena García-Palacios, University Jaume I. Castellon (Spain)

Background: Pain acceptance and willingness are important predictors of functioning in pain settings. However, a controversy exists as to whether pain acceptance and willingness are psychological states influenced by pain intensity or stable constructs that can only be changed with psychological treatment. The aim of our study was to test whether pain acceptance and willingness change as pain intensity decreases or they remain stable even if pain is treated. Method: To achieve this goal we monitored 37 pain patients using an app called “Pain Monitor” developed by our team. Patients responded to a measure of pain intensity, acceptance, and willingness daily during 30 days. Results: We did not find changes in pain acceptance or willingness including patients who had a clinically significant reduction in pain (>30%). Discussion: Our results suggest that pain acceptance and willingness are enduring psychological characteristics that may require psychological treatment to be changed. Results support the need for a multidisciplinary treatment of chronic pain.

12. Effect of Brief ACT Protocol Focused on the Use of the Metaphorical Body Language
Primary Topic: Clinical Interventions and Interests
Subtopic: ACT
Beatriz Harana Lahera, Ph.D. Student, Madrid Institute of Contextual Psychology (MICPSY)
Evangelina Ruiz García, MSc, Madrid Institute of Contextual Psychology (MICPSY)
Elena Belmonte Padilla, BS, Madrid Institute of Contextual Psychology (MICPSY)
Manuel Ariza Bernal, BS, Madrid Institute of Contextual Psychology (MICPSY)

The Acceptance and Commitment (ACT) therapeutic depends essentially on the use of metaphors.The main aim of this current study is the application of brief acceptance and commitment therapy (ACT) protocol focused on testing the effects of metaphors where bodily movement constitutes the source. A n=1 design is used with four adults with a compulsive – obsessive profile. The protocol was implemented successively across participants, and in turn, it was structured in three session based on the three key therapeutic strategies (Törneke, Luciano, Barnes-Holmes, & Bond, 2016): creative hopelessness, defusion, valued action. Different psychological flexibility and valued action measures will be used as pre-, in-trial and post-test. Results will be mainly discussed the need to conduct a clinical trial to compare the use of metaphorical body language in ACT with other types of therapy that specifically uses the body in the work for therapeutic change.

13. Effectiveness of Acceptance and Commitment Therapy as a Treatment for Veterans with Chronic Posttraumatic Stress Disorder
Primary Topic: Clinical Interventions and Interests
Subtopic: PTSD
Ellen J. Bluett, M.S., Utah State University
Brandon Yabko, Ph.D., Salt Lake City Veterans Affairs Medical Center
Michael Twohig, Utah State University

Background: Posttraumatic Stress Disorder (PTSD) is a common condition among military personal and veterans. Despite strong empirical support for first line treatments for PTSD, many individuals do not respond, demonstrate minimal gains post-treatment, and do not complete treatment (Garcia, Kelley, Rentz, & Lee, 2011; Steenkamp, Litz, Hoge, & Marmar, 2015). Some literature suggests, that avoidance may be the underlying factor contributing to treatment dropout and poor treatment gains (Walser & Westrup, 2007). Acceptance-based interventions target experiential avoidance and promote willingness to experience thoughts, feelings, and/or emotions, without changing their form, meaning, or frequency. One such therapy, Acceptance and commitment therapy (ACT) is an empirically supported cognitive behavioral intervention that aims to decrease experiential avoidance while increasing psychological flexibility. Research has shown ACT to be a promising intervention for the treatment of PTSD, however its effectiveness in veterans with chronic PTSD is limited. Taken together, the prevalence and chronicity of PTSD amongst military personal, along with the limitations of existing treatments, warrants the investigation of alternative treatment options for veterans with PTSD. Methods: Implementing an eight-week closed group design, this study examined the effectiveness of an ACT intervention for veterans with PTSD and subclinical PTSD who had previously completed a first line intervention for PTSD. Thirty-three veterans enrolled in the intervention, which focused on vitality (e.g., increasing valued living and decreasing experiential avoidance) rather than symptom reduction. A majority were male 87.9% (n = 29), White 84.8% (n = 28) with an average age of 49.6 (16.31). Results: Results found that 64.7% of veterans showed a favorable response to treatment as measured by a 5-point change in PTSD symptoms. One-way repeated measures ANOVAs (within-subject ANOVAs) were used to determine whether there was a statistically significant difference between pre-treatment, post-treatment, and follow-up on outcomes of interest. Results revealed a significant effect of time on PTSD symptoms, F(2, 64) = 3.40, p = .04, partial η2 = .096, with a small to moderate effect size, d = 0.31. Additional outcomes of interest including valued-living, depression, wellbeing, and moral injury by transgressions improved from pre-treatment to post-treatment. Of note, a majority of treatment gains were not maintained at follow-up. Discussion: Overall, results provide preliminary support for ACT as a second-line intervention for veterans with chronic PTSD. Findings from this study suggest that stepped-models of care for veterans with PTSD should be explored. Empirical and clinical implications are discussed along with the potential limitations and future directions of this study.

14. Effectiveness of Acceptance and Commitment Therapy on Resiliency and Codependency of Mothers of Addicts
Primary Topic: Clinical Interventions and Interests
Subtopic: ACT, Resiliency, Codependency, mothers, addicts
Leili Nourian, Ph.D student, Isfahan(Khorasgan) branch, Islamic Azad University, Isfahan, Iran

The purpose of this research was to determine the effectiveness of acceptance and commitment therapy on resiliency and codependency of mothers of addicts. The research used semi-experimental method with pretest-post test design with a control group. For this purpose, 32 subjects were selected via convenience sampling among the mothers of addicts who referred to an addiction treatment center of Isfahan (Iran). They were randomly divided into two groups of experimental and control groups (n1=n2=16). Both groups completed Connor – Davidson Resiliency Scale (CD-RISC) and Halyock Codependency Index (HCI) before and after the training (10 sessions, 1.5 hours each). Results of covariance analysis showed a significant increase in resiliency and significant decrease in codependency at the post test (P<0.05). The finding of this study confirmed the efficacy of acceptance and commitment therapy on resiliency and codependency of mothers of addicts.

15. Effectiveness of ACT in a PTSD Specialty Partial Hospitalization Program
Primary Topic: Clinical Interventions and Interests
Subtopic: PTSD
Catherine D'Avanzato, Ph.D., Brown Medical School; Rhode Island Hospital
Darren Holowka, Ph.D., Brown Medical School; Rhode Island Hospital
Sarah McCutcheon, M.S., Rhode Island Hospital
Kirsten Langdon, Ph.D., Rhode Island Hospital
Brian Pilecki, Ph.D., Rhode Island Hospital
Mark Zimmerman, M.D., Brown Medical School; Rhode Island Hospital

There has been growing research on Acceptance and Commitment Therapy (ACT) for the treatment of Posttraumatic Stress Disorder (PTSD), however RCTs and other studies examining its efficacy have lagged behind the research on ACT for other presenting concerns. Research on the efficacy of ACT in higher level care settings, including partial and inpatient hospital programs, is particularly lacking. ACT’s transdiagnostic approach may offer several advantages over traditional cognitive and behavioral interventions in the treatment of individuals with PTSD and trauma-related concerns in higher level care settings, who often present with high rates of comorbidity, greater complexity, and difficulties with a broad range of emotions including not only fear and anxiety, but also guilt and shame (Orsillo & Batten, 2005). The aims of this study are to examine the effectiveness of an ACT-based specialty track within a routine partial hospitalization setting. Previously, we presented preliminary results demonstrating significant reductions in PTSD symptoms, as indicated by the PTSD Check List (b = 1.1, t(58) = -2.6, p = .013), as well as ACT processes (FFMQ Mindfulness, t=3.9, p<.01, AAQ-II Psychological Flexibility, t=2.8, p<.05) in a small subset of 100 participants. Outcome data collected daily and at pre- and post- treatment on a complete sample of over 1,000 individuals completing the trauma track will be presented. Results on symptom change, functioning and quality of life, as well as ACT processes and their relation to treatment outcomes, will be presented. Implications for the integration of ACT for PTSD in similar routine clinical settings will be discussed.

16. Effects of a 12-Month Compassion-Focused Intervention in a Commercial Weight Management Programme: Self-Reassurance and Self-Compassion as Processes of Change
Primary Topic: Clinical Interventions and Interests
Subtopic: Weight management interventions
Cristiana Duarte, MSc, Ph.D. Candidate, Cognitive and Behavioural Centre for Research and Intervention, University of Coimbra
Carol Stalker, Ph.D. Student, College of Life and Natural Sciences, University of Derby
Francisca Catarino, MSc., College of Life and Natural Sciences, University of Derby
Jaskaran Basran, College of Life and Natural Sciences, University of Derby
Paul Gilbert, Ph.D., College of Life and Natural Sciences, University of Derby
Graham Horgan, Ph.D., Biomathematics and Statistics Scotland, Rowett Institute of Nutrition and Health
Liam Morris, Slimming World
James R. Stubbs, Ph.D.

Background: This study tested whether adding Compassion Focused Therapy (CFT) online video exercises into a commercial weight-management programme (WMP) helped individuals control eating behaviour compared to the regular programme, and whether changes in binge eating symptomatology were mediated by increases in self-reassurance related to aspects of eating, body weight and shape and by increases in self-compassion. Method: This was a two-arm, non-randomised parallel design (i) control arm: multicomponent WMP (ii) intervention: the same multicomponent WMP with the addition of 2 days CFT training for weight management group leaders and 8 online video exercises. Participants joined the trial arm to which their group leader was allocated: intervention (n = 428) or control (n = 547). Results: In the intervention group, there were small, significant reductions in binge eating symptomatology, self-criticism, shame (at 3-12 months), and emotional distress (3-6 months); and increases in self-reassurance and self-compassion (3-12 months). At 3 months, effects of the intervention on binge eating symptoms were significantly mediated by increases in self-reassurance and self-compassion. Discussion: Combining online digital CFT exercises and weight management behavioural skills may improve psychological wellbeing and reduce binge eating symptomatology for some people.

17. Evaluating Longitudinal Changes in Undergraduates’ Suicidal Ideation and Alcohol Use with a Brief Personalized Feedback Intervention Integrating Dialectical Behavior Therapy and Motivational Interviewing
Primary Topic: Clinical Interventions and Interests
Subtopic: College students, DBT, suicide, alcohol use, brief interventions
Charlotte D. Brill, M.S., University of Washington, Department of Psychology
Ursula Whiteside, Ph.D., NowMattersNow.org
Megan M. Kennedy, M.A., LMHC, University of Washington, Division of Student Life, Health and Wellness

Background: Suicidality and maladaptive alcohol use are both highly common among undergraduate college students in the United States (e.g., Lamis et al., 2014, 2016; Substance Abuse and Mental Health Services Administration [SAMHSA], 2014). These mental health issues frequently present comorbidly among undergraduates, such that, the more maladaptive undergraduates’ alcohol use, the greater their likelihood of experiencing suicidality (e.g., Gonzalez et al., 2009; Lamis et al., 2014, 2016; Schaffer et al., 2008). Efficacious brief interventions that target undergraduate students’ maladaptive alcohol use, such as the Brief Alcohol Screening and Intervention for College Students (BASICS) curriculum (Dimeff et al., 1999), exist; however, it is likely that such interventions do not fully address the needs of undergraduates who experience comorbid suicidality. In this study, we sought to address these unique needs with a modification of the existing BASICS program that incorporated content and principles of Dialectical Behavior Therapy (DBT), a third-wave behavior therapy that has been efficacious in treating suicidality and substance abuse (e.g., Linehan et al., 1999). Method: Participants were 35 undergraduate students (65.7% women) who reported heavy alcohol use and mood and/or anxiety symptoms. The intervention, DBT-BASICS, was delivered one-on-one in a 60-minute session. DBT-BASICS consisted in the traditional components of the BASICS intervention – feedback regarding drinking behavior, norms, consequences, and risk reduction tips, delivered in a Motivational Interviewing style – as well as feedback regarding depression and anxiety levels and related norms, identification and reinforcement of existing coping skills, and brief training in three skills from the skills group component of DBT. Prior to completing the intervention (i.e., baseline), participants completed measures on suicidal ideation, number of standard drinks consumed per week, past-month frequency of binge drinking episodes, and past-month alcohol-related problems. One- and three-months after completing DBT-BASICS, they completed the same self-report measures. Results: At both one- and three-months after completing DBT-BASICS, participants consumed fewer standard drinks per week, engaged in fewer episodes of binge drinking in the past month, and experienced fewer alcohol-related problems in the past month than they had at baseline. Baseline and one-month follow-up suicidal ideation severity did not differ; however, three-month follow up suicidal ideation severity trended towards significantly lower than baseline suicidal ideation. Discussion: Findings provide initial support for the efficacy of DBT-BASICS in reducing suicidal ideation as well as drinking problems among undergraduate students.

18. Evaluating the Effectiveness of One-Day Group Acceptance and Commitment Therapy Workshop for Non-Patient Irritable Bowel Syndrome: A Pilot Randomized Controlled Trial
Primary Topic: Clinical Interventions and Interests
Subtopic: Acceptance and Commitment Therapy, Irritable Bowel Syndrome, one-day intervention
Masataka Ito, M.A., Graduate school of psychology, Doshisha Unversity
Takashi Muto, Faculty of Psychology, Doshisha University

Back ground: Irritable Bowel Syndrome (IBS) is one of the most common functional disorders. Psychological treatment is effective for IBS patients. It is said that majority of IBS patients have gone through a period of non-patient IBS. However, Intervention for non-patients IBS have rarely been investigated. The current study examined the efficacy of one-day group ACT workshop for the non-patient IBS. Methods: 130 undergraduates who scored above the clinical cutoff in the Irritable bowel syndrome severity index recruited into this study as IBS non-patient. 25 non-patients who can participate one-day workshop were randomized to an intervention group or a waitlist group. Assessment were made at pre, post, 2 month, and 6 month. Intervention followed the protocol that is listed in ACBS web site as “ACT for Irritable Bowel Syndrome”. Results: Marginally significant difference in favor of ACT was seen in symptom severity and significant difference in a part of QOL at post assessment, but not in secondary and process measures at post assessment Discussion: The results showed one-day group ACT workshop improved IBS severity. This effect may not be caused by ACT, because proses measures did not show the significant change. Although there are some of limitations, one-day ACT workshop is promising approach for IBS non-patients.

19. Predictors of Adolescent Readmission after Psychiatric Hospitalization: An Assessment of the Impact of Psychiatric Follow-Up/Aftercare
Primary Topic: Clinical Interventions and Interests
Subtopic: Psychiatric Hospitalization
Kendra J. Homan, Ph.D., Mayo Clinic, Rochester MN
Susan L. Crowley, Ph.D., Utah State University, Logan UT
Jarrod M. Leffler, Ph.D.

Adolescent psychiatric illness is associated with a range of negative sequelea including poor academic outcomes, substance abuse, suicidality, and adult psychiatric illness. Concerns related to the severity of impairment increases the need for intensive levels of mental health care. For adolescents in an acute psychiatric crisis, inpatient psychiatric hospitalization is often necessary and is associated with improvements on global assessment scales at one-year follow-up after discharge (Green et al., 2007). However, hospitalization is not without limitations including annual costs over $3.9 billion, high rates of rehospitalization (34%-38% in 1 year), restrictive environment, lack of family involvement, and decreased hospital bed availability (Blader, 2004; Fontanella, 2008; Geller & Biebel, 2006; Ringel & Sturm, 2001). Factors associated with hospital readmission remains poorly understood. Several studies have examined the impact that patient (e.g., gender, diagnoses, severity of symptoms, comorbidity), family (e.g., parental mental illness, parental involvement), and treatment (e.g., length of stay, prior hospitalizations) characteristics have on IPH recidivism with mixed results. However, the impact of psychiatric follow-up/aftercare on readmission has not been investigated. Given the high rates of adolescent inpatient psychiatric hospitalization in the general adolescent population (969 per 100,000), understanding factors that contribute to readmission has important implications for decreasing IPH recidivism. The purpose of this study was to examine the impact that psychiatric follow-up/aftercare factors have on readmission. A retrospective cohort review of all adolescent patients (ages 12-17.9) who were consecutively admitted for a psychiatric hospitalization at a Midwestern hospital between January 1, 2015 and March 15, 2015 was conducted. The cohort consisted of 36 patients (M age=14.79 years, SD=1.3; 69.4% female; 80.62% White). Psychiatric follow-up/aftercare appointments made during hospitalization (i.e., medication management, psychotherapy, intensive outpatient therapy, chemical dependency treatment), appointment attendance within the first month following discharge, and psychiatric readmission was abstracted from patients’ medical/psychiatric records. Readmission was defined as an inpatient hospitalization occurring within two years of the adolescent's index admission. Results indicated that 10 patients (27.8%) were rehospitalized within two years of index admission. There was no statistically significant association between readmission and medication management appointment attendance, χ(1) = 0.016, p=.900, individual psychotherapy attendance, χ(1) = 0.002, p=.964, or intensive outpatient therapy attendance, χ(1) = 0.985, p=.321. There was, however, a statistically significant association between readmission and chemical dependency treatment attendance, χ(1) = 5.002, p=.025. Results of this preliminary review suggest that in general psychiatric follow-up/aftercare was not associated with psychiatric readmission. Implications for discharge planning and psychiatric follow-up/aftercare are discussed. Results are discussed in terms of the broader literature on readmission concerning the ongoing challenges in the field to better understand this concept.

20. The Effect of ACT WS for Teachers and Staffs Working for Children Having Disabilities II
Primary Topic: Clinical Interventions and Interests
Subtopic: Parent, children, disabilities
Shinji Tani, Ritsumeikan University
Kotomi Kitamura

Background: Teachers and staffs that are working with children and their parents learn the skills of ACT, and teach them mindfulness skills and other relating skills to ACT. It could be useful. Furthermore, teachers and staffs often have some mental health issues. Therefore, it could be beneficial for them to learn ACT on both children and themselves. The purpose of this research is to investigate the effects of ACT WS on acquisition of knowledge and skills of ACT, and mental health of participants. Methods: 38 participants attended the workshop. Three participants did not agree with the attendance of this research. 35 participants were divided into two groups for the waiting-list design (not randomized). The participants of waiting group attended workshop one week after finishing workshop for the experimental group. The participants of both the experimental group (N=18) and the waiting group (N=17) answered the questionnaires four times (Time1, Time2, Time3, and Time4). Four questionnaires (AAQ-II, BDI-II, FFMQ, and CFQ) were used to assess the effectiveness of the workshop. The knowledge test was also used to evaluate the knowledge of ACT. Workshop was conducted in a group format. It lasted for about five hours in a day. The textbook and PP slide were used. The common exercises and metaphors from ACT were provided, and the participants shared their experiences with each other. Results: The data getting from 24 participants who answered all questionnaires were analyzed. ANOVA (time*group) revealed the score CFQ (fusion) and knowledge test showed the significant interaction (time*group). The time effect was significant in AAQ-II, FFMQ (Observing), and BDI-II. T-test was conducted by getting two group data together in order to assess the effect between before and after the workshop. The result showed that the score of FFMQ (observing), CFQ (fusion), and the knowledge test were significantly changed after the workshop. Conclusion: The effects of the workshop were confused, because the effect of time was large. Many participants showed better mental health conditions before the workshop. The effects of the workshop on mental health were smaller.

21. The ACTonHEART Study: Feasibility, Acceptability and Preliminary Efficacy of a Brief Intervention Based on Acceptance and Commitment Therapy in a Cardiac Rehabilitation Setting
Primary Topic: Clinical Interventions and Interests
Subtopic: Cardiovascular disease
Chiara A.M. Spatola, Ph.D., Catholic University of the Sacred Heart; Istituto Auxologico Italiano
Cattivelli Roberto, Ph.D.
Emanuele A.M. Cappella, Catholic University of Sacred Heart, Milan
Giada Rapelli, Istituto Auxologico Italiano, Milano
Gianluca Castelnuovo, Catholic University of Sacred Heart, Istituto Auxologico Italiano, Milano
Enrico Molinari, Catholic University of Sacred Heart, Istituto Auxologico Italiano, Milano

Background: Modifiable risk factors, including life-style habits and psychological variables, account for approximately 90% of the population risk for cardiac events. Acceptance and Commitment Therapy (ACT) has been successfully applied to promote healthy behaviors and psychological well-being in patients with a number of chronic physical conditions. The aim of the present study is to evaluate the feasibility and acceptability of a new acceptance-based program for the modification of cardiovascular risk factors and the improvement of psychological well-being, compared to usual secondary prevention care. Method: A total of 60 patients have been recruited from an outpatient cardiac rehabilitation unit and randomly assigned to receive usual care or usual care + a brief ACT-based intervention. An unbalanced randomization has been applied with a 2:1 ratio, resulting in 39 participants assigned to the ACT group and 21 to the control group. The ACT group was administered three group therapy sessions, integrating educational topics on heart-healthy behaviours with acceptance and mindfulness skills. Data has been collected at baseline and post-treatment, while follow-up assessments are not yet available. Outcome measures include biological and functional indicators of cardiovascular risk (LDL cholesterol levels, body mass index and exercise capability) and self-reported psychological well-being (Psychological Well-Being Index). Moreover, in order to evaluate acceptability rates and satisfaction about the program we analyzed patients’ feedbacks collected through qualitative interviews. Results: The qualitative analysis of patients’ transcripts revealed interest about the experiential approach of the intervention, in particular mindfulness modules and metaphors. However, some patients suggested the need of a more intensive program with additional sessions, so that to achieve a deeper understanding of ACT principles and maintain its effects. In this regard, the desire for a follow-up meeting after the rehabilitation period strongly emerged. As for the efficacy, preliminary results showed significant changes in depression and well-being scores, in the ACTonHEART participants but not in the control group. Furthermore, a significant improvement in exercise capability was detected in all participants, regardless of treatment condition. Finally, in a subsample of patients with LDL cholesterol values above 80 we found a significant change of this indicator only in the experimental arm. Discussion: The ACTonHEART program showed good feasibility and acceptability, as reflected both by patients’ interviews and low drop-out rates. The results provided first evidence of efficacy in modifying some relevant cardiovascular risk factors during the program. However the overall aim of the ACTonHEART project is to evaluate the long-term maintenance of the changes, which will be possible only after the 12-months follow-up. Finally, we will discuss the implications of both quantitative and qualitative data in order to optimize program contents and its implementation. Trial registration: clinicaltrials.gov/ (NCT01909102)

22. The Connection Between the Relationship-Focused Values and Cortisol in Women with Breast Cancer
Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness
Soultana Mpoulkoura, San Jose State University
Kendra Fisher, San Jose State University
Jannet Lara, San Jose State University
Jennifer Gregg Ph.D., San Jose State University

Diagnosis with cancer brings significant challenges for survivors attempting to live full and meaningful lives. Studies have demonstrated that perceived social support may be related to both psychological variables and cortisol variability (Dukes Holland & Holahan, 2003; Turner-Cobb, Sephton, Koopman, Blake-Mortimer, Spiegel, 2000). This is important in that cortisol variability has been shown to be a predictor of long-term survival in breast cancer patients (Sephton, Sapolsky, Kraemer, & Spiegel, 2000). The present study sought to investigate how relationship-focused values impact psychological variables, quality-of-life, and cortisol variability in a group of early stage breast cancer patients (N = 41) exhibiting elevated levels of stress. Results indicate that marital status and relationship values serve as a significant predictor of diurnal cortisol. Results are discussed in terms of future research needed and possible applications of these findings.

23. The Effect of Universal Program Based on ACT for Adolescents Under Unusual Stress
Primary Topic: Clinical Interventions and Interests
Subtopic: Universal program, Adolescents, Self-esteem
Tomu Ohtsuki, Ph.D., Waseda University, Japan
Kenichiro Ishizu, Ph.D., University of Toyama, Japan
Yoshiyuki Shimoda, Ph.D., Saga University, Japan

Previous studies have provided evidence that experiential avoidance, which is a key concept in Acceptance & Commitment Therapy (ACT), is associated with mental health in adolescents, such as depression (Biglan et al., 2015; Paulus et al., 2016), well-being (Venta et al., 2012; Ciarrochi et al., 2011). But few studies have examined to evaluate the efficacy of ACT, especially universal intervention programs for adolescents. The present study explored the effect of the ACT based universal programs that aimed to enhance self-esteem and reduce depressive symptom for adolescents under unusual stress. Participants were 347 junior high school students preparing for a high school entrance exam. This study was conducted just a month before their exam. Participants were assigned to an ACT based intervention condition or a control condition in accordance with their school classes. Self-report measures which assess the tendency of experiential avoidance, depressive symptom, and self-esteem were collected at pre-intervention, post-intervention, and follow-up. The ACT based intervention which the authors developed was a class-wide universal program consisted 4 sessions (each 50 min) and focused a process of acceptance, value, and commitment. The results showed that ACT intervention prevented to increase experiential avoidance, enhanced self-esteem, and reduced depressive symptom, compared to the control group. Especially ACT intervention led to a significant increase in self-esteem regardless of the participant’s tendency of experiential avoidance at pre-intervention. These results provide evidence for the efficacy of ACT intervention program for adolescents. Additionally, present study shows the validity of ACT for the universal program aimed to enhance self-esteem in young generation.

24. Social Rank and Psychosis: Understanding Their Role in the Pathway to Depression
Primary Topic: Clinical Interventions and Interests
Subtopic: Self-compassion, depression and psychosis
Joana Gonçalves, University of Coimbra
Ricardo Viegas, University of Coimbra
Paula Castilho, Ph.D., University of Coimbra
Maria João Martins, University of Coimbra

Background: Previous studies have already shown how the experience of psychosis might be appraised as leading to greater personal loss and humiliation, which seems related with the emergence of comorbid depression. It has been also argued that depression might occur due to a compassionate deficit towards the self. Nevertheless, although the relationship between shame, self-compassion and depression have been empirically established, it remains unexploited in psychosis. This study aimed to explore the predictor role of shame and self-compassion in the experience of depressive symptoms in a sample of patients with psychosis. Method: Until now, 30 participants diagnosed with Psychotic Disorders completed self-report scales for the evaluation of external shame, self-compassion and depressive symptoms. Results: Preliminary results showed that higher levels of external shame and lower levels of self-compassion appear to be associated with depressive symptoms, and self-compassion emerges as explanatory factor of 40% of the variance of depression. Discussion: These results are in agreement with those reported by previous studies that analysed the role of self-compassion in depression and at the same time, seem to suggest that self-compassion might be an important target for interventions aiming to address depression during the course of psychotic disorders.

25. Stressors and Guilt in Dementia Caregivers: The Mediator Role of Cognitive Fusion
Primary Topic: Clinical Interventions and Interests
Subtopic: Caregivers, Guilt, Cognitive fusion
Laura Gallego-Alberto, M.A., Universidad Autónoma de Madrid
María Márquez-González, Ph.D., Universidad Autónoma de Madrid
Rosa Romero-Moreno, Ph.D., Universidad Rey Juan Carlos
Carlos Vara-García, M.A., Universidad Rey Juan Carlos
Isabel Cabrera, Ph.D., Universidad Autónoma de Madrid
Andrés Losada, Ph.D., Universidad Rey Juan Carlos
Jorge Aguilar-Álvarez, M.A., Universidad Autónoma de Madrid

Background: Caring for a relative with dementia has been associated with poor physical and psychological health. Although feelings of guilt are frequent among caregivers, the studies analyzing guilt in caregiving are limited. Behavioral and psychological symptoms of dementia in the care recipient (CR) may likely activate caregivers´ "negative" thoughts and feelings about him/her, and high levels of cognitive fusion may mediate the effects of these private experiences on emotional well-being, leading to guilt feelings. Objective: The goal of the present study is to analyze the mediator role of cognitive fusion in the relationship between the distress associated with disruptive behaviors of the CR and the caregivers´ guilt. Method: Participants are 173 dementia family caregivers. Face to face interviews were done assessing sociodemographic variables (e.g., gender, age), caregiver guilt, cognitive fusion and distress associated with behavioral and psychological symptoms in dementia (BPSD) of the CR. Hierarchical regression analyses were carried out to analyze the mediator effect of the cognitive fusion in the relation between distress associated with BPSD and caregivers ‘guilt, after controlling for the sociodemographic variables. Results: Significant and positive associations were found between distress associated with BPSD, cognitive fusion and guilt. We found a significant partial mediator effect of cognitive fusion in the relation between the distress associated with BPSD and caregivers’ guilt (β = 0.36, p <0.001.). Also, caregiver age showed a significant effect on guilt (β = -0.16, p <0.05.). Results of the Sobel test suggest that the association between distress associated with BPSD of the CR and guilt is significantly mediated by cognitive fusion (z’ = 3.21, p<0.001). Discussion: Our findings suggest that cognitive fusion is a relevant variable to understand the guilt experienced by caregivers. The results obtained suggested that defusion strategies may be of potential use in interventions aimed to decrease high levels of guilt in family caregivers.

26. Support Group for Parents of Children with Intellectual Disability
Primary Topic: Clinical Interventions and Interests
Subtopic: Parental skills empowerment
Dr. Lucia Marconi, Nation Health Service, Tuscany Northwest USL, Viareggio
Dr. Giovanna Canepa, Nation Health Service, Tuscany Northwest USL, Viareggio
Dr. Michele Carrozzini, Accademy of Cognitive and Behavioural Science, Parma

Background: The idea to start a support group for parents of children with intellectual disability grows up from the always more significant need for the families whose children have cognitive and behavioural problems. In the Territorial Service for Childhood and Adolescence Mental Heatlh ASL Nord-Ovest Toscana - Viareggio is always more common the request to take in charge children and adolescents with intellectual and learning diseases; usually these interventions last a lot, most of the time until the age of majority. Furthermore, jointly with the intellectual disability, we usually find some related problematic behaviour in the children, that questions the educational system of their parents. The behavioural problems of the child are basically correlated to worries, low self-esteem and fears of the parent about his or her role, and therefore to experienced stress feelings, external attribution of cause and low parental satisfaction (Hassall R., Rose J. & McDonald J., 2005). A lot of evidence-based reaserches demonstrated the principle “good parenting, good outcomes”: empowering the parenting skills we can obtain permanent improvements in learning, generally, in the growth processes and, generally speaking, in the welfare of the children (Cornish, 2008; Larivée et al., 2006; Nixon et al., 2005; Weiss et al., 2006). Method: The group was composed by 7 couples of parents with at least a child with intellectual disability (from 8 to 11 years old). We structured 8 meetings fortnightly, 90 minutes long, lead by the psychologist and the child psychiatrist of the Territorial Service. The main arguments choosen for the group were the following: • Positive qualities of the children • Parenting skills • Recovering activities • Support from the social network • Worries and fears of the parents Furthermore, in order to consider the specific needs of all the subjects and to customize the meetings, we built an ad hoc questionnaire that they filled in at the beginning of the first meeting. During the sessions we used specific material to work with parents of children 0-11 years old (Sostenere la genitorialità – strumenti per rinforzare le competenze educative, Lavigueur S., Coutu S. & Dubeau D., 2011). It is based on a great reaserch programme on parenting skills and on the activities that can empower them (Lavigueur S., Coutu S. & Dubeau D., 2001, pp. 171 – 220). Expected Results: First of all we expect an increase of the parenting skills, and in particular of the knowledge about the learning process and the right management of the behavioural problems. Furthermore, we expect an increase of the self-efficacy, through the comparison and the sharing of personal experiences, and a reduction of the perceived parental stress.

27. Support Group for the Italian Red Cross Rescuers
Primary Topic: Clinical Interventions and Interests
Subtopic: PTSD, Mindfulness
Dr. Lorenzo Pellegrini, Academy of Cognitive and Behavioral Science Parma

Background: The idea of creating a support group for rescuers stems from an increasing demand for interventions on personnel who directly intervened to provide assistance to the population stricken in a very short time by earthquake, heavy snow emergency and landslides. Interventions can not neglect the cultural framework in which rescuers operate. Prevention is based on key concepts such as "the rescuer", "the territory and its risks"; supporting means promoting a community culture of "coping" (adaptation, ability to cope with stress). A thorough knowledge of the territory and of its entire network of organization are essential elements in order to improve the "performance" in the emergency and to assess community needs. Operating in favor of the personnel in charge of emergencies means enhancing their skills and provide tools that safeguard a passively endured suffering because of psychological and unconscious emotional processes. It’s important to remember that the operating environment in which the rescuer operates is characterized by sudden changes and unpredictability, it evokes pain and risk and does not allow the rescuers an organic and adequate adaptation to cope with the emotional aspects related to the stress generated by the event. Natural disasters and emergencies destabilize the affected area and its inhabitants and undermine the community both from a geological and from a psychological point of view. Those operators who are called upon particularly to help the victims of unpredictable phenomena (earthquakes, floods, floodings, landslides, fires) require adequate preparation. It’s this knowledge that drives us to consider a culture attentive both to the rescuer and the needs of emergency victims, and to a better management of the sense of drama, inadequacy, vulnerability and helplessness that they both experience. Method: The group will be composed by 15 rescue workers. The course, led by a psychologist, will be delivered fortnightly, for a total of 8 meetings, each 90 minutes long. The main topics chosen for the group are as follows: - controlli s the problem not the solution - wilingness - creative impotence - acceptance - present moment In addition, in order to take into account the specific needs of all the participants and to customize the meetings, specifically designed questionnaires will be presented during the first meeting and the last one Expected Results: First of all, we expect an increase in the endurance of stress, an enhancement in coping strategies and resilience.

28. Turkish Version of Valued Living Questionnaire (VLQ): Preliminary Analysis of Reliability and Validity in Bipolar Disorder and Schizophrenia Sample
Primary Topic: Clinical Interventions and Interests
Subtopic: VLQ clinical sample
Hasan Turan Karatepe, Medeniyet University, School of Medicine, Department of Psychiatry, Istanbul, Turkey
M. Emrah Karadere, Hitit University, School of Medicine, Department of Psychiatry, Corum, Turkey
Kaasım Fatih Yavuz, Bakirkoy Mazhar Osman Mental Health and Neurological Diseases Education and Research Hospital, Bakırkoy, Istanbul, Turkey
Sevinc Ulusoy, Bakirkoy Mazhar Osman Mental Health and Neurological Diseases Education and Research Hospital, Bakırkoy, Istanbul, Turkey
Murat Aktepe, Arnavutkoy State Hospital, Istanbul, Turkey
Alparslan Cansız, Siverek State Hospital, Urfa, Turkey

Turkish Version of Valued Living Questionnaire (VLQ): Preliminary Analysis of Reliability and Validity in Bipolar Disorder and Schizophrenia Sample Objective: Valued living has been posited as a primary core process of Acceptance and Commitment Therapy (ACT) and has been theoretically associated with other core processes like mindfullness acceptance, and many important outcomes such as decreased psychological distress and improvements in quality of life. Valued Living Questionnaire (VLQ) is a self-evaluating scale that systematically assesses valued living, or the extent to which an individual contacts his or her chosen values in everyday life, from an ACT perspective. The aim of this study was to examine validity and reliability of the Turkish version of “Valued Living Questionnaire (VLQ) in clinical sample. Method: 101 participants who diagnosed Bipolar I Disorder and 110 participants who diagnosed schizophrenia being treated in the outpatient clinic of Bakirkoy Research and Training Hospital for Psychiatry and Neurology Hospital between the ages of eighteen to sixty five were included into the study. After taking informed consent; Sociodemographic Data Form, Turkish version of VLQ (TVLQ), Acceptance and Action Questionnaire-II (AAQ-II), Self as Context Scale (SACS), Cognitive Fusion Questionnaire (CFQ) and Freiburg Mindfulness Inventory (FMI) were administered to participants. Positive and Negative Syndrome Scale (PANSS) and Quality of Life Scale (QoLS) were applied to schizophrenia group by clinicians and Bipolar Disorder Functioning Questionnaire (BDFQ) were also administered to Bipolar Disorder group. For reliability analysis of TVLQ Cronbach’s alpha coefficient and item-dimension total score correlations were used. We also used principal component analysis for factor analysis and Pearson correlation analysis for convergent validity. Results: The mean age of participants was 39,46±8,76 years (age range: 21-64 years) and 50,7% (n=107) were female. With respect to reliability, good internal consistency was found with both the bipolar disorder and schizophrenia samples and across the VLQ Composite score, Importance and Consistency subscales (TVLQ-importance: Cronbach α= 0,807; TVLQ-consistency: Cronbach α= 0,916; TVLQ-composite: Cronbach α= 0,918). Also all items were positively correlated with each other. Principal factor analysis performed and it was detected that one dimension explained 57,98% of the total variance. Factor loading were changing between 0,64 and 0,84. Composite score was correlated with AAQ-II (r= -0,429; p<0,001), FMI (r= 0,529; p<0,001), CFQ (r= -0,373; p<0,001) and SACS (r= 0,591; p<0,001). Conclusion: The results of this study show that TVLQ is a reliable and valid scale for the assessment of valued living in clinical bipolar disorder and schizophrenia population.

29. The Impact of a RFT-based ACT Protocol on Impulsivity
Primary Topic: Clinical Interventions and Interests
Subtopic: Impulsivity
V. Alejandro Briones, Madrid Institute of Contextual Psychology (MICPSY)
Beatriz Sebastián, Madrid Institute of Contextual Psychology (MICPSY)
Matheus Bebber, Madrid Institute of Contextual Psychology (MICPSY)
Paula Cañeque, Madrid Institute of Contextual Psychology (MICPSY)

A RFT-based ACT protocol is presented, focused on the development of a repertoire of psychological flexibility for the management of impulsive behaviors in adults. The protocol application consists of 6 treatment sessions with a duration of 50 to 60 minutes, on a weekly basis, the last one being a follow-up session. The protocol focuses on three aspects (Törneke, Luciano, Barnes-Holmes, & Bond, 2016): (a) help the client discern the relationship between what he does and the problematic consequences of his behavior (functional analysis, creative hopelessness); (b) help the client discern his own thoughts, emotions and bodily sensations by establishing an observation distance as they emerge (defusion), and (c) help clarify and expand what is important in his life and what would be the steps in that direction (valued action). Results from pre-post-treatment measures are compared in the following questionnaires: AAQ-II (Acceptance and Action Questionnaire II, Ruiz et al., 2012); VQ (Valuing Questionnaire, Smout, Davies, Burns & Christie, 2014); CFQ (Cognitive Fusion Questionnaire, Gillanders et al., 2012); SCS (Self-control schedule, Rosenbaum, 1980) and EI (Impulsivity Scale, Plutchik & Van Praag, 1989). Daily frequency behavioral worksheets/self-reports of both impulsive behaviors and values-oriented behaviors are incorporated to the assessment, as well as a personal values measure, the Goals, Actions and Barriers Form (Hayes et al., 1999). Clinically relevant behaviors in session are analyzed and significant differences in the previous measures are discussed. * Study conducted as part of the Final Project of the Master in Contextual Therapies at the Madrid Institute of Contextual Psychology (MICPSY).

30. Acceptance and Commitment Therapy with Children: Evaluation of Two Interventions
Primary Topic: Clinical Interventions and Interests
Subtopic: Children
Fernanda Gongora Miguez, Federal University of Paraná
Ana Paula Viezzer Salvador, Federal University of Paraná

In the last few years, ACT became increasingly popular in the behavior-analytic clinic for the treatment of the adult population. Aiming to inquire its viability and effectiveness in the child population, this research sought to apply and evaluate two interventions based on the principles of ACT. Two children (Child A and Child B) with behavioral and anxiety problems, aged 10 and 7, along with their mothers took part in the study. This intervention consisted of 8 sessions lasting 50 to 60 minutes each. Child Acceptance and Mindfulness Measure (CAMM), Avoidance and Fusion Questionnaire for Youth (AFQ-Y) and the parent version of the Child Behavior Check List (CBCL) were the chosen instruments to evaluate the subjects pre and post intervention. The results showed post-intervention decrease in the behavioral problems targeted in both children, however, the anxiety symptoms of Child B remained stable. This study highlighted ACT as an effective model for the treatment of externalizing and internalizing problems during childhood.

31. Does Attending an Optional Meditation in an ACT-Based Acute Care Partial Hospitalization Program Improve Treatment Outcomes?
Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness
Brian Pilecki, Rhode Island Hospital/Alpert Medical School of Brown University
Theresa A. Morgan, Rhode Island Hospital/Alpert Medical School of Brown University
Catherine D'Avanzato, Rhode Island Hospital/Alpert Medical School of Brown University
Darren Holowka, Rhode Island Hospital/Alpert Medical School of Brown University
Kirsten Langdon, Rhode Island Hospital/Alpert Medical School of Brown University
Kristy Dalrymple, Rhode Island Hospital/Alpert Medical School of Brown University
Mark Zimmerman, Rhode Island Hospital/Alpert Medical School of Brown University

An optional meditation group was offered to patients in an ACT-based partial hospitalization program. Measures demonstrating adequate acceptability and feasibility of this meditation group will be summarized, as well as basic demographic information about the types of patients that choose to attend such a group. Differences between attending and non-attending patients will show whether daily meditation has an incremental impact on mindfulness skills that relate to improved treatment outcomes. Preliminary results of 348 patients suggest that patients who chose to attend a meditation group did not have any significant incremental improvements in experiential avoidance as measured by the AAQ-II (Hayes et al., 2006) or in mindfulness as measured by the FFMQ (Baer et al., 2006). However, preliminary results suggest that patients did show a significant increase in the non-judgmental sub-scale of the FFMQ from intake (M = 3.02) to discharge (M = 3.20; F = 4.70, p < .05). This finding suggests that meditation training may be particularly useful in cultivating non-judgmental awareness, or the ability to take a perspective that is more objective and related to the ability to accept thoughts and emotions as they are. Additional results will demonstrate whether attending meditation groups lead to improved outcomes in depression and anxiety. Such results may support the role of brief mindfulness-based interventions in acute medical settings to increase mindfulness skills and perhaps improve treatment outcomes.

32. Effect of a Short Mindfulness Intervention on the Cognitive Interference Caused by Pain
Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness
Louis-Nascan Gill, B.Sc., Université de Montréal
Vanessa Tabry, M.Sc., Concordia University
Kristina Martinu, Ph.D., CRIUGM
Adrianna Rodriguez-Ayotte, B.Sc., Université de Montréal
Natacha Vachon, B.Sc., Université de Montréal
Mathieu Roy, Ph.D., Concordia University
Pierre Rainville, Ph.D.

