INSTRUCTIONS FOR INSTALLING THE CONFERENCE APP

1. Go to your phone's app store. Search for Yapp. Install Yapp on your phone.
2. Open the Yapp app
3. Click on "Add an Existing Yapp"
4. Type ACBS in the box that says Enter Yapp Id and click "Go" or "Enter"
5. The ACBS World Conference logo will appear on your screen. Click on the logo and the app will open.

 

HOW TO USE THE CONFERENCE APP
Click on the upper left corner and a drop down menu will appear. This app contains the following information:

• Daily Schedule
• Tracks
• Venue Maps
• Poster Sessions
• People
• SIGs
• Chapters
• Affiliates

 

MY SCHEDULE

This app also has the "My Schedule" feature. If you find a session that you want to attend, scroll to the bottom of the session description and click on "Add Event to My Schedule." You can access your personal schedule by clicking on the calendar/star icon in the upper right corner of the schedule screen.

Sarah Cassidy, Ph.D.

Dr. Sarah Cassidy is an Educational, Child and Adolescent Psychologist. She completed her doctoral research on RFT interventions for intellectual deficit with Dr. Bryan Roche in 2009. She has been administering psychological assessments to evaluate learning and behavioural difficulties to children and adolescents as part of her private practice, and for the National Educational Psychological Services in Ireland for the last 18 years. In private practice, she works with children and families developing support plans for persons with learning and behavioural difficulties and treating children and adolescents in individual and group therapy contexts. She has extensive experience working in an educational psychology context and is trained in the use of several different therapeutic interventions for persons with educational and emotional/behavioural difficulties, including the use of ABA, ACT, CBT and Mindfulness Based Interventions to name a few. Dr. Cassidy also lectures to undergraduate and postgraduate students in educational psychology, child psychology, early childhood education, and guidance counselling at Maynooth University. She also trains parents, teachers and other clinicians how to deliver psychotherapeutic interventions within the ACT framework. She delivers individual and group therapy programmes to various populations in clinic and in schools throughout the country. She has published her psychological research in peer reviewed scientific outlets. She routinely speaks at schools and conferences, nationally and internationally, in relation to various aspects of child development and treatment of learning, behavioural and social/emotional difficulties. She has been invited to speak about her research on various Irish radio programmes and television programmes. She is the Chief Education Officer at www.RaiseYourIQ.com. She is also a professional member of the American Psychological Association, the Association for Child and Adolescent Mental Health, the Association for Contextual Behavioural Science and a panel member of the National Educational Psychological Service (SCPA) in Ireland. Finally, Dr. Cassidy is a chartered member of the Psychological Society of Ireland.

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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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Susan David, Ph.D.

Susan David, Ph.D. is one of the world’s leading management thinkers and an award winning Harvard Medical School psychologist. Her new #1 Wall Street Journal bestselling book, Emotional Agility based on the concept Harvard Business Review heralded as a Management Idea of the Year and winner of the Thinkers50 Breakthrough Idea Award, describes the psychological skills critical to thriving in times of complexity and change. She is a frequent contributor to the Harvard Business Review, New York Times, Washington Post, Wall Street Journal, and guest on national radio and television. Named on the Thinkers50 global list of the top management thinkers, Susan is a sought-after keynote speaker and consultant, with clients that include the World Economic Forum, EY, United Nations, Google, Microsoft, NASDAQ, and many other national and multinational organizations. Her focus is on defining and executing effective strategy, especially in the areas of engagement, high-performance leadership, and culture change. Susan is the CEO of Evidence Based Psychology, on the faculty at Harvard Medical School, a Cofounder of the Institute of Coaching (a Harvard Medical School/McLean affiliate), and on the Scientific Advisory Boards of Thrive Global and Virgin Pulse. Susan is also core faculty of the global Homeward Bound, an all-women leadership program that culminates in an expedition to Antarctica and aims at increasing the influence and impact of women in the sciences.