Pain spontaneously captures attention and disrupts ongoing cognitive processing, thereby potentially contributing to disability in various clinical conditions. Mindfulness and acceptation interventions have been suggested to improve the quality of life of chronic pain patients. This may partly reflect a decrease in the cognitive interference caused by pain (CICP). We assessed the effects of brief mindfulness and acceptation-based intervention on CICP using experimental methods in three groups of 15 healthy volunteers. Two interventions consisted of five 20 minutes/day intervention taking place in a quiet room with a facilitator. Participants of the first group practiced mindfulness exercises (Group 1: mindfulness meditation) and participants of the second group listened to, and discussed, text excerpts on mindfulness and acceptance (Group 2: discussion on mindfulness). The third group was not engaged in any intervention (Group 3: control). CICP was assessed before and after the intervention (Time), by measuring changes in working-memory performance (2-back task) induced by brief moderately painful stimulation applied on the forearm (vs non-painful control stimulation). CICP was confirmed by an decease in accuracy in the 2-back task during pain. The discussion group showed a significantly larger decrease in CICP following the intervention, compared to the others groups (3x2 ANOVA; F= 3,520, p = 0,039). This suggests that short interventions involving conceptual learning about mindfulness and acceptation might help reduce CICP while practical exercises of mindfulness meditation might be insufficient to produce such benefits.

33. Japanese Version of Child and Adolescent Mindfulness Measure: Development and Examination of its Reliability and Validity
Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness, Children
Hiramatsu Yuka, M.A., Graduate school of science for human services, Ritsumeikan University
Tani Shinji, Ph.D., Ritsumeikan University

Background: Few Acceptance and Commitment Therapy (ACT) studies for children have been conducted in Japan. One reason for this is that the Avoidance and Fusion Questionnaire for Youth is the only measure that can be used for children in Japan. This study aimed to develop a Japanese version of the Child and Adolescent Mindfulness Measure (CAMM) and examine its reliability and validity. Method: Participants included 500 children (189 boys and 311 girls). The examination was conducted from the middle of September 2016 to the middle of October 2016. A reexamination was conducted one month later to examine test–retest reliability. We conducted an online survey of the participants both during the examination and reexamination. We obtained the original author’s permission to develop a Japanese version of CAMM and for its translation, which was done by two researchers, one university student (first presenter), and one expert familiar with ACT (second presenter). After item translation, back translation was entrusted to a contractor. We conducted the investigation with the corrected items. We used SPSS statistics for analysis. Result: The exploratory factor analysis indicated that the Japanese version of CAMM had a one-factor model. A sufficient factor loading amount of 50 or more was indicated for all items. A confirmatory factor analysis revealed high compatibility (GFI > .90, AGFI > .85, CFI > .90). Next, we examined its reliability and validity using alpha coefficient and test–retest reliability; it was confirmed that the scale has high reliability. Furthermore, the Japanese version was revealed to have the same degree of correlation as the original through a correlation coefficient with related scales of psychological inflexibility and thought suppression. Discussion: From the results, factor analysis confirmed a factor structure similar to the original scale. High internal consistency, test–retest reliability, and sufficient convergent validity were also confirmed. The results demonstrated that the scale had good reliability and validity. However, as the age of some participants were unknown in this study, it is necessary to consider it and reanalyze. Moreover, it is necessary to examine the reactivity of the scale using clinical experimentation in the future.

34. Best Practices and Guidelines for Utilizing Digital Interventions to Improve Engagement and Adherence in Chronic Illness Sufferers An evidence-based review prepared in association with the European Federation of Psychologists' Association, Psychology a
Primary Topic: Clinical Interventions and Interests
Subtopic: E-HEALTH
Penelope Constantinou, University of Cyprus
Orestis Kasinopoulos, Ph.D candidate, University of Cyprus
Maria Karekla, Ph.D., University of Cyprus

Chronic health conditions cause a considerable burden in quality of life, often leading to a physical, psychological and social dysfunctioning of the sufferers and their family. There is a growing need for self-management and flexible provision of psychological services in terms of location (from the clinic to the home), personalized/tailored, and reaching underserved populations. Digital interventions (an umbrella term including e-health, m-health, internet-based, etc.) present with the potential of providing a wide range of self-management solutions that can improve functioning among chronic illness sufferers. Despite the potential of digital interventions in service delivery, concerns remain especially regarding the engagement of users that lead to low adherence rates, high attrition, and non-optimal exposure to the content of the intervention. Explanations of engagement difficulties present as the main culprits, human - computer interaction and user characteristic factors. To date there have not been any clear and concise guidelines for improved utilization and engagement in digital interventions. This paper aims to provide a holistic overview of user engagement factors, and to propose research informed guidelines for engagement and adherence planning in digital intervention development. These guidelines will inform and promote effective planning for engagement when building digital interventions thus maximizing adherence and optimal exposure in the treatment of chronic conditions.

35. The Comparison of Effectiveness of Acceptance and Commitment Therapy on Prevention of Addiction Relapse in Opium and Methamphetamine Consumers
Primary Topic: Clinical Interventions and Interests
Subtopic: Acceptance and Commitment Therapy, Relapse prevention, Opium, Methamphetamine
Asghar Aghaei, Prof., Department of educational science and psychology, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
Azam Saeedi Ghaleaghaei, Department of educational science and psychology, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran

Background: The purpose of this study was to compare the efficacy of acceptance and commitment therapy in prevention of addiction relapse in opium and methamphetamine consumers. Method: It was semi-experimental research and the study population consisted of all addicts who refereed to addiction treatment centers of Isfahan (Iran).From among 51 subject with diagnosis of opium and methamphetamine dependence(25 addicted to methamphetamine and 26 addicted to opiates)were selected by convenience sampling method and also were assigned into 4 groups randomly (a methamphetamine addicts experimental group: 12; a methamphetamine addicts control group: 13; an opiate addicts experimental group: 13; an opium addicts control group: 13).All participants were assessed by the AWARE Questionnaire(Advance Warningof Relapse). The experimental groups received 10 sessions of acceptance and commitment therapy but control groups did not receive any treatment. Results: The results of covariance analysis showed that there were no significant difference between opium and methamphetamine addicts in the extent of acceptance and commitment therapy based on prevention of relapse, But there were significant difference between methamphetamine addicts experimental group and methamphetamine addicts control group and also between opium addicts experimental group and opium addicts control group(P<0.01). Discussion: The general result was that though there was no significant difference in the impact of acceptance and commitment therapy on the prevention of relapse between methamphetamine and opiate addicts but it was effective on reducing the relapse rate in both groups.

36. ACTivate your service: Introducing an ACT model at the level of clinical intervention, training and supervision across the Adult Mental Health pathway of a rural county in the UK
Primary Topic: Clinical Interventions and Interests
Subtopic: Trans-diagnostic, service development
Rachel Black, CPsychol, 2getherNHSFT
Becky Greenhalgh, 2getherNHSFT
Philippa Capel, CPsychol, 2getherNHSFT
Andrew Turner, CPsychol, 2getherNHSFT

Background ACT is an approach which has been shown to be effective in many individual and group intervention studies. This collaborative and values based therapeutic framework is also highly relevant to service wide improvement. The 2gether trust in Herefordshire covers a geographically large area with a relatively small population and consequently low total number of staff. This context presents both challenges to service delivery and opportunities for innovative solutions. As a universal and trans-diagnostic model, ACT is ideal to address the a wide range of clinical presentations and staff support needs. This led to bold and joined up initiative to introduce ACT service wide. Method ACT groups in the acute and community services were piloted/developed for working aged adults in Herefordshire. Following positive outcomes, a service wide agenda was developed including: • An expanding therapy group programme. • A county wide training programme for staff. • Introducing ACT as an underpinning model in staff supervision. Measures To evaluate the effectiveness of the above, quantitative and qualitative measures were used: • AAQ2 • MAAS • “Three changes checklist” (TCC) • Bullseye valued living measure • Semi-structured interviews • Focus groups • Feedback forms Results Groups Improvements were observed across groups in the different services. T-tests (correlated) showed significant differences on pre and post quantitative scores for three of the four measures in the acute services group - AAQ2: t(25)=3.88, p<.001; MAAS: t(10)=2.91, p<.05; TCC: t(11)=2.26, p<.05; Bullseye: t(12) 1.91, p <.1 . Data from other groups to follow. The focus groups and semi-structured interviews showed how participants were using the learning and values in their lives. Discussion In Herefordshire, ACT as a core intervention, training schedule and supervision approach is now firmly embedded into the psychology service and forms a key part of the Working Age Adult Service operational policy. Although the function of the interventions was equivalent across all services, the form of the intervention appropriately varied by context. A number of additional benefits were observed and fed back by other staff members in the service, including: • Increased capacity to generalise learning across service areas. • Benefits of using a shared language with clients through transition and focus on values from the start of a newly forming relationship. • Multi-disciplinary staff feel better able to support continued engagement. • Further spread to other teams (Child and Adolescent services). • ACT informed policy changes.

37. Oncology Nurse Self-Care: A Literature Review of Interventions to Address Burnout and Compassion Fatigue
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Stress-management
William Kent, BSc, University of Chester
Nick Hulbert-Williams, Ph.D., University of Chester
Kevin Hochard, Ph.D., University of Chester
Ros Bramwell, Ph.D., University of Chester

Background: Oncology nurses are at high risk of stress, burnout and compassion fatigue: this has problematic consequences for absenteeism, staff turnover, and quality of patient care. Method: In this paper, we: (i) provide an overview of the literature concerning stress-management interventions for at-risk oncology nurses, and (ii) conceptually explore how ACT’s framework may be a suitable alternative. Results: Published data on stress-reduction interventions primarily use educational or psychotherapeutic frameworks. Overall, the efficacy of these interventions varies with regards to effect size and longevity. Papers reporting psychotherapeutic interventions often fail to report the underlying models and intervention components employed. Discussion: Given the overlap between the causes of stress-related problems in healthcare workers and therapeutic processes targeted in ACT, it is surprising that no studies have explored the efficacy of ACT in this population. To ensure that the intervention doesn’t add further burden, brief intervention formats are likely to be most acceptable and feasible.

38. Further Development and Psychometric Validation of a Novel Measure of Trait Mindful Eating
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Mindfulness
Lee Hulbert-Williams, University of Chester
Wendy Nicholls, University of Wolverhampton
Samantha Flynn, University of Chester
Nick Hulbert-Williams, University of Chester

Mindful eating has been promoted as a potential intervention for a range of weight- and eating-related issues. As the field moves from observational methods into full clinical trials, adequate process measures are needed if we are to be able to make claims about the specificity of such interventions. Our group had previously published the Mindful Eating Scale, a potentially useful measure, albeit with some shortcomings identified in the initial development work. In this follow-on study we recruited 236 participants to provide the data for a confirmatory factor analysis. Initial fit indices were less than ideal. We thus used the standard method to remove poorly performing items, shortening and strengthening the scale. Whilst fit indices were improved (e.g. RMSE improved from 0.079 to 0.055), further work may now be desirable to confirm the revised factor structure. We will present initial data on concurrent validity against body mass, weight fluctuation, and concern for dieting.

39. Dissemination of a Functional Analytic Psychotherapy (FAP)-Informed Intervention for Loneliness: Results from an Open Trial
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Functional Analytic Psychotherapy
Joseuda B C Lopes, MSc, Novum Paradigma
Fabian O. Olaz, Psy.D., National University of Córdoba-Integral Center of Contextual Psychoterapies (CIPCO)
Mavis Tsai, Ph.D., Independent Practice and University of Washington
Robert J. Kohlenberg, Ph.D., ABPP, University of Washington

Background: A lack of social connection or loneliness, described by poet Emily Dickinson as “the horror not to be surveyed” is a quiet devastation, a major public health epidemic (New York Times, September 5, 2016) linked to physical and mental ill health. In fact, data from 140 studies show that loneliness increases the risk of death more than excessive drinking, exposure to chronic air pollution and obesity, and as much as excessive smoking (Holt-Lunstad et al., 2015). This project is an in-progress treatment development study assessing the impact of FAP’s Awareness, Courage and Love (ACL) model (Tsai et al., 2009) on increasing social connection and alleviating loneliness in individuals worldwide. The Live with ACL Meetups foster a safe and accepting space to be one's true self, and yet create deep connections by being understanding, bold, and kind. Method: Monthly online 90 minute experiential trainings led by the 3rd author of both professional and non-professional individuals (recruited mainly through the FAP Facebook group) who were interested in creating Live with Awareness, Courage and Love (ACL) Meetups through Meetup.com in their hometown began in October 2016. These leaders are provided with monthly protocols , and agreed that: 1) they are willing to be participant leaders, to lead vulnerability with ACL; 2) they are partnering in bringing ACL to a global audience, and their creative input and expertise are encouraged; 3) they can ask for donations of up to $10 USD per attendee, but no one will be turned away due to inability to pay; 4) they will lead meetups in their hometown once a month or as their schedule permits; and 5) the ultimate aim is for non-professionals to feel comfortable in leading ACL Meetups so that this format can be widely disseminated. Results: First, dissemination data will be reported. Currently, Live with ACL Meetups have 3170 members in 27 cities, 12 countries (Belgium, Germany, Germany, Poland, Spain, Switzerland; Argentina, Brazil, Colombia; Australia, Canada, United States) and 4 continents (North America, South America Europe and Australia). Second, feedback data from the attendees of these meetups regarding what they found helpful and what they would like to see changed, will be summarized. Discussion: This study implements an innovative approach to dissemination and implementation to address the inconsistent adoption of evidence-based treatments (Centers for Disease Control & Prevention, 2006). As discussed by Addis, Wade & Hatgis (1999), barriers to dissemination include treatments that require expensive and time-consuming instruction and supervision that are not readily accessible. Dissemination and Implementation in this study are facilitated by: 1) using protocols that require minimal training or professional background; 2) using a readily available venue during the development process itself (Meetup.com) for both recruiting participants and delivering the intervention; and 3) recruitment of interested Meetup participants, typically non-clinicians, to participate in leading these groups. These groups facilitate exploring what deeply matters, sharing with courage, and listening with compassion. Participants leave with tools to enhance other relationships, and to move towards what they value most in life.

40. The Relationship between Experiencing Parental Psychological Aggression and Anger Expression Styles
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Children, Parenting
Leyla Ergüder, M.S., University of North Texas
Zeynep Hatipoglu-Sümer, Ph.D., Middle East Technical University

Having been exposed to psychological aggression from parents, children learn by observing and may imitate their parents` way of anger expressions (Bandura 1971). Thus, children's anger expression styles are shaped by their early experiences. Differences between anger expression styles are significant when examining the association of anger to psychopathology because anger expression styles are related to both physical and mental health (Stewart, Levin-Silton, Sass, Heller,& Miller, 2008). Experiencing aggression from parents was positively related to children’s use of detrimental anger expression styles for both genders (Wolf & Foshee, 2003). The purpose of the study is to investigate the association between experiencing parental psychological aggression and anger expression styles among college students. The sample of the study comprised of 614 college students from a public university in Hatay, Turkey. Emotional Abuse and Neglect Subscale of Childhood Trauma Questionnaire (CTS), Anger Expression Style Subscale of State-Trait Anger-Anger Expression Styles Inventory (STAXI), and Personal Information Form were used to collect data. Correlation analysis (Pearson product-moment correlation test) was utilized to test the hypothesized relationship between variables. The findings of the study demonstrated that for men, there were significant positive correlations between experiencing parental psychological aggression and anger expression styles of anger out and anger in (r = .16,p< .05,r = .25, p<.01, respectively), but correlation between experiencing emotional abuse/neglect and anger control, one of the sub-construct of anger expression styles, was negative and not statistically significant (r = -.12, p>.05). For women, findings revealed that the relationship between experiencing psychological parental aggression and anger expression styles were statistically significant and positive for anger out and anger in (r = .19,p< .01,r = .22, p<.01, respectively), and negative and significant for anger control (r = -.15,p< .01). Furthermore, the lowest relationships among associations yielded in correlation analysis was between expressing anger inwards and controlling anger. Results of the study suggested that expressing anger inwards positively associated with parental emotional abuse and neglect victimization. Also, externalizing anger was significantly and positively related with experiencing parental psychological aggression. Additionally, controlling anger variable of the anger expression style negatively associated with experiencing parental psychological aggression for women. Findings of the study revealed that college students who experienced emotional abuse and neglect from their parents demonstrate less control over their anger compared to students who do not have parental psychological abuse history. Moreover, college students who experience psychological aggression from their parents in their childhood more likely to express their anger outwards.Therefore, the findings of the study demonstrated the importance of the relationship between experiencing parental psychological aggression and anger expression styles.The theoretical and practical implications and recommendations for future research were presented.

41. The Role of Fears to Receive Kindness and Compassion from Others in the Link Between Early Affiliative Memories and Depression Symptoms
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Depression
Ana Laura Mendes, CINEICC, University of Coimbra
Cláudia Ferreira, CINEICC, University of Coimbra
Inês A. Trindade, CINEICC, University of Coimbra

In accordance with Gilbert and colleagues (2011), early adverse experiences characterized by feelings of shame, rejection and abuse may lead to the later experience of fearing to receive kindness and compassion and may be linked with several psychopathological conditions, such as depression. The current study tested a model which hypothesized that the fear of receiving compassion from others and social safeness and pleasure may act as mediators on the association between early positive affiliative memories and depressive symptomatology. The sample comprised 616 Portuguese women, aged between 18 and 65 years old, who completed validated self-report measures. The tested path model explained 41% of the variance of depressive symptomatology and showed excellent model fit indices. Results demonstrated that early memories of warmth and safeness with family figures presented a significant direct effect on depression symptoms and, in turn, an indirect effect through the mechanisms of fear of receiving compassion from others and social safeness and pleasure. Specifically, a lower report of early positive memories with family figures seems to explain higher levels of depressive symptomatology, via increased fear of receiving other’s compassion and kindness and decreased feelings of social safeness and connectedness. These findings seem to support the importance of developing in the community intervention programs which target maladaptive emotion strategies (e.g., being resistant to others’ kindness and compassion) and, in turn, promote mental health and well-being, especially in a context of early adverse experiences.

42. Using ACT with Adolescents Impacted by Cancer: The PEER Program
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Adolescents and Young Adults, Cancer
Pandora Patterson, Ph.D., CanTeen Australia. The University of Sydney
Elizabeth Kelly-Dalgety, CanTeen Australia
Fiona McDonald, Ph.D., CanTeen Australia. The University of Sydney

Background: A personal or familial cancer diagnosis can have a substantial negative impact on an adolescent’s distress levels and cancer related unmet needs. In this study, we developed and piloted a manualised 4-day therapeutic program (Place of Enablement, Empowerment and Relationships; PEER) for adolescents (11-17 years) based on Acceptance and Commitment Therapy (ACT). ACT was chosen as a framework due to its focus on increasing psychological flexibility and the capacity to cope with difficult thoughts and feelings. Method: Program effectiveness was assessed across three time points using validated measures for psychological flexibility, coping, mindfulness, self-compassion, sense of belonging and quality of life. Results: 175 adolescents participated across 6 pilots (age M=14.56 years, SD=1.72; 45.7% male). Significant improvements were found for supportive relationships, sense of belonging, coping, mindfulness and quality of life. These were maintained at follow-up for active and emotional coping, and mindfulness. Improvements in supportive relationships, active coping, sense of belonging and mindfulness were all greater for those whose psychological flexibility had greatest increases. Overall satisfaction for sessions was high (M=7.7/10, SD=1.85). Discussion: The results presented here demonstrate the effectiveness of a program grounded in ACT in improving the quality of living of adolescents impacted by cancer.

43. A Brief Acceptance and Commitment Therapy (ACT)–Based Group Program for Unemployed Individuals with Mental Health Problems
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Mental illness among unemployed people
Marie Christine Dekoj, Ph.D., Centre for Psychotherapy, Kitzberg Hospital, Bad Mergentheim
Lisa Gabriel, Department of Psychiatry II, University of Ulm and BKH Günzburg, Germany
Tobias Staiger, Ph.D., Department of Psychiatry II, University of Ulm and BKH Günzburg, Germany
Tamara Waldmann, Department of Psychiatry II, University of Ulm and BKH Günzburg, Germany
Thorsten Brosch, Kolping-Werk Augsburg
Nicolas Rüsch, Department of Psychiatry II, University of Ulm and BKH Günzburg, Germany

Background: People with mental illness often choose not to use mental health services and not to seek help with jobsearch and other psychosocial problems. This has harmful consequences for individuals, their families and society, such as poor clinical outcomes, continuing unemployment and productivity losses. In a Swedish study unemployed individuals with mental disorders who participated in ACT improved significantly on measures of depression, general health, and quality of life. Aim: To evaluate the acceptability, feasibility and efficacy of a brief ACT-based group program for unemployed individuals with mental health problems. Program participants should learn to behave flexibly in different situations and decide to live a value-based life. This is expected to reduce barriers to help-seeking among unemployed people with mental health problems. Methods: A pilot randomized controlled trial (RCT) with approximately 100 unemployed people with mental health problems planned. Interested individuals are screened via telephone. Inclusion criteria are being between 18 and 64 years of age, currently unemployed (persons receiving full disability pension are excluded) and psychological distress as indicated by a score ≥13 on Kessler’s K6 Psychological Distress Screening Scale. Participants are randomly allocated to the ACT intervention or a TAU control group. The ACT-based intervention consists of four sessions, covering the following topics: awareness, acceptance of unemployment and/or mental illness, values, disclosing mental health problems, and help-seeking. Assessments take part at baseline (t0), and 3 (t1) and 6 (t2) weeks after baseline. Results: Experiences with the acceptability and feasibility of the program and of conducting a Pilot-RCT in this population will be shared. Preliminary results of the intervention will be presented with respect to acceptance, value-based behaviours, help-seeking and motivation in terms of jobsearch and mental health service use. Discussion: The pilot-RCT will show whether a short ACT-based group program improves the motivation for mental health treatment and jobsearch among unemployed individuals with mental health problems by increasing value orientation and psychological flexibility.

44. From Feeling Inferior to Being Concerned About One’s Body Weight and Shape: The Weight of Body Image–Related Psychological Inflexibility
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Body Image
Joana Marta-Simões, CINEICC, University of Coimbra
Cláudia Ferreira, CINEICC, University of Coimbra
Inês A. Trindade, CINEICC, University of Coimbra

Psychological flexibility is described as an adaptive mechanism to deal with internal experiences. When associated with body image (i.e., the active contact with perceptions, thoughts, and feelings about one’s body image, without attempting to change or control them), it associates with lower body image dissatisfaction and disordered eating. On the contrary, body image difficulties and associated unhealthy eating behaviours have been linked to inflexibility toward distressing body image-related thoughts and feelings. Moreover, the perception that others evaluate one’s characteristics in a devaluing manner (external shame), and the tendency to feel inferior based on physical appearance, are both shown to associate with body image difficulties. The present study explored whether appearance-based social comparison with peers and shame would associate with higher body weight and shape concerns (main risk factors for eating disorders) via higher body image–related inflexibility. The study’s sample comprised 776 young adult Portuguese females. Results revealed that, although appearance-based comparisons with peers and shame directly associate with both weight and shape concerns, these relationships also seem to be significantly mediated by body image-related inflexibility. The path model accounted for 53% and 58% of the variances of body weight and shape concerns, respectively. Results seem to enhance that, in women, the attempt to alter the form, frequency, or intensity of private experiences, specifically those associated with one’s appearance, is often ineffective and costly. This study seems to support the pertinence of combining Compassion Focused Therapy and Acceptance and Commitment Therapy when treating and preventing disordered body image and eating.

Friday, 23 June, 18:15-19:15 - Poster Session #2

1. The Relationship Between Psychological Flexibility and Postpartum Depression: A Longitudinal Analysis with Mothers of Neonatal ICU Infants
Primary Topic: Behavioral medicine
Subtopic: Postpartum Depression
Yoly R. Villarreal, Ph.D., McGovern Medical School, University of Texas Health Science Center at Houston
Michelle R. Klawans, M.A., McGovern Medical School, University of Texas Health Science Center at Houston
Thomas F. Northrup, Ph.D., McGovern Medical School, University of Texas Health Science Center at Houston
Mackenzie L. Spellman, M.A., McGovern Medical School, University of Texas Health Science Center at Houston
Angela L. Stotts, Ph.D., McGovern Medical School, University of Texas Health Science Center at Houston

Background: Depression during the postpartum period affects 1 in 7 women and contributes toward adverse maternal and child health outcomes. This is especially true for mothers with infants admitted directly to the Neonatal Intensive Care Unit (NICU) who, in conjunction with typical depression risks must contend with exacerbated stressors associated with the NICU experience. Early detection and treatment of postpartum depression with NICU moms may help mitigate some of these risks, and psychological flexibility may be an especially important target for treatment. Avoidance and inflexibility around distressing private experiences may be related to the persistence of depression in the later postpartum period. We investigated the association between psychological flexibility shortly after delivery (baseline) and depression at 6 months postpartum in mothers whose infants were admitted to a NICU. Methods: As part of an ongoing NICU study targeting secondhand smoke (SHS) exposure, mothers of NICU infants (n=98) were administered the Center for Epidemiological Studies-Depression Scale (CES-D) and the Acceptance and Action Questionnaire II (AAQ-II) at baseline (range: 1 day – 2-weeks post-delivery); both measures were treated continuously. Additionally, the CES-D was re-administered approximately six months postpartum (follow-up). Multiple regression (PROC REG; SAS 9.4) was used to associate AAQ-II scores at delivery with CES-D scores at 6 months. Results: At baseline, 44% of NICU mothers had scores on the CES-D suggestive of clinical depression (i.e., >16). The mean CES-D score was 16.06 (SD=9.45) and scores ranged from 0 to 46. The mean score on the AAQ-II was 51.91 (SD=10.2) and scores ranged from 27 to 70. At follow-up, 21% of NICU mothers endorsed scores on the CES-D suggestive of clinical depression. Bivariate results showed greater psychological flexibility at baseline was related to lower depression at follow-up (β:-0.35, p < 0.001). Additionally, depression at baseline was related to depression at follow-up (β: 0.33, p < 0.001). Including baseline psychological flexibility and baseline depression in a multivariate regression, results indicated that psychological flexibility remained significantly predictive of depression at follow-up (β: -0.27, p = 0.0057) while depression at baseline did not (β: 0.189, p = 0.072). Depression at baseline explained 11% (R² = 0.11) of the variance of depression at follow-up, including psychological flexibility increased the overall model fit to 18% (R² = 0.18). Discussion: Psychological flexibility may play an important role in the mental health status of new mothers of NICU infants and may be even more significant than depression at delivery. Based on these findings, we are encouraged to assess psychological flexibility at delivery to identify mothers at risk for postpartum depression that extends beyond the perinatal period. Treatments, such as Acceptance and Commitment Therapy that target psychological flexibility may be efficacious at minimizing depression in the later postpartum period and improving maternal mental health outcomes, particularly for women who have medically at-risk children. Additional research is needed to further understand these relations among NICU mothers.

2. The Development of a Mindfulness Mobile App Targeting People Facing Infertility: The MindfulSpot
Primary Topic: Behavioral medicine
Subtopic: Mindfulness
Bárbara Monteiro, MSc, Instituto Superior Miguel Torga
Ana Galhardo Ph.D., Instituto Superior Miguel Torga; CINEICC_ faculta of Psychology and Educational Sciences of the University of Coimbra
Marina Cunha, Ph.D., Instituto Superior Miguel Torga; CINEICC_ faculta of Psychology and Educational Sciences of the University of Coimbra
Margarida Couto, Ph.D., Instituto Superior Miguel Torga
Frederico Fonseca, MSc, Instituto Superior Miguel Torga
Luis Abreu, Instituto Superior Miguel Torga

Background: Infertility is a medical and social condition presenting numerous challenges including psychological burden. Although most couples facing fertility issues and the demands of medical treatment are able to adjust, some of them may show psychological difficulties with clinical relevance such as depression and anxiety. Mindfulness approaches such as the Mindfulness Based Program for Infertility (MBPI) have been applied to people dealing with infertility showing promising results. Based on the MBPI a mindfulness app specifically designed for people facing infertility was developed – the MindfulSpot. Method: The MindfulSpot is a prototype mobile app that provides the chance of practicing mindfulness in a confortable and accessible way. This app covers informative audio and written texts. The audio contents correspond to mindfulness formal practice instructions and suggestions for informal practice, making possible its use throughout different moments of the day. Additionally to mindfulness instructions, users are invited to explore the informative menu that encompasses topics addressing emotional impact of infertility (e.g., common emotions, impact on the couple relationship, family, friends, etc.). Results: The efficacy of the MindfulSpot is still under analysis and results are expected to be available soon. Discussion: The MindfulSpot was designed as a tool for the promotion of mindfulness and acceptance skills. Accordingly, it is expected that it can help people to become more conscious of their experience dealing with it with openness and curiosity instead of trying to suppress, avoid or modify it and consequently decrease emotional distress. Moreover to its independent use it may also be used as a support tool of the MBPI.

3. Practices and Attitudes of Professionals Who Provide Psychological Treatments for People with Chronic Pain: A Comparison Across Approaches Within CBT
Primary Topic: Behavioral medicine
Subtopic: Chronic pain
Whitney Scott, King's College London
Francisco Montesinos Marin, Universidad Europea
Brandon Gaudiano, Alpert Medical School of Brown University
Lance M McCracken, King's College London

Background: Approaches broadly related to Cognitive Behavior Therapy (CBT) are dominant within current psychological treatments for chronic pain. This includes what might be called traditional CBT and newer generation CBT, including Acceptance and Commitment Therapy (ACT). Currently it is not known to what extent treatment providers working in the area of chronic pain might self-identify as adhering to one or the other of these orientations, and whether there are any further distinguishing features between these providers. The purpose of this study was to survey providers on these questions. Methods: During 2014 and 2015 participants were recruited from email lists for professionals with interest in psychology and chronic pain. Participants completed online questionnaires assessing basic demographic and educational information, therapeutic orientation, use of treatment methods, and processes of psychological flexibility. Results: Sixty-eight people (67.6% women) responded and provided data. The mean age was 45.2 years (sd = 11.1). Most were from the US (n = 28), followed by the UK (n = 17), Chile (n = 9), Portugal and Spain (each n = 4), or other (n = 6). Most were clinical psychologists (n = 48), health psychologists (n = 13), or other (n = 7). A total of 34 participants identified themselves as traditional cognitive behavior (TCB), 19 as “acceptance or mindfulness based,” (AMB) and 15 as some other orientation. The AMB providers reported greater use of “existential” or “humanistic” (p < .05) and “acceptance-based” approaches (p < .001), and there was a tendency for the AMB to use a wider range of these approaches, but there were no other group differences. In terms of specific methods, the TCB providers reported greater use of cognitive restructuring and relaxation compared to the ABM providers, but less use of exposure, mindfulness, cognitive defusion, values-clarification, metaphor and experiential exercises (all p < .001, except for the comparison of relaxation, p < .05). The two groups were not different in their intuitive versus experiential approaches to knowledge, or in their attitudes toward evidence-based practice. The two groups did not differ in their self-reported mindfulness or psychological flexibility. Discussion: The current data provide a preliminary probe of approaches and methods used and attitudes held by professionals from different orientations within CBT in chronic pain management. The data suggest that AMB providers currently represent a minority of providers, that their practices are consistent with the model they espouse, but that in many other ways they hold general attitudes consistent with the wider family of CBT.

4. Design of a Protocol for Addictions and Application of Contextual Therapy
Primary Topic: Behavioral medicine
Subtopic: Addiction
MªLuz Vallejo, Madrid Institute of Contextual Psychology (MICPSY)
Marina Díaz, Madrid Institute of Contextual Psychology (MICPSY)
Pablo Soto, Madrid Institute of Contextual Psychology (MICPSY)

There is a great amount of evidence which suggests that psychological inflexibility takes part in a variety of psychological difficulties, including problems with addiction to substances. The goal of the study was the design and application of an ACT protocol, making hierarchical and deictic frames explicit in three adults with addiction problems. The intervention protocol consisted of three individual sessions focused on (Törneke, Luciano, Barnes-Holmes, & Bond, 2016): (1) help the client connect with the consequences of the problematic behaviour, thus making him open to clinical change; (2) clarify areas of personal value; (3) and training the ability to differentiate himself from his private events (i.e. anxiety about substance consumption) and the promotion of actions that are consistent with what’s important for the clients. Measures were taken using psychological flexibility assessments before, during and post-treatment, and analysis of the clinical interactions in terms of the relational behaviour involved (Villatte, Villatte & Hayes, 2015). The final results showed a decrease on addictive behaviour.

5. Experiential Avoidance Longitudinally Impacts IBD Patients’ Physical Health: A Latent Growth Analysis
Primary Topic: Behavioral medicine
Subtopic: Inflammatory bowel disease; physical health
Inês A. Trindade, CINEICC, University of Coimbra
Cláudia Ferreira, CINEICC, University of Coimbra
José Pinto-Gouveia, CINEICC, University of Coimbra

Background: The current study aims to explore experiential avoidance’s influence on subsequent levels of physical health in patients with inflammatory bowel disease (IBD), a chronic and relapsing condition, known to significantly impact patients’ quality of life. Methods: The sample includes 116 IBD patients that completed validated self-report measures on an online platform in three different moments during an 18-month period. Latent growth curve models (LGMs) were conducted using structural equation modelling to estimate the growth trajectory of physical health (measured by a subscale of WHOQOL-Bref) conditioned by experiential avoidance (AAQ-II). Results: The conditional LGM model showed an excellent fit (CFI=1.00; TLI=1.00; IFI=1.00; SRMR=0.01) and indicated that experiential avoidance presented a significant negative effect on basal physical health levels (β=-0.40, p<0.001), demonstrating that individual presenting higher levels of experiential avoidance show lower levels of physical health. Furthermore, experiential avoidance presented a significant effect on the growth rate of physical health (β=0.28, p=0.015), that is, in this sample, this maladaptive emotion regulation process predicted individual differences in the growth and evolution of physical health. Conclusions: These novel findings may indicate that experiential avoidance, by being associated with paradoxical consequences and further negative affect, may cause physiological alterations that may be detrimental to physical health. Furthermore, experiential avoidance may compromise the engagement in health promoting behaviours (such as taking the prescribed medications or going to medical appointments) that can in turn impact on patients’ physical health. The present study adds an important contribution to literature by implying that promoting acceptance abilities might improve IBD patients’ health.

6. Prevention and Treatment of Psychosomatic and Psychosocial Symptoms Among Unemployed Individuals at Times of Socioeconomic Crisis: A Pilot Study of an ACT-Based Group Intervention
Primary Topic: Clinical Interventions and Interests
Subtopic: Unemployment, stress, quality of life
Charikleia Karatza, M.Sc., Aristotle University of Thessaloniki
Maria Karekla, Ph.D., University of Cyprus
Pagona Roussi, Ph.D., Aristotle University of Thessaloniki

Background: Over the past five years Greece has faced a major socioeconomic and humanitarian crisis. The implementation of severe austerity policies, the massive lay-offs and the very limited opportunities for work have led to a dramatic increase in unemployment. A direct consequence of this is the deterioration of mental and physical health in Greece. Some of the most prominent effects of unemployment on mental health are depression, elevation of stress, despair and worry, social exclusion and stigma, family and marital conflicts, marital dissolution, low self-esteem, shame and feelings of unworthiness. ACT’s stand that human suffering is normal and expected could help overcome the stigma, the sense of shame and guilt associated with unemployment and poverty. Most importantly, values clarification and committed action could address time management issues and help the unemployed invest their energy on working in life areas important to them regardless of their present employment and financial situation. Method: The primary aim of this study was to develop a novel ACT-based protocol designed for the unemployed and to pilot-test it in a group setting in order to test its effectiveness. The intervention consisted of nine weekly sessions lasting two hours each, conducted in two groups (total N=9, all females, mean age= 46.5). Participants were assessed before and after the intervention using multiple instruments including General Health Questionnaire (GHQ–28), Depression, Anxiety and Stress Scale (DASS 21), Pearlin Mastery Scale and a number of process measures. Hypotheses were tested using paired-samples t-test in order to evaluate the impact of the intervention on the dependent measures. Results: Pre-post results from two pilot groups demonstrated statistically significant decreases in stress, anxiety, depression and social dysfunction (GHQ-28) as well as statistically significant increases in sense of mastery (Pearlin Mastery Scale) and willingness/engagement in meaningful life activities. Additionally, a statistically significant decrease in medication intake and need for medical help was observed. Discussion: These preliminary findings suggest that an ACT-based group intervention could offer valuable help for the formulation of a novel, flexible, cost-effective intervention program for the unemployed, aiming at preventing and treating psychosocial and psychosomatic problems.

7. Changes in General Distress During a Psychological Treatment: The Role of Psychological Flexibility
Primary Topic: Clinical Interventions and Interests
Subtopic: Psychological flexibility
Nikolija Rakočević, M.A., Department of Psychology, Faculty of Philosophy, University of Novi Sad
Dragan Žuljević, Ph.D., Department of Psychology, Faculty of Philosophy, University of Novi Sad
Vesna Gavrilov - Jerković, Ph.D., Department of Psychology, Faculty of Philosophy, University of Novi Sad
Ivan Jerković, Ph.D., Department of Psychology, Faculty of Philosophy, University of Novi Sad
Milica Lazić, M.A., Department of Psychology, Faculty of Philosophy, University of Novi Sad

The change in psychological flexibility is considered a to be the key mechanism of change within the ACT theoretical framework. The aim of our study was to evaluate the potential of this construct in predicting the reduction of general distress during the ongoing psychotherapy treatment. Our initial study included 118 clients participating in free-of-charge psychological treatment in Psychological Counseling Center in Novi Sad. 74.8% of the participants were female and 25.2% male, ranging from 18 to 63 years of age (mode = 25). The treatment consisted of 10 sessions. It was conducted by 19 psychological counselors originating from REBT and Transactional analysis theoretical orientation. To assess the change of psychological flexibility and general distress, we administered Acceptance and Action Questionnaire II (AAQ-II; Bond et al, 2011) and Depression, Anxiety and Stress Scale 21(DASS-21; Lovibond & Lovibond, 1995) during the admission interview two weeks before the start of the treatment(n = 117), as well as before the first treatment session (n = 101), after the final treatment session (n = 47), and three months after the end of the treatment (n = 36). The results of regression analyses performed on the total sample suggest that the increase in psychological flexibility seem to be a marginally significant predictor of distress reduction before the treatment starts (ß = .23, p = .02) as well as after the end of the treatment (ß = .33, p = .05), but highly significant during the treatment (ß = .63, p <.01). Having in mind that the high dropout rate (69% of total sample), we repeated the analyses on the sample of clients which participated in all of the assessments. The results did not significantly differ from prior results suggesting the lack of predictive potential before (ß = .02, p = .87) and after treatment (ß = .33, p = .05), as well as excellent predictive potential during the treatment (ß = .67, p <.00). We can conclude that our results add up to the pool of empirical findings that emphasize the role of increase of psychological flexibility as a potential mechanism of psychological change. The theoretical and practical implications of the results will be discussed.

8. Development and Validation of an Implicit Measure of (Chronic) Pain-Related Fear, Avoidance and Acceptance in Adolescents
Primary Topic: Clinical Interventions and Interests
Subtopic: Chronic Pain, Adolescents
Melanie Beeckman, MSc, Ghent University - Department of Experimental-Clinical and Health Psychology - Ghent Health Psychology Lab
Sean Hughes, Ph.D., Ghent University - Department of Experimental-Clinical and Health Psychology - Learning and Implicit Processes Lab
Liesbet Goubert, Ph.D., Ghent University - Department of Experimental-Clinical and Health Psychology - Ghent Health Psychology Lab

Background and Aims: Chronic pain is a common health problem among adolescents. Until recently research has mainly focused on those pain-related contexts and antecedents (e.g., fear or avoidance of pain) that give rise to and maintain maladaptive functioning (e.g., physical disability, social and emotional problems). Others have recently started to investigate so-called ‘resilience’ factors (e.g., pain acceptance ) that can lead to successful daily functioning (e.g., continued engagement in valued activities). Although promising, such work has almost exclusively relied on self-report procedures that tap into people’s deliberate ‘explicit’ thoughts, feelings, and actions. We argue that a more sophisticated understanding of pain-related functioning in adolescents requires that their automatic (pain-related) thoughts, feelings, and actions also be taken into account. We are currently developing a version of the Implicit Relational Assessment Procedure (IRAP) that can assess implicit (pain-related) fear, avoidance, and acceptance responses. This work examines the relationship between explicit and implicit cognition as well as their relationship to (dys)functioning in adolescents. Methods: Two IRAPs were administered to 25 healthy adolescents (11-17 years; recruited through schools) to measure their implicit responses to acute pain. Participants were asked to engage in a 1-minute cold pressor task (CPT) and a neutral water task (i.e. control condition) before completing willingness-fear and approach-avoidance IRAPs. They were then asked to complete a second CPT while performing a tone detection task. Participants also completed task-specific and general pain-related self-reports. Results: On average most (92%) adolescents were able to meet IRAP performance criteria. Participants showed no implicit willingness, fear, approach, or avoidance responses towards the acute pain task, although implicit responses were found towards the neutral task. Only implicit and explicit willingness responses towards the (painful) CPT were (positively) related to one another. Although explicit pain-related responses did relate to performance on the painful CPT and tone detection task, implicit responses did not. Conclusions: The IRAP can be used with adolescents in a pain-related context. In a forthcoming study, the IRAP will be adapted to measure implicit responses in adolescents with chronic pain. Again, relations with explicit cognition and performance on a daily (painful) behavioral task will be explored.

9. Dimensions of Posttraumatic Stress Symptomology and Suicidal Ideation: The Role of Cognitive Fusion
Primary Topic: Clinical Interventions and Interests
Subtopic: PTSD; Suicide
John J Donahue, Psy.D., University of Baltimore
Joshua Humphreys, University of Baltimore

Background and Introduction: Following exposure to a traumatic event, posttraumatic stress (PTS) symptomology may persist, including re-experiencing symptoms, avoidance symptoms, negative alterations in mood and cognition, and alterations in arousal and reactivity. PTS symptoms are associated with a range of negative functional outcomes, including an increased risk for suicidality (LeBouthillier, McMillian, Thibodeau, & Asmundson, 2015; Tarrier & Gregg, 2004). However, PTS symptomology is multidimensional in nature, and when examining the relationships between individual symptom dimensions and suicidality, the negative alterations in mood and cognition cluster of symptoms has exhibited a more consistent link (Legarreta et al., 2015). This cluster is characterized by negative beliefs about oneself and the world, distorted blame, and persistent negative emotional states, and its relationship with suicidality is in accordance with the hopelessness theory of suicide (Abramson et al., 2000). Within the psychological flexibility model of psychopathology however, the context of thinking is critical in the development and maintenance of suffering, more so than the content of thinking (Hayes et al., 2012). Cognitive fusion is a process by which individuals relate to thoughts as the literal truth, thoughts are strongly believed, and behavior is markedly influenced by these thinking (Hayes et al., 2012). Within a fused context, it would be expected that the negative alterations in mood and cognition cluster of PTS symptoms would be strongly related to suicidality, whereas this relationship would likely be attenuated under contexts of low fusion. Aim and Hypothesis: The primary aim of this study is to investigate the moderating effect of cognitive fusion on the association between the negative alterations in mood and cognition cluster of PTS symptoms and suicidal ideation. After controlling for the remaining dimensions of PTS symptomology, we hypothesized that negative alterations in mood and cognition would be strongly associated with suicidal ideation when cognitive fusion is high, and weakly associated with suicidal ideation when cognitive fusion is low. We expected this association to be specific to the negative alterations in mood and cognition cluster, as we did not expect cognitive fusion to moderate the relationship between the other three clusters of PTS symptomology and suicidal ideation. Method: One hundred fifty-six community participants (51% women; mean age = 35.01, SD = 10.00) were recruited online as part of a larger study and selected for inclusion based on self-reported prior trauma exposure on the Brief Trauma Questionnaire (BTQ; Schnurr, 1999). Participants were administered an assessment battery which included the PTSD Checklist for DSM-5 (PCL-5; Weathers, et al., 2013), the Cognitive Fusion Questionnaire (CFQ; Gillanders et al., 2014), and a two-item measure of suicidal ideation and intent (SI). Results: PROCESS, a non-parametric bootstrapping procedure was conducted to test the hypothesis that CFQ would moderate the association between the negative alterations in mood and cognition symptom cluster (PCL-Mood and Cognition) and SI, after controlling for the remaining PCL subscales. Supporting our hypothesis, the overall model explained significant variance in SI, R2 = .33, F(6, 149) = 12.41, p < .001, preliminary results revealed that PCL-Mood and Cognition (B = .46. p < .01) and CFQ (B = .13, p < .05) significantly and positively predicted SI, and the addition of the PCL-Mood and Cognition - CFQ interaction term explained additional variance in SI, ΔR2 = .03, p < .01. Evidence of moderation was only found for the PCL-Mood and Cognition subscale, as significant interactions between CFQ and the other PCL-5 subscales did not emerge in the prediction of SI. Discussion. Results provide preliminary support for the role of cognitive fusion in clarifying the associations between negative beliefs and emotions and suicidal ideation in a trauma-exposed sample. Discussion will focus on future directions and possible clinical implications.

10. Social Anxiety: The Role of Experiential Acceptance in Avoidance Behavior of Social Situations
Primary Topic: Clinical Interventions and Interests
Subtopic: Social anxiety, adolescents
Maria do Céu Salvador, University of Coimbra
Maria João Martins, University of Coimbra
Sandra Vieira, University of Coimbra

Background: Acceptance and mindfulness-based approaches have been studied in social anxiety in order to better understand the emergence and maintenance of social anxiety symptoms. Herbert & Cardaciotto (2005) proposed a theoretical model in which behavioral disruption occurs as a function of experiential control and acceptance. This study sought to explore the mediator role of self-focused attention and experiential acceptance in the relationship between physiological/cognitive activation and behavioral avoidance of social situations. Method: The sample comprised 399 Portuguese adolescents (61% females) with a mean age of 15.38 (SD = 1.14). Participants completed the brief form of the Social Phobia and Anxiety Inventory for Adolescents (SPAI-B), the Social Anxiety-Acceptance and Action Questionnaire for Adolescents (SA-AAQ-A), the Self-focused Attention for Adolescents (SFA-A) and the avoidance subscale of the Social Anxiety and Avoidance Scale for Adolescents (SAASA). Two serial multiple mediation models were performed (according to one of the two IVs: i) cognitive activation, ii) physiological activation) with SFA (M1) and SA-AAQ (M2) as mediators, and behavioral avoidance as the outcome. Results: Both mediation models were statistically significant, accounting for 34% and 24% of the variance in behavioral avoidance, respectively. Discussion: Experiential acceptance and self-focused attention have an important role in the prediction of avoidance behaviors. These results may inform clinical practice and future studies in the social anxiety field. Keywords: Social anxiety; Acceptance; Social avoidance; Mediation.

11. A Brief Protocol Based on Acceptance and Commitment Therapy (ACT) for Emotional Eaters
Primary Topic: Clinical Interventions and Interests
Subtopic: Emotional Eaters
Zaida Callejón Ruiz, Madrid Institute of Contextual Psychology (MICPSY)
Edurne Maiz Aldalur, Madrid Institute of Contextual Psychology (MICPSY)
Noelia Vergel Vaquero, Madrid Institute of Contextual Psychology (MICPSY)

Study objective: Analyze the effect of a brief protocol based on Acceptance and Commitment Therapy (ACT) on emotional eating and weight reduction in obese people. Emotional eating is defined as eating in response to emotional arousal states, such as anger, fear or anxiety. The emotional eaters attempt to reduce the emotional distress by eating food rich in fats and sugars that typically generate a sense of well-being. Methods: Participants were six overweight or obese adults (BMI between 27 and 35 kg/m2) who scored above the mean and a standard deviation in the emotional eating subscale of the Dutch Eating Behaviour Questionnaire (DEBQ). A brief ACT protocol was implemented over three weeks following three core strategies indicated in Torneke et al. (2016). A multiple baseline design across participants was used. Baselines were obtained during at least two weeks and then interventions were applied. Three measures were administered: Acceptance and Action Questionnaire for Weight-Related Difficulties (AAQ-W), DEBQ and weight during the 6-week follow-up. Therapist-Participant’s interactions were analyzed during treatment implementation and were analyzed in the context of participants` reports that showed a positive change. Results –and limitations- were discussed according to the relational framing involved in the protocol implemented.

11. A New Status of Psychological Flexibility: A Possible Universal Indicator of Treatment-Induced Change
Primary Topic: Clinical Interventions and Interests
Subtopic: Psychological flexibility
Dragan Žuljević, Ph.D., Department of Psychology, Faculty of Philosophy, University of Novi Sad
Nikolija Rakočević, M.A., Department of Psychology, Faculty of Philosophy, University of Novi Sad
Vesna Gavrilov - Jerković, Ph.D., Department of Psychology, Faculty of Philosophy, University of Novi Sad
Ivan Jerković, Ph.D., Department of Psychology, Faculty of Philosophy, University of Novi Sad
Milica Lazić, M.A., Department of Psychology, Faculty of Philosophy, University of Novi Sad

The treatment induced increase of psychological flexibility is considered to be a crucial mechanism of psychological change within the ACT theoretical framework. It implies a full contact with the present moment as a conscious human being, as well as changing or persisting in behavior in the service of chosen values based on what the situation affords. The aim of our research was to explore the potential change in psychological flexibility as a function of treatment as usual, without performing any of the specific procedures conceptualized within the ACT theoretical and practical framework. Our initial study included 118 clients participating in free-of-charge psychological treatment in Psychological Counseling Center in Novi Sad. 74.8% of the participants were female and 25.2% male, ranging from 18 to 63 years of age (mode = 25). The treatment consisted of 10 sessions. It was conducted by 19 psychological counselors originating from REBT and Transactional analysis theoretical orientation, without any experience or education in ACT. Psychological flexibility was operationalised by Acceptance and Action Questionnaire II (AAQ-II; Bond et al, 2011) which has been administered during the admission interview two weeks before the start of the treatment (n = 117), as well as before the first treatment session (n = 101), after the final treatment session (n = 47), and at three months follow-up (n = 36). The analyses did not detect any significant differences between two pretreatment flexibility scores on the total sample (t(99)=.80; p=.93; d=.01) as well as on the final sample (t(34)=-.90; p=.37; d=.08). The significant increase of flexibility was detected while comparing the levels of flexibility at the beginning and the end of the treatment both on the total (t(46)=3.04; p<01; d=.44) and on the final sample (t(35)=2.96; p<01; d=.51), an also while comparing the end of the treatment with the three months follow-up (t(35)=3.31; p<01; d=.15). The results indicate the significant growth of psychological flexibility as a function of the non-ACT psychological treatment. It could be concluded that the change in psychological flexibility can be considered as a promising metatheoretical phenomenon, whose role in reaching and maintaining a treatment induced psychological change is yet to be investigated and specified.

13. ACT-Based Group Intervention for Children with Social Difficulties
Primary Topic: Clinical Interventions and Interests
Subtopic: Children, bullying
Lee Sook Huey, Methodist College Kuala Lumpur

Acceptance and Commitment Therapy has been explored in recent years as psychological intervention for children and adolescence with emotional difficulties and pain conditions. Nonetheless, the literature on its usefulness for children with social difficulties are almost non-existent. This pilot study aims to investigate the effectiveness of school-based intervention that utilizes principles of psychological flexibility for students with social difficulties. Five students (age 10-11) who demonstrated bullying behaviors were recruited to participate in a 7 weeks ACT group program at school with parental consent. The group session include components of value clarification, mindfulness exercises, defusion exercises, noticing and responding to self-judgement or prejudiced thoughts, and perspective taking exercises. Metaphors such as passengers on the bus metaphor were used to communicate the concepts. Pre and post measures of Child and Adolescent Mindfulness Measure (CAMM) and Social Skills Questionnaire were administered. Children showed significant improvements in mindfulness skills and social functioning at the end of the 7 weeks group sessions. This pilot study gives preliminary evidence on ACT-based group program on children with social difficulties.

14. Does an ACT-Based Group Intervention for Chronic Pain Affect Sleep Disturbance and Depressive Symptoms?
Primary Topic: Clinical Interventions and Interests
Subtopic: ACT, Chronic pain
Michaela Paraskeva-Siamata, M.Sc., University of Cyprus, Cyprus
Maria Karekla, Ph.D., University of Cyprus, Cyprus
Vasilis Vasiliou, Ph.D., University of Cyprus, Cyprus
Orestis Kasinopoulos, M.Sc., University of Cyprus, Cyprus
Maria Stavrinaki, M.Sc., University of Cyprus, Cyprus
Evaggelos Karademas, Ph.D., University of Crete, Greece
Yiolanda Christou, M.D., The Cyprus Institute of Neurology and Genetics, Cyprus
Savvas Papacostas, M.D., The Cyprus Institute of Neurology and Genetics, Cyprus

Background: Chronic pain is a long-term condition which is related to a number of negative consequences including depression, emotional difficulties (Von Korff et al., 2005) and sleep difficulties (Morin, Gibson, & Wade, 1998). Acceptance and Commitment Therapy (ACT) has been found to be effective for a number of psychological difficulties (Hayes et al., 2006), including chronic pain (McCracken et al., 2005). The present study aimed to examine the effectiveness of an 8-week group intervention based on ACT for chronic pain on sleep difficulties and depressive symptoms. Method: Twenty seven Greek and Greek-Cypriot chronic pain patients (74.1% women, age M=52.32) received the group intervention and completed a set of questionnaires including Athens Insomnia Scale (AIS) and Hospital Anxiety and Depression Scale (HADS) at pre-treatment, post-treatment and at 3-month follow-up. Results: Repeated measures ANOVA showed that there was a significant main effect of time on AIS scores (F(2,28)= 8.43, p<.05) and HADS scores (F(2,28)=5.43, p<.05). Specifically, sleep disturbance was significantly lower at post-treatment and at 3-month follow-up compared to pre-treatment while depressive symptoms were significantly lower at 3-month follow-up but not at post-treatment compared to pre-treatment. Moreover, it has been found that depressive symptoms before the intervention was an important predictor of sleep disturbance at 3-month follow-up (F(1,25)= 11.190, p<.05, R2=.309) but not at post-treatment. Discussion: Results show that ACT is an effective treatment for chronic pain helping individuals to cope with difficulties facing because of pain. Moreover, support is given to the idea that ACT effectiveness can immediately be seen after intervention in some aspects but not other and that psychological state before treatment can be a useful predictor for treatment effectiveness in the long-term.

15. Relations Between Each Factor of Self-Compassion and Social Anxiety Symptoms
Primary Topic: Clinical Interventions and Interests
Subtopic: Social anxiety，Self-compassion
Kazuya Inoue, Graduate School of Human Sciences, Waseda University
Kenji Sato, Faculty of Integrated Arts and Sciences, Tokushima University
Hiroaki Kumano, Faculty of Human Sciences, Waseda University

In recent years, studies on self-compassion and social anxiety have increased (e.g., Werner et al., 2012). However, there are insufficient detailed studies in Japan. Therefore, this study examined the relations between self-compassion and social anxiety tendency. Participants (136 undergraduates; 79 men, 57 women; mean age 18.52 ± 1.79 years) completed the Self-Compassion Scale (SCS), the Sort Fear of Negative Evaluation Scale (SFNE), the Social Phobia Scale (SPS), and the Acceptance and Action Questionnaire II (AAQ-II). Results of liner regression analysis revealed the total points of Self-compassion had a high impact on SFNE (β ＝ −.51, p < .001）and SPS（β ＝ −.55, p < .001）. Moreover, the results of stepwise multiple regression analysis showed the effects of each factor of self-compassion on social anxiety symptoms. The results also showed the impact isolation, self-kindness, and over-identification had on SFNE. In addition, SPS was influenced by isolation, over-identification, and common humanity. Although self-compassion includes many factors, the factors that had an actual impact on social anxiety were isolation, self-kindness, over-identification, and common humanity in this study. In the future, more empirical research is necessary for the self-compassion.

16. Fast Improvement in a Short ACT Intervention Delivered by Novice Therapists
Primary Topic: Clinical Interventions and Interests
Subtopic: Depression
Katariina Keinonen, Ph.D. Student, University of Jyväskylä
Heidi Kyllönen, University of Jyväskylä
Piia Astikainen, University of Jyväskylä
Raimo Lappalainen, University of Jyväskylä

Background: The poster aims to introduce key findings on fast improvement and its effect on treatment outcome in a six session ACT intervention delivered by novice therapists. Fast improvement was defined as reaching the status of recovered or improved in the RCI classification after two sessions. Method: Data from 56 clients diagnosed with depression were analyzed for differences in treatment outcome on measures of symptomatology and therapeutic processes. 23 % were classified as fast improvers. Results: Fast improvement on the BDI-II was associated with superior results both on the level of depressive symptomatology and psychological flexibility at posttreatment. There were no pretreatment differences in the pretreatment measures, but pretreatment diagnosis was associated with fast improvement. Discussion: Fast improvement can be useful as a long-term prognostic tool. Recognizing and predicting fast improvement could be useful in planning treatment on an individual level and on a community level.

17. Impact of a Mindfulness Intervention (MBSR) on Clinical Severity and Inflammatory Biomarkers in Patients with Fibromyalgia: A Preliminary Analysis of EUDAIMON Data
Primary Topic: Clinical Interventions and Interests
Subtopic: Fibromyalgia
Laura Andrés-Rodríguez, MSc, Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain.
Adrián Pérez-Aranda, MSc, Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain.
Xavier Borràs Hernandez, Faculty of Psychology, Universitat Autonoma de Barcelona, Barcelona, Spain
Albert Feliu-Soler, Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain.
Andrés Martín-Asuero, Ph.D., Instituto Esmindfulness
Juan Vicente Luciano, Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain.

Fibromyalgia (FMS) is a disabling syndrome characterized by chronic widespread musculoskeletal pain, increased pain sensitivity including allodynia and hyperalgesia, along with fatigue, sleep and mood disturbances, which has been related to a chronic sub-inflammation. Objectives: To explore the relationship between mindfulness, clinical symptomatology of FMS and inflammatory biomarkers, along with examine the impact of a MBSR intervention on the FMS symptoms and on post-treatment levels of pro- (IL-6, IL-8), anti-inflammatory cytokines (IL-10), and hs-CRP in serum. Methods: Nineteen patients with FMS were randomly allocated to TAU+MBSR or TAU conditions and the following measures were administrated at baseline and at post-intervention: FIQ-R (Revised Fibromyalgia Impact Questionnaire), HADS-A/D (Hospital Anxiety and Depression Scale-Anxiety/Depression), PSS-10 (Perceived Stress Scale-10), FFMQ (Five Facet Mindfulness Questionnaire). Blood samples were taken for evaluating levels of inflammatory biomarkers in serum. Results: Significant correlations between specific mindfulness skills and FMS symptomatology were found, as well as with IL-8 and hs-CRP. Remarkably, MBSR was able to significantly change most of the clinical variables (functional status, anxiety and depressive symptoms) although the serum levels of cytokines remained unchanged. Conclusions: MBSR reduces clinical severity of FMS, though a potential role of chronic sub-inflammation could not be clearly demonstrated.

18. Psychometric Properties of the Spanish Version of Cognitive Emotion Regulation Questionnaire (CERQ) in Patients with Fibromyalgia
Primary Topic: Clinical Interventions and Interests
Subtopic: Fibromyalgia
Adrián Pérez-Aranda, Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain
Laura Andrés-Rodríguez, Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain
Elvira Reche, Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain
Albert Feliu-Soler, Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain
Xavier Borràs, Stress and Health Research Group (GIES), Faculty of Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
Juan V. Luciano, Teaching, Research & Innovation Unit, Parc Sanitari Sant Joan de Déu, St. Boi de Llobregat, Spain

The term emotional regulation comprises different strategies oriented to modify the occurrence, intensity or duration of an emotional state by altering some of the emotion’s antecedent factors or by modifying some aspect of the emotion itself. Difficulties in emotional regulation seem to be very relevant in clinical contexts and may play a critical role in chronic pain conditions such as fibromyalgia syndrome (FM). Garnefski, Kraaij and Spinhoven designed in 2001 the Cognitive Emotion Regulation Questionnaire (CERQ) in order to assess the conscious cognitive strategies for emotional regulation. In this study we analyzed the psychometric properties of the Spanish version of the CERQ in a sample of fibromyalgia patients (n= 231). All participants completed the CERQ altogether with the Fibromyalgia Impact Questionnaire (FIQR), the Center for Epidemiologic Studies Depression Scale (CESD), the State-Trait Anxiety Inventory (STAI-T) and the Pain Catastrophizing Scale (PCS) for the assessment of convergent validity. Confirmatory factor analysis yielded the same 9-factor structure reported by Garnefski and colleagues: Acceptance, Positive refocusing, Refocus on planning, Positive reappraisal, Putting into perspective, Self-blame, Rumination, Catastrophizing and Blaming others, grouped in two second-order factors (adaptive and maladaptive strategies) with all items showing significant factorial weights (from .51 to .93). Interestingly, in our sample, we found the Acceptance factor to be more related to the second-order factor of maladaptive strategies (.29) than to the adaptive ones (.14). We found a high internal consistency of the instrument (α= .84) and its subscales (α= .77 - .93). All CERQ’s adaptive strategies but Acceptance and Refocus on planning subscales showed negative significant correlations with clinical outcomes (r=−.55 to r=−.13). Positive significant correlations between maladaptive CERQ strategies and symptomatology were also reported (with ranging from r=.13 to .47). Our findings suggest that the Spanish version of the CERQ is a psychometrically sound self-report instrument to assess cognitive strategies for emotional regulation in patients with FM. The implications of these findings are discussed in relation to chronic pain and emotion regulation research.

19. Brief Protocol for the Development of Repertoires of Psychological Flexibility in Depression Patterns
Primary Topic: Clinical Interventions and Interests
Subtopic: Depression
Jorge Alcalá Rivero, Madrid Institute of Contextual Psychology (MICPSY)
Joan Rullan Pou, Madrid Institute of Contextual Psychology (MICPSY)
Maria Jesús Rubio Martin, Madrid Institute of Contextual Psychology (MICPSY)
Alba María Navarro Mateu, Madrid Institute of Contextual Psychology (MICPSY)

The effectiveness of a brief intervention protocol developed on contextual and functional bases to promote psychological flexibility in depressive profiles is analyzed. The instruments and measures used are BDI for depressive symptomatology, AAQ-2 and CFQ for psychological inflexibility, and VQ for values-oriented actions. The protocol consists of a training in MET for the development of psychological flexibility, being structured in 3 sessions that correspond to the three central strategies of intervention indicated in Törneke, Luciano, Barnes-Holmes & Bond (2016). Thus, activities are developed so that the clients know how to discriminate relations between functional classes of their own behavior and their problematic consequences, so they can perform a training framed in hierarchy with the deictic “I” and develop an alternative behavioral repertoire in the direction of personal values. Results are discussed in terms of the frames involved in clinical interactions (Villatte, Villatte and Hayes, 2015) and the relevance of brief interventions.

20. Acceptance and Commitment Therapy (ACT) for Co-Occurring Posttraumatic Stress Disorder (PTSD) and Alcohol Use Disorders (AUD) in U.S. Military Veterans: Preliminary Treatment outcomes
Primary Topic: Clinical Interventions and Interests
Subtopic: PTSD, alcohol use disorders, military veterans
Eric Meyer, Ph.D., VA VISN 17 Center of Excellence for Research on Returning War Veterans
Barbara Hermann, Ph.D., Burlington, VT VA
Sonja Batten, Ph.D., Booz Allen Hamilton
Bryann DeBeer, Ph.D., VA VISN 17 Center of Excellence for Research on Returning War Veterans
Paula Schnurr, Ph.D., National Center for PTSD-Executive Division
Robyn Walser, Ph.D., National Center for PTSD-Dissemination and Training

Background: PTSD and AUD frequently co-occur. Treatment outcomes, including treatment retention, are sub-optimal. We present the preliminary outcomes from an uncontrolled pilot trial of ACT for co-occurring PTSD and AUD in veterans. This is the follow-up to a recently published manual development study (Hermann et al., 2016, Journal of Contextual Behavioral Science). Method: PTSD diagnoses were made using the Clinician Administered PTSD Scale for DSM-5 (CAPS-5) and AUD using the Structured Clinical Interview for DSM-5 (SCID). Amount and frequency of drinking were assessed using the Timeline Follow-back interview (TLFB). Functional disability and quality of life were assessed using the World Health Organization measures (WHODAS, WHOQOL). PTSD could be related to any type of trauma, though combat was the most common. Treatment consisted of 12 weekly individual psychotherapy sessions. Participants could receive concurrent pharmacotherapy, but not concurrent psychosocial treatment for PTSD or AUD. Between-session practice consisted of daily mindfulness practice, worksheets to highlight ACT core processes, and behavioral assignments. Goals related to reducing drinking were made collaboratively; abstinence was not a required goal. Results: 43 participants were assigned to treatment, of whom 29 completed ten or more sessions (67.4% intent-to-treat completion rate), 11 dropped out, and 3 never started treatment. Among treatment completers, pre-post treatment outcomes included significant reductions in PTSD symptom severity (p < .001; d = .79; large effect), number of drinking days (p < .001; d = .91; large effect), heavy drinking days (p < .001; d = .88; large effect), total drinks (p = .002; d = .65; medium effect), and depression symptoms (p = .02; d = .48; medium effect). Improvements in functional outcomes were observed in terms of improved quality of life (p = .001; d = -.54; medium effect) and reduced functional disability (p = .08; d = .35; small effect). These improvements were accompanied by reductions in experiential avoidance and psychological inflexibility (p = .03; d = .43; small effect). Discussion: Overall, these preliminary outcomes suggest that ACT may have promise as a treatment for people with co-occurring PTSD-AUD.

21. ACT Protocol in Anxiety Disorder/Panic Attack
Primary Topic: Clinical Interventions and Interests
Subtopic: Anxiety
Yolanda Bueno Aguado, Micpsy Madrid
Jennifer Escolano Martinez, micpsy madrid
Guillermo Matia, micpsy madrid
Sofia Rodriguez de la Plaza, micpsy madrid

Aceptance and commitment therapy (ACT) has proven effective generating psychological flexibility in clients with Anxiety Disorders. This work tries to add evidence from a brief protocol of three consecutive sessions based on act-rft movements. The treatment procedure was applied in patients with high physical symptoms such as palpitations, chest pressure, choking sensation, instability or lack of balance, dizziness, paresthesias of the arms and legs (cramping, feeling asleep member ...) Rapid breathing or hyperventilation, headaches and contractures. In addition, all of them present a significant reduction in the quality of life due to avoidance actions that prevent contact with sources of personal value. The sessions have a special focus on therapeutic alliance, functional analysis, the use of metaphors co-created with the patient, training in perspective and the clarification of valuable actions in the patient. More specifically, this protocol is structured following the strategies of functional analysis in the first session, defusion / distancing exercises of physical and bodily sensations, as well as the contents of thought, in the second session and, in the third, a suggested guide for the patient to focus on their values (Törneke, Luciano, Barnes-Holmes, & Bond, 2016). Measures include pre-post treatment questionnaires (AAQ II, CFQ) and analysis of clinical interactions in terms of the relational behavior involved (Villatte, Villatte and Hayes, 2015). "Estudio realizado en el contexto del Trabajo Fin de Máster en Terapias Contextuales en Madrid Institute of Contextual Psychology (MICPSY)."" Master's final proyect for the master of contextual psychology in Micpsy Madrid." Key words: ACT, RFT, protocol, anxiety, panic attacks, defusion, metaphors, values.

22. Adversity and Psychopathology: The Mediating Role of Experiential Avoidance
Primary Topic: Clinical Interventions and Interests
Subtopic: Schizophrenia, Depression
Leticia Martínez Prado, Universidad Complutense de Madrid
Almudena Trucharte Martínez, Universidad Camilo José Cela
Alba Contreras Cuevas, Universidad Complutense de Madrid
Regina Espinosa López, Universidad Camilo José Cela
Carmen Valiente Ots, Universidad Complutense de Madrid

Background: Childhood trauma has been related to many mental disorders and has been implicated in both the formation and maintenance of psychopathological symptoms. However, little is understood about the mechanism through which these traumatic experiences impact on psychopathology. Experiential avoidance (EA) is a regulatory strategy characterized by efforts to control or avoid unpleasant thoughts, feelings and bodily sensations. It´s been suggested that EA is an important transdiagnostic process in the development of mental disorders. We hypothesized that adversity plays a direct causal role in maintaining paranoia ideation and depressive symptoms in people with with severe mental disorders and that the effect of trauma would be mediated by EA. Method: All 111 participants were recruited from the Hospital Universitario Clínico San Carlos and completed a battery of self-report questionnaires including a measure of persecutory ideation (PQI; McKay et al., 2006), depression (BDI-II; Beck et al., 1988), EA (Acceptance and Action Questionnaire-II) and a trauma screening (THS; Carlson et al., 2011). Seventy five had a diagnosis of schizophrenia spectrum disorder and thirty-six had a diagnosis of depression disorder. Results: Regardless of the diagnostic status, our findings suggest a significant mediation effect of EA between childhood sexual abuse and depressive symptoms (Z = 2.61, p= 0.009) and a significant mediation effect of EA between accumulative adverse events and paranoia ideation (Z = 1.96, p= 0.02). Discussuion: This study provides evidence for the role of EA in the maintenance of depression and paranoid ideation, a role of central relevance, both to the design of psychological interventions and to the conceptualizations of mental disorders.

23. An Attempt to Measure Experiential Avoidance in Daily Life Using Ecological Momentary Assessment
Primary Topic: Clinical Interventions and Interests
Subtopic: Experiential avoidance
Taiki Shima, Graduate School Human Sciences, Waseda University
Hikari Honda, Graduate School Human Sciences, Waseda University
Hiroaki Kumano, Faculty of Human Sciences, Waseda University

Background: In most studies, experiential avoidance is measured using Likert-type scales such as the Acceptance and Action Questionnaire-II (Bond et al., 2011). Likert-type scales are useful for measuring experiential avoidance tendency but fail to accurately capture individual events, behaviors, or contexts. To obtain more detailed information regarding the measurement of experiential avoidance, new methods are required. Ecological momentary assessment (EMA; Stone & Shiffman, 1994) is a measurement method that involves repeated collection of daily life, real-time data in natural environments. Consequently, this method can avoid recall bias and collect data with high ecological validity. The current study examines whether EMA can be used to measure experiential avoidance in daily life. Method: Twenty-four students (female = 18, mean age = 19.88 ± 1.45) participated in this study. They completed a questionnaire (sent via e-mail) three times a day for 10 days. Additionally, the participants completed the questionnaire when unpleasant events occurred. This questionnaire comprised the following items: pre-behavior mood (1: unpleasant to 7: pleasant), behavior, content of thought, and post-behavior mood (1–7). Because experiential avoidance is considered to be maintained through negative reinforcement, the response which the participants' mood improved (pre-behavior mood < post-behavior mood) was seen as experiential avoidance. To specify experiential avoidance, the responses when they felt unpleasant (pre-behavior mood < 4 or when they had negative thoughts) were selected from the collected data. Subsequently, each participant’s experiential avoidance percentage (the response which their mood improved/the response when they felt unpleasant) was calculated. Although experiential avoidance may be effective in the short term, it is not beneficial in the long term (Hayes et al., 2012). Therefore, the long-term mood (the average of pre-behavior mood in all responses) of each participant was calculated. Further, Spearman’s rank correlation was calculated. Results: One participant who had only one response when she felt unpleasant was excluded. Therefore, the data collected from the remaining 23 students (female = 17, mean age = 19.87 ± 1.49) were analyzed. Among the 696 responses obtained, 238 were related to when the participants felt unpleasant, and 98 fulfilled the experiential avoidance criteria. This study's analysis showed weak negative correlation (ρ = −.394, 95% CI [−.669, .068], p = .097); however, this result was marginally significant. Discussion: Although the result was marginally significant, it was demonstrated, as hypothesized, that long-term mood may deteriorate if experiential avoidance is increased in daily life. Given the foregoing discussion, EMA may be used to measure experiential avoidance in daily life. However, the measuring procedure used in this study can be improved and refined to measure experiential avoidance based on contingency. This finding was obtained by continuing the research published at the 17th Asian Congress on Psychosomatic Medicine.

24. The Social Anxiety – Acceptance and Action Questionnaire for Adolescents (SA-AAQ-A): Study of the Psychometric Properties in a Portuguese Sample
Primary Topic: Clinical Interventions and Interests
Subtopic: Social Anxiety Disorder, Adolescents, Assessment
Sandra Vieira, University of Coimbra
Maria João Martins, University of Coimbra
Maria do Céu Salvador, University of Coimbra
Megan MacKenzie, Ryerson University
Nancy Kocovski, Wilfrid Laurier University

Background: Given the increasing research on acceptance-based interventions in youth, the development of instruments that target specific disorders and processes is necessary to ensure a reliable understanding of the mechanisms involved in the efficacy of such interventions. The present study aimed to translate, adapt, and analyze the psychometric properties of the Social Anxiety – Acceptance and Action Questionnaire (SA-AAQ; MacKenzie & Kocovski, 2010), an instrument designed to assess the acceptance of social anxiety symptoms, to a sample of Portuguese adolescents. Method: Factor structure, internal consistency, convergent and discriminant validity were examined in a sample of 599 Portuguese adolescents (60.8% females) aged between 14 and 18. Temporal reliability was assessed in a subsample of 145 participants. In addition to the SA-AAQ-A, participants completed the Child and Adolescent Mindfulness Measure, the Social Anxiety Scale for adolescents, the Multidimensional Anxiety Scale for Children and the Children's Depression Inventory. Results: Confirmatory factor analysis suggested a two-factor structure (Acceptance and Action). Good (.92) and acceptable (.77) internal consistency were found for the Acceptance and Action subscales, respectively. Paired t-test and Pearson correlation between scores with a 5-week interval indicated a good temporal stability for both the Acceptance and Action subscales. Good convergent validity and discriminant validity were also found, although less robust results were found for the Action subscale. Discussion: The SA-AAQ-A is a sound instrument for assessing acceptance of social anxiety for an adolescent population. Keywords: Social Anxiety Disorder, Acceptance, Action, Acceptance and Commitment Therapy (ACT)

25. A Systematic Review of the Effectiveness of Acceptance and Commitment Therapy (ACT) for Body Image Dissatisfaction and Weight Stigma in Adults
Primary Topic: Clinical Interventions and Interests
Subtopic: Body image disatisfaction
Catrin Griffiths, University of the West of England
Heidi Williamson, University of the West of England
Fabio Zucchelli, University of the West of England
Tim Moss, University of the West of England

Background: Body image dissatisfaction and perceived weight stigma are prevalent and associated with physical and psychological ill-health. Acceptance and Commitment Therapy (ACT) is increasingly being employed to target both, yet little is known regarding its effectiveness. Method: This review aimed to systematically identify ACT intervention studies for improving body image and weight stigma, evaluate their quality and comment on effectiveness. Results: After searching 12 databases, 4 studies were identified and reviewed. Studies used randomised controlled trial designs and evaluated online and face-to-face ACT interventions of varying durations and intensity. The small number of studies of varied methodological quality emphasised that ACT for body dissatisfaction and weight stigma is not yet established. However, findings support the facilitative role of psychological flexibility in reducing body dissatisfaction and indicate that brief online, as well as lengthy and face-to-face delivery may be useful. Discussion: ACT may be a promising approach for this population, worthy of further rigorous research.

26. Effectiveness of Acceptance-Based Self-Help for Individuals with Visible Difference and Social Anxiety: A Pilot Randomised Controlled Trial
Primary Topic: Clinical Interventions and Interests
Subtopic: Self-help, Visible Difference
Luke Powell, University of Sheffield
Andrew Thompson, DClinPsy, University of Sheffield

Background: Individuals with visible difference in appearance (such as burns, skin and hair conditions and craniofacial differences) commonly experience distress due to appearance-related concerns. For some individuals, appearance-related concerns can have profound psychological impact, including reductions in quality of life, self-confidence and an increase in social anxiety. Thompson (2009) reported 30% of individuals referred to secondary care due to a dermatological condition exhibit clinically significant levels of distress, demonstrating a need for accessible resources. Self-help materials may be an accessible method of support for individuals with visible difference who are distressed. Additionally, the ‘severity’ of the visible difference does not predict distress (Moss, 2005) and thus psychological intervention focuses on managing the impact of the condition, rather than trying to change the condition itself. This intervention strategy aligns well with Acceptance and Commitment Therapy (ACT). Recent findings have demonstrated ACT self-help has been beneficial for a variety of clinical populations, including those experiencing anxiety, depression, and chronic health conditions. This study aimed to develop and examine an acceptance-based self-help booklet for individuals with visible difference. Specifically, the booklet aimed to: 1) increase psychological flexibility, 2) reduce appearance-related anxiety and 3) improve quality of life. Method: A pilot randomised controlled trial was used. Participants were individuals who self-identified as having a visible difference. Recruitment occurred through relevant charities, who advertised via social media. Participants were randomised to either the four-week intervention or a waitlist. Data were collected at pre- and post-intervention. The self-help materials were developed by the lead researcher and there are three core modules: 1) awareness of our experience (including mindfulness and willingness), 2) changing the impact of our thoughts and 3) values, goals and barriers. Results: This study is on-going with recruitment set to commence in April or early-May. Preliminary findings may be available by late-June. Data will be analysed to ascertain differences between the two groups and differences between pre- and post-intervention. Discussion: The preliminary findings will be used to discuss implications for ACT both within a self-help context and for use with individuals with visible difference and appearance-related concerns.

27. The AAQ-II Translation to Georgian: A Preliminary Validation Study
Primary Topic: Clinical Interventions and Interests
Subtopic: Assessment
Nino Gogichadze, Ilia State University, GNNT
Teona Lodia, Ivane Javakhishvili Tbilisi State University, GNNT
Nata Meparishvili, Ilia State University, GNNT
Jodi Polaha, East Tennessee State University

Background: The Acceptance and Action Questionnaire-II (AAQ-II) was developed to measure the central tenets of Acceptance and Commitment Therapy (ACT) – psychological inflexibility, acceptance, and experiential avoidance (Bond et al., 2011). Consistent with the theoretical orientation, Bond et al. showed the AAQ-II reliably predicts a range of outcomes from mental health to work absenteeism. The AAQ-II has been translated and studied in at least 22 languages. The present study aims to identify psychometric functioning of the Georgian version. This study represents the first ACT-oriented empirical endeavor in the Republic of Georgia, a developing country. Methods: The AAQ-II was translated to Georgian using best practice procedures recommended in the literature (Borsa, Damasio, & Bandeira, 2012). Questionnaires were then distributed among the students and staff of Tbilisi Ilia State University in the Republic of Georgia using an online interface. A total of 352 participants completed the survey, with bachelors level students representing 79% of the sample and the remainder distributed among graduate students and administrative staff. Questionnaires included the AAQ-II and two standard measures already established in Georgia: the Worlds Health Organization’s WHO-5, a short self-report instrument which measures subjective psychological well-being dimension of overall perceived quality of life and the Satisfaction with Life Scale (SWLS; Diener, Emmons, Larsen, & Griffin, 1985) is focused to asses global Life Satisfaction. Results: Analyses of the chronbach’s alpha for each measure showed acceptable internal validity; AAQ-II (α = .863); WHO-5 (α = .873); and SWLS (α = .959). Consistent with a growing body of literature across many countries and cultures, analyses revealed a negative correlation between psychological flexibility as measured by the AAQ-II and WHO-5 (r = -.336, p≤.001). No significant correlation was found between WHO-5 and SWLS, or AAQ-II and SWLS. Discussion: Results provide some support that the Georgian translation of the AAQ-II appears to be an appropriate and valid measure for assessing psychological flexibility. We plan to provide detailed information regarding specific item analysis and implications for future research. This preliminary study is the first to initiate the translation of essential ACT concepts to the Republic of Georgia and paves the way for future research and clinical endeavors, particularly the important connection between these researchers and others doing like-work in other countries.

28. Routine Outcomes in Psycho-oncology: Problems and Possibilities
Primary Topic: Clinical Interventions and Interests
Subtopic: Psycho-oncology, ACT, cancer
Sari Harenwall, DClinPsych, The Maggie Keswick Jencks Cancer Caring Centres Trust
Karen Verrill, The Maggie Keswick Jencks Cancer Caring Centres Trust
Lesley Howells, DClinPsy, The Maggie Keswick Jencks Cancer Caring Centres Trust
David Gillanders, DClinPsy, University of Edinburgh

Background: There is ongoing debate surrounding routine outcomes in clinical practice with many primary health care providers in the UK adopting a more uniform approach to routine outcome data collection, which is embedded in their daily practice. However, there is little consensus within psycho-oncology, with variation in the use of outcome measures and investment in the infrastructure to support data collection nationally and globally. This is a first attempt at demonstrating outcomes using ACT in a community cancer charity setting whilst developing a sustainable framework by collaborating with local Universities and offering undergraduate psychology students placements to support data entry. Therefore this service evaluation has two primary aims; 1) to explore clinical outcomes and the fidelity of ACT in community psycho-oncology and 2) to test the feasibility and utility of an innovative and cost effective approach to auditing. Method: Audit data (n=112-123) was collected as part of routine clinical practice in a third sector community cancer centre. Service users were affected by cancer either directly (personal diagnosis) or indirectly (partner/relative/bereaved). This was a naturalistic sample with some being in active treatment, and some being treated with curative or non-curative intent. The number of treatment sessions ranged from 2-26 with a mean of 5.49 and median of 4.00. Routine outcome data was measured by the Distress thermometer (DT), the Acceptance and Action Questionnaire-II (AAQ-II) and the Clinical Outcomes in Routine Evaluation – Outcome Measure (CORE-OM). A smaller number of participants (n=74) completed written end-of-therapy feedback. Volunteer assistant psychologists were recruited from local psychology undergraduate courses annually. Volunteers were then trained in data entering and supervised by a clinical psychologist. Results: Paired sample t-test for the DT, CORE-OM and AAQ-II for pre and post treatment measures demonstrated significant results (p= 0.000) with large effect sizes (cohen’s d = 1.36-179). End of therapy feedback indicates that clients’ found therapy helpful and ACT principles were learnt. In particular, acceptance of thoughts and feelings were reported by a large proportion of clients’ to be helpful. Discussion: Data suggests that ACT can lead to significant improvement in psychological flexibility and well-being in people affected by cancer in routine practice. However, more rigorous data from multiple centres and therapists needs to be collected, not only to build on the growing evidence base for ACT in cancer populations but also for quality assurance purposes. Working closely with Universities’ with aspiring and enthusiastic psychologist is likely to be mutually beneficial. Implication for designing data collection and reporting systems will be discussed.

29. Effectiveness of a 10-Week Pilot Acceptance and Commitment Therapy Group for Social Anxiety Disorder: Results from an Acute Care General Hospital
Primary Topic: Clinical Interventions and Interests
Subtopic: Social Anxiety
Neil Levitsky, M.D., University of Toronto
Marlene Taube-Schiff, Ph.D., Ryerson University
Samantha Fashler, Ryerson University
Aiden Mehak, Ryerson University

Background: Acceptance and Commitment Therapy (ACT) has been shown in randomized controlled trials to be an effective treatment for Social Anxiety Disorder (SAD). To date, only one RCT has been done with ACT groups for social anxiety (Kocovski et al., 2013). This pilot study examined the feasibility and effectiveness of using this ACT protocol (Kocovski et al., 2013) in a naturalistic setting within an acute care general hospital. Methods: 13 adult out-patients diagnosed with SAD were enrolled in a 10 session, weekly ACT group at North York General Hospital in Toronto, Canada. The following rating scales were completed at the first and last sessions: Leibowitz Social Anxiety Scale (LSAS), Social Phobia Inventory (SPIN), Self-Compassion Scale (SCS), and the Post-event Processing Inventory (PEPI). Results: We found that total SPIN scores (n=11) were significantly reduced from week 1 (M = 39.5; SD = 10.9) to week 10 (M = 29.4; SD =10.3), p = 0.006. The total LSAS scores (n=8) were significantly reduced from week 1 (M = 65.4; SD = 27.1) to week 10 (M = 39.3; SD = 11.1), p = .015. LSAS subscales of social avoidance and performance avoidance significantly decreased while total avoidance, total fear, total fear of social, and total fear of avoidance did not significantly change. The total SCS scores (n = 11) significantly increased from week 1 (M = 2.4; SD = .7) to week 10 (M = 3.1; SD = .6), p = .005. All SCS subscales (except over-identification) significantly increased over the course of the group. The total PEPI scores (n = 11) were significantly reduced from week 1 (M = 46.5; SD = 9.5) to week 10 (M = 37.1; SD = 10.5), p = .003. All PEPI subscales significantly decreased. Discussion: This 10-week ACT group proved to be feasible with promising results. Consistent with our results, the aim of ACT is to increase value-based action, with the reduction of anxiety/fear not being a core treatment goal. Changes on the SCS scale highlight the impact of the mindfulness and self-compassion interventions. We believe our results suggest that this ACT protocol can be effective in a naturalistic setting but further research should replicate these findings within a larger sample size.

30. FACT*: Focused Acceptance and Commitment Therapy Enhanced by Functional Analytic Psychotherapy for the Treatment of Social Anxiety Disorder. Mixing Single Subjects Designs and Group Design to Test Efficacy and Efficiency of Direct Measures
Primary Topic: Clinical Interventions and Interests
Subtopic: FACT, FAP, ACT, Social Anxiety Disorder, SAD, Multiple Baseline
Roberto Cattivelli, Istituto Auxologico Italiano IRCCS, Department of Psychology, Catholic University of Milan, Milan, Italy
Nicola Maffini, Private Practice
Alessandro Musetti, Department of Literature, Arts, History and Society, University of Parma, Parma, Italy
Giorgia Varallo, Istituto Auxologico Italiano IRCCS
Chiara Spatola, Istituto Auxologico Italiano IRCCS, Department of Psychology, Catholic University of Milan, Milan, Italy
Emanuele Cappella, Department of Psychology, Catholic University of Milan, Milan, Italy
Gianluca Castelnuovo, Istituto Auxologico Italiano IRCCS, Department of Psychology, Catholic University of Milan, Milan, Italy

Background: Focused Acceptance and Commitment Theory focus on ways to improve behavioral flexibility for brief therapy and consulting settings and is considered cost-effective , high efficient treatments, with generally equal outcomes but better sustainability compared with more traditional Cognitive Behavioral Treatments, especially for brief hospitalizations or out-patients settings. Method: We tested the effectiveness/efficiency of a FACT intervention, a brief 6 hour protocol for outpatient diagnosed with Social Anxiety Disorder (SAD), to change SAD-related behaviors directly observed during sessions and collected in directed ways between sessions. Methods involved in this study are quite innovative, including direct collected data with technological devices as smartphone and activity trackers and including a point to point behavioral data collection. Psychometric measurements through Outcome Questionnaire 45.2 and AAQ-II are consistent with behavioral data. Results & Discussion: Findings of the study are promising, suggesting an increase of value-related behaviors and a reduction of avoidance responses.