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lore m. dickey, Ph.D.

lore completed his training as a Counseling Psychologist at the University of North Dakota in 2011. He completed his pre-doctoral internship year at Duke University in Counseling and Psychological Services. Following graduation, Dr. dickey completed a 10-month post-doctoral fellowship at the Morehouse School of Medicine in the Satcher Health Leadership Institute.

Dr. dickey served as an Assistant Professor in the Department of Psychology and Behavioral Sciences at Louisiana Tech University in Ruston, LA. In addition to teaching graduate courses in the fields of Counseling and Counseling Psychology, he also served as a research advisor for students and directed the Psychological Service Clinic. Currently he serves as an Assistant Professor and Doctoral Training Director for the Combined Counseling/School Psychology PhD program in the Department of Educational Psychology at Northern Arizona University.

Dr. dickey's love of advocacy began in childhood. Similarly, his love for research was sparked as an undergraduate. He is deeply committed to ensuring that all voices are heard both in research and in addressing social injustices that trans people are subjected to on a daily basis. He served as the co-chair for the American Psychological Association task force for the development of Guidelines for Psychological Practice with Transgender and Gender Nonconforming Clients. He has presented throughout the world on topics related to understanding the transgender experience and is considered an expert. He has been recognized with numerous awards for his work and is known as a pioneer in the field of transgender psychology.

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Sue Johnson, Ed.D.

Sue Johnson, Ed.D. is the leading developer of Emotionally Focused Therapy (or EFT). She is a Professor Emeritus of Clinical Psychology at the University of Ottawa, Distinguished Research Professor in the Marital & Family Therapy Program at Alliant University in San Diego, Director of the International Centre for Excellence in Emotionally Focused Therapy (ICEEFT) and Director of the Ottawa Couple and Family Institute Inc. Sue received her doctorate in Counseling Psychology from the University of British Columbia in 1984. She is a registered psychologist in the province of Ontario, Canada, and a member of the many editorial boards of professional journals.

Dr. Johnson has received a variety of awards acknowledging her development of EFT and her significant contribution to the field of couple and family therapy and adult attachment. Sue has been appointed as a Member of the Order of Canada, the country’s highest civilian honor recognizing outstanding achievement, dedication to the community and service to Canada. In 2016, she was named Psychologist of the Year by APA, and has been honored by AAMFT for her Outstanding Contribution to the Field of Couple and Family Therapy. Sue has numerous publications in the field of couple therapy and attachment. Her most recent research in her lab includes Changes in Relationship-Specific Attachment in Emotionally Focussed Couple Therapy (JMFT) and Soothing the Threatened Brain: Leveraging Contact Comfort through Emotionally Focused Therapy (PLOS ONE). This study included a brain scans showing how contact with a loving partner mitigates threat and fear responses. Sue’s most recent book, Love Sense: The Revolutionary New Science in Romantic Relationships, outlines the new understanding of why and how we love based on scientific evidence and cutting-edge research. Sue is also the author of the bestseller, Hold Me Tight: Seven Conversations for a Lifetime of Love. Sue’s other books include The Practice of Emotionally Focused Couples Therapy: Creating Connection (2nd Ed, Routledge, 2004) - the basic text on EFT for couple therapy, Emotionally Focused Couple Therapy with Trauma Survivors (Guilford, 2002) and edited books such as Attachment Processes in Couples Therapy (Guilford, 2003).

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Louis Lefebvre, Ph.D.

I have done a Ph.D. in psychology at the University of Montréal, an internship in neurophysiology at the CNR in Pisa, and a postdoc in zoology at the University of Oxford (with Richard Dawkins). I have been a professor in the Department of Biology of McGill University since 1980, and am Director of the Minor in Science for Arts. I am also an associate researcher at the ecology research center (CREAF) of the Autonomous University of Barcelona. In addition to papers on innovation and cultural transmission, mostly in birds, I have published four novels and regularly show photo and object assemblages in galleries in southern Québec.