31. Flex Game: The game of the Psychological Flexibility
Primary Topic: Clinical Interventions and Interests
Subtopic: Therapeutic Tool
Erica Oliveira Faria, Private Practice

Flex Game is a therapeutic tool that was designed based on the theoretical assumptions from Acceptance and Commitment Therapy. This game is composed of colored wooden blocks with symbolic representations of emotions. Stacked blocks form a tower, which represents life experiences. A six-sided dice, with different colors in eachside, represents uncontrollable internal or external events. When tossed, the color defines which block is to be removed from the tower, independently of the position it is in, and this piece may compose a new construction. For ACT, psychopathology is seen as psychological inflexibility that arises from attempts to control private events. Constructing psychological flexibility goes through awareness and acceptance of private experiences, and commitment to action based on personal values. The ACT therapist uses metaphors and experiential exercises for the client to contact its private experiences instead of avoiding them.

32. Beyond the use of protocols in the treatment of BPD in Colombia
Primary Topic: Clinical Interventions and Interests
Subtopic: Borderline Personality Disorder
Alexandra Avila Alzate, Centro de Terapias Contextuales, Bogotá-COL
Carolina Prieto, Centro de Terapias Contextuales, Bogotá-COL
Mónica Ramos, Centro de Terapias Contextuales, Bogotá-COL
Lucía Delgado, Centro de Terapias Contextuales, Bogotá-COL

Borderline Personality Disorder has been addressed specially by DBT in the last decades, however, in Colombia limited clinicians count with formal DBT training and experience. Few years ago, clinical programs started to include third wave approaches for complex clinical cases. Even so, only the basics were studied and CBT remains dominant in the clinical field. Having the chance to conform a DBT team, starting to use most part of the protocol suggestions brought us to conclude that CBT and DBT still could work together for treating BPD. The importance of managing both perspectives can support the specific requirements that each case requires, but we also found the need of disseminating contextual therapies in our country. We would like to share a life worth living experience and first clinical case in our Contextual Therapies Center located in Bogota, Colombia.

33. Psychometric properties of the Spanish version of the Valuing Questionnaire (VQ) in Spain.
Primary Topic: Clinical Interventions and Interests
Subtopic: Process measures of potential relevance to ACT
Paula Odriozola-González, Ph.D., Universidad de Valladolid y Universidad Europea del Atlántico
Francisco J. Ruiz, Ph.D., Fundación Universitaria Konrad Lorenz
Juan Carlos Suárez-Falcón, Universidad de Educación a Distancia
Mª Rosario Perucha Ramos, Práctica privada de psicología sanitaria

The Valuing Questionnaire (VQ) is a measure of valued living according to the definition of values of the acceptance and commitment therapy (ACT). It has a robust two-factor structure, comprising Progress and Obstruction. The VQ has shown good internal consistency and convergent and divergent validity. The current study analyzed the psychometric properties and factor structure of the Spanish version of the VQ in Spain. The VQ was administered to a total sample of 880 participants, including a general population sample and a clinical sample. The results were very similar to those obtained in the original VQ version. Internal consistency across the different samples was good. The two-factor model showed a good fit to the data.The mean Progress and Obstruction scores of the clinical sample were lower and higher, respectively, than the scores of the nonclinical sample. Correlations with other constructs were in the expected direction. In conclusion, the Spanish version of the VQ shows good psychometric properties in Spain.

34. To Evaluate the Psychometric Properties of the ISTACTS Rating Scale Among the Muslim Community
Dr. Tahereh Seghatoleslam, University of Malaya Centre of Addiction Sciences (UMCAS), Kuala Lumpur, Malaysia
Prof. Hussain Habil, Psychiatry Department at Mahsa University, Kuala Lumpur, Malaysia

Aim: To evaluate the psychometric properties of the rating scale. It was designed by basis of the Islamic Spiritual Therapy (IST) and Acceptance Commitment Therapy (ACT) Scale (ISTACTS) among the Muslim Community. Materials and Methods: in this cross sectional study 210 healthy volunteers that were selected randomly from Muslim Community at University Malaya, Malaysia. If they agreed to be participle in the study, the scale was distributed among them. They completed anonymous scale, about thirty minutes. Instruments: The scale was designed by two psychologists and two psychiatrists. The content was divided into ten parts. It includes: the six core of the ACT, and in addition four parts of the IST which are individual , social behaviour, Islamic rituals (such as five time prayers), and Islamic believes ( for instance: belief in one God). Results: This study is under process and the results are still being analysed. In the main article the results will be presented by researchers.

35. Acceptance and Commitment Therapy (ACT) for Adolescent Psychiatric and Substance Use Disorders: Results from Stage 1a Development
Primary Topic: Clinical Interventions and Interests
Subtopic: Substance Use Disorders/Adolescence
Julia Timmerman, LCSW, Denver Health and Hospital Authority
Christian Thurstone, M.D., Denver Health and Hospital Authority/University of Colorado

Background: There are few models for integrated treatment of adolescent psychiatric and substance use disorders. Many youth in substance treatment drop out and do not achieve abstinence. To address these limitations of adolescent substance treatment, this study begins to develop a novel treatment approach. Methods: Participants were 82 youth enrolled in a hospital-based clinic and three school-based clinics. Only youth who had been in treatment for at least 16 weeks were included. Participants also included the 8 therapists who administered the intervention. All youth were offered 12 weeks of manual-standardized, individual treatment consisting of: motivational interviewing, acceptance and commitment therapy, contingency management, family sessions and medication-assisted treatment. Sessions were audio-recorded monthly for fidelity monitoring. Outcome measures for the hospital-based clinic included the following: number of sessions attended, proportion of days used substances in the past 7 days (for those with non-zero baseline use, n=39), Outcome Rating Scale (ORS) (0=poor wellness, 40=optimal wellness), Session Rating Scale (SRS) (0=poor session, 40=optimal session), urine drug screens and qualitative feedback from therapists. Outcome measures for the school-based clinics included number of sessions attended, proportion of days used substances in the past 7 days (for those with non-zero baseline use, n=29), a measure of school engagement (0=minimal school engagement, 30=maximum school engagement), modified ORS (0=poor wellness, 10=optimum wellness), SRS, urine drug screens and qualitative feedback from therapists. Statistical analyses included descriptive statistics and pre-post comparison of continuous outcome measures using dependent t-tests or non-parametric equivalent. This study was approved by the Colorado Multiple Institutional Review Board. Results: Mean ORS scores increased from 22.5 to 29.3 (p<0.0001) and from 6.8 to 7.8 (p=0.050) in the hospital and school-based samples, respectively. The median proportion of days used decreased from 0.6 to 0 (p=0.0035) and from 0.4 to 0 (p=0.0004) in the hospital- and school-based samples, respectively. School engagement scores increased from 20.2 to 23.7 (p=0.011) in the school-based sample. The mean SRS score was 37.0 (SD=2.2) and 38.2 (SD=2.8) in the hospital- and school-based samples, respectively. All audio-recordings received passing scores. Therapists reported satisfaction with the intervention and recommended adaptations to the manual. Discussion: The results provide a novel, manual-standardized treatment for adolescent psychiatric and substance use disorders. This manual-standardized treatment should undergo Stage 1b testing to evaluate the feasibility of a larger, controlled trial and to estimate effect size.

36. Changing the Pattern of Subjective Well-Being in the Context of Psychological Treatment: The Role of Self-efficacy
Primary Topic: Clinical Interventions and Interests
Subtopic: Mechanism of change
Vesna Gavrilov-Jerkovic, Department of Psychology, University of Novi Sad, Serbia
Milica Lazic, Department of Psychology, University of Novi Sad, Serbia
Dragan Zuljevic, Department of Psychology, University of Novi Sad, Serbia
Nikolija Rakocevic, Department of Psychology, University of Novi Sad, Serbia
Ivan Jerkovic, Department of Psychology, University of Novi Sad, Serbia

Vast amount of research in psychotherapy established the efficacy of a range of psychological treatments. However, research also demonstrates that treatment varies widely in its effects, and it is estimated that 15% of patients get worse following treatment. Mechanisms of change may play an important role in the effects achieved by treatments, but we still have little knowledge of for whom and why psychotherapy works. According to social learning theory, changes in psychotherapy are mediated by strengthening expectations of personal efficacy. The aim of this study was to explore differences in self-efficacy during the treatment between persons whose subjective well-being improved at the end of therapy, and persons which well-being remained the same or worsened after psychotherapy. Longitudinal data were collected in four waves from 63 clients, who finished treatment (70% female, 18 to 63 years). Clients were participating in free-of-charge psychological treatment in Psychological Counseling Center. The treatment consisted of 10 sessions. It was conducted by 19 psychological counselors originating from REBT and Transactional analysis orientation. Participants completed the measure of self-efficacy (A Short Version of the Self-Efficacy Optimism Scale), life satisfaction (Satisfaction with Life Scale) and positive and negative affect (Positive and Negative Affect Schedule) during the admission interview two weeks before the start of the treatment, after third, sixth, and after the final treatment session. The results of latent profile analysis performed in each wave consistently indicated three classes: the high SWB, medium SWB and low SWB group of clients. 39 clients change their class to better one during psychotherapy (G1), while 24 clients retained class, or have worse class after treatment (G2). Results of latent growth modeling show that there is increase in self-efficacy in both groups (G1 and G2). The results of multivariate analysis of variance show that there was no difference in the level of self-efficacy between the two groups of clients before the treatment and after the first three sessions. However, the difference appears after the sixth and also after the last treatment session for the benefit of the clients of the first group indicating that the self-efficacy has a potential to be one of the mechanisms of therapeutic change, but only in the middle and the end phase of treatment. Practical and theoretical implications of the findings will be discussed.

37. Cognitive Fusion: Concept and Validation of the German Version of the Cognitive Fusion Questionnaire CFQ-D
Primary Topic: Clinical Interventions and Interests
Subtopic: Cognitive Fusion Questionnaire
Dr. Claudia China, Mühlenbergklinik Holsteinische Schweiz, Bad Malente-Gremsmühlen
Dr. Laura Birke Hansen, Mühlenbergklinik Holsteinische Schweiz, Bad Malente-Gremsmühlen
Dr. Dieter Benninghoven, Mühlenbergklinik Holsteinische Schweiz, Bad Malente-Gremsmühlen

Background: Within the ACT model of psychological flexibility, cognitive fusion (CF) refers to a person’s attitude towards their own thoughts and beliefs, more specifically, the extent to which they identify with their own thoughts and beliefs. This concept is of growing interest for those treating chronic conditions, e.g. pain. Recently developed measures of CF are available in English but so far, are lacking in German. Methods: This study aims to explore the reliability and validity of the German translation of the Cognitive Fusion Questionnaire CFQ by Gillanders et al. (2014) within a sample of chronic pain patients (n=200), currently inpatient at a rehabilitation clinic, and a non-clinical sample of university students (n=100). In addition, the patients complete a set of standard clinical measures as well as the German translation of the Psychological Inflexibility in Pain Scale (PIPS). Results: Using confirmatory factor analysis we establish the dimensionality of cognitive fusion as assed by the CFQ-D. Psychometric properties are provided including measures for reliability (i.e. internal consistency, retest-reliability), convergent validity and face validity. In addition, the contribution of CF to pain, level of functioning, life quality, depression and catastrophizing is tested by means of multiple regression analyses. Discussion: The findings will be discussed in terms of demonstrated usefulness.

38. Contributions of B.F. Skinner's writings to understand Functional Analytic Psychotherapy’s Middle-Level Terms
Primary Topic: Clinical Interventions and Interests
Subtopic: Functional Analytic Psychotherapy
Rodrigo Nunes Xavier, Universidade de São Paulo
Sonia Beatriz Meyer, Universidade de São Paulo

Functional Analytic Psychotherapy (FAP) is a treatment derived from a Skinnerian functional analysis of successful interventions for interpersonal problems. Its description changed from a purely behavioral language to the Contextual Behavioral Science's Middle-Level Terms (MLTs) for several reasons, as to wide spread FAP to non-behaviorists practitioners. Even acknowledging reasons like this one, an emerging problem is that therapists and researchers who adopt the behavior analytic approach have found difficulties to understand how the new MLTs can add any advantage to the original conceptualization of FAP. Therefore, it is also necessary to spread FAP's MLTs to behaviorists. What is presented is a narrative review of B.F. Skinner's main writings summarizing what he published about the terms awareness, courage, and love. It is hoped that this synthesis will provide a clearer understanding and a greater refinement about the FAP's target and its purpose.

39. Psychological and Cognitive Flexibility in Relationship to Age and Anxiety
Primary Topic: Functional contextual neuroscience and pharmacology
Subtopic: Psychological Flexibility, Cognitive Flexibility, Anxiety, Age, Executive functions, ACT.
Xavier Montaner Casino, Universitat Autònoma de Barcelona
Jeroni Muñoz Galindo, Hospital Ricard Fortuny
Mélodie Pulgarín Linero, Universitat Autònoma de Barcelona
Mercè Martínez Vallès, Hospital Ricard Fortuny

Background: Psychological Flexibility is linked to health and well-being and is an identified treatment outcome for therapies such as Acceptance and Commitment Therapy (ACT). In the other hand, Cognitive Flexibility is a neuropsychological construct, a component of executive function, that has a significant conceptual overlap with Psychological Flexibility. They both pretend to manifest the ability to change behavior in response to environmental change, and an impairment in both has shown an association with psychopathology. In this study, we meant to clarify the overlap between these two constructs and to discover its relationship with the state-anxiety and age in a normal sample. Method: Type of study: Descriptive Sample: 48 employees of the Ricard Fortuny Hospital (CSSV), with ages between 21 and 59 years old (=38,21; SD=12,7), 78,6% female and 21,4% male. Exclusion criteria: Acquired brain injury. Psychopharmacological treatment. Diagnosis in Axis I of the DSM-IV Measurement instruments: Subtest of the State-Trait Anxiety Inventory (STAI-R), Acceptance an Action Questionnaire-II (AAQ-II), Trail Making Test A and B (TMTA and TMTB) Statistical Analysis: SPSS Statistics 19.0 software Results: A significant relationship was found between age and Cognitive Flexibility (p<.001, r=520), but not between age and Psychological Flexibility (p=.698). On the other hand, significant relationship was found between anxiety-state levels and Psychological Flexibility (p<.001, r=817), while there was none between anxiety-state levels and Cognitive Flexibility (p=.221). Lastly, no relationship was found between Psychological Flexibility and Cognitive Flexibility (p=.948). Discussion: This study has identified that, although both Psychological and Cognitive Flexibility have definitional and conceptual overlap, only Psychological Flexibility shows a significant relationship with anxiety in a normal sample. On the other hand, we found the widely documented negative relationship between age and Cognitive Flexibility in our sample, while we found no relationship between age and Psychological Flexibility. Finally, our findings reaffirm the results of previous studies suggesting that there is no clear association between Cognitive Flexibility and Psychological Flexibility, and suggest that poor Cognitive Flexibility (common in older adults) may not be an impediment in the application of ACT in older people.

40. Revisión sistemática de la Terapia de Aceptación y Compromiso (ACT) en adolescentes
Áreas temáticas (principales): Fundamentos filosóficos y teóricos
Diana Riaño-Hernández, Pontificia Universidad Javeriana
Vanessa Riveros Fiallo, Pontificia Universidad Javeriana
Luis Manuel Silva, Pontificia Universidad Javeriana
Juan Eduardo Pulido, Pontificia Universidad Javeriana
Angélica Ramírez y Paula Villa, Pontificia Universidad Javeriana

La Terapia de Aceptación y Compromiso (ACT) se caracteriza por ser una terapia centrada en trabajar orientado a las personas a dirigirse hacia las cosas que son importantes para ellas y facilitar que se conecten con los valores personales, donde se identifican aquellas áreas de la vida que se deben fortalecer. Igualmente, es importante resaltar que la terapia se centra en mostrar el costo que la evitación experiencial ha tenido respecto a sus valores; es decir, que el cliente vea cuales son los valores que se han comprometido por la evitación de los eventos privados. Este estudio realiza una revisión sistemática de ACT en adolescentes, ya que cuando se realiza la búsqueda en Scopus en cuanto a la producción existente que evidencie la aplicación de ACT en adolescentes se encontró que desde el año 2007 viene incrementando el número de publicaciones con esas características, de esta manera en el 2007 se identifican cinco artículos publicados en Scopus y mientras que en el año 2014 se registraron 34 artículos. Para esta revisión se desarrolló un protocolo de búsqueda. Las bases consultadas fueron Scopus, Science Direct, Redalyc, Psynet, Web of Science, Dialnet, Scielo, ACBS. Los términos de búsqueda se usaron en español e inglés: (Intervención AND terapia de aceptación y compromiso AND "adolescen*) y (Terapia de aceptación y compromiso AND "adolescen*). Las búsquedas fueron realizadas de forma independiente por cuatro investigadores capacitados para realizar las búsquedas, una vez realizadas se triangularon los datos. Los resultados muestran que con esos términos de búsqueda en las bases de datos se encuentran 563 artículos, de esos 563 se seleccionaron los artículos que cumplían los criterios básicos por análisis de título y resumen, para luego realizar la lectura completa de los mismos y realizar la codificación. Los resultados de la codificación muestran el análisis respecto a las variables dependientes e independientes, tipos de estudio, diseños, características de las poblaciones con las cuales se están llevando a cabo intervenciones con adolescentes y componentes de ACT trabajados en las intervenciones y resultados reportados por la aplicación de la terapia. Se brinda con esta revisión sistemática información útil que permite a los investigadores tener una guía práctica en cuanto a cómo se está realizando intervención desde ACT con adolescentes con la finalidad de permitir tomar decisiones en cuanto a la terapia con adolescentes y la realización de futuras investigaciones.

41. Justificación y diseño de un estudio que compara una intervención basada en Terapia de Aceptación y Compromiso con una intervención basada en Mindfulness en enfermos oncológicos
Áreas temáticas (principales): Clinical Interventions and Interests
Sub-categoría temática: ACT, Mindfulness, oncology, cancer
Verónica Castrillo Sarmiento, clinical psychologist, Universidad de Salamanca
Cristina Caballo Escribano, Ph.D., Universidad de Salamanca
Manuel Ángel Franco Martín, Ph.D., Universidad de Salamanca
Andrea Taboada López, Complejo Asistencial de Zamora
Carmen Ortiz Fune, Complejo Asistencial de Zamora

El cáncer es una enfermedad que afecta el bienestar físico y psicosocial de los pacientes. La angustia surge en todas las fases de la enfermedad, desde el diagnóstico y tratamiento hasta la supervivencia. Los factores de riesgo modificables, incluidos los hábitos de vida y las variables psicológicas, han demostrado tener un papel importante en la influencia de la morbilidad y la mortalidad en los pacientes con enfermedades físicas. Las Terapias Contextuales como Aceptación y Compromiso (ACT) y Mindfulness, han demostrado resultados prometedores. ACT ha mostrado eficacia en la promoción de comportamientos saludables, y mejora del bienestar psicológico en condiciones crónicas de salud. Además los programas basados en la aceptación revelan una alta satisfacción con el tratamiento y mejora en la calidad de vida. Sin embargo, hasta la fecha ningún estudio ha evaluado la diferencia entre estos dos tipos de intervención en población oncológica. ACT pretende la aceptación de los síntomas al servicio de lo que es valioso para la persona, mientras que Mindfulness tiene como objetivo la aceptación del momento presente a través de prestar atención sin juzgar a lo que sucede en el aquí y ahora. Método: Aproximadamente 30 pacientes serán reclutados del servicio de oncología y serán asignados aleatoriamente a uno de los dos grupos de tratamiento, para recibir una intervención basada en ACT o en Mindfulness. Las intervenciones se llevarán a cabo en cinco sesiones de terapia grupal integrando temas educativos sobre comportamientos saludables. Los participantes serán evaluados al inicio, seis semanas después y en un seguimiento a los seis y doce meses. Se utilizará un diseño parcialmente anidado para equilibrar los efectos debido a la agrupación de participantes en pequeños grupos de terapia. Las medidas de resultado primarias incluirán calidad de vida y flexibilidad psicológica.

42. Efectividad tras 14 sesiones de tratamiento desde la perspectiva de ACT y FAP
Áreas temáticas (principales): Intervenciones y aspectos clínicos
Sub-categoría temática: Tratamientos eficaces
Saray Cáliz Aguilera, Universidad Europea de Madrid
Lidia Budziszewska, Universidad Europea de Madrid

Background: Estudio de caso individual en el que se evaluó y trato durante 14 sesiones a una paciente desde la perspectiva de ACT y FAP. Métodos: Instrumentos: Se utilizaron para la evaluación 3 cuestionarios - SLC-90: Cuestionario para evaluar la presencia de síntomas psicológicos y psicopatológicos. - CFQ: cuestionario de 7 ítems para evaluar la fusión cognitiva. -AAQ-II: cuestionario de 7 ítems que mide la inflexibilidad psicológica y el grado de evitación experiencial El caso se llevo desde la perspectiva de ACT y FAP usando metaforas etc.... Resultados y Discussión: Tras revisar los resultados obtenidos tras las 14 sesiones y comparar las puntuaciones pre y post tratamiento, podemos observar una reducción significativa en los síntomas psicológicos que presenta la paciente así como de su grado de fusión cognitiva y de evitación experiencial. Además se ha producido un aumento de las CCR2 y CCR3, así como una disminución de las CCR1. El sujeto esta siendo capaz de identificar, distanciarse y tolerar los pensamientos, emociones, cogniciones y sensaciones que experimenta ante eventos difíciles, haciendo espacio a la aceptación de eventos privados dolorosos y reduciendo notablemente las conductas de rumia y evitación. Esto está propiciando un mayor acercamiento por parte de la paciente a todo aquello que es importante para ella, sus valores.

43. Malestar Emocional y Tipo de Cáncer en Pacientes con Enfermedad Oncológica Avanzada
Áreas temáticas (principales): Intervenciones y aspectos clínicos
Sub-categoría temática: Cuidados Paliativos
Isabe Ramirez Gendrau, Residente de Psicología Clínica, Consorci Sanitari de Terrassa (Hospital de Terrassa, Barcelona).
Cristina Enero Gonzalez, Consorci Sanitari de Terrassa (Hospital de Terrassa, Barcelona).
Anna Garcia Caballero, Consorci Sanitari de Terrassa (Hospital de Terrassa, Barcelona).

INTRODUCCIÓN Y OBJETIVOS La literatura científica en Cuidados Paliativos (CP) señala que los pacientes con enfermedad oncológica avanzada están sometidos a elevados niveles de estrés durante el proceso de diagnóstico y tratamientos a los que están expuestos, repercutiendo de forma directa en su bienestar emocional. El objetivo de la presente investigación es analizar, en pacientes con enfermedad oncológica avanzada, el grado de malestar emocional (ME) que presentan y si existen diferencias según el tipo de cáncer diagnosticado. MÉTODO Muestra formada por 50 pacientes (54% mujeres, edad media: 68.24 años (SD 11.97), ingresados en unidades hospitalarias (CP y oncología) del Consorci Sanitari de Terrassa (CST, Barcelona) por enfermedad oncológica avanzada (52% Otros; 18% Colorrectal; 16% Mama; 8% Pulmón; 3% Gástrico). Todos los pacientes mantenían seguimiento con la unidad de CP durante el ingreso. Para cada paciente se registraron datos sociodemográficos, biomédicos y psicológicos. El nivel de malestar emocional se valoró mediante el cuestionario de Detección de Malestar Emocional (DME).Se aplicaron las pruebas Chi cuadrado y ANOVA entre variables para el análisis de los datos, los cuales se llevaron a cabo con el programa estadístico IBM SPSS Statistics Versión 21. RESULTADO A partir del análisis estadístico, los resultados mostraron relación significativa entre el tipo de cáncer padecido y el grado de ME (p 0.037, p< 0.05) siendo mayor en el cáncer de pulmón (x = 16.25 (5.476)) y menor en el colorrectal (x= 9.67 (3.571)). En todos los subtipos de càncer estudiados, la puntuación media de ME se sitúa por encima de punto de corte del instrumento utilizado (x= 11.18 (4.317)). Los resultados no mostraron diferencias significativas en relación al subtipo de cáncer padecido y el tipo de preocupación predominante que presentaban. CONCLUSIONES Los resultados hallados confirman la presencia de elevado ME en pacientes diagnosticados de enfermedad oncológica avanzada. Además los datos sugieren que existen diferencias en el nivel de ME experimentado entre los pacientes según el tipo de enfermedad oncológica, siendo el cáncer de pulmón el que mayor ME acarrea en la muestra estudiada. Los resultados del estudio suman evidencia en la necesidad de detectar el ME de forma precoz en pacientes oncológicos dada la elevada presencia de estresores a los que están sometidos. Además sugieren la importancia de una intervención precoz multidisciplinar e idiosincrásica según el tipo de cáncer padecido para mejorar la calidad de vida de estos pacientes.

44. Tratamiento Cognitivo-Conductual Grupal Breve en Trastornos Adaptativos
Áreas temáticas (principales): Intervenciones y aspectos clínicos
Sub-categoría temática: Trastorno adaptativo
Marina Torrens-Lluch, Servicio de Salud Mental. Consorci Sanitari de Terrassa (Barcelona)
Anna Soler i Roca, Servicio de Salud Mental. Consorci Sanitari de Terrassa (Barcelona)

Objetivo: Los trastornos adaptativos se definen como una respuesta emocional -con aparición de síntomas emocionales o comportamentales- ante un estresor identificable, conllevando un malestar o deterioro clínicamente significativo. Si bien constituyen entre un 10 – 30% de los pacientes que son visitados en los centros de Salud Mental, todavía no hay consenso en relación al abordaje terapéutico óptimo y existe poca literatura acerca de la eficacia del tratamiento. El objetivo del presente estudio es analizar la efectividad del tratamiento cognitivo – conductual grupal para los trastornos adaptativos, incluyendo los subtipos con sintomatología depresiva, ansiosa y mixta. Método: La muestra se compone de 98 pacientes (34 hombres y 64 mujeres) atendidos en el Centro de Salud Mental del CST, todos ellos cumplían criterios para el diagnostico de Trastorno Adaptativo, según el DSM IV – TR. El rango de edad comprende de los 19 a los 78 años con una media de 45 años. A nivel sociodemográfico, un 12,5% está soltero, un 62,5% casado y un 25% divorciado/separado. Se han llevado a cabo diversos grupos de carácter breve (6 sesiones de una hora de duración con una periodicidad semanal) donde se realiza una intervención psicoeductiva y de aprendizaje de técnicas cognitivo – conductuales para al manejo de los síntomas y el afrontamiento al estrés. Se realizó una evaluación pre y post tratamiento: se administraron el Inventario de Depresión de Beck (BDI), el Inventario de Ansiedad Estado – Rasgo (STAI) y la Escala de Autoestima de Rosenberg (RSE). Los datos han sido analizados mediante el SPSS versión 22 (IBM). Resultados: En primer lugar se analizaron las puntuaciones tanto de depresión como de ansiedad y autoestima de la evaluación previa al tratamiento en relación al sexo, la edad, el estado civil y el nivel educativo, no obteniendo diferencias significativas entre los subgrupos. En la evaluación post tratamiento se evidencia una reducción significativa de las puntuaciones en ansiedad rasgo (p<.004), ansiedad estado (p<.006) y depresión (p<.003). Sin embargo, las diferencias en la puntuación de autoestima pre y post tratamiento no fueron significativas (p.119). Además, se observa una mayor reducción específica de la sintomatología ansiosa -menor puntuación STAI- en aquellos pacientes con un nivel de estudios bajo y en cambio una mayor reducción específica de la sintomatología depresiva –menor puntuación BDI- en aquellos pacientes con un mayor nivel educativo. Conclusiones: En conclusión, una intervención grupal breve basada en la terapia cognitivo – conductual permite alcanzar cambios en el trastorno adaptativo, evidenciándose una mejoría significativa de los síntomas y por tanto demostrando la efectividad del tratamiento.

45. Desenganchados de la vida: Flexibilidad psicológica en pacientes en tratamiento con metadona
Primary Topic: Intervenciones y aspectos clínicos
Sub-categoría temática: Abuso de sustancias
Andrea Taboada López, Complejo Asistencial de Zamora
María del Carmen Ortiz Fune, Complejo Asistencial de Zamora.
Verónica Castrillo Sarmiento, Asociación Contra el Cáncer. Zamora
Mónica Santos Rivas, PsicAct
Laura Turiel Flórez

Introducción: Los programas de mantenimiento con metadona han mostrado ser un tratamiento eficaz reducir el consumo de drogas. Sin embargo, las diferencias inter e intraindividuales dificultan entender las variables implicadas en la eficacia de este tipo de intervención. Su conceptualización como tratamiento de reducción de daño en lugar de mejora de la calidad de vida, los riesgos asociados a la dosis y la comorbilidad presente en este grupo, hacen necesario seguir desarrollando modelos comprehensivos de conceptualización e intervención. El gran desarrollo teórico y práctico de la Terapia de Aceptación y Compromiso y sus bases filosóficas, ha dado lugar a un gran número de estudios que avalan su eficacia en pacientes dependientes de múltiples sustancias. Entre estos avances destaca la definición de “flexibilidad psicológica” como “una clase funcional, una operante, que consiste en responder a la propia conducta en un marco de jerarquía con la perspectiva deíctica-YO”. En este trabajo, recogemos la idea teóricamente bien desarrollada de que la falta de un patrón comportamental flexible basa el abuso de sustancias, y con ello, del no abandono del uso de metadona durante largos períodos. Pretendemos estudiar la flexibilidad psicológica en un grupo de pacientes en tratamiento con metadona, relacionándolo con la presencia de otras dificultades. Métodos: La muestra estuvo compuesta de 13 pacientes en tratamiento con metadona. Se aplicó un protocolo de evaluación compuesto por una medida de psicopatología general (SCL-90-R), un screening de trastornos de la personalidad (IPDE) y dos medidas de flexibilidad psicológica, una relacionada con el constructo general (AAQ-II) y otra específicamente referida al ámbito del consumo de sustancias (AAQ-SA). Resultados: Se encuentra un elevado nivel de psicopatología general, siendo la media de este grupo el percentil 85,54. Es elevada la presencia de Trastornos de Personalidad, siendo los más frecuentes el límite, el obsesivo-compulsivo y el evitativo. La inflexibilidad psicológica es alta en el AAQ-II (X= 34,45) y AAQ-SA (x=68,54). La relación entre malestar psicopatológico general y flexibilidad es más estrecha con los datos obtenidos en el segundo, dibujando un perfil casi idéntico. Discusión: Nuestros resultados son congruentes con lo reflejado en la literatura. En primer lugar, encontramos una alta comorbilidad relacionada con altos niveles de inflexibilidad psicológica. También en cuanto a la idoneidad de utilizar instrumentos que evalúen este constructo en el grupo de consumidores de sustancias específicamente, ya que AAQ-II y AAQ-SA parecen mostrar información relacionada, aunque no solapada. La conceptualización de los problemas de abuso de drogas como un patrón de regulación conductual inflexible, permite entenderlo en base a la actuación directamente controlada por las funciones que se desprenden de los eventos privados presentes en cada momento, dando lugar a acciones fusionadas que generan una vida “desenganchada” de las cosas que tienen significado para la persona. Ello permitirá diseñar tratamientos más integrados, basados en el lenguaje y la cognición y alejados de la topografía de la conducta. Esto dará lugar a intervenciones que logren para nuestros pacientes una mejor calidad de vida, de forma más duradera.

46. Aplicación de ACT a Grupo de Pacientes de ESM
Áreas temáticas (principales): Intervenciones y aspectos clínicos
Sub-categoría temática: Psicoterapia grupal de Act en adultos Salud Mental
Rosa Elena Mateo Álvarez, Psicóloga Clínica Hospital de Burgos
Verónica Castrillo Sarmiento, Psicóloga Clínica Asociación Española Contra el Cáncer
Laura Álvarez Cadenas, PIR Hospital Universitario de Burgos
Diana Cobo Alonso, PIR Hospital Universitario de Burgos
Iván Torres Viejo, PIR Hospital Universitario de Burgos

Objetivo: Análisis de los resultados obtenidos en la aplicación de un programa grupal de ACT para pacientes del Equipo de Salud Mental. Material Y Método: Estudio cuasiexperimental con diseño intragrupo pretest-postest sin grupo control. Los cuestionarios: MAAS (Mindfulness Attention Awareness Scale, adapt. Luciano y Ruiz 2007), AAQ-II (Preliminary psychometric properties of the Acceptance and Action Questionnaire-II, adapt. Luciano y Ruiz, 2007), WBSI (White Bear Supression Inventory (Wegner, D. M., y Zanakos, S. 1994) y Escala de Autocompasión SCS de García-Campayo. Participaron 13 pacientes atendidos en consulta de Psicología Clínica y/o Psiquiatría del ESM con diversos diagnósticos. El protocolo se realiza durante 12 semanas en sesiones de 90 minutos de duración. Primeramente se contextualiza la terapia, se hace Análisis funcional, se genera desesperanza creativa, se emplearon técnicas de defusión para hacer emerger funciones, se generan claves de jerarquía-deícticas, contacto con el momento presente, diferenciación del yo, clarificación de valores y compromiso de acción. Se incluye cultivo de la autocompasión. Resultados: Los pacientes van tomando perspectiva, aprendiendo a contactar con lo que piensan, sienten y hacen en el momento presente, a diferenciar entre el yo contenido y el yo contexto, a generar distancia del contenido y abrir espacio a la aceptación. Se potencia la flexibilidad psicológica y van clarificando valores y dirigiendo su conducta hacia lo que de verdad les importa. Los resultados en las medidas cuantitativas - postest no pueden incluirse en este resumen dado que el programa se encuentra aún en curso. Conclusiones: La aplicación de la Terapia de Aceptación y Compromiso a grupos de pacientes de Salud Mental supone una intervención terapéutica novedosa, flexible, que se adapta a las necesidades del paciente y grupo de pacientes, modelo de salud y no de enfermedad, que altera los contextos verbales que tienen atrapado al paciente y que apuesta porque aprenda a elegir la dirección de su vida para que ésta sea más amplia y llena de significado. Cultivando la autocompasión se refuerza al paciente para que sea consciente de su propio sufrimiento y se responda a sí mismo con bondad y comprensión. No obstante, hacer hincapié en la necesidad de seguir trabajando e investigando sobre la efectividad y eficacia de ACT.

47. Morir antes de tiempo: Terapia de Aceptación y Compromiso en Cuidados Paliativos
Áreas temáticas (principales): Intervenciones y aspectos clínicos
Sub-categoría temática: Cuidados Paliativos
Andrea Taboada López, Complejo Hospitalario de Zamora
Verónica Castrillo Sarmiento, Asociación Contra en Cáncer. Zamora.
María del Carmen Ortiz Fune, Complejo Hospitalario de Zamora
Mónica Santos Rivas, PsicAct

Introducción: Los cuidados paliativos se conciben como “el enfoque que mejora la calidad de vida de pacientes y familias que se enfrentan a problemas asociados con enfermedades que amenazan la vida, a través de la prevención y alivio del sufrimiento, por medio de la identificación temprana e impecable evaluación y tratamiento del dolor y de otros problemas físicos, psicológicos y espirituales”. Es frecuente que aparezcan eventos privados indeseados en los afectados. Si esto da lugar a un patrón rígido de funcionamiento basado en la evitación, nos encontramos el Trastorno de Evitación Experiencial (TEE), con resultados negativos en la vida de las personas. Aquí presentamos los resultados obtenidos de un protocolo de intervención funcional-contextual, para conocer la eficacia de la Terapia de Aceptación y Compromiso en el abandono de la evitación y la generación de repertorios más flexibles de conducta. Teniendo en cuenta que el psicólogo también puede verse envuelto en conductas de evitación experiencial que pueden interferir en su labor profesional, se analiza la presencia de barreras y la actuación del profesional en relación a las mismas, así como su relación con los resultados finales del tratamiento. Se estudiarán también las dificultades encontradas en la aplicación de este protocolo y se harán sugerencias para solventarlas de cara a futuros trabajos. Métodos: se aplicó el protocolo a una muestra de 7 pacientes atendidos por un Equipo de Cuidados Paliativos Domiciliario. Los criterios de inclusión fueron ser paciente de dicho recurso o cuidador principal del mismo, y mostrar un patrón de evitación que causase interferencia en la vida cotidiana. Se utilizaron instrumentos de autoinforme para evaluar el grado de bienestar del paciente durante cada semana de intervención, su implicación en actividades valiosas y la satisfacción del paciente y familia con el tratamiento. Las barreras del terapeuta fueron recogidas por el mismo en relación a cada intervención, y clasificadas en función de su intensidad y grado de fusión. Resultados: Se encuentra una media de 3,85 puntos de bienestar psicológico antes de la primera sesión, que se eleva hasta un 6,14 tras la intervención. La satisfacción de paciente y familia fue elevada en todos los casos (X=9, X=9,57). Las barreras del terapeuta fueron medias (42,85% de los casos) o altas (57,14%). Se planificó la sesión en un 71,42% de los casos. El grado de fusión fue bajo en el 80% de los casos, siendo mayor cuando la sesión no fue planificada. De igual modo, la planificación precedió a mayores aumentos en el bienestar informado por el paciente (aumenta de media 2,4 puntos). Se encuentra relación inversa entre el grado de fusión con las barreras y el bienestar del paciente (a menor fusión, mayor diferencia entre el bienestar autoinformado antes y tras la intervención). Discusión: La aplicación de intervenciones psicológicas protocolizadas en cuidados paliativos es compleja. También lo es la investigación de resultados de las mismas. Por ello, las limitaciones metodológicas de este trabajo solo permiten extraer hipotésis a confirmar en posteriores investigaciones. En cuanto a los resultados obtenidos vemos que han sido positivos, y que tanto pacientes como familiares se muestran satisfechos. Por tanto, ACT supone un enfoque útil y aceptable en el campo de los cuidados paliativos. En segundo lugar, destacar que es fundamental el trabajo personal continuado del terapeuta, de forma que este logre aumentar su flexibilidad psicológica, para optimizar los resultados de sus intervenciones. Para ello, parece útil la planificación de las sesiones.

48. Impactos de la Terapia de Aceptación y Compromiso en la calidad de vida de personas con estrés postraumático y depresión.
Áreas temáticas (principales): Intervenciones y aspectos clínicos
Sub-categoría temática: Estrés postraumático, trastorno depresivo mayor, calidad de vida
Angelica Nathalia Vargas Salinas, Contextual Behavioral Science and Therapy Institute
Michel André Reyes Ortega, Contextual Behavioral Science and Therapy Institute

El estrés postraumático (TEPT) es el único trastorno psiquiátrico al que se le atribuye una causa concreta de la sintomatología (exposición a un evento traumático), que limita y afecta la calidad de vida de las personas. Los tratamientos con mayor evidencia para trabajar con este problema, no contemplan las comorbilidades y están orientados a la disminución de síntomas y no a la calidad de vida. En este estudio de tipo pretest - postest con dos seguimientos, a los 3 y 6 meses, participaron dos grupos de personas diagnosticadas con TEPT crónico y trastorno depresivo mayor, un grupo participó de ACT (n=11) y el otro de Terapia de Exposición Prolongada (TE) (n=11), ambas intervenciones constaron de 12 sesiones en formato grupal. Se midieron los impactos en sintomatología depresiva, estrés postraumático y calidad de vida, ambos tratamientos muestran disminución de síntomas en TEPT (p ≤ 0.002) y en depresión (p ≤ 0.000), peros solo ACT mantiene los cambios a lo largo de seis meses, mientras que en la calidad de vida ACT muestra impactos significativos en preocupaciones, desempeño físico, aislamiento, percepción corporal, funciones cognitivas, actitud ante el tratamiento, tiempo libre, vida cotidiana y redes sociales (p ≤ 0.05) y solo TE muestra cambios en el aislamiento, tiempo libre, vida cotidiana y familia (p ≤ 0.05) y solo se mantienen en el primer mes.

49. Protocolo breve basado en la Terapia de Aceptación y Compromiso: a propósito de un caso de Trastorno Adaptativo
Áreas temáticas (principales): Intervenciones y aspectos clínicos
Sub-categoría temática: Protocolo de intervención en atención ambulatoria
Mª del Carmen Ortiz Fune, Psicóloga Residente en el Complejo Asistencial de Zamora
Manuel Mateos García, Psicólogo General Sanitario en Centro de Asesoramiento Sevilla
Andrea Taboada López, Psicóloga Residente en Complejo Asistencial de Zamora
Verónica Castrillo Sarmiento, Psicóloga Clínica en Asociación Española Contra el Cáncer

En algunos contextos clínicos, como es la atención a pacientes en el sistema público de salud, se hace imprescindible aplicar las terapias de una forma breve y eficiente, tratando de obtener los mejores resultados empleando menos tiempo. En este contexto, la mayor parte de las demandas atendidas se refieren a problemas adaptativos con síntomas de ansiedad y/o depresión, en cambio a menudo nos encontramos que tras la aplicación de tratamientos habituales (Terapia Cognitivo Conductual y psicofármacos) un elevado porcentaje de pacientes acaban siendo crónicos, consumiendo muchos recursos. Se diseñó, con el objetivo de mejorar el servicio de salud mental ambulatoria, un programa de intervención breve basado en la Terapia de Aceptación y Compromiso. El programa se compone de cuatro sesiones que recogen todos los elementos de la terapia (desesperanza creativa, defusión y clarificación de valores) así como la posibilidad de ser ampliado en el seguimiento para adaptarlo a casos particulares, tratando siempre de no superar las 8 sesiones. En el presente trabajo, se presentan los resultados obtenidos tras la aplicación del protocolo a una paciente de 29 años con Trastorno Adaptativo Mixto (sintomatología ansiosa y depresiva). Al inicio de la intervención la paciente presentaba puntuaciones elevadas en el Inventario de Depresión de Beck y el Inventario de Ansiedad de Beck, así como niveles elevados de Evitación Experiencial reflejados por el AAQ-II. El protocolo de intervención se aplicó en un centro de salud público de la provincia de Zamora, por una terapeuta que se encontraba en formación en Terapias Contextuales. Las sesiones tuvieron una duración de entre 45 y 60 minutos, y se desarrolló a lo largo de siete sesiones durante tres meses, se consideró oportuno ampliar tres sesiones de seguimiento dadas las características de la paciente (el motivo principal de asistir a consulta había sido su embarazo y dio a luz durante el tratamiento). Las sesiones de seguimiento consistían principalmente en reformulación del análisis funcional y algunos ejercicios puntuales de defusión y trabajo con valores. La evolución de la paciente se midió con un registro de malestar y acciones valiosas adaptado para el caso. Tras la intervención, se apreciaron cambios significativos en el patrón de comportamiento de la paciente, que presentaba una conducta dirigida a valores y mayor flexibilidad y apertura ante la presencia de malestar. Por todo ello, consideramos que la inclusión de este tipo de protocolos de intervención en Atención Primaria podría mejorar considerablemente el Sistema Público de Salud.

50. Dejar de fumar con ACT
Áreas temáticas (principales): Prevención e intervenciones comunitarias
Sub-categoría temática: Terapia de Grupo, Metáforas, Tabaquismo, Adicciones
Verónica Castrillo Sarmiento, Universidad de Salamanca
Andrea Taboada López, Complejo Asistencial de Zamora
Carmen Ortiz Fune
Rosa Mateo Álvarez, Hospital Universitario de Burgos
Mónica Santos Rivas
Iván Torres Viejo

Actualmente existe evidencia que muestra la eficacia de la Terapia de Aceptación y Compromiso (ACT) en la alteración de los comportamientos adictivos, y en el mantenimiento de la abstinencia a largo plazo. ACT ha mostrado ser eficaz en el desarrollo de una vida consistente con los valores personales cuyo coste principal supone afrontar el malestar que se deriva de la abstinencia. Se exponen los elementos terapéuticos utilizados en un programa de tratamiento grupal, se analiza su utilidad, y se evalúa el nivel de compromiso y malestar durante el proceso. Además se presentan los resultados de abstinencia en el seguimiento. La muestra estuvo compuesta por 30 adultos, con una duración promedio de más de 20 años de consumo. Se analizan los resultados pre y postratamiento, análisis durante el proceso terapéutico así como seguimiento a los 3 y 6 meses. Los principales resultados indican una abstinencia a los 6 meses mayor del 60%. Por todo ello, parece que se consiguen tasas de éxito terapéutico prometedoras. Distintas revisiones indican una eficacia general promedio de 20 – 45% de éxito. Quizás ACT consiga mayores tasas de éxito a largo plazo porque las personas con historia de consumo de tabaco, suelen tener experiencia en hacer compromisos y romperlos, por lo que temen comprometerse. Desde ACT se trabaja el compromiso en cada sesión, no como un resultado, sino que se trata de un compromiso con una dirección valiosa. Por lo que, el compromiso de dejar de fumar no significa que no pueda haber una recaída. En definitiva, este compromiso significa que la persona está dispuesta a dejar de consumir tabaco porque esa elección está en consonancia con sus valores y ese compromiso incluye la responsabilidad de elegir retomar el rumbo cuantas veces sean necesarias.

51. Shame, Guilt and Substance Use Coping: The Mediating Role of Self-Compassion
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Self-Compassion
Christina Chwyl, Portland Psychotherapy
Jason B. Luoma, Portland Psychotherapy

Background: Shame and guilt have distinct relationships with alcohol consumption and alcohol-related problems. While shame-proneness typically predicts more drinking and drinking-related problems, guilt-proneness typically predicts less drinking and fewer drinking-related problems. Although shame- and guilt- proneness may prove relatively resistant to intervention, other, more modifiable variables may mediate the relationship between these emotions and drinking motives. Objectives: Investigate whether two potentially modifiable variables may mediate the relationship between shame and negative drinking outcomes: self-compassion and the motivation to drink to cope with anxiety (a variable highly related to experiential avoidance and linked to problematic substance use). Method: One hundred and seven community-dwelling, non-abstaining adults completed self-report measures of shame, guilt, drinking motives, and drinking-related problems. Results: Shame-proneness, but not guilt-proneness, predicted people’s motivation to drink to cope with anxiety. Importantly, meditational models showed that self-compassion mediated the relationship between shame-proneness and drinking to cope with anxiety. Path analysis showed that shame-proneness led to drinking to cope through decreases in self-compassion, which, in turn, led people to experience fewer interpersonal alcohol-related problems. Discussion: Together, our results underline the distinct consequences of shame- and guilt-proneness, and reveal that self-compassion may play an important role in drinking motives and ensuing alcohol-related problems amongst shame-prone people. Future longitudinal and experimental studies may clarify the temporal and causal relationships amongst these variables.

52. Brief Evidence-Based ACT-Enhanced Parenting Intervention to Promote Young Adolescents’ School Engagement
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Group based interventions
Larry Dumka, Ph.D., Sandford School of Social and Family Dynamics, Arizona State University, USA

This poster presents ways ACT was integrated in a universal group-based parenting intervention already been shown to be effective (the Bridges to High School program; http://psycnet.apa.org/journals/ccp/80/1/1/). This skills-focused intervention aims to prevent school disengagement and behavioral health problems in middle school age adolescents (11-13 years old) by increasing parents’ capacity to monitor adolescents, enact effective limits, and stay connected. ACT enhancements were integrated to increase parents’ psychological flexibility to optimize skill learning and committed action. These enhancements are described including activities to clarify parenting values, brief mindfulness exercises to increase parents’ present moment attention when communicating with adolescents, and strategies to promote defusion to reduce parent-adolescent conflict. Lessons from implementing the intervention are shared.

53. How Do Compassionate and Acceptance Strategies Explain Feelings of Social Safeness and Depression Symptoms?
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Depression
Cláudia Ferreira, CINEICC, University of Coimbra
Ana Laura Mendes, CINEICC, University of Coimbra
Andreia Máximo, University of Coimbra
Maria João Dias, University of Coimbra
Inês A. Trindade, CINEICC, University of Coimbra

The ability to present a kind and compassionate attitude towards the self has been consistently linked to psychological well-being and lower levels of depressive symptoms. On the other hand, individuals who present a critical and judgmental self-relationship tend to become more vulnerable to the development of several psychopathological conditions. The current study explored experiential avoidance and feelings of social safeness and connectedness as mediators between self-compassion and self-judgment and depression symptoms. Participants in this study were 413 individuals of both sexes (126 males and 287 females), aged between 18 and 60 years old, who completed validated self-report measures. Path analysis explained 35% and 35% of the variances of social safeness and pleasure and depressive symptomatology, respectively, and demonstrated excellent model fit indices. Results revealed that experiential avoidance mediated the impact of self-compassion and self-judgment in feelings of social safeness and pleasure and depression symptoms. Particularly, a compassionate self-to-self relationship seem to be associated with lower depression symptoms through a lower tendency to avoid or control unwanted inner events and more feelings of safeness and connectedness. On the other hand, harsh critical attitudes towards the self were linked to the adoption of maladaptive emotion regulation processes (such as experiential avoidance) and to lower feelings of safeness and connectedness within social relationships and, in turn, to higher levels of depression symptoms. These findings offer significant clinical and research implications, emphasizing the role of emotion regulation processes in the promotion of psychosocial well-being and mental health, and supporting the relevance of combining Acceptance and Commitment Therapy (ACT) and compassion-based interventions.

54. Physiological and Psychological Barriers to Progressing Along the Stages to Quit Smoking Among People with Schizophrenia
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Smoking cessation
Yim-wah Mak, RN, RM, Ph.D., School of Nursing, The Hong Kong Polytechnic University
Winnie WY Lau, BA, School of Nursing, The Hong Kong Polytechnic University
Alice Yuen Loke, Ph.D., School of Nursing, The Hong Kong Polytechnic University

Background: Studies are lacking on the barriers that influence the stages of readiness to quit smoking among people with schizophrenia. Objective: To identify the physiological and psychological contributors to progressing along the stages of change in smoking behavior among people with schizophrenia. Method: From 47 community-based mental health care settings in Hong Kong, we recruited 219 participants who were current smokers and who had been diagnosed with schizophrenia. Results: Participants at the precontemplation stage showed significantly less perceived support from family and friends, lower self-perceived importance of quitting and confidence in being able to quit, but better mental health related-quality of life. Higher self-perceived importance of quitting and confidence in being able to quit were important psychological predictors to a later stage of readiness to quit smoking. Conclusions: The result indicated the impact of the patients’ self-perceived confidence and self-perceived importance of smoking cessation on their progress along the stages of readiness to quit smoking. Strategies designed to increase these psychological factors, such as health education and modeling effects, may contribute to increasing their motivation to quit.

55. Can Psychological Flexibility Model Predict Prosocial Behavior in Anti-Social Personality?
Primary Topic: Prevention and Community-Based Interventions
Oktay Şahin, MD, Ergani State Hospital, Diyarbakir, Turkey
K. Fatih Yavuz, Bakırköy Mental Health and Neurological Diseases Hospital, Istanbul, Turkey
Ahmet Nalbant, MD, Bakırköy Mental Health and Neurological Diseases Hospital, Istanbul, Turkey

The aim of this study is to determine how psychological inflexibility model predicts social functioning and clinical severity in people with ASPD. Current study includes 220 individuals with ASPD. Socio-demographic data form, Interpersonal Reactivity Index (IRI), Perspective Taking sub-scale (PT), Acceptance and Action Questionnaire-II (AAQ-II), Self as Context Scale (SCS), Cognitive Fusion Questionnaire (CFQ), Social Functioning Scale (SFS) were applied. According to results, total scores of Social Activities(SA) sub-scale were predicted by SCS and CFQ. Social Engagement (SE) sub-scale was predicted by SCS and AAQ-II. Interpersonal Communication (IC) sub-scale was found to be predicted by CFQ and SCS. Total scores for SCID-II ASPD were predicted by AAQ-II. Our study points out the results that self as context, cognitive fusion and experiential avoidance attitudes also predict both social functioning and the severity of APD in individuals with APD.

56. Work-Related Stress, Psychological Flexibility and Organizational Wellfare in a Sicilian Hospital
Primary Topic: Organizational behavior management
Subtopic: Work-related stress, organizational welfare
Giovambattista Presti, University of Enna "Kore"
Valeria Squatrito, University of Enna "Kore"
Francesca Mongelli, University of Enna "Kore"
Melina Di Blasi, University of Enna "Kore"
Enrica Basile, University of Enna "Kore"
Paolo Moderato, Istituto Europeo per lo Studio del Comportamento Umano (IESCUM)
Tiziana Ramaci, University of Enna "Kore"

Health workers are, by definition, in contact with patients living emotionally complex situations, which can threaten their psychological well-being and capacity to work effectively. Under these conditions a key role is played by the way they relate to their own internal events (thoughts, emotions, feelings, memories, etc.). We aimed to evaluate the relationship between stressful working environment and individual and contextual factors and organizational context. One third of the staff in service at a Sicilian Hospital were in. Measures were: Mayer D’Amato Questionnaire (M_DOQ10), Occupational Stress Indicator (OSI), Mindfulness Attention Awareness Scale (MAAS), Acceptance and Action Questionnaire – II (AAQ-II), Valued Living Questionnaire (VLQ). A total of 411 questionnaires were collected. Data show that Sicilian health workers have low levels of psychological flexibility (AAQ-II average = 48.88, d.s. = 8.61) and have good levels of awareness (MAAS average = 4.59, d.s. = 0.93). OSI scores show that causes of problems are attributed to organization rather than individual (external locus of control); the main sources of pressure are attributed to the managerial role and the climate. Workers have a good way to deal with stress.

57. Study Protocol for the Development and Testing of a Questionnaire to Measure Mindfulness, Acceptance and Commitment
Primary Topic: Other
Subtopic: Questionnaire
Nina Schulze, Dipl.-Psych., Neuropsychiatric Center Hamburg-Altona, Germany
Silja C. Reuter, Neuropsychiatric Center Hamburg-Altona, Germany
Peter Tonn, M.D., Neuropsychiatric Center Hamburg-Altona, Germany

Background: The objective of this study is to create and evaluate a questionnaire that measures the levels of mindfulness, acceptance and commitment in the general population. Methods: Based on our daily clinical experience, we created an item pool with 90 items which measure the scales mindfulness, acceptance, and commitment. This item collection was presented to a group of experts, which reduced the number of items to 60 items. The next step will be to present the questionnaire to a sample of n = 1000 participants, recruited from the general population in Germany. After completing the data collection, the questionnaire will be checked for its quality by calculation (item difficulty etc.). The final version of the questionnaire should contain less than 30 items. In a second study, the questionnaire will be correlated with related questionnaires (construct validity). Discussion: There are only a few questionnaires to measure mindfulness, acceptance, and commitment in German-speaking countries. We want to create a valid measuring instrument to fill this gap. Currently we have finished the first step of a three-step-process.

58. The Impact of Experience on Implicit Attitudes Towards Children with Language Disorders and Autism
Primary Topic: Relational Frame Theory
Subtopic: IRAP
Francisco Cabello, Ph.D., Universidad de Murcia (Spain)
Silvia Abellan, Universidad de Murcia (Spain)
Ana Vanesa Valero, Universidad de La Rioja (Spain)

Research has shown that healthcare and education professionals hold negative attitudes about children with disabilities, which can impact their work (Pruett & Chan, 2006; Wright, 1988). In this poster we use the IRAP procedure in two separate studies to examine implicit attitudes towards children with language disorders and autism, and to analyze the impact of clinical experience on these attitudes. In Study 1, participants were 34 speech-therapy students that were about to have their first clinical practice, so that the IRAP was administered before and after this practice. In Study 2, participants were 37 teachers in two mainstream schools; 17 had experience with children with autism, and 16 did not. Results from both studies show (1) that having actual experience with disabled children produced a change in implicit attitudes; (2) that attitudes towards children with language disorders or autism were not affected; and (3) that attitudes towards normal children became more positive. In other words, experience with disabled children produced a more positive view of normal children in both speech-therapy students and teachers, rather than a decrease in negative attitudes. These findings are discussed in the context of the impact that implicit attitudes can have in the professional work of healthcare and education professionals.

59. Learning Model of Metaphorical Reasoning for Children with Autism Spectrum Disorders
Primary Topic: Relational Frame Theory
Subtopic: Autism
Fen-Fen Wang, University of Chinese Academy of Sciences
Zhuo-Hong Zhu, Institute of Psychology，Chinese Academy of Sciences

A considerable amount of research has indicated that children with autism spectrum disorders (ASD) have difficulty with figurative language, specifically with metaphorical language. As a common language phenomenon and competence, metaphor is a restriction to the language development and interpersonal communication of children with ASD. However, few studies have attempted to teach children with ASD to understand metaphor. Relational framing theory (RFT) came up with a behavioral approach to the topic of metaphorical language and it treats relating, per se as learned behavior. The current study attempted to construct and evaluate the learning model of metaphorical reasoning for children with ASD in China by means of multiple exemplar training for teaching them to establish the relational frames among subjects in a metaphor. Research also explored children’s behavior changes during the training. Participants included four children, ages 12-16. Results suggest that the learning model is effective for teaching children with ASD to learn metaphorical reasoning. The data for all four children with diagnosis of autism revealed their success in post-training phase and probe session, for accuracy data in all sessions reached above 80%. Two of them even got 100% in five or six sessions. Furthermore, generalization to untrained metaphors was found and one of them even demonstrate the generalization to create their own metaphors.

61. CBS Consistent Definitions of Relational Coherence, Incoherence and Ambiguity
Primary Topic: Relational Frame Theory
Subtopic: Relational Coherence
Sam Ashcroft, The University of Chester
Lee Hulbert-Williams, The University of Chester
Kevin Hochard, The University of Chester
Nick Hulbert-Williams, The University of Chester

Coherence is fundamental to many theories in psychology. For example, coherence is implicated in the development of a sense of meaning, it is at the core of Cognitive Dissonance Theory, it explains basic findings such as the Stroop effect, and it is part of the Multi-Dimensional Multi-Level framework that currently steers much of RFT research. Despite this central importance, coherence has not been defined satisfactorily within CBS. The lack of a precise definition of coherence may be holding back research in CBS. Even within CBS, scholars use the term coherence in multiple ways, which means that research contributions, rather than being cumulative, threaten to become divergent and imprecise. We present CBS consistent definitions of coherence, incoherence and ambiguity that will enable discussion and investigation of these concepts with precision, scope and depth. Our intention is that these definitions will simultaneously steer and invigorate a cumulative body of research on coherence.

62. Citation Analysis of Relational Frame Theory: 2009-2016
Primary Topic: Relational Frame Theory
Subtopic: Relational Frame Theory
Martin O'Connor, MSc, University College Dublin
Lynn Farrell, University College Dublin
Anita Munnelly, University College Dublin
Louise McHugh, University College Dublin

Relational Frame Theory (RFT) is a contemporary account of language and cognition rooted in behavior analysis. This paper presents a citation analysis of the RFT literature that follows on from that conducted by Dymond, May, Munnelly and Hoon (2010) who examined the evidence base for and impact of RFT between 1991 and 2008. The current analysis focused on empirical and non-empirical studies citing RFT-related search terms and their publishing outlets in the period from 2009 to 2016. A particular emphasis was placed on Empirical RFT articles, which were organized by frames targeted, country of origin and participant demographics. The analysis revealed 522 papers that met inclusion criteria. Of these 289 were Empirical and 233 were Non-Empirical. The Empirical category included 160 Empirical RFT and 129 Empirical Other. The Non-Empirical category included 110 Review and 123 Conceptual. This analysis provides further evidence of substantial growth in RFT research.

63. Consolidating ACT Training in Uganda
Primary Topic: Supervision, Training and Dissemination
Subtopic: Mindfulness
Racheal D. Nuwagaba-K

The presentation will be about the Consolidation of ACT training in Uganda. ACT training started in 2014 and since then a number of students and mental health practitioners have had an opportunity to get trained. This has been based at Makerere University and Butabika hospital. ACT has been embraced by many practitioners because concepts like psychological flexibility and mindfulness are fresh to the world of mental health and answer questions not covered by therapies like Cognitive Behavioral therapy. The aim of training is to have ACT adopted by therapists in treating patients and also engaging it in the under and post graduate curriculum. In this effort, a number of training have been organised by Dr. Rosco Kassujja and the Special Interest Group (SIG) with support of the ACBS community. As a result of the training, the feedback from attendees is positive and ACT seems highly applicable in the local settings they work. Going forward, the SIG will work to follow up trainees so as to ensure effectiveness through supervision of both SIG members and therapists. More organizations are to be trained so as to increase the number of people using ACT. The SIG is putting up an organizing committee for better formalization of ACT plans in Uganda. Hence growth of ACT work in Uganda.

64. Polish Adaptation of the Valuing Questionnaire (VQ) and the Committed Action Questionnaire (CAQ)
Primary Topic: Theoretical and philosophical foundations
Subtopic: Values, Commited Action
Magdalena Hyla, University of Silesia in Katowice
Lidia Baran, University of Silesia in Katowice
Bartosz Kleszcz, Private Practice

The main aim of the poster is to present the Polish version of Valuing Questionnaire (VQ) and Committed Action Questionnaire (CAQ). In successive studies we established psychometric properties of given questionnaires. In study one (N=325) we conducted factor analysis to confirm factor structure of questionnaires. We also tested reliabilty of questionnaires and their theoretical validity (relations with psychological flexibility, wellbeing and depression). In study two (N=177) we confirmed factor structure of questionnaires after changes post study one and also tested stability at an interval of two weeks. In study three (N=70) we tested reliability and validity of the final scale (relationship with psychological flexibility, global motivation, midfullness, boredom proneness). The main objectivity of the presentation is to share the specific data along with discussing steps of the studies and comparing the results with other cultural adaptations of VQ and CAQ.

65. Interface between Acceptance and Commitment Therapy and Strategic Therapy
Primary Topic: Theoretical and philosophical foundations
Subtopic: Theoretical reflection
Carina Magalhães, Master Research Fellow, School of Psycology, University of Minho
Joana Silva, Post-doc fellow, School of Psycology, University of Minho
Miguel M. Gonçalves, Ph.D. Professor, School of Psycology, University of Minho

This poster aims to analyse and compare the main aspects of Acceptance and Commitment Therapy and Strategic Therapy, including treatment components and processes. ACT is based on the premise that psychological problems result and are perpetuated by clients’ attempts to avoid or attenuate unpleasant emotions, which frequently prevents their movement toward valued goals. Thus clinical work is centred on promoting psychological flexibility. On the other hand, Strategic Therapy assumes that problems are produced and maintained by rigid and repetitive behavioural sequences that may limit clients’ movement toward adaptation and change. These dysfunctional patterns that result from the repetition of the same strategies constitute the main target of therapeutic work, through the deliberate intervention on the clients’ ongoing system, emerging in therapeutic interaction. By exploring the commonalities between ACT and ST intervention strategies we find that they both imply a functional approach, focusing on what is occurring rather than why is occurring. Moreover, both models have a conceptual framing that privileges the contextual change in order to stop clients’ usual pattern of functioning namely by blocking the features that are part of the problem.

66. Moving Beyond Traditional Latent Variable Models: Exploring the Concept of Psychological Flexibility and Experiential Avoidance Through a Dynamical Network
Primary Topic: Theoretical and philosophical foundations
Subtopic: Measurement
Sofie Vindevogel, Ph.D., University College Ghent
Maarten De Schryver, Ghent University
Yvonne Barnes-Holmes, Ghent University
Ciara McEnteggart, Ghent

Traditional latent variable models, such as a reflective or formative model, are characterized by simplicity, linearity, monocausality and dualism (e.g., Borsboom et al., 2003). They exclude the possibility of causal and self-amplifying loops and trajectories whereby observable variables play a role in the etiology of other variables. Moreover, these arborescent models only allow us to study unitary and not multipath relations between construct and variables, limiting the understanding of multidirectional progress and how variables may be connected through multiple, causal relations. We argue that the study of psychological flexibility (PF) as measured by the AAQ should be built upon a multifactorial framework and that relations among these multiple factors, and the dynamics they invoke, should be the primary unit of analysis. We therefore present a network approach to PF as an alternative, comprehensive model to further both the substantive theorizing and empirical investigation of PF itself.

67. Mapping Acceptance and Commitment Therapy’s (ACT) Middle-Level Terms: A Structured Conceptualization
Primary Topic: Theoretical and philosophical foundations
Subtopic: Middle-level terms
Maarten De Schryver, Ghent University
Prof. Dr. Dermot Barnes-Holmes, Ghent

The development of acceptance and commitment therapy (ACT), and “third-wave” therapies generally, has involved the introduction of, an increasing reliance upon, the use of middle-level terms (e.g., defusion, acceptance, willingness, values-based action, self-as-context). Such terms have been deemed useful in terms of facilitating communication among both researchers and clinicians, while recognizing that such terms lack the relative precision of technical terms associated with traditional behavior analysis and relational frame theory. There has been some debate around the benefits, but also the potential disadvantages and risks, involved in the use of middle-level terms. Rather than simply continue with this largely abstract discussion, it may be useful to consider adopting another strategy. One such strategy would be to develop a conceptual framework that allows researchers and practitioners to visualize how each middle level term or construct relates statistically to the specific behaviors that they are meant to capture. The current poster will present the method of “concept mapping” as one way in which to achieve this objective. Engaging in such an exercise may help to better understand how middle level terms are related to each other and could help to reduce unnecessary overlap and redundancy.

68. Behavior (in Its Own Right) as the Subject Matter of a Behavioral Contextual Approach: the Case of Attitudes and Social Cognition
Primary Topic: Theoretical and philosophical foundations
Subtopic: Attitudes and Social Cognition
Henrique Mesquita Pompermaier, MS., Universidade Federal de São Carlos
João Henrique de Almeida, Ph.D., Universidade Federal de São Carlos

A non-mediational comprehension of psychological phenomena is one of the greatest principles underpinned by a behavioral perspective in Psychology. In this sense, different authors have argued on the necessity of considering behavior in its own right as the subject matter of a psychological science. Radical Behaviorism can be considered the most prominent approach in this sense. However, a theoretical analysis of Skinner’s work shows that the indication of behavior as the subject matter of a behavioral science is not completely achieved. Based on this analysis, we discuss the possibilities of completion of this behavioral perspective in Contextual Behavioral Science. To illustrate the difficulties and potentialities of a contextual comprehension, we consider theoretical and empirical works on attitudes and social cognition develop at Contextual Behavioral Science literature.

Friday, 23 June, 19:15-20:15 - Poster Session #3

2. Risk and Protective Factors for Internalization Following Bullying Victimization in Middle Schoolers
Primary Topic: Clinical Interventions and Interests
Subtopic: Children, Bullying, PTSD, Depression, Risk and Protective Factors
Chelsea VanderWoude, M.A., Southern Illinois University
Mary Louise Cashel, Ph.D., Southern Illinois University

Background: Research has consistently shown that bullying victimization creates lasting and compounding effects. Bullying increases a student’s likelihood to experience a range of emotional and behavioral disorders, such as anxiety, depression, and Oppositional Defiant Disorder (ODD). A recent study by Boyes and colleagues (2014) reported that scores of victimization were predictive of internalizing behaviors, measured by symptoms depression, anxiety, and posttraumatic stress disorder symptoms, at a one-year follow-up. These results indicate that there is a significant relation between victimization and disorders but few studies have examined the development of such difficulties. The current study seeks to evaluate risk and protective factors related to the development of depression and symptoms of PTSD in the context of bullying victimization. Method: This study collected data from 64 students from two separate rural middle schools. Each student completed a packet of measures assessing each of the relevant constructs. Bullying victimization was assessed with the The Bully Survey – Student Version (BYS-S; Swearer & Carey, 2003). Symptoms of depression and posttraumatic stress were assessed using Center of Epidemiological Studies Depression Scale Revised (CES-DR; Eaton, Muntaner, Smith, Tien, & Ybarra, 2004) and the University of California at Los Angeles Posttraumatic Stress Disorder Reaction Index (UCLA PTSD-RI; Steinberg, Brymer, Decker, & Pynoos, 2004). Thought suppression and social support was assessed using the the White Bear Thought Suppression Inventory (WBSI; Wegner & Zanakos, 1994) and the Child and Adolescent Social Support Scale (CASSS; Malecki & Elliott, 1999). Results: A correlational analysis was conducted between the BYS-S, CES-DR, UCLA PTSD-RI, WBSI, and the CASSS. Results indicated a significant relation between the BYS-S and symptoms of depression (r = .703) and posttraumatic stress disorder (r = .688). Results showed a significant relation between symptoms of depression and thought suppression (r = .711) and social support (r = -.343). Similarly, results also demonstrated a significant correlation between symptoms of PTSD and thought suppression (r = .603) and social support (r = -.316). Gender differences were evaluated using an independent samples t-test. The results indicated that there were no gender differences for symptoms of posttraumatic stress and depression. However, there were significant results for thought suppression based on gender. Female students obtained higher scores for thought suppression than male students (t = 1.83, p < .001, d = .81). Discussion: These results provide further support to the literature by indicating that bullying victimization is related to symptoms of internalization. Moreover, these results also suggest that thought suppression and social support may serve as risk and protective factors for the development of symptoms of depression and posttraumatic stress following bullying victimization. This study provides preliminary evidence to suggest that thought suppression is influenced by a student’s gender. The relation between gender, symptomology, and thought suppression will be discussed as well as clinical implications.

3. Self-Compassion and Fears of Compassion: A Comparative Study in Clinical Samples with Personality Disorders, Psychosis, and Eating Disorders and a Non-Clinical Sample
Primary Topic: Clinical Interventions and Interests
Subtopic: Compassion
Paula Castilho, University of Coimbra
Maria João Martins, University of Coimbra
Raquel Guiomar, University of Coimbra
Diana Carvalho, University of Coimbra
Joana Gonçalves, University of Coimbra
Marta Simão, University of Coimbra

Background: Self-compassion has been described as having a protective role in various forms of psychopathology. Therefore, compassion-based interventions have been emerging with promising results particularly among samples with diagnosis associated with self-criticism and shame issues. Nevertheless, authors have stressed the possibility of fears of affiliative emotions (e.g. compassion) emerging in people with highly activated threat-defense system. This study sought to compare the levels of self-compassion and fears of compassion (FOC) a) between clinical and non-clinical samples; and b) among three different clinical samples with diagnosis associated with difficulties in emotional regulation (personality disorders-PD, psychosis-PSY and eating disorders-ED). Method: A clinical sample of people with PD (n=53; 67.9% female; 33.47 years old), psychotic-spectrum disorder (n=50; 62% male; 32.48 years old) and ED (n=32; 100% female; 29.75 years old) was collected as well as a non-clinical sample (n=50; 74%; 37.94 years old). The participants filled in the FOC scales and self-compassion scale. Non-parametric mean comparisons and post-hoc analysis were performed. Results: The combined clinical sample had significantly higher levels of FOC and lower levels of self-compassion than the non-clinical sample. In FOC a tendency for differences between the clinical and non-clinical groups was found but not between the clinical groups. A similar pattern was found for common humanity. ED and PSY had higher levels of self-criticism, isolation and over-identification than PD. ED and PD had significantly lower levels of mindfulness and self-kindness than PSY. Discussion: Although the three diagnostic groups represented in the present study might benefit from compassion-based interventions our results preliminarily show that tailoring those interventions for specific populations may bring advantages. Other clinical and research implications are discussed. Keywords: Fears of compassion; Self-compassion; Fears of compassion; Personality disorders; Psychosis; Eating disorders

4. Can We Improve Self-Compassion with a Brief Perspective-Taking Intervention?
Primary Topic: Clinical Interventions and Interests
Subtopic: Self-compassion
Lee Hulbert-Williams, Ph.D., University of Chester
Rosina Pendrous, University of Chester

Self-compassion has been linked to general psychological well-being in observational studies. Self-compassion is conceptualised as self-kindness, mindfulness plus a sense of common-humanity, yet little research has been done on any single component. We hypothesised that common-humanity, being able to see suffering as shared, requires perspective-taking. Adopting a Relational Frame Theory analysis of perspective-taking, we devised a brief computerised intervention where participants were asked to identify with another person, or with themselves at another time, having the same self-referential negative thoughts (SRNT) reported by the participant. Undergraduate students (N=35) completed both trait and state self-compassion scales before being randomised to the experimental intervention or control. Participants provided a negative self-referential thought and rated it on state distress, willingness and believability. The perspective-taking intervention asked participants to describe what they would say to comfort someone when imagining, 1) someone close to them, 2) a young child, and 3) themselves as a young child, in each case this person was experiencing something akin to the SRNT provided. Those who completed a brief perspective-taking intervention (N=18) had significantly increased levels of state self-compassion (p=0.009, partial eta-squared= 0.19) and significant reductions in distress (p<0.001, partial eta-squared= 0.34) immediately after, compared to those who completed a memory task (N=17). Interventions based on an RFT analysis of perspective-taking may be useful to increase state self-compassion and reduce distress towards a negative self-referential thought. Whether longer interventions can generalise this behaviour to the status of ‘trait’ remains to be seen.

5. Two Focus Groups Comprised of Veteran Service Users and ACT Trained Practitioners Working Together to Adapt an ACT Group Protocol Specifically for Veterans
Primary Topic: Clinical Interventions and Interests
Subtopic: Veteran, co-production, group
Jennifer Ring, Veterans' First Point Lanarkshire, NHS Lanarkshire
Charlie Allanson-Oddy, Veterans' First Point Lothian, NHS Lothian
Nicola Cogan, Veterans' First Point Lanarkshire, NHS Lanarkshire

Background: Whilst generic mental health services in the UK are available to veterans, there are now specialist services for ex-forces and their families. This study sought to co-produce and adapt a generic ACT group protocol (Tansey & MacLeod, 2016) for veterans with mental health needs accessing a veteran specialist service. Method: Focus groups were conducted based across two specialist service site locations and comprised of veteran service-users and ACT-trained practitioners. Participants in the focus groups were asked to review and evaluate written, verbal, and activity-based material within the ACT group protocol. They were also asked to problem-solve and develop adaptations where necessary. The aim was to ascertain veteran's perceived sense of relevance, credibility and accessibility of the group protocol for them; whilst maintaining fidelity with the ACT model. Focus groups were audio recorded and transcribed in full verbatim and qualitative data was analysed using a thematic approach. Results: Thematic outcomes relating to the unique needs and experiences of veterans enabled meaningful and credible adaptations to be made to the ACT group protocol. Discussion: In co-producing and adapting the ACT group protocol to address the specific mental health needs of veterans accessing a veteran specialist service, it is envisaged that co-facilitation of the group with ACT-trained practitioners and veteran peer support workers will further enhance the relevance, credibility and accessibility of the group for veteran service users.

6. Application of Acceptance and Commitment Therapy in a Lobectomized Patient: Case Report
Primary Topic: Clinical Interventions and Interests
Subtopic: ACT, Traumatic Brain Injury, Neuropsychology, Anxiety
Xavier Montaner Casino, Universitat Autònoma de Barcelona
Mélodie Pulgarín, Universitat Autònoma de Barcelona

Introduction: There is a growing body of evidence around the idea that Acceptance and Commitment Therapy might facilitate adaptation and acceptance of changed functioning and life circumstances following a severe Traumatic Brain Injury. That is the case of people who suffer from pharmacoresistant epilepsy. In this cases, the only therapeutic alternative is surgical resection of the cerebral tissue in which the epileptic focus is found. In the following poster we present a case report of a right temporal lobectomy to which ACT was applied during the neurorehabilitation process. Method: Case Information: A 41 year old woman who underwent surgery due to pharmacoresistant epilepsy. Two years after the right temporal lobe resection , she attended a neuropsychological rehabilitation service due to problems of visual memory, attention concentration, clinical anxiety, and experiential avoidance linked to social situations. Pre and post measures: Complete neuropsychological examination, State and Trait Anxiety Inventory (STAI-T), Acceptance and Action Questionnaire II (AAQ-II), and Fear of negative Evaluation Scale (FNE). Intervention: We did an ACT based intervention during 2 months, 2 sessions per week. The clinical focus was on cognitive impairment acceptance, and we used verbal strategies and external aids in the form of notes to compensate the memory impairment. Results: The response to treatment at two months resulted in a significant improvement of clinical anxiety (STAI-T pre = 42; post = 22 ) and a decrease in social avoidance behaviors (FNE pre = 26; post = 19), which resulted in a better acceptance of cognitive impairment in front of people (AAQ-II pre = 39; post = 17 ). Conclusions: Our case report suggests that Acceptance-Based Therapies may be a prerequisite to cognitive rehabilitation interventions, as they allow patients to accept their deficits and emotions instead of avoid them. This kind of gain can be translated in lower anxiety, that could improve the process of neuropsychological rehabilitation.

7. Testing the Efficacy of a Low Intensity Internet Therapy for Chronic Illness (@LIIT-CI): The Specific Contributes of Mindfulness and Explicit Compassion Practices
Primary Topic: Clinical Interventions and Interests
Subtopic: Chronic Ilness
Inês A. Trindade, CINEICC, University of Coimbra
Sérgio Carvalho, CINEICC, University of Coimbra
Cláudia Ferreira, CINEICC, University of Coimbra
Paula Castilho, CINEICC, University of Coimbra
David Gillanders, The University of Edinburgh
José Pinto-Gouveia, CINEICC, University of Coimbra

Background: There has been an increasing demand for e-health interventions, namely those specifically targeted for chronic health conditions due to the link between chronic illness and decreased quality of life and mental health. The current study thus aims to develop and test the efficacy of an online low-intensity intervention for chronic illness (@LIIT.CI) in a sample of Portuguese college students (aged between 18 and 35) living with a chronic illness. More specifically, the study aims to test the hypothesis that adding a compassion-focused component in a mindfulness intervention significantly improves results in several outcome and process measures. Method: Participants will be selected according to a cut-off value of 5 in a 5-items measure of illness impact. Exclusion criteria (the presence of severe psychopathology) will be assessed by a clinical psychologist using SCID-I and SCID-II. Participants will be randomly assigned into three conditions: 1) a Mindfulness condition (a 2-hour psychoeducation workshop + 4 week mindfulness intervention - Mindful breathing, Body scan, Mindfulness of sounds, Mindfulness of thoughts; 2) @LIIT-CI: a Mindfulness + Compassion condition (a 2-hour psychoeducation workshop + a 4 week mindfulness intervention + compassion-focused intervention - Soothing Rhythm Breathing and Loving Kindness; 3) a control condition (2-hour support group meeting + a 4 week online forum discussion between patients). Results: We expect that the illness impact on quality of life will be lower in participants who had a 4-week mindfulness intervention, as well as lower levels of depression and anxiety symptoms, when compared to the control condition. Additionally, we expect that participants in the @LIIT-CI condition (with an additional 2-week compassion component) will present better results when compared with both the 4-week mindfulness intervention and control condition. Conclusions: We expect that our results will corroborate the hypothesis that adding an explicit compassion-focused component to a mindfulness programme boosts the efficacy of the intervention.

8. The Take ACTION Program: Acceptability of a Behavioural Activation and ACT-Based Group Intervention for Participants Dealing with Chronic Illness
Primary Topic: Clinical Interventions and Interests
Subtopic: Chronic Illness
Catherine Ethier, Psy.D. ( c ), Université du Québec à Trois-Rivières
Marie-Claude Blais, Ph.D., Université du Québec à Trois-Rivières
Pierre Gagnon, M.D., Université Laval
Maïra Filteau, Psy.D. (c), Université du Québec à Trois-Rivières
Frédérick Dionne, Ph.D., Université du Québec à Trois-Rivières

Take ACTION is a manualized intervention based on Behavioral Activation and Acceptance and Commitment Therapy. This program involves five weekly group sessions (and two additional booster sessions at 1-3 months) delivered by two therapists. It has been implemented among participants dealing with chronic illness such as fibromyalgia, back pain, diabetes, multiple sclerosis or a physical disability. Take ACTION aims to help participants reengage in their life by performing committed actions (values-based) while fostering acceptance of painful experiences (emotions, thoughts, and sensations). It targets the negative avoidance cycle that is likely to develop when people experience distressful emotions in the context of stress, life changes and losses, as their coping resources may be overloaded. We piloted the Take ACTION program among 16 participants at the psychology clinic of the Université du Québec à Trois-Rivières over two groups. Preliminary findings on program's acceptability show no attrition throughout the program. 93,75% of participants missed out on only 2 sessions or less, 60% of whom attended every session. While participants seem to be globally satisfied with treatment, data on treatment’s acceptability (satisfaction, treatment modalities and structure, perception of the therapists and exercises and documentation) are still being collected and will be analysed for this poster. These pilot data support Take ACTION as an acceptable brief group-based approach for helping participants dealing with chronic illness.

9. Exploring the Predictive Effects of Social Support and Experiential Avoidance on Psychological Health in Breast Cancer Patients: A Longitudinal Analysis
Primary Topic: Clinical Interventions and Interests
Subtopic: Cancer
Inês A. Trindade, CINEICC, University of Coimbra
Cláudia Ferreira, CINEICC, University of Coimbra
José Pinto-Gouveia, CINEICC, University of Coimbra

Background: Social support has been considered an important factor in physical and mental functioning, especially during stressful situations such as living with an oncologic condition. This study aims to analyse the effects of social support and experiential avoidance, a key maladaptive emotion regulation process to the Acceptance and Commitment Therapy model, in a sample of breast cancer patients. Methods: Twenty-five females diagnosed with breast cancer, with ages between 41 and 85 years, completed validated self-report measures (MSPSS, AAQ-II and WHOQOL-Bref) in two different times, spaced 8 weeks apart. All patients were under Radiotherapy treatment during the study’s recruitment. A hierarchical regression analysis was performed to explore the predictive effects of social support and experiential avoidance on psychological health. Results: Results demonstrated that social support significantly predicted psychological health in the first step of the analysis, with an effect of 0.58 (p = 0.007), explaining 34% of the variance of this outcome. Nevertheless, when experiential avoidance was added to the analysis in the second step, social support became a non-significant predictor (p = 0.114) and experiential avoidance presented a significant effect of -0.74 (p < 0.001) on psychological health. In the final step of the regression analysis experiential avoidance thus became the only significant predictor of the model, which explained 76% of patients’ psychological health. Conclusions: These findings go in line with previous research demonstrating the relevant, determining and detrimental impact of experiential avoidance on mental health. Future research should explore the possible moderator effect of experiential avoidance on the relationship between social support and psychological health with larger oncologic samples.