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Christopher R. Martell, Ph.D., ABPP

Christopher R. Martell, Ph.D., ABPP is a psychologist and Clinic Director of the Psychological Services Center at the University of Massachusetts Amherst, Department of Psychological and Brain Sciences. He is board certified in clinical psychology and behavioral & cognitive psychology through the American Board of Professional Psychology and is a founding fellow of the Academy of Cognitive Therapy. The co-author of eight books, he has published widely on behavioral treatments for depression, couples therapy, and issues affecting gay, lesbian and bisexual individuals. He is first author of Behavioral Activation for Depression: A Clinician's Guide, and Depression in Context: Strategies for Guided Action. He was a research therapist on three RCTs of behavioral and cognitive-behavioral therapies, and has been a research consultant on efficacy, training and dissemination studies of behavioral activation (BA) in the U.S., U.K., Sweden and the Netherlands.

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Giovambattista "Nanni" Presti, M.D., Ph.D.

Nanni was trained as a Medical Doctor and attended a Clinical School in Psychotherapy as a post-doc, and received his Ph.D. in Behavior Analysis. As Associate Professor at Kore University in Enna, he coordinates the undergrad program in Psychology. Nanni has a broad experience of teaching and living outside Italy and helped establishing as Treasurer the European Association for Behavior Analysis. He founded and co-managed IESCUM, which has fostered the diffusion of CBS in Italy. He deepened his research interests in BA and ABA focusing on the early equivalence studies and then RFT. Alternating clinical and basic science interests, he encountered ACT at the turning of the millennium, after knowing its first steps. Nanni served ACBS co-chairing the meeting in Parma and serving on the Conference Committee for Washington. He has served on the ACBS Board as a member-at-large for the past two years and co-founded the Italian ACBS Chapter.

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Jonathan Tarbox, PhD, BCBA-D

Dr. Jonathan Tarbox is the Program Director of the Master of Science in Applied Behavior Analysis program at the University of Southern California, as well as Director of Research at FirstSteps for Kids. Dr. Tarbox is the Editor-in-Chief of the journal Behavior Analysis in Practice and serves on the editorial boards of several major scientific journals related to autism and behavior analysis. He has published four books on autism treatment, is the Series Editor of the Elsevier book series Critical Specialties in Treating Autism and Other Behavioral Challenges, and an author of well over 70 peer-reviewed journal articles and chapters in scientific texts. His research focuses on behavioral interventions for teaching complex skills to individuals with autism and applications of Acceptance and Commitment Training (ACT) to applied behavior analysis. 

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Peter Turchin, Ph.D. 

Peter Turchin is an evolutionary anthropologist who works in the field of historical social science that he and his colleagues call Cliodynamics. His research interests lie at the intersection of social and cultural evolution, historical macrosociology, economic history and cliometrics, mathematical modeling of long-term social processes, and the construction and analysis of historical databases. Currently he investigates a set of broad and interrelated questions: How do human societies evolve? In particular, what processes explain the evolution of ultrasociality—our capacity to cooperate in huge anonymous societies of millions? Why do we see such a staggering degree of inequality in economic performance and effectiveness of governance among nations? Turchin uses the theoretical framework of cultural evolution to address these questions. Currently his main research effort is directing the Seshat Databank project, which builds and analyzes a massive historical database of cultural evolution that enables us to empirically test theoretical predictions coming from various social evolution theories.

                               

Here are the folks who are putting it all together and make WC16 a success:

Program Committee Chairs:

Program Committee Members:

Saturday, July 28
1:20-2:50pm
Location: Rue Notre-Dame / Rue Saint Denis

Session 116

• Introducing The Mindfulness Triangle - The simplest way of teaching the "unteachable"  

Reuben Lowe, B/A Hons, Healthscope

This short presentation will introduce The Mindfulness Triangle, a simple model to teach mindfulness to all people, especially the young, or those that like things very simple (and that's most of us, right?) In this presentation I will show you how you can teach The Mindfulness Triangle, even to the "unteachable". It couldn't be more simple. I've introduced thousands of people to mindfulness, and this is my favourite model to use. And most people find it very effective and incredibly easy to recall. Once the foundations of The Mindfulness Triangle are understood and have become experiential (this takes 5 mins max!), it is an excellent model to use for mindfulness in the everyday sense, as well as for cognitive defusion and acceptance of emotions exercises. I will also be providing extra teaching resources for all those who wish to use this model, if you need them.

• The Matrix for Sports Performance  

Sebastian G. Kaplan, PhD, Wake Forest UNiversity School of Medicine
Laura Sudano, PhD, University of California San Diego

Athletes experience a variety of performance impairing internal experiences, such as fear of failure, muscle tension during competitions, and thoughts about predicted failures. Athletes often work with mental performance specialists on strategies for overcoming such barriers to success, which frequently take form of relaxation exercises, thought stopping, or other methods to address unwanted thoughts, feelings, or physical sensations. Coaches may also employ such strategies to help their athletes succeed. While many athletes find these methods helpful, many will also experience continued worsening of their performance as these internal experiences further deplete their focus and energy. Acceptance-based strategies have also become effective strategies in the world of sport performance. The matrix (Polk and Schoendorff, 2014) is a recently developed visual framework for applying acceptance-based intervention principles in clinical settings. The presenters, in their roles as mental health and performance professionals integrated in a college sports medicine clinic, have used the matrix with several athletes. This presentation describes the application of the matrix with a baseball pitcher experiencing significant performance challenges.

• Will the Real ___ Please Stand Up? Getting into the ACT of Impostor Phenomenon.  

Nelly A. Dixon, Ed.D., BCBA, LBA, Purdue University - Global (Kaplan University)

Do you ever feel like an Impostor? Are you afraid that your true inabilities will be discovered? Impostor Phenomenon (IP) affects millions of high performing individuals, but many individuals do not even realize that their experience has a name! Identifying the key aspects of IP and fitting them into the conceptual model of Psychological Inflexibility can provide a roadmap for alleviating the anxiety-driven behaviors that Impostors typically display. Get your inner Impostor into the ACT and reclaim your identity! You won’t need a mask the next time you hear, "Will the real (You) please stand up?"

• Got Gender? Improving trans awareness and competence for mental health providers by expanding psychological flexibility  

C. Virginia O'Hayer, Ph.D., Drexel University College of Medicine
Emily J. Marino, PsyD, Philadelphia Veterans Association

Transgender and gender non-conforming (T/GNC) individuals have increased prevalence of suicide and self-harm (Peterson et al, 2017), substance abuse (Herbst et al., 2007), depression, and anxiety (Budge et al, 2013). T/GNC individuals are also at elevated risk for psychotherapy drop-out, due in no small part to therapist factors. Limited therapist knowledge, patient burden of educating uninformed therapists, therapist avoidance of or over-focus on trans-related issues, and stigma are frequently cited as reasons for dropout (APA, 2015). We aim to improve competence by helping providers experientially apply existing contextual approaches to the construct of gender. First, we conduct a mindfulness exercise to contact the present moment and access values. Then, we guide participants through defusion and self-as-context exercises to re-examine their relationships to the construct of gender. We also propose workable options for T/GNC-welcoming language and therapy practices. Then, we suggest committed action: resources and tools to help patients navigate their pursuit of authenticity. Finally, we end with a self-compassion exercise to help us repair any past transgressions that our prior ignorance may have caused.

• ACT with Chronic Illnesses  

C. Virginia O'Hayer, Ph.D., Drexel University College of Medicine
Caitlin O’Loughlin, Drexel University College of Medicine
Reina Aikens, Drexel University College of Medicine
David Bennett, Drexel University College of Medicine

ACT has proven successful in managing chronic pain (McCracken et al., 2006), smoking (Gifford et al., 2004), substance use (Hayes, S. C., et al., 2004), anxiety, depression (Ost, 2014), and somatic problems (A-Tjak et al, 2015). Recently, our team has developed a 6 week manualized ACT intervention for individuals living with HIV/AIDS (ACT with HIV), cystic fibrosis (ACT with CF), and a single case study of pancreatic cancer (ACT with PanCan). This intervention was applied in the form of a randomized control trial to 54 patients with HIV/AIDS. It was also applied via telehealth (using HIPAA-compliant WebEx webcam) in an open trial for 13 patients with CF, and in person for another 6 patients with CF. The ACT with PanCan case study utilized a less structured adaptation guided by our manuals. ACT was associated with decreased depression, anxiety, shame, and increased engagement among each of these samples. Retention has been high, with nearly all patients requesting a continuation of ACT beyond the 6 scheduled sessions. Applications to other chronic illnesses are considered for future directions.