10. Fears of Compassion in Psychosis: Preliminary Results on Reliability, Validity and Dimensional Structure of the Fears of Compassion Scales
Primary Topic: Clinical Interventions and Interests
Subtopic: Psychosis
Maria João Martins, University of Coimbra
Paula Castilho, University of Coimbra
Joana Gonçalves, University of Coimbra
Diana Carvalho, University of Coimbra
Célia Barreto Carvalho, University of Azores
Ana Telma Pereira, University of Coimbra
António Macedo, University of Coimbra

Background: Fears of compassion (FOC) include experiencing defensive emotions and reactions when receiving or giving compassion: to and from others and self-compassion. The FOC scales were developed to measure the fears of compassion in these compassion flows. This study sought to preliminary study the reliability and validity of the FOC scales in a sample of patients with a diagnosis of psychosis, as well as to preliminarily explore their dimensional structure. Method: The sample of participants with a diagnosis of a psychotic disorder (n=99) was mostly male (76.8%) with a mean age of 33.65 (SD = 8.93) and 10.87 years of education (SD = 3.45). The participants filled in the FOC scales and a subsample filled the self-compassion scale (n=50). Reliability and validity analysis were performed in SPSS software and CFA and EFA with MPLUS software. Results: Adequate internal consistency was found for the three scales (alpha=.84, .90 and .92, respectively) and significant negative associations were found with self-compassion components. The FOC for others unifactorial solution was the only that had adequate fit to the data (RMSEA=0.06, CFI=0.94; TLI=0.92; SRMR=0.07). Exploratory factor analysis on the FOC from others yield an alternative two-factor structure (‘self’ and ‘other’ oriented) with adequate fit (RMSEA=0.07, CFI=0.95; TLI=0.92; SRMR=0.05). CFA on the FOC for self had unacceptable fit. EFA indicated that the unifactorial structure might be the better factor solution although we did not find acceptable fit indices. Discussion: The FOC scales seem to have adequate reliability in psychosis population. The negative associations with self-compassion are indicative of validity although further study is needed. Although the dimensional structure study is still preliminary, it can provide orientation for future research on FOC scales with people with psychotic disorders. Keywords: Fears of compassion; Psychosis; Factor analysis; Reliability; Validity

11. Functioning Better if not Feeling Better: An ACT Intervention for Patients with Early-Onset Dementia
Primary Topic: Clinical Interventions and Interests
Subtopic: Dementia, health
Andrew Carr, Ph.D., VA Greater Los Angeles, UCLA
Mario Mendez, M.D., Ph.D., VA Greater Los Angeles, UCLA

In the United States (US), the CDC (2014) estimates that over 20 million individuals each year have a form of acquired brain injury (e.g. cerebrovascular accident, traumatic brain injury) and over eight million individuals have a dementia syndrome. People affected not only represent a major health issue, but also represent a significant financial burden with charges for hospital visits estimated at around four billion dollars per year in the US, which expected to increase with continued proliferation of cerebrovascular risk factors and aging population (Cooper et al., 2004; Wimo, Winblad, & Jönsson, 2010). These neurodegenerative conditions impact the psychological, social, and occupational functioning of these individuals. Early-onset dementia, dementia occurring prior to age 60, represent a burden to their families as often these individuals are caught between caregiving for aging parents and children (Werner, Stein-Shvachman, & Korczyn, 2009). Furthermore, the behavioral features of these syndromes cause significant distress for both patients and their caregivers(Mendez & Shapira, 2011). Given these patients, also tend to have less insight about their socioemotional state, they struggle to respond to interventions (Carr, S. Samimi, Paholpak, Jimenez, & Mendez, 2016). No intervention to date has been shown to mitigate neurodegeneration completely; additionally, there is a paucity of behavioral interventions studied in this population. The current study examined 30 people with early-onset dementia (10 with early-onset Alzheimer’s disease, 10 with frontotemporal dementia, and 10 with acquired brain injuries of mixed etiology). Participants were selected from consultation services at Huntington Memorial Hospital. This project was under the auspices of the IRB board of the University of California, Los Angeles. Each participant underwent a neuropsychological and neurological evaluation. Pre-intervention and post-intervention, patients and their caregivers completed inventories including: the Beck Anxiety Inventory (BAI; Beck & Steer, 1990) , the Geriatric Depression Scale (GDS; Parmelee & Katz, 1990), the Neuropsychiatric Inventory, (NPI; Cumming et al., 1994), and the Socioemotional Dysfunction Scale (SDS; Barsuglia et al., 2014). Participants were randomly assigned to an ACT-based intervention group or to a supportive counseling control group, such that five participants from each diagnosis were either the intervention or control group. The course of the treatments lasted for two months. Each participant completed three 15-minute sessions per week, of which one occurred in person while the other two visits involved telehealth visits in either voice and video formats. Statistics and graphs were computed using SPSS version 21 software. The intervention and control groups did not differ significantly by age, demographic factor, cognitive status, or neuropsychiatric variable. Comparing treatment groups by anxiety between time points, no significant interaction occurred, p = .125. When measuring across treatment and control groups, there was a slight, but significant reduction in self-reported anxiety over time, ( = .65, F(1, 30) = 7.65, p = .015.) However, there were no differences in self-reported anxiety occurred over time when comparing intervention group to treatment group, p = .35. For self-rated depression (GDS), no interaction or time differences occurred for the groups, p = .59 - .69. However, comparing the treatment groups post-hoc at post-intervention, the ACT group reported more depressive symptoms than the control group, p = .023. However, a different pattern emerged for caregiver ratings of the participant functioning. On caregiver ratings of patient neuropsychiatric function, there was a significant treatment group by time interaction, ( = .66, F(1, 14) p = .018). Specifically, the intervention group was rated to have fewer neuropsychiatric symptoms across time-points across intervention while the control group remained relatively stable. Similarly, when caregivers rated the socioemotional dysfunctional symptoms of the participants, the ACT group reduced problematic socioemotional behaviors compared overtime while the control group remained stable, ( = .71, F(1, 14) = 5.68, p = .032. In conclusion, this study examined an ACT-based intervention in an early onset dementia sample. Whereas early-onset dementia patients, who tend to have less emotional insight, reported no major differences in the mood functioning; from the caregivers’ perspective, there was marked decrease of behavioral disturbances. Although many of them did not “feel better” they may be functioning better overall.

12. Gender Differences in Response to Daily Peer Hassles Among Adolescents: The role of Experiential Avoidance
Primary Topic: Clinical Interventions and Interests
Subtopic: Children/Adolescence
Ana Xavier, University of Coimbra, Portugal
Marina Cunha, Instituto Superior Miguel Torga, Coimbra, Portugal
José Pinto-Gouveia, University of Coimbra, Portugal

Background: Literature reports gender differences in emotion regulation processes throughout developmental phases. Adolescence is a developmental period with increased risk for psychopathology, where emotion dysregulation may play an important role. The current study aims to test the mediating role of rumination, experiential avoidance, dissociation and depressive symptoms in the association between daily peer hassles and non-suicidal self-injury among adolescents. Additionally, this study explored gender differences in these associations. Method: The sample consisted of 776 adolescents, of them 369 are males (47.6%) and 407 are females (52.4%), with ages between 12 and 18 years old from middle and high schools in Portugal. Participants completed self-report questionnaires to measure variables under study. Results: The effect of daily peer hassles on non-suicidal self-injury is mediated by brooding, experiential avoidance, dissociation and depressive symptoms. Male adolescents are more likely to engage in brooding and experiential avoidance in response to daily peer hassles, whereas female adolescents are more likely to engage in non-suicidal self-injury in response to internal distress. Discussion: The adaptive regulation of emotions is critical for psychological well-being, especially in adolescence. The development of adaptive emotion regulation processes, such as acceptance and mindfulness skills, may help adolescents to cope with daily hassles and internal distress.

13. Group Treatment for OCD: Preliminary Evaluation of Treatment Effectiveness and Client Perceptions of Change
Primary Topic: Clinical Interventions and Interests
Subtopic: OCD
Annette Dufresne, Ph.D., University of Windsor
Chantal Boucher, M.A., University of Windsor
Tsubasa Sawashima, M.A., University of Windsor
Simritpal Malhi, M.A., University of

There is growing data on the effectiveness of ACT for Obsessive Compulsive Disorder (e.g., Twohig et al., 2010). There is also evidence supporting the effectiveness of group CBT⁄ERP treatment for OCD (Jonsson & Hougaard, 2009). We examined the effectiveness of a 6-week ACT-based outpatient group treatment program for individuals with OCD symptoms. Additionally, we sought to better understand the process of change from the client’s perspective. Pre- and post-treatment data were gathered from 7 clients participating in the group. Results indicated that 86% of clients showed a decrease in Total OCI (Foa et al., 1998) distress scores from pre- to post-treatment, and for 57% of clients the decrease was sufficient to be a reliable change. Maintenance of gains will be examined at a 3-month follow-up at a group booster session. Clients also completed a modified Helpful and Hindering Aspects of Therapy form (Llewelyn, 1988) after each group session to obtain information on their perceptions of change. Themes that emerged in a qualitative analysis of client feedback data included: acceptance/safety (e.g., feeling acceptance, get to talk openly), sense of community/feeling understood (e.g., feel others understand, feeling part of a community), new realizations (e.g., made me more aware of my issues with avoidance), changing relationship to thoughts/feelings (e.g., my thoughts separate from me, necessity of allowing myself to feel anxious), focus toward values (e.g., realizing what is important), and willingness (e.g., helped me feel more willing to put the practices into effect). The results indicate that ACT-based group treatment is a promising treatment for OCD. Group cohesion and support that are uniquely available in group treatment are suspected to be an important mechanism of change that should be further investigated.

14. Group-Based Acceptance and Commitment Therapy Preceded by an Experimental Attentional Bias Modification Procedure for Residual Symptoms of Depression
Primary Topic: Clinical Interventions and Interests
Subtopic: Depression
Tom Ostergaard, University of Oslo
Tobias Lundgren, Ph.D., Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institute, Stockholm, Sweden
Robert Zettle, professor, Wichita State University
Rune Jonassen, Ph.D., Clinical Neuroscience Research Group, Department of Psychology, Oslo, Norway
Catherine Harmer, professor, Psychopharmacology and Emotional Research Lab (PERL), University Department of Psychiatry, Oxford, UK
Vegard Haaland, Ph.D., Clinical Neuroscience Research Group, Department of Psychology, Oslo, Norway
Nils Inge Landrø, Clinical Neuroscience Research Group, Department of Psychology, Oslo, Norway

Background: This project studies the effect of group based Acceptance and Commitment Therapy (ACT) and Attention Bias Modification (ABM) in secondary prevention of major depression (MDD). ACT is a modern behaviour therapy combining acceptance and mindfulness processes with commitment and behaviour change processes. ACT has shown a treatment effect for MDD and promising results in secondary prevention for other patient groups. The experimental cognitive bias modification (ABM) procedure has been shown to reduce surrogate markers of depression vulnerability in patients in remission from depression. The aim of the current project is to explore if ABM enhances ACT treatment. The study will assess whether ACT in combination with ABM is better than ACT alone in reducing residual symptoms. Thus it combines ideas and science from the field of behavioural psychology and neuropsychology. As such, the approach represents an exciting opportunity for secondary prevention using acceptable, non-drug interventions. Method: The present study has an experimental as well as a quasiexperimental design. Former depressed participants (N=200) will be randomized to ABM or a control-condition without bias modification. All participants recruited at one of the sites (Sørlandet Hospital) will after the ABM/Control-intervention receive an 8-week group based ACT-intervention, no intervention will be given at other sites. The dependent variables are cognitive, neurobiological and emotional markers of vulnerability as well as frequency of major depressive episodes over a 12-month follow up. Results: The study is still ongoing. Approximately 150 persons will have completed the first part of the study (ABM and ACT) by june 2017, and we will be able to present preliminary results at the acbs world conference. Discussion: Treatments in depression are mostly offered in one format, and are seldom combined. If formats are combined they are often closely interrelated theoretically and philosophically. It could be argued that ACT and ABM differ from each other when it comes to theoretical and philosophical paradigms. Paradoxically this may also be why ACT and ABM may work well together. The two treatments target the same mechanism but on different levels cognitively, theoretically and philosophically. The hypothesis is that the two treatments complement each other, and that ABM treatment augments ACT treatment. A positive attentional bias established through ABM is expected to make the subjects more available for the psychological interventions of ACT. ABM could be thought to involve “lower order” cognitive processes, which is implicit attention without apparent language or cultural-based processes involved. ACT, on the other hand, involves “higher-order” cognitive processes where explicit attention is made to language and cultural practices.

15. How Bullying May Influence the Development of Disordered Eating Symptoms in Adolescence: The Mediator Role of Body Image Shame
Primary Topic: Clinical Interventions and Interests
Subtopic: Disordered eating; Adolescence
Cristiana Duarte, Msc., Ph.D. Candidate, Cognitive and Behavioural Centre for Research and Intervention, Faculty of Psychology and Educational Sciences, UC
José Pinto-Gouveia, M.D., Ph.D., Cognitive and Behavioural Centre for Research and Intervention, Faculty of Psychology and Educational Sciences, UC
James Stubbs, Ph.D., Appetite Control and Energy Balance Research Group, School of Psychology, University of Leeds

Cross-sectional studies suggest that body image shame mediates de association between bullying experiences and eating psychopathology in adolescent girls. The current study examined these associations through a prospective design that involved three waves of data collection in a nonclinical sample of adolescent girls assessed over three years. The mediator effect of body image shame on the association between bullying experiences with peers and eating psychopathology was examined through a path analysis. Results revealed that body image shame significantly mediated the relationship between bullying and disordered eating symptomatology. Data suggests that the extent to which experiences of victimization with peers may influence the development of disordered eating symptoms is influenced by how these experiences may become internalized as shame focused on physical appearance. Bullying prevention programmes that target shame and promote compassion and acceptance could decrease adolescents' risk of developing body image issues and disordered eating.

16. Hyperactivity and Emotions Research action with a group of children in a Childhood Adolescent Mental Health Service
Primary Topic: Clinical Interventions and Interests
Subtopic: Children, Mindfulness
Beatrice Milianti, neuropsychiatrist, UFSMIA Lucca
Anna Belmonte, neuropsychiatrist, Ufsmia Lucca
Gini Francesca, psychologist
Annamaria Marongiu, psycotherapist, ufsmia Lucca

The Action Research has been founded as a necessity of the Childhood and Adolescent Mental Health Territorial Service (UFSMIA USL North West Tuscany - Lucca Italy) to meet the growing demand for assessment and support with respect to attention difficulties, ostility and conduct disorder for students from the Primary and Secondary School. It is estimated that in Italy 4% of children fall within the diagnostic criteria with male/female ratio 2:1 (APA 2013). The diagnostic criteria of ICD-10 identifies a more homogeneous sample of children with severe disorder but underestimate the presence of children with significant attention difficulties and hyperactivity which should be properly taken into account. In a 2006 study Lahley et al. have indeed found that only 26% of subjects diagnosed with ADHD according to DSM-IV also met the ICD-10 criteria. The most evident manifestations are hyperactivity, impulsivity and acting out with little capacity to emotional modulation and attention impairment for long times. Before coming to a clear diagnosis, leveraging our experience we have structured a work in phases aimed at supporting a preventive function. The working hypothesis starts from the detection of a low tolerance to frustration on the part of the patient sample combined with hypersensitivity to the analog aspects of the Communication. The work uses an approach aimed at strengthening emotional intelligence which allows a grasp inner emotional signals and ability to communicate them to others. The intervetion want to develope emphatic capacity towards other people translating signals emotional that they can be mimicked in the emotional brain.The exercises activate the prefrontal areas and associative areas involving the circuit between the visual cortex, amygdala and connected areas covered by the neuromotor and visceral system. The working group is composed of 7 children between 7 and 10 years old come to the service for the challenges identified in the school and also in the family. Research Action has been divided into phases. An initial evaluation phase with standardized instrument and projective tests for incoming and outgoing children. A subsequent stage of the intervention divided into: -psychoeducational work with children in small groups every two weeks for 9 sessions lasting 75 minutes - Testing for parents (CBCL) and teachers (cbcl) with subsequent psychoeducational moments The Instruments: The inbound children were tested to check IQ (WISC IV), attentional skills (BIA), tolerance to frustration through a projective test (Rosenzweig), a survey of personality with the use of test C.A.T. The same tests will be repeated in output and after the psychoeducational group work unless the cognitive tests. The structure of the work in small groups is: - Initial phase of socialization through presentation games - Central working phase of individual emotions that would bring the self-narration and experience of mirroring and empathic listening among children - Experience of mindfullness (act for kids) - Final phase with closing feedback and greetings Expected Results: Increased awareness of them-Self and their bodily space through experiential work, improved ability to self-regulation of enactments with greater awareness of emotional experiences, better capability of empathy and development of appropriate social interactions among peers and with adults . As regards of adults better management skills with strategies tailored to meet the needs of children. This work is to be considered a pilot project that will see the continuation of the work of fortnightly meetings for the small group. In perspective it is being evaluated starting a Parent Traning job in small group for parents.

17. Loss of Self as a Cancer Caregiver: Learning from RFT and ACT to Develop More Effective Psychological Interventions to Improve Wellbeing
Primary Topic: Clinical Interventions and Interests
Subtopic: Adult Cancer Caregivers, Self-concept, psychological wellbeing
Jayne Joy, University of Chester
Professor Nick Hulbert-Williams, University of Chester
Dr. Lee Hulbert-Williams, University of Chester
Dr. Brooke Swash, University of Chester

Background: Psychological sequela and vulnerability to increased mortality can manifest when caring for someone with cancer at the end of life. Immersion into an informal caregiving role can be overwhelming and challenging. This may lead a person to experience personal identity loss, or ‘loss of self’ ‑ a concept known to predict poor psychological well-being. Method: A systematic search and narrative review of current literature was performed as a starting point for a developing programme of work. Results: Our review of existing literature highlighted multiple psychosocial interventions that have been tested to improve psychological well-being for cancer caregivers. Nineteen systematic reviews, appraising these different approaches, were sourced from examination of computerised databases and hand searches. Evaluation found the impact of interventions on psychological outcomes to be inconsistent and overall efficacy questionable. To date, no study has tested the usefulness of Acceptance and Commitment Therapy (ACT) in this specific population. Discussion: The development of effective interventions for cancer caregivers is vital. Interventions that target loss of self seem especially suitable. Given the emphasis on concepts of self within the ACT model, this therapeutic approach holds promise. An emerging body of work exploring ACT processes from a Relational Frame Theory (RFT) perspective attempts to offer deeper insight and development of optimally specific intervention components. Extension of this research by studying loss of self for caregivers seems a logical next step. Robust measures and development studies of intervention components for ‘self’ are currently scarce. Therefore, our objectives are to (i) develop a psychometrically sound and clinical useful measure of self-concept, and (ii) to draw on latest RFT science to develop and test specific components for those in this population who are struggling with loss of self.

18. MAC-CBT Group Therapy for Adult Attention Deficit Hyperactivity Disorder
Primary Topic: Clinical Interventions and Interests
Subtopic: Adult ADHD, acceptance, activity, mindfulness, MAC-CBT
Isabelle Kuchler, M.Sc, Neuropsychiatric Center Hamburg Germany
Dr. Peter Tonn, Neuropsychiatric Center Hamburg Germany

Background: Attention deficit hyperactivity disorder (ADHD) symptoms are often assumed to decease in adolescence, however in up to 60% of children, ADHD persist to adulthood. The prevalence estimates for adult ADHD over ten countries in America, Europe and the middle east is assumed to be averaged 3.4%. In many cases adult ADHD leads to mental distress and decrease in quality of life like difficulties finding a job to be successful with, a higher risk to be dismissed from their jobs, difficulties in relationships and more break-ups. Currently pharmacological therapy is the number-one choice ADHD treatment. Despite its evidenced effects of pharmacological interventions there are side effects, contraindications and non-responders which send some patients disliking the use of medication and asking for alternative treatments. In previous studies mindfulness-based interventions already have shown similar effects in neural regions as pharmacological treatment and positive changes in ADHD symptoms, quality of life, awareness and concentration. The following study wants to improve mindfulness-based treatment approaches in ADHD with a new therapy concept. Methods/Design: Mindfulness, acceptance, commitment and cognitive behavioral group therapy (MAC-CBT) combines 3rd wave therapies with focus on mindfulness meditation, acceptance of unchangeability, commitment to new goals with elements of cognitive behavioral therapy. The design of this study is a single-center, parallel-group, randomized superiority trial. MAC-CBT is a newly designed mindfulness-based treatment with CBT-elements for adults with ADHD. Included patients will be allocated randomly to MAC-CBT or to progressive muscle relaxation training (PMR by Jacobson). Data about ADHD symptoms, quality of life, awareness and concentration will be collected on the base of various questionnaires. Participants will be assessed two times before treatment to determine natural course of adult ADHD and two times after treatment to evaluate short and long term effects. Discussion: This trial will offer new knowledge about the effects of third wave therapies on ADHD. Furthermore the following study is one of few studies that will compare ADHD treatment to relaxation training instead of comparison to waiting list. The aim of the following study is to verify previous outcomes of mindfulness-based treatments on ADHD and to evaluate superiority of mindfulness towards relaxation programs.

19. Measuring Psychological Flexibility in Chronic and Acute Pain
Primary Topic: Clinical Interventions and Interests
Subtopic: Chronic Pain
Chiara Vona, Kore University, Enna (Italy)
Valeria Squatrito, Kore University, Enna (Italy)
Giovambattista Presti, Kore University, Enna (Italy)
Paolo Moderato, IULM University, Milan (Italy)

A battle which has no solution is usually undertaken by those who experience chronic in the desperate attempt to reduce or eliminate it. Changes in patient’s lifestyle can give a temporary relief, but in the long term drain his life and lead to a worsening of the general physical and psychological conditions. Psychological flexibility is defined as the ability to act effectively in the light of personal values, even in the presence of thoughts, emotions and body sensations interfering with one’s life. Several studies have related it to the bettering in functioning and quality of life of patients with chronic pain. To test the relation between pain, quality of life and psychological flexibility, two groups of hospitalized patients suffering from either acute (n=75) or chronic (n=100) pain were assessed by the following measures: Acceptance and Action Questionnaire-II (AAQ-II), the Chronic Pain Acceptance Questionnaire-Revised (CPAQ-R), the Valued Living Questionnaire (VLQ), the Hospital Anxiety and Scale (HADS), the Survey on the State of Health (SF-36), the Illness Perception Questionnaire (IPQ), the McGill Pain Questionnaire (MPQ), and the Visual Analogue Scale (VAS) to measure pain intensity at the time of the interview, in the last 24hrs and in the last week. A group of 123 students served as a healthy control group. Measures aimed to investigate the possible relation between psychological flexibility and levels of anxiety and depression, cognitive representations of illness, psychological impact of the disease, intensity of perceived pain. Results shows that there is no statistical difference in the two patients group and in the control group in the level of depression and anxiety symptoms as measured by HADS (total HADS score is 21,30 (3,45) for chronic pain group, 21,16 (3,05) for acute pain group and 22,44 (2,83) for control group). No statistical difference were detected in the CPAQ scores between the two experimental groups, while AAQ-II differed between chronic and acute pain (t (59) = 2.59, p = .012) and also between control group and chronic patients ( t (83) = 3.44, p = .001). A correlation between psychological flexibility (AAQ-II and CPAQ) and health status (SF-36) was found in the two pain groups.

20. Nonverbal Events in Psychotherapy and Impact on Outcome: A Literature Review
Primary Topic: Clinical Interventions and Interests
Subtopic: Nonverbal communication, Emotions
Tien Kuei, MSc, University of Glasgow

This poster presents a literature review of studies on Nonverbal events in psychotherapy and relation to clinical or process outcomes. 22 studies were isolated in the review. Design and methodology issues of measuring nonverbal behaviors will be illustrated, as well as results that impact on outcome which can inform clinical practice.

21. Outcomes of a Brief ACT Intervention Among University Students with Borderline Personality Disorder Symptoms
Primary Topic: Clinical Interventions and Interests
Subtopic: Borderline Personality Disorder
Martine Coulombe, M.Sc., Ph.D.(c), Université du Québec à Trois-Rivières
Chantal Thibodeau, M.Sc., Centre d'aide aux étudiants, Université Laval
Frédérick Dionne, Ph.D., Université du Québec à Trois-Rivières

Background: Borderline personality disorder (BPD) affects 1-2% of the general population, mostly women (75%) and half of cases begin between age of 18 and 25. Approximately 75% of these people will engage in self-harm behaviors, 50% will make suicidal attempts and 5% of them will ultimately die from suicide (CSMC, 2015). BPD is characterized by instability in relationships, identity and affects (APA, 2013). Research on ACT and BPD is relatively new but recent studies linked ACT processes, like experiential avoidance and lack of psychological flexibility, to the emotional dysregulation inherent to BPD. (Buckholdt et al., 2015, Gratz et al., 2012; Hill et al., 2012). Method: This pre-experimental design research evaluates the effectiveness of a brief ACT intervention among 82 university students (Mean age = 25) with BPD or traits (92% women) on ACT processes like experiential avoidance (AAQ2), cognitive fusion (CFQ28, MBSI) and mindfulness (MAAS), and different aspects of functioning related to BPD like impulsivity (BIS-10), problem-solving (QAP) and beliefs (PBQ). Data were collected from 2013 and 2016 at Laval University, Quebec City. Results: Repeated measured analysis yielded significant results across all variables. Effects sizes ranged from small to moderate. Discussion: Despite some limitations mostly due to the pre-experimental design, the results demonstrate the importance to pursue further study on ACT with BPD. Findings are discussed in terms of future developments.

22. Psychometric Properties of the Avoidance and Fusion Questionnaire for Youth (AFQ-Y) in Colombia
Primary Topic: Clinical Interventions and Interests
Subtopic: Assessment
Daniela Salazar-Torres, Fundación Universitaria Konrad Lorenz
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz
Cindy L. Flórez, Fundación Universitaria Konrad Lorenz

The aim of this study is to describe and analyze the content validity and psychometric properties of the Avoidance and Fusion Questionnaire for Youth (AFQ-Y; Greco, Lambert, & Baer, 2008) in children between 9-13 years old in Colombia. The AFQ-Y was administered to approximately 800 students from third to eighth grade who attended private and public schools in the Cundinamarca Department of Colombia. The results showed that the AFQ-Y had a good internal consistency, with Cronbach’s alpha of .89. The instrument showed a two-factor solution: experiential avoidance and cognitive fusion. The AFQ-Y showed theoretically coherent correlations with other constructs such as emotional symptoms, pathological worry, negative repetitive thinking, and generalized pliance. In conclusion, the AFQ-Y shows good psychometric properties in Colombia.

23. Psychometric Properties of the Generalized Pliance Questionnaire: Children in Colombia
Primary Topic: Clinical Interventions and Interests
Subtopic: Asesssment
Daniela Salazar-Torres, Fundación Universitaria Konrad Lorenz
Cindy L. Flórez, Fundación Universitaria Konrad Lorenz
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz

The GPQ is a measure of generalized pliance for adults that has shown excellent psychometric properties and a one-factor solution. In this study, we aim to analyze a modified version of the GPQ for children that is called the Generalized Pliance Questionnaire for Children (GPQ-C) in Colombian. Approximately 800 children between 9 and 13 years old responded to the GPQ-C and other measures questionnaire. The children attended private and public schools in the Cundinamarca Department of Colombia. The results showed that the CPQ-C had a good internal consistency, with Cronbach’s alpha of .86 and a one-factor structure. The CPQ-C showed theoretically coherent correlations with other constructs such as emotional symptoms, pathological worry, negative repetitive thinking, and cognitive fusion. In conclusion, the CPQ-C shows good psychometric properties in Colombia.

24. The Effectiveness of Acceptance and Commitment Therapy (ACT) in Improving Stress and Wellbeing for Employees in a Hospital Setting
Primary Topic: Clinical Interventions and Interests
Subtopic: Stress and General Wellbeing
Josh Hope-Bell, UWE Bristol
Dr. Olivia Donnelly, North Bristol Trust NHS
Dr. Nic Hooper, UWE Bristol
Fabio Zuchelli, UWE Bristol
Lois Coy

Stress and poor general wellbeing in the workplace is an issue affecting many in the UK. The healthcare sector is particularly prone to high levels of stress and low levels of wellbeing among its employees because of the “high pressure” nature of the work, staff cuts and staff shortages. Consequently, various interventions have been developed to help healthcare staff better manage stress. One such intervention, which has been heavily evaluated in the workplace context but not so much with hospital staff, is Acceptance and Commitment Therapy (ACT). This talk will describe a piece of recently conducted research that aimed to evaluate the effectiveness of the 2+1 ACT model. Results, which indicated positive outcomes, will be discussed in terms of how to improve research of this kind in future studies.

25. The Effectiveness of an Art-Based ACT Group Therapy Program with Young Adolescents
Primary Topic: Clinical Interventions and Interests
Subtopic: Early Adolescence
Aja Meyer, Ph.D., Johns Hopkins All Children's Hospital
Heather Agazzi, Ph.D., ABPP, University of South Florida

Background: Acceptance and Commitment Therapy (ACT) has become more widely used with children and adolescents in recent years. Unfortunately, the research on ACT has not kept pace with its popularity in practice and therefore, few empirical studies on the efficacy of this intervention for youth exist. Of the available literature, research findings indicate that ACT can be beneficial for adolescents with OCD (Armstrong, 2013; Yardley, 2012), depression (Hayes, Boyd, & Swell, 2011), anorexia (Heffner et al., 2002), externalizing behavior (Bencuya, 2013), chronic pain (Gauntlett-Gilbert et al., 2013; Ghomian and Shairi, 2014), and PTSD (Woidneck et al., 2014). Many studies have resulted in positive outcomes, such as increased acceptance and defusion (Swain, Hancock, Dixon, Koo, & Bowman, 2013) and decreased depressive symptoms (Livheim, Hayes, Ghaderi et al., 2015). While studies indicated that ACT results in improvements in symptomatology and quality of life outcomes, very few studies have included measures to specifically assess changes in the core components of ACT including cognitive defusion, values and committed action. Clinicians have discussed the need for adaptations to ACT to meet the biopsychosocial developmental needs of children and adolescents. Some recommended adaptations include: increased behavioral activation, age-appropriate examples, personalized goals, and the inclusion of peers. Additionally, there is a dearth of evidence for ACT among children under 12 years of age and in ACT treatment delivered in group formats. As such, we seek to extend the emerging evidence for ACT with young adolescents aged 10-12 years in a group setting. Method: Five to seven young adolescents, ages 10-12 years, with diagnoses of an anxiety disorder will participate in an 8-week group therapy program entitled Acceptance and Commitment Therapy: Experiential Adolescent Group Program (Louise Hayes and Julie Rowse, 2008). The program aims to utilize experiential art media, such as paint and clay, to help facilitate understanding of ACT concepts. Through artwork, it is hoped that adolescents are better able to explore their own experiences without getting caught up in language processes. Confirmatory research will be used to test the hypotheses surrounding expected improvements in awareness and acceptance of internal processes (assessed with the Child Acceptance and Mindfulness Measure [CAMM]) as well as improvements in psychological flexibility, decreases in cognitive fusion and experiential avoidance (as measured by the Avoidance and Fusion Questionnaire for Youth [AFQ-Y8]), and decreases in anxiety symptoms (assessed with the Multidimensional Anxiety Scale for Children, 2nd edition [MASC 2]). All measures will be administered pre- and post- treatment. Results: Potential Results. Over the course of the study, it is expected that young adolescents who participate in the ACT group therapy program will self-report increases in self-awareness, and acceptance without judgment (as measured by the CAMM). We also expect to observe decreases in cognitive fusion and experiential avoidance with an increase in psychological flexibility (as measured by the AFQ-Y8) and decreases in anxiety symptoms (as measured by the MASC 2). Discussion: In summary, we hypothesize that the ACT group therapy program is likely to be an effective, time-limited group treatment for young adolescents that will increase psychological flexibility, improve mindfulness skills, and decrease cognitive fusion and experiential avoidance.

26. The Effects of an ACT Group Therapy Program for Adolescents in an Outpatient Psychiatry Setting
Primary Topic: Clinical Interventions and Interests
Subtopic: ACT wtih teens
Pascale St-Amand, Ph.D., CISSS Chaudière-Appalaches
Isabelle Rose, Ph.D., CISSS Chaudière-Appalaches
Maude Lafond, Université du Québec à Trois-Rivières
Joel Gagnon, Ph.D. (c), Université du Québec à Trois-Rivières
Frederick Dionne, Ph.D., Université du Québec à Trois-Rivières

Background: The demand for services in child and adolescent psychiatry are growing. In this context, it is important to develop and evaluate brief, effective, and well-adapted interventions for adolescents. To date, cognitive and behavioral therapy (CBT) remains the most empirically supported form of psychotherapy for teenagers. However, one in four teenagers would not respond to this type of intervention (Bluett et al., 2014). In recent years, Acceptance and Commitment Therapy (ACT) has attracted the attention of researchers and clinicians in the field (Ciarrochi, Hayes, & Baily, 2012; Turrell & Bell, 2016). To our knowledge, there are more than 15 clinical studies on ACT with adolescents. Despite encouraging results on psychological flexibility processes and symptoms (e.g. anxiety and depression), further studies are needed to better understand the impact of these interventions in clinical settings (Swain, Hancock, Dixonn, & Bowman, 2015). Method: The purpose of this pre-experimental study is to evaluate the effects of a six-session intervention program based on the self-help Get out of your mind and into your life for teens (Ciarrochi et al., 2012). The sample is comprised of 24 teenagers between the ages of 14 and 17 years (71% girls) who attended an outpatient child psychiatry clinic in Quebec (Canada). Results: Mean comparisons analyses revealed that, in line with our hypothesis, the intervention was associated with a reduction in anxiety and depressive symptoms, as well as improvements in psychological flexibility processes. Discussion: Findings are discussed in terms of future developments to enhance the quality and the efficacy of the intervention.

27. Effectiveness of an Interdisciplinary (ACT + PT) Outpatient Program on Functional Capacity for People with Chronic Low Back Pain
Primary Topic: Clinical Interventions and Interests
Subtopic: Chronic back pain
Heather Poupore-King, Ph.D., Stanford Pain Management Center
Corinne Cooley, DPT, OCS, Stanford Pain Management Center

Background: Self-efficacy, distress, and fear are primary mediators of disability for people suffering with chronic low back pain (CLBP) (Lee, 2015). Chronic low back pain is a high health care cost, leading cause of disability and interferes with patient’s quality of life, as well as a reason to seek medical/health care treatment. Though evidence shows intensive interdisplinary care (5x/week) that includes Acceptance and Commitment Therapy (ACT) can improve chronic pain acceptance in patients with chronic pain, reduce depressive symptoms, reduce pain -related anxiety, and physical disability at both at 3 months post treatment and up to 3 years (Vowel, 2011) there is less research that demonstrated effects in an outpatient, less intensive interdisciplinary intervention. In various health care systems, intensive inpatient interdisciplinary interventions are not available to a patient with chronic low back pain despite the patients continued report of high levels of disability and high use of medical treatment costs. This study includes an outpatient interdisciplinary approach with pain psychology intervention (ACT) and physical therapy interventions (PNE, therapeutic exercise, group exercise) delivered for 4 hours each session 2x/week for 6 weeks for a total of 48 hours of interdisciplinary treatment aimed at reducing distress and pain-related fear of movement, reducing disability and improving participation in patient-chosen valued activities. Methods: Our pilot program included 6 participants, with chronic low back pain with a mean age of ___ and average time of back pain as ___ years. Intervention included: 2 hours of pain psychology, 2 hours of physical therapy for each session, 2 sessions for 6 weeks, for a total of 48 hours of intervention at an outpatient -based pain management center. The pain psychology interventions included 1 hour of ACT, 30 minutes of meditation techniques/ mindfulness, and 30 minutes of values based goal setting. The physical therapist had attended 2 ACT workshops and discussed with the pain psychologist content for each session, and how to incorporate recently learned concepts in the gym / exercise portions of the intervention. Results: The Roland Morris Disability Questionnaire (RMDQ) initial (pre intervention) mean score was 14.5 and reduced to 5.8 post intervention and greater than the MCID of 7 for the RMDQ, or from 60% disabled to 24% disabled, which is clinically significant. The Chronic pain acceptance score (CPAQ) initial mean score was 50. 8 and increased to 73.3, which are similar changes seen in the intensive inpatient study (Vowels, 2011). Discussion: A 6 week outpatient interdisciplinary program (ACT +PT) reduces disability and improve chronic pain acceptance at pre-and post-intervention in patients with chronic low back pain.

28. Turkish Version of Valued Living Questionnaire (VLQ): Preliminary Analysis of Reliability and Validity in Non-Clinical Sample
Primary Topic: Clinical Interventions and Interests
Subtopic: VLQ nonclinical sample
M. Emrah Karadere, Hitit University, School of Medicine, Department of Psychiatry, Corum, Turkey
Hasan Turan Karatepe, Medeniyet University, School of Medicine, Department of Psychiatry, Istanbul, Turkey
Kaasım Fatih Yavuz, Bakirkoy Mazhar Osman Mental Health and Neurological Diseases Education and Research Hospital, Bakırkoy, Istanbul, Turkey
Sevinc Ulusoy, Bakirkoy Mazhar Osman Mental Health and Neurological Diseases Education and Research Hospital, Bakırkoy, Istanbul, Turkey
Alparslan Cansız, Siverek State Hospital, Urfa, Turkey
Murat Aktepe, Arnavutkoy State Hospital, Istanbul, Turkey

Turkish Version of Valued Living Questionnaire (VLQ): Preliminary Analysis of Reliability and Validity in Non-clinical Sample Background: Valued Living Questionnaire (VLQ) is a self-evaluating scale that has been developed to measure the extent to which an individual contacts his/her chosen values, an important construct in Acceptance and Commitment Therapy. The aim of this study was to examine validity and reliability of the Turkish version of “Valued Living Questionnaire (VLQ). Method: The sample consisted of 210 healthy volunteers including hospital employees and their relatives who had no psychiatric complaints between the ages of eighteen to sixty five. After translation, back-translation and pilot assessment of Turkish version of VLQ (TVLQ) completed; socio-demographic data form, Acceptance and Action Questionnaire-II (AAQ-II) and TVLQ were administered to participants. For reliability analysis of TVLQ Cronbach’s alpha coefficient and item-dimension total score correlations were used. We also used principal component analysis for factor analysis and Pearson correlation analysis for convergent validity. Results: The mean age of participants was 35,93±10,77 years (age range: 18-65 years) and 60.5% (n=127) were female. Statistically significant results supported TVLQ’s reliability. Inter-item consistency was adequate for both ‘importance’, ‘consistency’ and composite subscales (TVLQ-importance: Cronbach α= 0,793; TVLQ-consistency: Cronbach α= 0,883; TVLQ-composite: Cronbach α= 0,879). Also all items were positively correlated with each other. Principal factor analysis performed and it was detected that one dimension explained 48,87% of the total variance. Factor loading were changing between 0,58 and 0,83. Composite score were negatively correlated with AAQ-II (r= -0,195; p<0,01). Conclusion: The results of this study show that TVLQ is a reliable and valid scale for the assessment of valued living in non-clinical population.

29. Embodying the Compassionate Self: How Does Practice Quality Impact the Effectiveness of a Compassion Training Program?
Primary Topic: Clinical Interventions and Interests
Subtopic: Compassion
Marcela Matos, Ph.D., University of Coimbra - CINEICC (Cognitive and Behavioural Centre for Research and Intervention), Portugal
Cristiana Duarte, Ph.D., University of Coimbra - CINEICC (Cognitive and Behavioural Centre for Research and Intervention), Portugal
Joana Duarte, Ph.D., University of Coimbra - CINEICC (Cognitive and Behavioural Centre for Research and Intervention), Portugal
José Pinto-Gouveia, Ph.D., M.D., University of Coimbra - CINEICC (Cognitive and Behavioural Centre for Research and Intervention), Portugal
Paul Gilbert, Ph.D., OBE, Centre for Compassion Research and Training, University of Derby, College of Health and Social Care Research Centre, Derby

Research has demonstrated that compassion mind training (CMT) is effective on the promotion of well-being, however the impact of the quality of the practice remains to be explored. A recent study of the effect of a two-week compassionate mind training intervention on well-being, also investigated participants’ qualitative and subjective experiences of the practices. This paper will explore how participants who completed a brief CMT program (n=77) experienced the compassion practices, and the impact of the quality of these experiences on the effectiveness of the intervention and the development of the compassionate self. Results reveal that it is not so much the frequency of the practice, but the usefulness of the concept of compassion and the embodiment of the compassionate self in everyday life and moments of difficulty that are associated with increases in compassion for the self, for others and from others, reassured self, positive affect and compassionate goals, and decreases in self-criticism, fears of compassion and stress.

30. The Psychological and Physiological Impact of a Brief Compassion Training Intervention: An Exploration of Processes of Change in Positive Affect
Primary Topic: Clinical Interventions and Interests
Subtopic: Compassion
Marcela Matos, Ph.D., University of Coimbra - CINEICC (Cognitive and Behavioural Centre for Research and Intervention), Portugal
Joana Duarte, Ph.D., University of Coimbra - CINEICC (Cognitive and Behavioural Centre for Research and Intervention), Portugal
Cristiana Duarte, Ph.D., University of Coimbra - CINEICC (Cognitive and Behavioural Centre for Research and Intervention), Portugal
José Pinto-Gouveia, Ph.D., M.D., University of Coimbra - CINEICC (Cognitive and Behavioural Centre for Research and Intervention), Portugal
Nicola Petrocchi, Ph.D., John Cabot University, Rome, Italy
Paul Gilbert, Ph.D., OBE, Centre for Compassion Research and Training, University of Derby, College of Health and Social Care Research Centre, Derby

This study explores the impact of a two-week Compassionate Mind Training (CMT) intervention on emotional, self-evaluative and psychopathology measures and on heart-rate variability (HRV), and explores processes of change in positive affect. Participants (general population and college students) were randomly assigned to one of two conditions: CMT (n=56) and Wait-List Control (n=37). At post-intervention the experimental group significantly increased compassion for the self and openness to the compassion from others, safe and relaxed positive affect, and HRV; and showed reductions in shame, self-criticism and fears of compassion. Mediation analyses revealed that changes in positive affect (safe and relaxed) were mediated by increases in compassion for the self and openness to the compassion from others, and by decreases in fears of compassion. Improvements in HRV mediated the impact of the CMT intervention on relaxed affect.

31. But What Exactly Are Values? A brief discussion about the concept and utility of values in the clinical setting
Primary Topic: Clinical Interventions and Interests
Subtopic: Values
Aline Simões, Universidade Federal da Bahia
Tiago Ferreira, Ph.D., Universidade Federal da Bahia
Bruno Oliveira, Private Practise
Amanda Raña, Universidade de São Paulo

The context of psychotherapy involves ethical, theoretical and technical matters regarding practical limits and possibilities. Two of such relate to the definition of goals to clinical practice and therapist’s limitations when formulating and executing such objectives. Given the central role that the concept of “values” seem to have in these matters in current behavioral therapeutic models, this paper intends to analyze and discuss perspectives regarding this concept as brought by authors such as Skinner, Leigland, Plumb, Wilson and Harris in order to propose a definition, using low-level terms, that can generate basic and applied research without losing its relevance to the clinical setting. We propose that values are stable and diverse qualities of behavior that have acquired reinforcing function by being described by the individual or his community. Further utility of such a definition involves its precision and focus on aspects that are under direct influence of the patient.

32. Testing a Brief ACT-Based Intervention for Potent Suicide Risk-Factors: A Lab-Based Analogue Study
Primary Topic: Clinical Interventions and Interests
Subtopic: Burdensomeness, Suicide, Brief intervention
Kevin Hochard, Ph.D., University of Chester
Sam Ashcroft, BSc, University of Chester
Lee Hulbert-Williams, Ph.D., University of Chester

The Integrated Motivational Volitional (IMV) model of suicidal behaviour (O’Connor, 2011) outlines several predictive factors for suicide. Social support and belongingness are protective factors, while defeat and entrapment exacerbate suicidality. Accordingly, these factors are key intervention targets. Murrell et al. (2014) suggest Acceptance and Commitment Therapy may be beneficial for suicide prevention and Collins et al. (2016) provide supporting evidence for the mitigating effect of mindfulness on low belonging. This experimental analogue study compares brief manualized ACT-consistent, CBT-consistent, or placebo interventions. Following the intervention, participants were exposed to Cyberball, an online game designed to induce feelings of social ostracism. Physiological and psychometric measures of stress were obtained, in addition to behavioural measures of willingness to re-engage with the aversive task. We discuss the implication of these results on future ACT-based suicide prevention interventions.

33. Acceptance and Commitment Therapy for Weight Control
Primary Topic: Clinical Interventions and Interests
Subtopic: Obesity, weight control
Maria Christina Geraldini Ferreira, Ph.D.Candidate, Pontificia Universidade Catolica de Goias
Sonia Maria Mello Neves, Ph.D., Pontificia Universidade Catolica de Goias

Research conducted to verify the efficacy of Acceptance and Commitment Therapy (ACT) for eating-related problems, such as high concern about weight, body image dissatisfaction, obesity, subclinical eating pathology and eating disorders, has shown promising results. We selected six studies that applied ACT to people with higher than normal Body Mass Index (MBI) to identify their procedures, measures, obtained results and follow-up. These studies used in their interventions a protocol based on the book by Hayes, Strosahl and Wilson (1999). The six studies used scales and questionnaires as a measure for efficacy of results and process of change; four of which used the Acceptance and Action Questionnaire for Weight (AAQ-W); one used the Body Image-Acceptance and Action Questionnaire (BI-AAQ); three used MBI; two used the Self-Monitoring of problematic eating; one used the Self-Monitoring of hunger and satiety; and five conducted three-month follow-up. Evidence from all the studies supported ACT as an effective instrument for change.