• Tell Me What You Want, What You Really, Really Want: ACT-ing from the Heart with Eating Disorders  

Margaret K. Notar, MA, MSW, RSW, Private Practice, Waterloo, ON; Faculty of Social Work, Wilfrid Laurier University, Kitchener, ON, Canada

Clients with eating disorders are recognized for being a highly ambivalent group, a factor that adds to their complexity when providing psychotherapeutic treatment (Juarascio et al., 2013). This Ignite presentation will highlight how a focus on function, present moment emotions, heartfelt intention and values can begin to free clients from life with an eating disorder. This will be illustrated with three case examples demonstrating how avoidance was renounced by clients in favour of more uncomfortable but meaningful actions. It will emphasize how therapists can mindfully honour clients' emotional pain and encourage them to experiment with more heartfelt behaviours in the service of acting according to who and what matters to them. The end result? Clients can find themselves behaving more authentically, like the person they want to be. Consequently, they may find that there is less need in their life for the eating disorder.

• Pain interference and opioid use are lower after major surgery in patients receiving Acceptance and Commitment Therapy: Clinical practice-based outcomes from the Toronto General Hospital Transitional Pain Service  

Muhammad Abid Azam, Pain Research Unit, Department of Anesthesia and Pain Management, Toronto General Hospital & Department of Psychology, YorkU
Aliza Z. Weinrib, Ph.D., Pain Research Unit, Department of Anesthesia and Pain Management, Toronto General Hospital
Janice Montbriand, Pain Research Unit, Department of Anesthesia and Pain Management, Toronto General Hospital
Lindsay C. Burns, Pain Research Unit, Department of Anesthesia and Pain Management, Toronto General Hospital & Department of Psychology, YorkU
Joel Katz, Pain Research Unit, Department of Anesthesia and Pain Management, Toronto General Hospital & Department of Psychology, YorkU

Background: Chronic postsurgical pain (CPSP) and associated long-term opioid use are major public health concerns. Aims: This clinical practice–based study reports on preliminary outcomes of the Transitional Pain Service (TPS) acceptance and commitment therapy (ACT) program for patients at-risk for CPSP and persistent opioid use. Methods: ANOVAs were used to compare patients who received ACT (n=91) or no ACT (n=252) at first and last TPS visits for pain, pain interference, sensitivity to pain traumatization, pain catastrophizing, anxiety, depression, and opioid use. Results: ACT patients had a higher rate of preoperative mental health conditions (P < 0.001) with higher opioid use (P < 0.001) at first visit than no ACT patients. Pain, pain interference, pain catastrophizing, anxiety, and opioid use were reduced for both groups by last visit (P < 0.05). ACT group demonstrated greater reductions in opioid use, pain interference, and depressed mood (P = 0.001) by last visit. Conclusion: Preliminary outcomes suggest that ACT was effective in reducing opioid use while pain interference and mood improved.

• Experiential Avoidance and Problematic Health Behavior  

Anne I. Roche, MA, University of Iowa

Research has indicated that a variety of formally different problematic health behaviors may arise from a common higher order factor or have a common function (Cooper et al., 2003; Donovan & Jessor, 1985; Kingston, Clarke, Ritchie, & Remington, 2011). Experiential avoidance, which can be conceptualized as any attempt to alter or change the form or frequency of an unpleasant internal experience, may be this common function (Hayes, Wilson, Gifford, Follette, & Strosahl, 1996). This presentation will discuss how topographically dissimilar problematic health behaviors (e.g., smoking, overeating) may be functionally conceptualized as inflexible responses to unpleasant internal experiences (e.g., a craving or urge). Additionally, the presentation will present meta-analytic data evidencing the efficacy of acceptance- and mindfulness-based interventions for health behavior change outcomes such as smoking cessation and weight loss. Finally, this talk will discuss the clinical and public-health implications of improvements in health behavior change intervention efficacy.