34. Psychological Flexibility Affecting Psychological Well-Being: A Study on Italian Youths
Primary Topic: Clinical Interventions and Interests
Subtopic: Adolescents, psychological flexibility, measures
Emanuele Rossi, Psy.D., Associazione Psicologia Cognitiva (APC) - SPC - Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Erika Melchiorri, Psy.D., Associazione Psicologia Cognitiva (APC) - SPC - Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Alessia Panzera, Psy.D., Associazione Psicologia Cognitiva (APC) - SPC - Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)

This poster presents an exploratory study on Italian adolescents concerning the existence of a direct correlation between psychological inflexibility and psychological distress and, as a consequence, the existence of a direct correlation between psychological flexibility and psychological well-being. The outcomes presented here emerge from two wide validation studies on a total sample of 1315 Italian adolescents. About 17 measures assessed psychological flexibility and inflexibility (with a particular focus on mindfulness facets, such as acceptance, presence, awareness), psychological distress (anxiety, depression, somatization, dissociation, perceived stress), psychological well-being and quality of life. The scores obtained were submitted to a correlation analysis in order to explore the relationship existing between the ACT core processes and psychological well-being. The implications of the study reveal themselves to be crucial to both researchers and clinicians.

35. A Research Update on Italian Clinical Instruments Usable for Measuring Psychological Flexibility and Inflexibility During the Adolescence
Primary Topic: Clinical Interventions and Interests
Subtopic: Adolescents, psychological flexibility, measures
Emanuele Rossi, Psy.D., Associazione Psicologia Cognitiva (APC) - SPC - Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Erika Melchiorri, Psy.D., Associazione Psicologia Cognitiva (APC) - SPC - Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)
Alessia Panzera, Psy.D., Associazione Psicologia Cognitiva (APC) - SPC - Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)

This poster illustrates in short the last research update on three clinical instruments available in Italy in order to measure psychological flexibility and inflexibility in the developmental age. The key focus of this poster is on three self-report instruments: (1) Child and Adolescents Mindfulness Measure (CAMM), measuring mindfulness and acceptance; (2) Avoidance and Fusion Questionnaire for Youth (AFQ-Y), assessing fusion and experiential avoidance resuming the theoretical foundations of Acceptance and Commitment Therapy; (3) Mindful Attention Awareness Scale for Adolescents (MAAS-A), measuring mindfulness as a "receptive state of attention and awareness of the present experience". Using these tools in clinical practice has led to very promising implications. However, it is necessary to deepen the study of psychological flexibility on Italian children and adolescents broadening the range of the evaluation tools.

36. “Unfolding the Values of Work” A Qualitative Study on How Therapists in an Occupational Rehabilitation Program Based on Acceptance and Commitment Therapy (ACT) Experience That They Attend to Their Participants´ Return-To-Work Process
Primary Topic: Clinical Interventions and Interests
Subtopic: Return-to-work rehabilitation
Nina Elisabeth Klevanger, M.A., Ph.D. candidate, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
Marius Steiro Fimland, Ph.D., Researcher, NTNU - Norwegian University of Science and Technology, Trondheim, Norway & Hysnes Rehabilitation Center, St. Olav’s U. Hospital
Professor Roar Johnsen, NTNU - Norwegian University of Science and Technology, Trondheim, Norway
Marit By Rise, NTNU - Norwegian University of Science and Technology, Trondheim, Norway

Objectives: Musculoskeletal pain, common mental disorders and other unspecific disorders are responsible for a large part of the sick-leave in the western world, and comorbidity is very common. We are therefore currently investigating a generic group-based occupational rehabilitation program which included patients with these disorders in the same therapy group. The program was multidisciplinary, consisting of physical training, work-related problem solving and psychological therapy. The prevailing therapy approach was Acceptance and Commitment Therapy (ACT), a third wave behavioural and cognitive therapy intended to increase psychological flexibility by using acceptance and mindfulness processes, and commitment and behaviour change processes. Few studies have examined ACT when used in rehabilitation intended to support return-to-work, and no studies have so far investigated therapists’ experience with providing occupational rehabilitation programs based on ACT. The aim of this study was therefore to explore how therapists experience that they attend to their participants´ return-to-work process in an occupational rehabilitation program based on Acceptance and Commitment Therapy (ACT). Methods: This was a qualitative interview study supported by participant observation. The therapists were interviewed regarding their experiences of working with occupational rehabilitation based on ACT, and how they attended to the return-to-work process of their participants. In addition, the rehabilitation program was investigated through participant observation, focusing on how supporting return-to-work was attended to during the program. The interviews were analysed according to Interpretive Phenomenological Analysis (IPA), and informed by the analysis of field notes from the participant observation. Results: The results of this study show that the therapists had a twofold goal for the rehabilitation program; to help participants build a meaningful life, and engage in sustainable work participation. We identified five processes of change that the therapists used in order to help participants to move towards these goals; 1) enabling the participants´ ownership to their rehabilitation process, 2) identifying the complex causes of sick leave, 3) changing how the participant related to own and others´ expectations, 4) unfolding the personal values of work, and 5) exploring the scope of the participants´ agency. The therapists described that the changes they sought to facilitate were long-term processes that exceeded the timeframe of the rehabilitation program, and that they could only help instigate them and enable the participants to uphold them long-term. Conclusion: The results from this study implicate that therapists experience that it is feasible to use ACT as an approach in return-to-work rehabilitation, but that the approach presents restrictions on how the topic of return-to-work may be attended to throughout the program.

37. Eye Tracking Patterns of an Autistic Child Before and After a Multiple-Exemplar Training to Follow the Direction of the Adult Gaze
Primary Topic: Educational settings
Subtopic: Autism
Carolina Coury Silveira, MS, Universidade Federal de São Carlos (UFSCar)
João Henrique de Almeida, Ph.D., Universidade Federal de São Carlos (UFSCar)
Andréia Schmidt, Universidade de São Paulo (USP)
Sérgio Fukusima, Universidade de São Paulo (USP)
Camila Domeniconi, Universidade Federal de São Carlos (UFSCar)

The use of eyetracker to identify unusual looking tracking patterns in individuals with autism has traditionally been used for diagnostic purposes. Research employing the eyetracker to investigate changes in this pattern throughout a learning process has not yet been documented. The objective of the present study was to examine changes in the gaze orientation of an autistic child (Max) during a joint attention teaching, in which the participant should follow the gaze of a sample (profile face aimed at an object at your left or right). For this, Max should point or name to which comparison (of animal, fruit or vehicle) the sample was looking after given the instruction "what is he seeing? ". A multiple-exemplar training with differential reinforcement was performed, gradually increasing the number of comparisons around the face that was positioned in the center of the computer screen. Max presented 0% of correct answers at the baseline and after completing the MET (14 sessions), responded 87.5% correct in the post-test. The results of the eye-tracking equipment indicated differences in the number of records for each of the stimuli in the post-test compared to the pre-test. The Mann Whitney test indicated statistically significant decreases in the mean records of gaze for the comparison stimuli that appeared above the model (p <0.05) and for the sample (p <0.01). In addition, it indicated a statistically significant increase in the mean records for the correct comparison stimuli (p <0.05). The tendency to decrease the ocular fixations to the distractor stimuli and the sample were contingent on the increase of the observations to the correct comparison stimuli. It was possible to verify the change in the stimulus control of the participant´s gaze following, after changes in the contingencies of reinforcement of the joint attention. Even more important, the results highlight the importance of S + for establishing an adequate gaze tracking pattern. Keywords: eye-tracking; autism; Joint attention; multiple exemplar training.

38. RFT Based Educational Interventions in the Context of the Italian National Health System
Primary Topic: Educational settings
Subtopic: Language and Learning Disorders
Melissa Scagnelli, Istituto Europeo per lo Studio del Comportamento Umano (IESCUM)
Concetta Messsina, University Kore of Enna
Martina Leuzzi, University Kore of Enna
Francesca Brasca, Fondazione IRCCS Cà Granda – Ospedale Maggiore Policlinico
Antonella Costantino, Fondazione IRCCS Cà Granda – Ospedale Maggiore Policlinico
Giovambattista Presti, University Kore of Enna
Paolo Moderato, IESCUM, Istituto Europeo per lo Studio del Comportamento Umano, Libera Università di Lingue e Comunicazione IULM

This work is based on a collaboration between IESCUM and UONPIA Foundation IRCCS Cà Granda Hospital - Ospedale Maggiore Policlinico, over 4 months focused on brief interventions in 11 children, aged between 3 and 11 years, with language and learning disorders (mostly dyslexia).Training based on Relational Frame Theory aimed to teach categorization and reading-writing skills (for schoolage children).Training is based on frame of coordination.Children were taught two relationships, AB and BC respectively, and tested a series of derived relational responses choosing C in the presence of A and viceversa. In the reading protocol by sillabic words in upper-case letters formed stimuli in class A, picture of those words were stimuli class B, and words in lower-case letter were class C stimuli. In the categorization training a vocal stimulus “Give me X” was the class A stimuli, where X is the name of the category, and class B and C stimuli were formed by three different instances each of the X category. Derived relations tested responses to “Tell me the names of all the X you know” and “Y is an…”, where Y is the name of a member of the category X. Over a limited number (7) of training sessions RFT based training was effective in promoting the extension of lexical repertoire, the development of categorization in language impaired kids, and amelioration of reading skills in dyslexic kids. Standardized testing demonstrated beneficial effects in language skills beyond the category offered. In dyslexic children improvements in speed and accuracy scores emerged.

39. Can a Specialist Physical Education Program, Incorporating Mindfulness Based Activities, Have a Positive Impact on Children’s Body Acceptance? Findings from the Australian Lifestyle of our Kids (LOOK) Longitudinal Study
Primary Topic: Educational settings
Subtopic: Mindfulness, body acceptance
Lisa Olive, Ph.D., Deakin University
Rohan Telford, University of Canberra

Background: In clinical and research contexts, mindfulness as a specific type of meditation practice has been described as a “non-elaborative, non-judgemental awareness” of present-moment experience. Preliminary research in young adults has shown that mindfulness is associated with acceptance of one’s body and identity, however, less research has examined these relationships in younger populations. This study investigates the effects of specialist-lead physical education (S-PE) program, which incorporates mindfulness based activities, on children’s body acceptance during the course of primary (elementary) school. Method: Data from the Lifestyle of our Kids (LOOK) longitudinal study involving 736 initially grade 2 children (370 boys M age = 8.18; 366 girls M age = 8.13) from 29 primary schools were analysed. Schools were randomly allocated to intervention (13 schools) or control groups (16 schools). Intervention groups received 90 min/week of S-PE from visiting specialists as part of, and not in addition to the recommended 150 min/week of PE set out by the Australian Government. On average, 20-to-25% of class time was allocated to mindfulness based activities. Control groups received all of their 150 min/week of PE from classroom teachers, with no specific mindfulness content. Approximately 86% of the children had one or both parents of Caucasian descent, 8% of Asian descent, 3% Australian Aboriginal or Torres Strait Islander or 1% Polynesian, and we had no data on 2% of the families. Participants completed assessments of Appearance Beliefs in Children Scale (ABC-S), a measure of body acceptance and satisfaction, in grade 2 prior to the commencement of the intervention and again in grade 3 after receiving approximately one year of the intervention. Measures of percent body fat (DEXA), puberty (Tanner scale) and physical activity (pedometers) were also assessed as potential confounds. Results: Children receiving S-PE reported greater improvements in overall body acceptance (p = 0.042) and on the appearance satisfaction subscale (p = 0.028) compared to children of the control group. There was some evidence of similar trends toward improvements in self-perceptions acceptance subscale (p = 0.050) and perceptions by others subscale (p = 0.087) and less evidence for acceptance of physical attributes subscale (p = 0.116). Discussion: Physical education (PE) programs utilising specialist PE teachers, which incorporate mindfulness based activities, may improve body acceptance and satisfaction among children beyond that which is achieved through ‘usual practice’ PE delivered by classroom teachers. The improvements reported here stemmed from the existing time allocated to PE in schools. No additional time was added for PE meaning there was no disruption to the existing school curriculum. Our findings provide support for the use of mindfulness practices in PE as a means for improving body acceptance in children, which can reach almost all children.

40. The Portuguese Version of the Teacher Acceptance and Action Questionnaire: Preliminary Data
Primary Topic: Educational settings
Subtopic: Assessment
Ana Galhardo, Ph.D., Instituto Superior Miguel Torga; CINEICC-Faculty of Psychology and Educational Sciences of the University of Coimbra
Bruna Cravalho, Intituto Superior Miguel Torga
Marina Cunha, Ph.D., Instituto Superior Miguel Torga; CINEICC-Faculty of Psychology and Educational Sciences of the University of Coimbra

Background: Experiential avoidance (EA) can be defined as a process that occurs when people are unwilling to remain in contact with particular private experiences (e.g., bodily sensations, emotions, thoughts) and it has been pointed as being related to psychopathological symptoms. The development of self-report instruments for the assessment of EA has deserved the attention of researchers and specific versions of the Acceptance and Action Questionnaire (AAQ-II) are now available targeting different populations. The Teacher Acceptance and Action Questionnaire (TAAQ) is one of these specific instruments. The current study sought out to explore the factor structure and psychometric properties of the Portuguese version of the TAAQ. Method: A total of 255 teachers (213 women and 42 men) took part in the study. An email containing the aims and inclusion criteria as well as a link to an online platform was sent to several teachers associations. Informed consent was mandatory and participants completed a set of self-report measures including a sociodemographic and professional questionnaire, the Teacher Acceptance and Action Questionnaire, the Depression, Anxiety and Stress Scales, and the Five Facet Mindfulness Questionnaire. Results: Principal component analysis extracted a single component explaining 56.93% of the variance. Component loadings ranged from .-43 to .86; communalities ranged from .19 to .74. The Cronbach’s alpha estimate of internal consistency was .87, the item-total correlations ranged from -.25 to .87. Correlations with the other measures were as expected, suggesting its convergent and discriminant validity. Discussion: The Portuguese version of the TAAQ demonstrated a single component structure easy to interpret, high internal consistency, convergent and discriminant validity. The TAAQ appears to be a reliable and valid measure of EA in teachers. This can be an easy to use self-report instrument for the assessment of EA considering that teachers are a professional group particularly exposed to psychological problems (e.g., depression, burnout, substance use).

41. About the Development of ACT-Program for Implementing ACT on the Web
Primary Topic: Evolution
Subtopic: Vocational Rehabilitation
Fumiki Haneda, Vocational Counselor, Startline Co.Ltd

On the Startline Co., Ltd., we are consulting on employment of persons with disabilities and managing satellite offices with support for persons with disabilities. At our company, ACT is carried out in the initial training for disabled people who are working in satellite office and trained for improvement of employability to persons with disabilities using employment transition support agencies. There are also many people who have mentally handicapped persons and people with developmental disabilities who are enrolled in the satellite office, incorporating ACT exercises into their daily occupational life and practicing it. On the other hand, in the practice of ACT, it is important to know how to feed back on awareness and doubt of each person, at what timing and how to combine various exercises, There is need for consideration on effective practice methods. Also, considering that not only our company but also the place of practice with various rehabilitation will expand, we will provide stable exercise and contents, support practical daily exercise, collect behavioral information in everyday situations and management efficiency improvement will be a major issue. Features of this software developed this time are as follows. ● You can practice ACT exercises on the Web using PCs, smartphones, tablet terminals, etc. ● You can record and reference your own practice results, and you can send it to a supporter by e-mail etc. ● You can periodically record behavioral data such as actions committed to value. ● You can add new exercises at any time. ● You can register exercises on the Web, such as using sentences, sounds, and videos. ● Supporters adjust the exercises that individual users can implement according to individual needs, and the functions of management, such as providing it from time to time, are also substantial. In this presentation I would like to introduce these features, examples of utilization, possibility of future application.

42. Effects of a Mindfulness-Based Stress Reduction-Sport Performance Program (MBSR-SP) in Athletes Self-Compassion and Flow
Primary Topic: Performance-enhancing interventions
Subtopic: Mindfulness-based intervention on sports
Bruno Carraça, FMH-University of Lisbon
Sidonio Serpa, FMH-University of Lisbon
Joan Palmi, INEFC-Lleida University
Catia Magalhães, Polytechnic Institute- ESEV

Background: The field of sports psychology is now utilizing mindfulness, compassion, and acceptance-based strategies because it appears to support the development of a broad range of essential capacities including regulation of attention, motivation, arousal, cognitive functions related to perception and motor control, self-compassion, recovery, social connectedness, and leadership (Moore, 2009; Aherne et al., 2011; Birrer et al., 2013; Mosewich, Crocker, Kowalski, & Delongis, 2013; Deci & Ryan, 2000; Monshat et al., 2013). Objectives: The aim of these two studies was to evaluate the effectiveness of the Sport Performance- Mindfulness Based Stress Reduction Program (MBSR-SP) program, an 8-week MBSR-SP designed to train elite athletes to be more self-compassionate, awareness and improve dispositional flow. Methods: elite soccer players (n= 28) were assigned to an eight-week mindfulness intervention (MBSR, Kabat-Zinn, 2003), or a wait-list control condition (n=29). The participants completed pre-post test measures of mindfulness, flow, self-compassion, experiential avoidance, psychopathology symptoms, and sport-related rumination attributions. The instruments used are well-know and reliability and were conducted analyses of covariance. Results: Analyses showed significant positive effects on the mindfulness intervention group compared with the waitlist control group, namely intervention participants reported significantly larger increases in self-compassion (f= 6.122; p= .0017), mindfulness (f=12.811; p= .001), and flow (f= 7.765; p= .007). Discussion: Results suggest that the MBSR-SP program appears to be effective at facilitating dispositional flow, as well at enhancing self-compassion, mindfulness on elite soccer athletes. Keywords: self-compassion; mindfulness; flow; elite athletes

43. Training program based on ACT & Mindfulness to improve well-being and performance in kickboxing fighters
Primary Topic: Performance-enhancing interventions
Subtopic: ACT-Mindfulness and sport performance
Adrián Muñoz, University of Malaga
J.J Macías, University of Malaga
Frank Bond, Goldsmiths, University of London

One of the purposes and challenges of science is to improve the quality of life of people. For years, strategies have been implemented in other fields, such as sports, with promising results.The aim of the present study was to examine the effectiveness of a training program based on Acceptance and Commitment Therapy (ACT) and Mindfulness, to improve well-being and performance in kick-boxing fighters. The sample consisted of 10 participants, randomly assigned in two conditions: control (n=5) and experimental (n=5). Competitive anxiety levels were assessed using the Competitive Anxiety Scale (SAS-2); The degree of acceptance through the Acceptance and Action Questionnaire (AAQ-II); Mindfulness through the Mindful Attention Awareness (MAAS) scale, before and after training. The analysis of the data showed an improvement in all the variables analyzed in the experimental group, compared to the control group, being statistically significant for: acceptance (p = .026) and mindfulness (p = .049); but no statistically significant for SAS-2. In conclusion, we consider the benefits of applying an intervention based on ACT and Mindfulness to enhance sports performance.

44. CheerApp: Mobile Application Based on ACT
Primary Topic: Performance-enhancing interventions
Subtopic: Technology, mobile ACT
Giovambattista Presti, University of Enna"Kore"
Valentina Costanza, University of Enna"Kore"
Alberto Catania, University of Enna"Kore"
Davide Cutaia, University of Enna"Kore"
Melina Di Blasi, University of Enna"Kore"
Francesca Mongelli, University of Enna"Kore"
Paolo Moderato, Istituto Europeo per lo Studio del Comportamento Umano (IESCUM)

With the advent of smartphones and wereable devices many health applications have been created for the psychological and physical well-being; they are able to follow individual at any time and often the opportunity of extending the area of action of a psychotherapist outside the traditional therapeutic setting. About 30% of applications provides a sort of knowledge about the disorders and many of them are self-help type. "CheerApp" is an application for mobile devices, which has been prototyped, based on the Acceptance and the Commitment Therapy. The App has two interfaces: one for the psychotherapist in which patients are recordered, assign exercises and assessment scales, notify text messages; the other app is for patients to allow them to perform ACT-Based exercises assigned by the therapist. 'CheerApp', was born from the union of the two terms "to cheer up" and "App" which stands for "application.". The app aims to provide new ways to manage ACT therapy compared to more traditional therapeutic setting. Thanks to the simple and intuitive interface it makes the therapeutic exercises possible, improving the consistency to ACT daily treatment. Future research will show if effective in various psychopathological conditions.

45. Assessment of Cognitive Fusion among Portuguese Samples: Psychometric Properties and Factor Structure of the Cognitive Fusion Questionnaire
Primary Topic: Performance-enhancing interventions
Subtopic: Assessment measure of cognitive fusion
José Pinto-Gouveia, M.D., Ph.D., CINEICC, University of Coimbra, Portugal
Alexandra Dinis, Ph.D., CINEICC, University of Coimbra, Portugal
Sónia Gregório, Ph.D., CINEICC, University of Coimbra, Portugal
Ana Pinto, MSc., CINEICC, University of Coimbra, Portugal
Cristiana Duarte, MSc., Ph.D. Candidate, CINEICC, University of Coimbra Portugal

Background: Acceptance and Commitment Therapy (ACT) conceptualizes human suffering as a result of psychological inflexibility. Within ACT's model of psychopathology cognitive fusion, broadly defined as the entanglement with thoughts, is a key psychological process. Attending to the importance of measuring fundamental psychological processes within clinical and research settings, and given the need of adapting existent measures for non-English speakers, this cross-sectional study addresses three aims: (1) to explore the underlying factor structure of the Portuguese Cognitive Fusion Questionnaire (CFQ); (2) to test the measurement invariance of its latent structure across three different Portuguese samples; and (3) to evaluate the psychometric characteristics of this particular measure of cognitive fusion. Method: A total of 800 subjects from the Portuguese general population completed the CFQ and a subsample of 408 participants completed additional measures of mindfulness, metacognitions, decentering, psychopathological symptoms, and life satisfaction. Statistical analysis included Confirmatory Factor Analysis (CFA), Multigroup Confirmatory Factor Analysis (MCFA), and tests of reliability and convergent validities. Results: The CFAs conducted separately for the three samples supported the hypothesized unidimensional factor structure for the Portuguese CFQ, with all models tested showing an adequate model fit. The Multigroup CFA confirmed the invariance of the measurement model across the three samples, giving additional evidence for the existence of a general factor of cognitive fusion underlying the scale. Additionally, CFQ showed a good internal consistency among the samples under study (Cronbach’s Alpha coefficients >.70). At last, results from product-moment Pearson correlations between cognitive fusion and other variables (mindfulness, decentering, metacognitions, psychopathological symptoms and life satisfaction) attested for the convergent validity of CFQ. Discussion: This study corroborates prior research and supports the validity and reliability of CFQ as a suitable measure to assess cognitive fusion. Results are also favorable to the use of the Portuguese version of CFQ for research purposes. Future research should focus on the psychometric exploration of this measure within clinical groups.

46. The Development of a Mobile Health Care Application for Spinal Cord Injury Patients Using Acceptance and Commitment Therapy (ACT)
Primary Topic: Performance-enhancing interventions
Subtopic: Spinal Cord Injury
Julion Marrinan, M.A., William James College

Background: In 2015, the National Spinal Cord Injury Statistical Center stated that “the number of people in the U.S. who are alive [in 2014] who have a spinal cord injury (SCI) has been estimated to be approximately 276,000 persons.” However, this does not account for the lack of literature and research surrounding psychological interventions for those living with spinal cord injuries. Spinal cord injuries can be debilitating; those affected may find normal tasks of daily living to be challenging. The intersection of health care and mobile technology has recently found itself to be in high demand. An electronic mobile application that delivers mental health interventions through mobile devices such as cell phones and tablets may benefit the spinal cord injury population in a new way. Given the prevalence of those affected by injuries to the spine in the United States, it would be meaningful to examine the various ways in which the field of psychology might begin to address this population’s mental health concerns. Not only would it be important to develop psychological interventions for SCI patients living in the United States; it would be meaningful to expand this initiative worldwide. One can imagine how transportation and access to outpatient mental health care can be challenging for individuals who are either wheel chair bound or bed ridden as a result of an SCI. Seeing how many SCI patients struggle with mobility issues, a mobile application that delivers an evidence based psychological treatment may be better suited for reaching the population than solely utilizing office visits alone. Method: The purpose of this project is to develop a mobile healthcare application for the SCI population that utilizes an evidence based psychological intervention- specifically, acceptance and commitment therapy (ACT). This section will highlight the procedures for developing the application. The development of the proposed application is informed by the Mobile Application Rating Scale (MARS) - these include ratings of engagement, functionality, aesthetics, information quality, and subjective quality (Stoyanov et al., 2015). In addition to these criteria, the expert review process, revision of an existing prototype, and the procedures for finalizing the prototype will all be discussed. Procedures for Development: The researcher will create interactive worksheets for each core process of ACT with the guidance of existing ACT and CBT treatment manuals/resources. The worksheets will be tailored specifically to meet the physical and psychological needs of SCI patients. The author will then present the drafted content to a software engineer for development. Additionally, the professional input of five expert reviewers will be sought in order to hone the application and produce a version that is ready for circulation. This feedback will inform the researcher, doctoral committee, and software engineer in drafting the final version of the software. The application’s content will be based on the recommendations set by the MARS; engagement, functionality, aesthetics, information quality, and subjective quality. Engagement: To ensure that the user will find use of the application compelling, the following will be required for inclusion of any content or design feature: a. Does the application possess entertaining elements? b. Can it address individual psychological concerns? c. Will the user be engaged by the content? d. Can the content be customized to meet the needs of SCI patients? e. Does it directly address the specific issues of the SCI population? Functionality: It is imperative for the proposed application to function and deliver the core content with minimal interference or obstacles. The following will be required for inclusion of any content or design feature: a. Application will perform as designed with no systematic or software errors. b. Application will require minimal effort from the user to navigate content effectively. c. Interface design will clearly indicate the features of application for the user to navigate. Aesthetics: An argument can be made for the importance of a mobile application’s visual appeal and draw to the consumer/user. Although the researcher generally agrees with this viewpoint, the content, information, and delivered interventions certainly surpass this concern. The following will be required for inclusion of any content or design feature: a. Is the application aesthetically pleasing? b. Does the layout of the application cater to the physical limitations of SCI patients? c. Is the content and layout of the application visual appealing? d. Do graphics and visual learning aids capture the attention of users? Information Quality: The content will be drawn from the literature review of this study as well as treatment manuals and other mhealth apps in the area of intervention using an ACT or CBT approach. The following will be required for inclusion of any content or design feature: a. Does the information address the core processes of ACT? b. Does the information apply to the purpose of the application? c. Information is neither excessive nor deficient b. Has research demonstrated the effectiveness of this information? c. Is the content appropriate for interactive therapeutic exercises? d. Can the information/exercise be delivered on a mobile device? Subjective Quality: Using the MARS guidelines, an effort will be made to create an application that leaves users satisfied and captivated by its usage. The researcher will develop the mobile application while remaining cognizant of the following criteria: a. Is the application worthy of recommending to others? b. Is the application stimulating enough to prompt repeated use? c. Would a consumer pay for such an application? If so, how much? d. What is the overall star rating of the application? Expert Review of Prototype: The completed prototype will be reviewed by five professionals hailing from the fields of psychology, health care and software engineering. A broad range of viewpoints based on varied experiences associated with healthcare applications was sought in order to identify issues in content and design. The criteria for the selection of these experts are as follows: Expert One- Licensed clinical psychologist with prior experience in the development of software applications. Experts Two and Three- Neuroexercise specialists with bachelor degrees in exercise science who possess at least two years of work experience as neuroexercise specialists at a rehabilitation facility. Expert Four- Clinical psychologist employed by the Department of Veteran Affairs and currently practicing on a rehabilitation unit at a VA hospital. Expert Five – Software engineer currently employed as an application developer Each will be solicited by the researcher via phone or email. Each will be provided with a summary of the study and expectations for their participation. Those agreeing to participate will read and sign an informed consent addressing their rights and responsibilities as research participants. Each reviewer will be asked to provide feedback in each of the MARS categories: engagement, functionality, aesthetics, information quality, subjective quality. Additionally, reviewers will be prompted to comment on the application’s efforts to safeguard the protected health information of potential users. Revision of Prototype: Gained feedback data will be discussed with the researcher’s doctoral committee and a consensus decision will be made regarding modifications to the application. Elected modifications will be incorporated into the final coding of the application which will then be ready for clinical testing. Results: It was determined that a mobile health care application for spinal cord injury patients was able to be constructed in accordance with the MARS system. The researcher was able to create interactive worksheets for all of the core processes of ACT. The core processes of ACT and psychological flexibility were defined as terms in a separate area of the application for users to access as a glossary. In addition to these features, a news feed containing the latest science and medical news pertaining to SCI was created. The application also possesses the capability for users to communicate with their outpatient mental health provider; however, a user must request access from their provider prior to using this particular feature. This allows providers to determine whether a given patient is appropriate to correspond with them through the application’s messaging system. Discussion: The researcher recommends testing the application with the spinal cord injury population in clinical settings such as hospitals, rehabilitation centers, and neuroexercise gymnasiums in order to obtain data regarding the application’s therapeutic effects. Additionally, the researcher believes that multiple treatment modules must be created prior to launching the full version of the application, as a single course of treatment would expire rather quickly and may leave users un-stimulated and dissatisfied with application’s ability to assist them in achieving treatment goals.Therefore, it would be meaningful for the researcher to market the application as a “fee for content” application. This business practice is similar to the tactics that are employed by popular mobile game and self-help application developers. This would allow the researcher to be reimbursed for creating additional treatment modules as opposed to consumers purchasing the application once.

47. Body Image-Related Psychological Inflexibility: A Moderator of the Impact of Body Image Discrepancy in Weight Concern and Control Behaviours
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Body Image
Cláudia Ferreira, CINEICC, University of Coimbra
Joana Marta-Simões, CINEICC, University of Coimbra
Inês A. Trindade, CINEICC, University of Coimbra

Body image-related psychological inflexibility defines as the incapability of fully contacting feelings, thoughts, and beliefs about one’s body appearance in the present moment, which motivates the engagement in maladaptive strategies to alter their form, frequency and intensity. As a non-adaptive strategy, body image-related psychological inflexibility often results in the overvaluation of such feelings and thoughts, and may lead to unhealthy body-controlling strategies (e.g., dieting). The present study aimed at analyzing the moderator role of body image-related psychological inflexibility in the association of the perception of discrepancy between one’s actual and idealized body appearance with body weight concerns and with the intention of engaging in dieting behaviours. Participants in this study were 782 Portuguese young female adults. Results revealed that body image-related psychological inflexibility appeared as a moderator of both the relationships of body appearance-related perceived discrepancy with weight concerns and with dietary intentions. Specifically, for the same levels of body appearance-related discrepancy, women who were more inflexible towards body image-related internal events revealed higher concerns about their weight and more marked intentions to engage in dieting practices. Overall, the present analyses seem to suggest that body image-related psychological inflexibility exacerbates the impact of perceiving a discrepancy between one’s actual and desired body image in the intensity of weight concerns and in the intention to engage in a diet. These results underline the pertinence of targeting body image inflexibility in intervention programs for the promotion of a balanced and healthy relationship with body image in females.

48. Building Pro-Social Communities in Sierra Leone
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Pro-Social, Global Mental Health
Edmond Brandon, commit & act
Tien Kuei, commit & act

commit and act centre in Sierra Leone practices Prosocial and ACT in our meetings, trainings and workshops to change behavior. We have helped people to create rich, full and meaningful lives, whilst accepting that life inevitably brings pain. we use ACT mindfulness exercises to help handle painful thoughts and feelings, and the matrix teaches communities to take valued directions towards the goals that really matter. In the recent fight against Ebola, we trained teachers that have gone into the communities to help to break the chain of transmission of Ebola in the Bo district with cultural-specific behavioral changes. The Poster presents case examples from Gender-based violence, ACT training for health workers and the various pro-social groups run by the centre.

49. Acceptance and Commitment Training for Employees’ Wellbeing: Results From a Randomized Controlled Trial
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Well-being at work, ACT intervention, burnout, work-related stress
Laurence De Mondehare, Université du Québec à Montréal
Simon Grégoire, Université du Québec à Montréal
Laurence Morin, Université du Québec à Montréal
Cloé Fortin, Université du Québec à Montréal
Lysa-Marie Hontoy, Université de Montréal

Background: The healthcare sector is a stressful work environment where more professionals suffer from mental health problems (Michie et Williams, 2003; Walsh et Walsh, 2001). The prevalence of depression among nurses is 9% while it varies between 4 and 7% within the general population (Shields et Wilkins, 2006). In 2005, nearly one-fifth of nurses reported that their mental health condition had impaired their ability to perform their job normally (Shields et Wilkins, 2006). These problems have individual and organizational consequences. In addition to decreasing the quality of life of professionals and the quality of care provided, they contribute to increase absenteeism, turnover rate, workplace accidents and medical errors (“Association paritaire pour la santé et la sécurité du travail du secteur affaires sociales”, 2009). Recently, interventions have been offered within workplaces to help employees develop different abilities related to mindfulness. These interventions include Acceptance and Commitment Therapy (ACT) (Hayes, Strosahl, & Wilson, 2012), which aims increase wellbeing by helping people develop their psychological flexibility, namely the ability to be in contact with the present moment and to engage in actions consistent with their personal values rather than automatic and maladaptive actions. Studies on ACT interventions offered at work show that they seem to help reduce symptoms of stress, anxiety, depression and burnout and improve satisfaction and psychological flexibility (ex.: Flaxman, Bond et Livheim, 2013). However, very few studies have been conducted with healthcare professionals. Moreover, the contribution of the different ACT processes is still unknown. The objective of this project is to evaluate the effectiveness of an ACT-based intervention designed to help healthcare professionals cope with work-related stress and better understand the impact of the different ACT processes. Twenty-three healthcare professionals from two different public organizations in Canada participated in this project. The intervention consists of four 2-hour workshops and was based on six core components: acceptance, defusion, contact with the present moment, values, committed actions and self-as-context. Method: A randomized controlled trial was used to assess changes in psychological wellbeing, psychological distress, and psychological flexibility over the course of the intervention. Data were collected with self-report questionnaires among 23 employees both before and after the intervention. Results: Analysis of variance showed that compared to a wait-list control group, employees who took part in the workshops reported more psychological wellbeing and less distress. They also reported greater psychological flexibility: they were more mindful, engaged in valued actions and less prone to fuse with their difficult thoughts. Zero-order correlations based on gain scores suggested that changes in psychological wellbeing and distress were associated with changes in psychological flexibility. A qualitative evaluation of the employee’s experience was also done through focus groups at the end of the intervention. Employees explained that they had found many ways to integrate what they had learned during the workshops into their everyday life, at home and at work. They also mentioned that it was beneficial to have the opportunity to take a pause at work to take care of their wellbeing, clarify their values and take concrete actions to live a more engaged and meaningful life. They said that the interventions had helped them connect more easily to present moment experiences which allowed them to be more focused and present with the people they interact with. Discussion: This study contributes to the field of organizational psychology and behavioral-contextual science by introducing a novel ACT-based group intervention specifically designed for healthcare professionals and assessing its impact on psychological flexibility and wellbeing.

50. The Effect of Psychological Flexibility on Implicit and Explicit Stigma Toward Mental Illness
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Stigma
Natsumi Tsuda, Graduate school of Doshisha University
Takashi Muto, Ph.D., Doshisha University

Background: The purpose of this study is to figure out the difference of stigma toward mental illness between high and low psychological flexibility groups. Method: Psychological flexibility was measured by the Japanese Version of the Acceptance and Action Questionnaire-II (AAQ-II), 7-item version. Eighteen undergraduate students in the High AAQ-II score group and nine in the Low AAQ-II score group were included in this study. Implicit stigma toward mental illness was measured with the Implicit Association test (IAT). Explicit stigma was measured with the Japanese version of the Link stigma questionnaire. Procedure: Participants came to the experimental room and answered the IAT and the Link stigma questionnaire. The order of measures was counterbalanced. Results: (1) There was no significant difference of stigma between High and Low AAQ-II groups (IAT: t(25) = −0.178, n.s., Link stigma questionnaire: t(25) = −0.378, n.s.). (2) There was no relation between IAT and Link stigma questionnaire scores (r = .11, n.s.) Discussion: In this research, there was no difference of stigma toward mental illness between high and low psychological flexibility groups. There were some needs to compare the change of implicit stigma between pre- and post-intervention.

51. Effectiveness of Psychoeducation Applications Using Acceptance and Commitment Therapy on Reducing Test Anxiety in High School Students
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Test Anxiety
Engin Büyüköksüz Ph.D. Student, Okan University
Raşit Avcı, Muğla Sıtkı Koçman University

The purpose of this experimental study is to observe the effectiveness of Psychoeducation Applications using Acceptance and Commitment Therapy on reducing test anxiety in high school students. From İstanbul-Maltepe Uğur Temel High School, with 7 students in Experimental Group (6 Female, 1 Male), and 10 students in Control Group (4 Female, 6 Male), a total of 17 students with high scores on exam stress inventory has participated in the research. The scale includes 20 statements, and has two sub-dimensions; delusion and perception. In this study, Experimental and Control Group’s pretest and posttest randomized experimental design has been used. Group applications using Acceptance and Commitment Therapy has been applied to the Experimental Group once a week, for 75 minutes for the duration of 6 weeks. The scale has been applied twice, once before the sessions and once at the last session. Analysis of covariance has been used to analyze the data. According to the data analysis, the interference in the experimental group has been successful in reducing the exam anxiety of the participants (F=6,967, p<.05). The end results of the research have proved that the acceptance and commitment therapy is effective in reducing the test anxiety.

52. RFT Training to Teach Complex Skills: A Direction to IIIrd aba Generation Training
Primary Topic: Relational Frame Theory
Subtopic: Autism
Giovambattista Presti, Department of Human and Social Science, Kore University
Maria Josè Sireci, Department of Human and Social Science, Kore University
Paolo Moderato, Istituto Europeo per lo Studio del Comportamento Umano (IESCUM)

Relational Frame Theory (RFT) is a powerful account of human language and cognition, developed in the past decade on the basis of research from Hayes and Barnes-Holmens. According to RFT, such complex human behaviors can be conceptualized as a through an examination of derived relational responding, the ability of respond to relations between stimuli (Hayes, Barnes-Holmes e Roche, 2001). In recent years research has implemented more and more RFT based training to teach language and other abilities to children with autism in order to make learning faster and more efficient and increase novel behavior. From an RFT’s perspective language is a complex behavior that can be explained like the ability to respond to derived relations: humans can respond appropriately to the relationship between stimuli in the absence of a history of learning. Is the frame that elicit a variety of studies applied to study and implement advanced skills in language, cognition and academic tasks. From this point of research we had build different training, designed for children with autism and other developmental disabilities, based on RFT and addressed to build complex abilities like reading, writing and counting. We present some different training RFT based and new datas from children with different type of disabilities, from learning impairement to epylepsia.

53. Face-Off: Does Religious Context Alter the Way We “Read” Faces?
Primary Topic: Relational Frame Theory
Subtopic: Implicit Relational Association Procedure (IRAP)
Valeria Squatrito, University of Enna "Kore"
Giovambattista Presti, University of Enna "Kore"
Annalisa Oppo, Sigmund Freud University (SFU)
Paolo Moderato, Istituto Europeo per lo Studio del Comportamento Umano (IESCUM)

Prejudice (as a verbal operant class) is the result of processes of derivation and transformation of stimulus function. Using the Implicit Association Test (IAT) various studies have demonstrated that people with western race and white skin show a relatively strong racial stereotype (Dasgupta, McGhee and Greenwald, 2000; Greenwald et al., 2002; Monteith, Voils and Ashburn-Nardo, 2001; Livingston, 2002; Ottaway, Hayden and Oakes, 2001). The present study aims to empirically test the validity of an implicit model of analysis of facial recognition of positive and negative emotions (specifically joy and fear) in the context of the symbols of the Christian and Islamic religion using Implicit Relational Association Procedure (IRAP). Specifically, our hypothesis was that religious symbols could alter the derivation of joy or fear. The subjects participated in the study are homogeneous with respect to socio-demographic characteristics. Assessed with self-report questionnaries empathy, values, authoritarianism, the degree of bias for inequality between social groups. In our population study subjects indipendently relate joy and fear to religious symbols Higher levels of fusions (CFQ; r=.536; p=.015), lower levels of psychological flexibility (AAQ-II, r=-.473; p=.035) and higher levels in right-wing authoritharism (RWA; r=.562; p=.045) were related to high speed in relating “joy to cross”. The subjects were more quick to associate the expression of joy to the Christian symbol than the expressions of joy and fear with the Islamic symbol; they also associated faster the expression of fear with the Christian symbol than this expression with the Islamic ones. Data show that the model seems fitted to explore how emotions are related to religious symbols.

54. Implicitly Measuring the Context of Healthy Food Choices
Primary Topic: Relational Frame Theory
Subtopic: Functional Nutrition, Implicit Relational Assessment Procedure (IRAP)
Andrea Modica, University of Enna “Kore”
Valeria Squatrito, University of Enna “Kore”
Annalisa Oppo, Sigmund Freud University (SFU)
Giovambattista Presti, University of Enna “Kore”
Paolo Moderato, Istituto Europeo per lo Studio del Comportamento Umano (IESCUM)

Decision making can be conceptualized as responding to stimuli based on the relationship between elements which have been learned by the individual; choice can be a consequence of the short and immediate relational responses of the individual, or of more elaborated and extended relational responses. Modern Nutrition Science has gone beyond the classical concepts of nutrient deficiency and basic nutrition adequacy, focusing on the concept of “positive” or “optimal” nutrition. Research is now focused on the identification of those biologically active food components which are able to reduce the risk of contracting diseases and possibly capable of optimizing physical and mental health. The aim of this pilot study was to analyze the relationships between implicit and explicit behavior in relation to food choice. Fifty subjects, mostly students from Kore University of Enna, underwent the Implicit Relational Assessment Procedure task. The subjects were put in front of a combination of stimuli relating to the potential purchase of affordable food or functional food. They were requested to choose a functional food in the context of price or food quality. Research show that both criteria were equal evaluated by subjects, however food quality appeared to be the primary criterion of choice compared to food price.

55. Examining Differences in Gender-STEM Bias Between STEM and Non-STEM Students
Primary Topic: Relational Frame Theory
Subtopic: IRAP
Lynn Farrell, University College Dublin
Louise McHugh, University College Dublin

Background: Only 28% of science researchers worldwide are women. Research has identified implicit gender-bias as a major barrier to women’s progression in Science, Technology, Engineering and Maths (STEM). Therefore, in order to understand this bias fully we must examine it implicitly as well as explicitly. Much of the research in this area has relied upon self-report measures or relative measures of implicit bias such as the Implicit Association Test (IAT). Previous IAT research suggests that individuals studying/working in STEM fields exhibit different levels of implicit male-STEM bias than those in non-STEM fields. The Implicit Relational Assessment Procedure (IRAP) utilised in this study allowed a non-relative examination of gender-STEM bias among STEM and non-STEM students to probe this difference further. Method: STEM and non-STEM male and female university students (N = 61) completed an IAT, an IRAP and a rating scale measuring gender-STEM bias. Results: The IRAP revealed a more complex picture of gender-STEM bias. All groups demonstrated a significant implicit pro-male-STEM bias however there was also evidence directionally of a pro-female-STEM bias. This pro-female-STEM bias only reached significance among female STEM students. Correlations were observed between the explicit and implicit measures, particularly the IRAP. Discussion: This study allowed a deeper examination of gender-STEM bias among STEM and non-STEM students. The presence of a pro-female-STEM bias (though weak for most groups) has implications for the development of interventions. If this relational response can be made more normative it may influence attitudes and behaviour towards women in STEM.

56. Examining the Malleability of Gender-STEM Bias Among Adults
Primary Topic: Relational Frame Theory
Subtopic: IRAP
Lynn Farrell, University College Dublin
Louise McHugh, University College Dublin

Background: Women constitute <25% of STEM workforce in Ireland (Accenture, 2014), while worldwide only 28% of science researchers are women (UNESCO, 2015). Gender equality would enhance economic growth and opportunities for women (Global Gender Gap Report, 2015; Gatta & Trigg, 2001). The greatest barrier for women in STEM is systematic gender-bias that is often implicit (National Academy of Sciences, 2006). Implicit bias lacks the awareness, intention or control of explicit responses (Hughes, Barnes-Holmes & Vahey, 2012) and can predict behaviour better than explicit attitudes, particularly with socially sensitive domains. Thus it is important to understand the nature of this bias and intervene against it. The aim is to reduce gender-STEM bias by strengthening the relationship between women and STEM. Method: Participants are assigned to one of four intervention conditions: (i) perspective-taking of a female scientist, (ii) exposure to counter-stereotypical exemplars, (iii) psychoeducation regarding implicit gender-STEM bias or (iv) control group. Gender-STEM bias is then assessed implicitly using the Implicit Relational Assessment Procedure (IRAP) and explicitly using rating scales. Participants return one day later and their bias is assessed implicitly and explicitly again without re-exposure to their specific intervention condition. Results: Statistical analysis will determine (i) If gender-STEM bias is influenced by a relevant bias intervention? (ii) If this reduction lasts for 24hours? (iii) Which intervention is the most effective at influencing gender-STEM bias? Discussion: Results will be discussed in relation to the greater detail offered by the IRAP when examining bias malleability and future applications of successful gender-STEM bias interventions. By determining an effective intervention that influences gender-STEM bias we will be able to implement it with key groups, (e.g. academic faculty), who may influence the academic and career choices of individuals interested in STEM.

57. ¿Se Puede Predecir el Abandono en un Tratamiento Grupal de Mindfulness?
Áreas temáticas (principales): Intervenciones y aspectos clínicos
Sub-categoría temática: Mindfulness
Laura Camacho Guerrero, Ph.D., Hospital la Plana (Vila-Real, Castelló)
Cristina Colomina Llobell, Hospital la Plana (Vila-Real, Castelló)
Selene Martínez Lluesma, Hospital la Plana (Vila-Real, Castelló)
Carlos David Collado Navarro, Hospital la Plana (Vila-Real, Castelló)
Ingrid Nebot García, Hospital la Plana (Vila-Real, Castelló)

Entre los problemas que presentan las terapias grupales se encuentra la tasa de abandonos (entre 25 y 60%). Este trabajo analiza las características sociodemográficas y clínicas de pacientes de la Unidad de Salud Mental de Carinyena (Vila-Real) que abandonaron un grupo de intervención basada en Mindfulness en comparación con los que acabaron el tratamiento. La muestra está compuesta por 58 pacientes: 82,8% fueron mujeres, de entre 30 y 50 años. La tasa de abandonos fue de 53,4%. El protocolo de evaluación incluyó: Cuestionario de Calidad de Vida, Cuestionario de Autoeficacia, STAI-E/R, BDI-II, Escala de Inadaptación y MAAS. Los análisis de comparación de medias no evidenciaron diferencias significativas en ninguna de las variables sociodemográficas y clínicas entre aquellos pacientes que abandonaron el grupo y los que permanecieron en él. Sería interesante analizar cualitativamente los motivos que llevaron al abandono, dado que las variables cuantitativas exploradas no ayudaron a predecir la adherencia.

58. Efectividad del Tratamiento Grupal Basado en Mindfulness en un Contexto de Sanidad Pública
Áreas temáticas (principales): Intervenciones y aspectos clínicos
Sub-categoría temática: Mindfulness, Sanidad pública
Ingrid Nebot García, Hospital la Plana (Vila-Real, Castelló)
Selene Martínez Lluesma, Hospital la Plana (Vila-Real, Castelló)
Laura Camacho Guerrero, Ph.D., Hospital la Plana (Vila-Real, Castelló)
Cristina Colomina Llobell, Hospital la Plana (Vila-Real, Castelló)
Carlos David Collado Navarro, Hospital la Plana (Vila-Real, Castelló)
Yolanda Vilar Mollar, Hospital la Plana (Vila-Real, Castelló)

Algunos de los beneficios de las intervenciones grupales basadas en Mindfulness son el aumento en la calidad de vida y la mejora en autoeficacia y en actitud de conciencia plena. Este trabajo examina si se replican estas mejoras en una muestra de 58 pacientes con síntomas ansioso-depresivos de la Unidad de Salud Mental de Carinyena (Vila-Real, Castellón), que participaron en una intervención grupal basada en Mindfulness (6-12 pacientes, ocho sesiones semanales, dos horas de duración). Se realizó una evaluación basal y otra al finalizar la intervención, incluyendo diferentes variables sociodemográficas y clínicas. Los resultados mostraron un aumento estadísticamente significativo en calidad de vida, autoeficacia y actitud de conciencia plena. Los resultados aportan nueva evidencia a favor del tratamiento grupal basado en Mindfulness. El formato grupal hace que esta terapia sea coste-efectiva y pueda implementarse de forma fácil en contextos de sanidad pública.

59. Efecto del Entrenamiento Mindfulness Self-Compassion sobre Bienestar Psicológico y Autocompasión en Profesionales de la Salud Durante Su Formación
Áreas temáticas (principales): Intervenciones y aspectos clínicos
Sub-categoría temática: Entrenamiento en Autocompasion
Jose Ramón Yela Bernabé, Ph.D., Universidad Pontificia de Salamanca
Maria Angeles Gómez Martínez, Ph.D., Universidad Pontificia de Salamanca
Antonio Crego Diaz. Ph.D., Universidad a Distancia de Madrid
Laura Jiménez Gómez, Asociación Española contra el Cáncer
Elena Sánchez Zaballos, Universidad Pontificia de Salamanca

De acuerdo al modelo de Neff (2003), la autocompasión está constituida por tres componentes: ser bondadoso en lugar de crítico con uno mismo (amabilidad hacia uno mismo), percibir nuestras propias experiencias no como algo aislado, sino como parte de lo que le sucede a todos los seres humanos (humanidad compartida), y ser conscientes de nuestras propias experiencias sin juzgarlas, en lugar de sobreidentificarnos con ellas (mindfulness). Los psicólogos podrían beneficiarse de intervenciones que incrementaran su nivel de autocompasión, lo cual podría fortalecer sus relaciones con los clientes, reducir la fatiga y el burnout derivados de empatizar constantemente con ellos e incrementar su bienestar. Algunos trabajos han revisado la eficacia de intervenciones basadas en el empleo de mindfulness y meditación de trato amable hacia uno mismo (loving kindness) sobre el desarrollo de la autocompasión. A pesar de las limitaciones metodológicas, los estudios ofrecen cierto apoyo a la hipótesis de que las intervenciones basadas en mindfulness pueden incrementar la autocompasión en profesionales de la salud. En lo relativo a la meditación de trato amable hacia uno mismo, hay resultados alentadores en muestras no clínicas de que este tipo de entrenamiento puede incrementar la autocompasión y la compasión hacia el sufrimiento de los otros (Boellinghaus, Jones y Hutton, 2013; 2014). Tanto la auto-compasión como compasión con el sufrimiento de los demás son cualidades importantes en los terapeutas. Estas variables están relacionadas con características de calidez y empatía en la relación terapéutica; además cultivar la autocompasión podría proteger a los profesionales de la salud contra el riesgo de burnout derivado del continuo desgaste de empatizar constantemente (Klimecki y Singer, 2011). De este modo, podría ser útil entrenar a los clínicos en desarrollar autocompasión, dado que podría desempeñar un papel importante a la hora de mantener su propia salud mental (Kuyken y cols., 2010; Ringenbach, 2009) . Germer y Neff (2013) propusieron un programa estructurado de entrenamiento en autocompasión mindful -Mindfulness Self-compassion (MSC)-, que se desarrolla a lo largo de 8 semanas. Tiene un formato grupal, y se ha mostrado útil para generar mejorías significativas en estado de ánimo (ansiedad y depresión), autocompasión, atención plena o mindfulness y calidad de vida en muestras no clínicas. También en la disminución de psicopatología asociada (Jiménez, Yela y Riesco, 2016). Nuestro estudio piloto emplea este programa de entrenamiento MSC con una muestra de estudiantes de Posgrado en Psicología General Sanitaria (N=11), con una edad media de 27,18 años (Sd=7,54). Se evaluó el efecto de este entrenamiento en autocompasión a través de la Self-Compassion Scale (SCS),ansiedad (STAI), depresión (BDI), Bienestar Psicológico (PWBS) y Satisfacción con la Vida (SWLS). Se llevaron a cabo evaluaciones pre-post, y dado el tamaño reducido de la muestra, empleamos la prueba no paramétrica de Wilcoxon para llevara a cabo las comparaciones. Resultados: se apreciaron cambios significativos en las puntuaciones globales en autocompasión (SCS) de la muestra (z = -2,673; p=.008) como consecuencia del entrenamiento, y en concreto en el componente de Amabilidad hacia uno mismo (z = - 2,199; p=.028) y Humanidad compartida (z= -1,793; p=.073), aunque no en el componente Mindfulness de la autocompasión.También se apreciaron cambios significativos en la puntuación total de la Escala de Bienestar Psicológico (PWBS) (z= -2,047; p=.041), y más en concreto en las Escalas de Autonomía (z=-2,728; p=.006), Dominio del entorno (z= -2,680; p=.007) y Autoaceptación (z=-1,896; p=.048). No se apreciaron cambios significativos en las escalas de Crecimiento personal, Relaciones positivas y Propósito en la vida.Tampoco se apreciaron cambios significativos en la escala de Satisfacción con la vida (SWLS). Dado que se trata de una muestra no clínica, tal y como sucedió cabía esperar que no se apreciaran cambios en las escalas de Ansiedad (STAI) y Depresión (BDI). Se discuten los resultados valorando la utilidad de el entrenamiento MSC en los futuros profesionales de la salud en el ámbito de la intervención psicológica, a la hora de dotarles de estrategias personales de manejo de las dificultades que puedan aparecer en el contexto de su trabajo cotidiano, así como de mejora en su bienestar psicológico.

60. Protocolo de tratamiento psicológico del duelo basado en un modelo integrador en madres que viven un nuevo embarazo tras una pérdida perinatal
Áreas temáticas (principales): Intervenciones y aspectos clínicos
Sub-categoría temática: Modelo psicológico integrador
Anna Torà Ardèvol, Hospital Universitari Mútua de Terrassa
Clara Mercadé Carranza, Hospital Universitari Mútua de Terrassa
Itxaso Figueras Urenga, Hospital Universitari Mútua de Terrassa

Introducción: La pérdida de un hijo al inicio de la vida constituye uno de los estresores emocionales más intensos que puede experimentar una mujer (Mota et al., 2011). Las parejas se sienten solas e incomprendidas en su dolor. La poca validación que socialmente se da a las pérdidas perinatales reprime muchos duelos, los acorta innecesariamente y muchas mujeres que se permiten vivirlo son culpabilizadas y se autoculpabilizan por ello (Claramunt, 2009). Los mensajes del entorno a menudo invitan a sustituir la pérdida del hijo muerto con el nacimiento de un siguiente hijo y en el caso del nuevo embarazo, los padres pueden experimentar sentimientos de ambivalencia entre la alegría por un nuevo embarazo y la tristeza/dolor por la muerte del hijo que estaban esperando (Claramunt, 2009). Esta autora describe cambios en la vivencia del siguiente embarazo entre los que destacan el miedo, la hipervigilancia y las conductas de evitación. En el CSMA Rambla (HUMT) se ofrece atención psicológica a las parejas que han sufrido este tipo de pérdidas. Método: El método ha consistido en una revisión sistemática de la bibilografía disponible sobre la intervención psicológica en el duelo y en la adaptación de dicha literatura a las características particulares de las madres que viven un nuevo embarazo durante el proceso de duelo por una pérdida perinatal. Procedimiento: La intervención específica en el proceso de duelo de madres que viven nuevos embarazos tras una pérdida perinatal se basa en el modelo de Worden (2002). Aborda las siguientes tareas psicológicas: 1) Aceptación de la realidad de la pérdida; 2) Trabajo en la gestión de las emociones y el dolor; 3) Adaptación al medio después de la pérdida y 4) Recolocación emocional y orientación a la vida. Conclusiones: El impacto de una pérdida perinatal y su repercusión en el siguiente embarazo eviencian la necesidad una intervención psicológica que visibilice y valide las necesidades específicas de estas madres.

61. Interferencia de las barreras del terapeuta en ACT: un caso de rumia obsesiva
Áreas temáticas (principales): Intervenciones y aspectos clínicos
Sub-categoría temática: Barreras del terapeuta
Mª del Carmen Ortiz Fuen, Psicóloga Residente en el Complejo Asistencial de Zamora
Manuel Mateos García, Psicólogo General Sanitario en Centro de Asesoramiento Sevilla
Andrea Taboada López, Psicóloga Residente en Complejo Asistencial de Zamora
Verónica Castrillo Sarmiento, Psicóloga Clínica en Asociación Española Contra el Cáncer

El presente trabajo ofrece una reflexión sobre cómo las barreras del terapeuta pueden perturbar el proceso de intervención. Cuando se está aplicando la Terapia de Aceptación y Compromiso y/o la Terapia Analítico Funcional, es importante analizar la influencia de las barreras del terapeuta, especialmente cuando la intervención se está llevando a cabo por un terapeuta con poca experiencia y que se encuentra en formación. Esta reflexión se presenta en el contexto de un caso de rumia obsesiva, en tratamiento desde hace 12 años en un servicio público de salud mental. A lo largo de este periodo, se le habían aplicado múltiples diagnósticos, tales como Trastorno de Ansiedad Generalizada, Trastorno Mixto de la Personalidad, Trastorno Paranoide de la Personalidad y Trastorno límite entre otros, así como varias intervenciones (Terapia Cognitivo Conductual y psicofármacos). Durante estos 12 años, la paciente había presentado diversos ciclos de seguimiento y abandono del tratamiento, tanto psicológico como psiquiátrico, en el ámbito público y privado. Es en 2016, momento en que la paciente vuelve a consulta tras un largo periodo sin intervención, cuando se inicia la terapia basada en ACT. En el momento en el que se inicia el tratamiento la paciente presenta constantes rumiaciónes con respecto a numerosos ámbitos de su vida, incapacidad para tomar decisiones, fluctuaciones en el estado del ánimo, dificultades en las relaciones sociales, había abandonado múltiples actividades, se encontraba de baja laboral y mostraba incapacidad para discriminar numerosos aspectos de su comportamiento así como para identificar sus valores. La intervención, de 12 sesiones de duración, se compuso del análisis funcional de las conductas de evitación, identificación de CCRs en sesión, desesperanza creativa, defusión y trabajo centrado en clarificar valores. En este caso concreto, las barreras del terapeuta le llevaron a emitir conductas que entorpecieron el proceso terapéutico, tales como dejarse llevar por la rumia y ceder ante las demandas de la paciente. Estas conductas del terapeuta entorpecieron considerablemente el proceso de intervención, alargándolo y haciéndolo menos efectivo. Por todo ello consideramos que tener en cuenta dichas barreras y contar con supervisores es fundamental para este tipo de intervenciones, especialmente cuando se cuenta con poca experiencia.

62. Intervención grupal basada en Mindfulness: resultados en ansiedad y depresión
Áreas temáticas (principales): Intervenciones y aspectos clínicos
Sub-categoría temática: Mindfulness, Sanidad pública
Carlos David Collado Navarro, Hospital la Plana (Vila-Real, Castelló)
Laura Camacho Guerrero, Ph.D., Hospital la Plana (Vila-Real, Castelló)
Cristina Colomina Llobell, Hospital la Plana (Vila-Real, Castelló)
Ingrid Nebot García, Hospital la Plana (Vila-Real, Castelló)
Selene Martínez Lluesma, Hospital la Plana (Vila-Real, Castelló)
Lorena Rodríguez Díaz, Hospital la Plana (Vila-Real, Castelló)

Cada vez existe más evidencia sobre los beneficios para la salud física y psicológica del tratamiento grupal basado Mindfulness. El presente trabajo tiene como objetivo explorar su eficacia en un contexto de salud pública, lo que apoyaría su inclusión en el actual sistema público de salud mental español. La muestra estuvo compuesta por 58 pacientes (82,8% mujeres, edad media 39,16 años; DT = 11,52) con sintomatología ansioso-depresiva que asistían a una Unidad de Salud Mental. Los grupos (de 6-12 personas) recibieron 8 sesiones semanales de dos horas de duración, dirigidas por dos terapeutas. Los análisis indicaron un descenso significativo en todas las variables de estudio (ansiedad, depresión e inadaptación) tras el tratamiento, con tamaños del efecto entre medios y altos. Así, los resultados van en la línea de trabajos anteriores y apoyan la implantación del tratamiento grupal basado en Mindfulness en el sistema público de salud mental español.

63. Datos preliminares de un protocolo para manejo de evitación experiencial en adolescentes
Áreas temáticas (principales): Intervenciones y aspectos clínicos
Sub-categoría temática:
Diana Riaño-Hernández, Pontificia Universidad Javeriana
Paula Alexandra Atehortúa Rivera, Pontificia Universidad Javeriana
Vanessa Riveros Fiallo, Pontificia Universidad Javeriana
Luis Manuel Silva, Pontificia Universidad Javeriana

En el último reporte de salud mental de la Organización mundial de la salud se informa que los adolescentes en Colombia presentan dificultades asociadas a ansiedad, fobia social, depresión o comportamientos disruptivos en el contexto social, académico y familiar. Desde la Terapia de Aceptación y Compromiso (ACT) dichos comportamientos se abordan como Trastorno de Evitación Experiencial (TEE). El TEE se caracteriza porque las personas no están dispuestas a entrar en contacto con sus Pensamientos Privados Problemáticos (PPP), por lo que desarrollan patrones de evitación, que a corto plazo son funcionales, pero a largo plazo generan mayores problemas ya que afectan diferentes áreas del individuo, alejándolas de las cosas que son importantes para ellas. El propósito de este estudio fue evaluar la efectividad de un protocolo centrado en desesperanza creativa, defusión y valores para reducir los pensamientos repetitivos negativos, los patrones de evitación, las conductas agresivas y aumentar la flexibilidad psicológica y acciones valiosas. Los participantes fueron tres adolescentes de 13 y 17 años, estrato 3, residentes en la ciudad de Bogotá, escolarizados, que evidencian trastorno de evitación experiencial y un grado de afectación media en al menos dos áreas de funcionamiento y los padres de los adolescentes quienes evidenciaban niveles bajos de ansiedad. Se planteó un diseño intra-sujeto con medidas repetidas, donde se estableció una línea de base en las medidas repetidas durante tres semanas, tanto para padres como para los adolescentes. Posteriormente se realizó la intervención con una duración de cuatro sesiones para los adolescentes y tres sesiones para los padres. Se continuó con un período de seguimiento. Las medidas recolectadas fueron: depresión, ansiedad y estrés (DASS-C); preocupación (PSWQ-C); pensamiento negativo repetitivo (PTQ-C); pliance generalizado (CPG); agresividad (AQ-PA); depresión (IDEREN); ansiedad (IDAREN); aceptación (CAMM); flexibilidad psicológica (AFQ-Y). Los datos preliminares muestran que el protocolo de intervención puede ayudar a reducir los pensamientos repetitivos negativos tanto para padres como adolescentes, los patrones de evitación y las conductas agresivas. Se concluye que el protocolo puede funcionar para reducir síntomas problemáticos de los adolescentes y ayudar a disminuir ansiedad en padres, además de conectar a las adolescentes y padres con sus valores en relación al proyecto de vida que están construyendo. Sin embargo, para futuros estudios se debe tener en cuenta con mayor precisión la labor de los padres dentro del proceso terapéutico pues se reconoció que la interacción familiar puede limitar el efecto de la intervención.

64. Datos preliminares sobre el efecto de un protocolo breve en ACT para disminuir estrategias de experiencial
Áreas temáticas (principales): Intervenciones y aspectos clínicos
Sub-categoría temática:
Diana Riaño-Hernández, Pontificia Universidad Javeriana
Paula Alexandra Atehortúa, Pontificia Universidad Javeriana
Vanessa Riveros Fiallo, Pontificia Universidad Javeriana
Luis Manuel Silva, Pontificia Universidad Javeriana

El Trastorno de Evitación Experiencial (TEE) se caracteriza porque las personas generan diferentes repertorios de evitación para no entrar en contacto con eventos privados que les resultan aversivos. Esto puede llevar a que se pierda de vista lo que es valioso para el individuo e impedir que se desarrollen acciones valiosas. Se identifica que estas personas han invertido la mayoría de su tiempo en preocuparse y realizar diferentes acciones que les permitan eliminar el malestar, lo cual a corto plazo les ha resultado efectivo, pero a largo plazo el resultado es que poco a poco van abandonando las cosas que son importante para ellos. El objetivo de este estudio consistió en evaluar la efectividad de un protocolo de cuatro sesiones, fundamentado en la terapia de aceptación y compromiso (ACT), sobre la presencia de pensamientos recurrentes que servían como estrategia de evitación. Los participantes fueron dos adultos, quienes presentaban pensamientos repetitivos como una estrategia de evitación experiencial y exhibían síntomas de malestar emocional. Se planteó un diseño intra-sujeto con medidas repetidas, donde se estableció una línea de base en las medidas repetidas durante tres semanas. Posteriormente se realizó la intervención con una duración de cuatro sesiones y se continuó con un período de seguimiento. Las medidas recolectadas fueron: pensamientos repetitivos (PSWQ, RRS-SF, ATQ-F y ATQ-B), evitación experiencial (AAQ-II), fusión cognitiva (CFQ) y síntomas de malestar emocional (DASS-21 y GHQ-12), junto con actuación en dirección a los valores (VQ). Tras la aplicación del protocolo se presentó reducción en el TEE y aumento en la medida de actuación en dirección a los valores (VQ). Se concluyó que el protocolo de cuatro sesiones parece ser efectivo para desmontar el ciclo de evitación experiencial y aumentar las acciones valiosas. Lo anterior pudo haber ocurrido dado que la terapia de aceptación y compromiso se centra en clarificar los valores para elegir la dirección de la vida, recurrir a otra forma de actuación frente a los eventos privados como alternativa al intento de control para reducir el malestar que generan, potencializar la flexibilidad psicológica para elegir cómo responder frente a éstos y al sufrimiento, y alterar los contextos verbales que mantienen la evitación experiencial. Aun así, dado el tamaño de la muestra, se reconoce la limitación del estudio para establecer generalizaciones.

65. Una experiencia de Supervisión por Pares y Grupo de Estudio
Áreas temáticas (principales): Supervisión, formación y difusión
Sub-categoría temática: Entrenamiento en habilidades terapeuticas
Maria José Lami, Ph. D., Instituto de Psicoterapia Conductual Contextual (IPsiCCo)

Se comparte una experiencia de una combinación entre el Modelo de Supervisión por Pares de Portland (Thompson, Louma, Terry, Lejeune, Guinter y Robb, 2015) y un Grupo de Estudio en Santiago del Estero, Argentina. En esta provincia argentina residen 631 psicólogos (Colegio Oficial de Psicólogos de Santiago del Estero, 2017) sobre una totalidad de aproximadamente un millón de; y una Universidad Católica que ofrece formación en Licenciatura en Psicología; la principal orientación teórica de los profesionales es psicoanalítica o psicodinámica. A finales del año 2015 comenzamos la experiencia de reunirnos una vez por semana durante 1 hora y media de duración, con el objetivo de leer y aprender sobre Terapia de Aceptación y Compromiso. La bibliografía utilizada fue: 1- Wilson, K. y Luciano, C. (2002) Terapia de Aceptación y Compromiso (ACT) Un Tratamiento Conductual Orientado a Los Valores. Madrid: Pirámide. 2- Hayes, S., Strosahl, W., Wilson, K. (2014) Terapia de Aceptación y Compromiso. Proceso y práctica del cambio consciente (Mindfulness). Madrid: DESCLEE DE BROUWER. Esta actividad se mantiene hasta la fecha. A principios del año 2017 se sumó a esta actividad un espacio de Supervisión por Pares desde el modelo de Portland conservando la estructura, formato, roles y valores de este Modelo, sumándose a éstos los valores propios de los integrantes posterior a un trabajo de clarificación de los mismos (¿Cuáles son los valores que nos guían como terapeutas ACT?). El grupo estuvo constituido en un principio (el grupo es abierto) por 5 psicoterapeutas con diversas formaciones de base, pero que asistieron durante todo el año 2016 al grupo de estudio. Con diversos años de experiencia clínica (de 2 a 15 años), diversas edades (de 26 a 40 años), diversos ámbitos de trabajo entre otras diferencias. En cada encuentro del grupo de estudio se comienza con un ejercicio de Mindfulness de 5 a 10 minutos guiados, en su mayoría, por la coordinadora general, sin embargo esta función es también rotativa a voluntarios. Y luego se continúa con la lectura de manera ordenada y secuencial dando logar a debate abierto, dudas y consultas donde todos opinan. El modelo de Supervisión de Portland se mantiene en su totalidad como lo presentan los autores. Se presentarán los resultados de dicha experiencia en la voz de las participantes luego de su asistencia durante 4 meses (es decir 4 sesiones de Supervisión y 15 encuentros de Grupo de Estudio) y la repercusión percibida en su práctica clínica. Así como datos relativos a la adherencia, puntualidad, expresiones espóntaneas y observaciones durante las supervisiones. Conservando la confidencialidad de los datos y el consentimiento informado de las participantes.

66. El Contexto Social en una Prueba Grupal IRAP sobre Estereotipos de Género: Influencia del Carácter Mixto o Separado por sexos del Grupo de Aplicación / Social context in a collective IRAP application about gender stereotypes: mixed vs single gender groups
Áreas temáticas (principales): Teoría de los Marcos Relacionales
Sub-categoría temática: IRAP
Jose Errasti, Ph.D., Universidad de Oviedo
Hugo Martínez Martínez, Universidad de Oviedo
Carmen Rodríguez Muñiz, Universidad de Oviedo
Jennifer Márquez García, Universidad de Oviedo
Alejandro Maldonado Lucena, Universidad de Oviedo
Álvaro Menéndez, Universidad de Oviedo

Introducción: El IRAP (Implicit Relational Assessment Procedure) es un procedimiento desarrollado por Barnes-Holmes para la evaluación de creencias, actitudes y otros elementos cognitivos implícitos, vinculado a la Psicología Contextual y a la Teoría del Marco Relacional. Habitualmente se han estudiado variables que afectan al rendimiento en el IRAP relacionadas con los estímulos presentados, pero pocas veces se ha estudiado la influencia de aspectos de la propia situación social de aplicación de la prueba. Así mismo, es habitual que la prueba se aplique individualmente para evitar que su complejidad dé lugar a altas tasas de abandono. Método: Esta investigación se centra en varias aplicaciones grupales del IRAP (N total=75) sobre los estereotipos de género. Se han distinguido dos condiciones: en la primera, la prueba se aplica en grupos mixtos compuestos por 5 mujeres y 5 hombres; en la segunda, la prueba se aplica en grupos separados por sexos, bien 10 mujeres o bien 10 hombres. Resultados: Un 70,7% (53 de 75) de los participantes superaron los bloques de ensayo y llegaron a los bloques de test. Las puntuaciones D en todos los tipos de ensayos tanto para hombres como para mujeres mostraron diferencias estadísticamente significativas respecto de 0. En las cuatro condiciones experimentales, tanto los hombres como las mujeres mostraron mayor sesgo de género en los grupos separados por sexo que en los grupos mixtos. Esta diferencia alcanzó significación estadística en el caso de las mujeres contestando a ensayos consistentes acerca de los hombres. Conclusiones: La aplicación colectiva del IRAP es una alternativa interesante a la aplicación individual habitual. El contexto social en el cual se aplica el IRAP influye sobre la ejecución de los participantes. Los estereotipos de género están presentes tanto en hombres como en mujeres. Estos estereotipos son mayores cuando las personas se encuentran en grupos de su mismo sexo y menores cuando se encuentran en grupos mixtos.

67. Efecto de la Variación en la Cantidad de Modalidades sobre la Adquisición y Transferencia de Discriminaciones Conticionales
Áreas temáticas (principales): Teoría de los Marcos Relacionales
Sub-categoría temática: Discriminaciones condicionales
Luis Alberto Quiroga-Baquero, Fundación Universitaria Konrad Lorenz
Carlos Wilcen Villamil-Barriga, Universidad de Guadalajara
Harold Esteban Mendoza-Duran, FUNDACIÓN UNIVERSITARIA KONRAD-LORENZ
Christian Parra-Olarte, Universidad del Rosario

En el campo de análisis del control abstracto de estímulo, se ha propuesto que el ajuste del comportamiento a las denominadas contingencias de abstracción, supone el responder a propiedades modales variantes de los estímulos presentes (propiedades dimensionales) en términos de propiedades modales constantes que son relacionales (propiedades instruccionales). Dado esto, se propuso evaluar el efecto de la variación en la cantidad de modalidades concurrentes en los estímulos de segundo orden, muestra y comparaciones en una tarea de igualación de la muestra de segundo orden sobre el establecimiento de control abstracto de estímulo. En un primer experimento, se varió el número de propiedades dimensionales: los estímulos de segundo orden indicaban las relaciones de identidad o diferencia ensayo a ensayo bajo dos modalidades: forma y color y se varió el número de modalidades de los estímulos muestra y comparaciones en las fases de entrenamiento o en las fases de prueba de transferencia dando lugar a cuatro grupos experimentales. Con el objetivo de evaluar el efecto en la variación concurrente entre propiedades dimensionales e instruccionales, en un segundo experimento se presentó la misma variación en las modalidades de los estímulos muestra y comparaciones, pero adicionalmente los estímulos de segundo orden indicaban la relación y modalidades pertinentes. Los resultados muestran una relación lineal entre el número de modalidades y el porcentaje de aciertos en fases de transferencia, mientras que no se observan efectos en las fases de entrenamiento. Asimismo, la variación concurrente en el número de modalidades en todos los segmentos de estímulo, auspicia mejores desempeños en fases de entrenamiento y transferencia. Estos hallazgos se discuten en términos de las conceptualizaciones acerca del control abstracto de estímulo y de la formación conceptos.

68. Atribución mediante marcos relacionales y efecto en la autoestima
Áreas temáticas (principales): Teoría de los Marcos Relacionales
Sub-categoría temática: IRAP
Manuel Murillo de las Heras, Universidad de Almería
Xana Grech Pesquera, Universidad de Almería
Carmen Luciano Soriano, Universidad Almería y Madrid Institute Contextual Psychology -MICPSY.
Zaida Callejón, Universidad de Almería
Jorge Ruiz, Universidad de Almería
Bárbara Gil-Luciano, Universidad de Almería

The contextual analysis of self-components is relevant to analyze their verbal nature but also their role in controlling own behavior. The aim of this study is to analyze the effect of amplifying self-components on self-steem reports by using explicit participants` reports and by using an IRAP preparation that might be explicit the implicit beliefs. Thirty participants responded to maisntrain self-steem questionaire and reported the positive personal characteristics. Then, they were ramdomly distributed in two conditions. The experimental participants received a relational training to enhance the positive personal charateristics (a cue was related to positive arbitrary stimuli and positive personal characteristics while other cue was related to opposite characterisitcs). Then, they responded to the self-steem questionnaire. Finally, and IRAP was implented to respond to real-self (the one connected to one` experiences) and to the ideal-self. Self-steems reports and the differences between the experimental and control participants on the IRAP are discussed.

69. La pérdida perinatal como factor de riesgo para el desarrollo de Trastornos de Ansiedad y del Estado de Ánimo en el siguiente embarazo
Áreas temáticas (principales): Prevención e intervenciones comunitarias
Sub-categoría temática: Trastornos de Ansiedad y Trastornos del Estado de Ánimo
Clara Mercadé Carranza, PIR, Hospital Universitari Mútua de Terrassa
Anna Torà Ardèvol, Hospital Universitari Mútua de Terrassa
I. Figueras Uranga, Hospital Universitari Mútua de Terrassa

Introducción: Una pérdida perinatal supone un impacto traumático en diferentes áreas de la vida de la madre que la sufre y tiene una repercusión en su proyecto de futuro. El siguiente embarazo tras esta pérdida supone un complejo proceso psicológico caracterizado por miedo, ansiedad e hipersensibilidad, percepción permanente de peligro y aparición de conductas de evitación y seguridad. Este proceso puede derivar en trastornos psiquiátricos en las madres, principalmente del estado de ánimo y de ansiedad. El presente estudio evalúa los cambios emocionales, cognitivos y conductuales que experimentan las madres en este siguiente embarazo durante la etapa perinatal. Método: El método utilizado ha consistido en una entrevista semi-estructurada a cuatro madres que han sufrido una pérdida perinatal previa al nuevo embarazo. Resultados: Los resultados reflejan cambios afectivos como la presencia de miedo a que se repita el mismo desenlace que en el embarazo anterior, el sentimiento de apego, tristeza y pérdida por el hijo fallecido, la percepción de invalidación por parte del entorno y el estado de alerta permanente. En relación a los cambios cognitivos, destacan las anticipaciones catastrofistas, los recuerdos relacionados con el bebé anterior y los pensamientos de comparación de los dos procesos. Finalmente, en el plano conductual, aparecen evitaciones de la expresión emocional y de situaciones relacionadas con la pérdida, así como conductas de comprobación y seguridad dirigidas a la búsqueda de control y a la sobreprotección del bebé en gestación. Palabras clave: pérdida perinatal, nuevo embarazo, duelo, salud mental perinatal. Conclusiones: La experiencia de la pérdida perinatal influye de forma significativa en la vivencia del siguiente embarazo. Los resultados obtenidos subrayan la importancia de atender estas características específicas de estos procesos y la conveniencia de un apoyo psicológico durante este periodo.

Powerpoints and handouts files added where available. If you would like your materials to be added to this list, please email it to acbsstaff@contextualscience.org.

Pre-Conference Workshops 

Tuesday-Wednesday, 20-21 June, 2017

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Brief Interventions for Radical Change: Basics of Focused Acceptance and Commitment Therapy (FACT)
Kirk Strosahl, Ph.D, Patricia Robinson, Ph.D., Thomas Gustavsson
Handout
Powerpoint

The Therapeutic Relationship in ACT: Cultivating Present and Powerful Client Connections in Acceptance and Commitment Therapy
Kelly G. Wilson, Ph.D.
Powerpoint

An introduction to compassion focused therapy (CFT)
Paul Gilbert, Ph.D., Dennis Tirch, Ph.D., Laura Silberstein, Psy.D.
Powerpoint 1
Powerpoint 2
Powerpoint 3
Powerpoint 4
Powerpoint 5

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Conference Sessions

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Thursday, 22 June

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3. Harnessing the Power of the Present Moment in ACT/ Aprovechar el Poder del Momento Presente en ACT
Kirk Strosahl, Ph.D, Patricia Robinson, Ph.D.
Handout
Powerpoint

8. ACT with Multicultural Competence: An Experiential Workshop using ACT Principles and Exercises to Bolster Multicultural Competence: College/University SIG
Adia Gooden, Ph.D., Giovanna Rivano-Gomez, Psy.D., Cat Goyeneche, Psy.D
Handout

9. Using the Science of Positive Psychology to Enhance Psychological Flexibility, Clinical Practice, and Therapist Self-Care
Lanaya Ethington, Ph.D.
Powerpoint
Handout
Handout

10. Uncovering the Process of "Creative Hopelessness" 
Rikke Kjelgaard, M.Sc
Robyn Walser, Ph.D.
Powerpoint

12. Same Technology, Different Delivery: Varieties of Formats of ACT Interventions for Chronic Health Problems
Dayna Lee-Baggley, Ph.D.
Handout 1
Handout 2
Handout 3
Handout 4

21. Ignite Session
Your Therapist Doesn't Feels Like a Fraud? You Should Look for Another Professional! 
Giovanni Pergher, MS
Powerpoint
4 Paths to Wholeness
Marianela Medrano
Handout 1
ACT in Sex-therapy
Charlotte Makboul
Powerpoint
Building Community Through Mindfulness and Committed Action
Annette Dufresne
Powerpoint The Words Don't Work
Jim Lucas
Powerpoint

24. ACT Interventions for Health Problems
Dayna Lee-Baggley, Ph.D.
Handout 1
Handout 2
Handout 3
Handout 4

35. Using Technology to Better Assess and Enhance Psychological Flexibility Among College and University Students: College/University SIG Sponsored 
Jack Haeger, M.S., Jennifer Krafft, B.A., Michael Levin, Ph.D.
Powerpoint
Frederick Dionne, Ph.D., Guillaume Raymond, Ph.D., Joel Gagnon, Ph.D., Simon Grégoire, Ph.D.
Powerpoint
Simon Grégoire, Ph.D., Lise Lachance, Ph.D., Christophe Chénier
Powerpoint

37. Sessions with IMPACT: Interpersonal Mindfulness Processes in Acceptance & Commitment Therapy
Russ Harris
Powerpoint

42. Using Different Methods to Study Clinical Applications I 
Benjamin M. Ramos, M.Sc.
Powerpoint

43. Burnout Inoculation: Using ACT to Prevent Burnout in the Workplace and in Yourself
Dayna Lee-Baggley, Ph.D.
Timothy Gordon
Handout 1
 

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Friday, 23 June

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62. Clinical Application of RFT in Practice
Yvonne Barnes-Holmes, Richard Bennett, Joe Oliver
Handout 1
Handout 2

67. Metaphor: From Science to Psychotherapy
Niklas Törneke, M.D.
Powerpoint

65. "I’ll do it later": Overcoming Procrastination in College Students with ACT 
Frederick Dionne, Ph.D
Powerpoint

72. Applying ACT Processes and SelfCompassion to Develop Psychological Flexibility with Survivors of Suicide: Quebec Chapter Sponsored 
Francis Lemay, Ph.D., Fernando Parada Zelada, Psy.D.
Powerpoint 

74. Delivering Acceptance and Commitment Therapy for Smoking Cessation/Aplicación de la Terapia de Aceptación y Compromiso para dejar de fumar 
Martin O'Connor, MSc, Louise McHugh*, Ph.D.
Powerpoint (Prezi Link)
Handout

75. Evoking, Exploring and Shaping Relevant Bodily Responses: Contextual Medicine SIG Sponsored
Maarten Aalberse, Niklas Törneke
Powerpoint

76. Activando paso a paso: Tratamiento de Activación Conductual para Depresión (BATD) 
Fabian Maero, Licenciada Paula José Quintero
Handout 1

85. Recent Innovations in Applying Acceptance and Commitment Therapy and the Psychological Flexibility Model to Chronic Pain 
Marie-Eve Martel, M.A., Psy.D., Whitney Scott, Ph.D., Frédérick Dionne, Ph.D., Josée Veillette, Psy.D., Joseph Chilcot, Ph.D., Lance M. McCracken, Ph.D.,
Handout

87. Ten Mistakes you don't want to make as an ACT Therapist
Rikke Kjelgaard, M.Sc
Powerpoint

89. Evolution on Purpose: Why the Ultimate Success of CBS is Tied to Applied Evolution Science/
Evolución del propósito: Por qué el éxito final de la CBS está ligado a la ciencia de la evolución aplicada
Steven C. Hayes, Ph.D
Powerpoint

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Saturday, 24 June

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96. ACT in Organizations
Søren Braskov, M.Sc., Asger Neumann, M.Sc
Powerpoint

95. Am I Still Doing ACT?
Danielle Moyer, MS, Jacqueline A-Tjak, MSc, Matt Boone, Matthieu Villatte Ph.D., Darrah Westrup, Ph.D.
Handout 1

98. Metaphor in Practice
Niklas Törneke, M.D., Jennifer Villatte, Ph.D.
Handout 1 

99. Live Demonstrations: ACT with Challenging Clients
Russ Harris
Handout 1

109.  Our Roles in Social Change: Living a Science More Worthy of the Challenge of the Human Condition
Priscilla Almada, Magnus Johansson, Anthony Biglan, Dennis Embry
Powerpoint

115. Acceptance, Mindfulness and Compassion-Based Interventions for Problem Eating Behaviors 
Lara Palmeira
Powerpoint
Vivian Costa Resende Cunha, MSc., Sônia Maria Mello Neves, Ph.D.
Powerpoint

116. The ACT of Self Forgiveness: A Principles-Based Response to Intrapersonal Offence 
Grant Dewar
Powerpoint
Powerpoint with Audio
Powerpoint with notes

121. How Should CBS React to the Replication Crisis in Psychology?
Emily Sandoz, Ph.D., Steven C. Hayes, Ph.D., Ian Hussey, Ph.D., Lance McCracken, Ph.D., Roger Vilardaga, Ph.D.
Powerpoint

128. Applying and Adapting ACT with Adults with Intellectual Disabilities
Mark Oliver, Steve Noone, Matt Selman
Powerpoint

131. Living with the Stuff that Sucks: Using ACT Flexibly with Adolescents 
Ben Sedley
Powerpoint

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Sunday, 25 June

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134. The Science of Arts in Functional Analytic Psychotherapy (FAP): Functional Analytic Psychotherapy SIG Sponsored 
Holly Yates, Stavroula Sanida
Powerpoint

146. Delivering Acceptance & Commitment Therapy in Acute Settings: Some Reflections: Psychosis SIG Sponsored 
Joris Corthouts, Brian Pilecki, Catherine M. D'Avanzato, Claire Turner, Ariel Farroni
Handout

152. The Mindfulness Based Program for Infertility (MBPI): A seven-year follow-up study
Ana Galhardo, Ph.D., Marina Cunha, Ph.D., José Pinto-Gouveia, M.D., Ph.D.
Powerpoint