• Acceptance as a protective factor from PTSD, depression and anxiety : A Belgian study based on the terrorist attacks of March 22th 2016.  

Ilios Kotsou, Ph.D., Chaire Mindfulness, Bien-Etre au travail et Paix économique, Grenoble Ecole de Management & Université Libre de Bruxelles
Christophe Leys, Ph.D., Faculty of Psychology, Université Libre de Bruxelles, Brussels, Belgium
Pierre Fossion, Brugmann Hospital, Université Libre de Bruxelles, Brussels, Belgium

Background: On Tuesday March 22, 2016, three suicide bombings occurred in Brussels, Belgium: two at the Brussels International Airport and one in Maalbeek subway station. Thirty-two civilians were killed and more than 300 people were injured. Islamic State of Iraq claimed responsibility for the attacks. Two days following these attacks, our research team started a prospective study about the psychological consequences of this collective trauma. Aim: The authors conducted a prospective study aiming at observing the evolution of Post-traumatic Stress Disorder (PTSD) and depressive and anxiety disorders symptoms (DAD) and the protective role of acceptance (AAQ) after the Brussels March 2016 terrorist attacks. Method: They collected data on a non-clinical sample of 464 participants through an on-line questionnaire, two days (time 1) and three months (time 2) after the attacks. They measured the level of PTSD, DAD and AAQ at time 1 and 2. Results: They observed a negative relationship between AAQ and both DAD and PTSD symptoms. Conclusions: Results confirm the protective function of acceptance.

• Why Laugh? Exploring the Connections Between Humor and Acceptance and Commitment Therapy  

Lisa DeHahn Jade, MS, Southern Maine ACT Community

The purpose of this presentation is to MAKE PEOPLE LAUGH, while also allowing them to better understand the role (and intentional application) of humor and defusion in practice. Using research regarding the evolutionary and biological functions of laughter, as well as specific practice techniques, participants will increase personal understanding of how to use humor as a tool for increased psychological flexibility. Following this presentation, participants will be able to identify the role of humor in defusion and avoidance behaviors, will have practiced two techniques for utilizing humor as an ACT tool (defusion exercises), and will have gained resources for further study/ self-research.

• My miscarriages as a therapist: shame, healing and serendipity  

Giovanni K. Pergher, M.S., Faculdades Integradas de Taquara

In this presentation I’ll describe some difficult clinical situations in which I deployed badly timed interventions that yielded detrimental effects to the therapeutic process and ruptures in the therapeutic relationship. Some of these miscarriages are related to the difficulties involving the incorporation of ACT principles within a long term CBT practice, like the case in which I completely lost contact with the client issues in order to apply a mindfulness technique. Other miscarriages were related to my own psychological inflexibility, pushing me away from a therapeutic move. One example occurred when an attractive female client revealed that fell in love with me and because of it our sessions were not being therapeutic. My response was a cold and invalidating analysis of her dysfunctional pattern of being attracted for unavailable men. The miscarriages described had in common two major aspects: 1) My interventions were, at some level, harmful for the client, and I’m ashamed for having done that; and 2) these situations lead to unexpected discoveries and healing opportunities.

• The Transition from Clinician to Supervisor  

Annette Dufresne, Ph.D., C.Psych., University of Windsor

Clinical supervision requires a delicate balancing to ensure both a helpful learning experience for the supervisee and effective treatment for the client. In the majority of cases, there is also an evaluative role that must be integrated into the supportive helper role. With this expanded role and increase in responsibility, successfully shifting from clinician to supervisor involves not only expanding supervisory skills, but also having the willingness to face internal obstacles. In this talk, I will draw upon some existing research literature on supervision, as well as my own personal experiences, to bring to light some of the challenges involved in making this transition, and to present some suggestions on making the transition effectively. Drawing from an ACT perspective, I will speak to some of the values we might consider in supervision work, as well as the internal obstacles that may pull us away from our values. Consideration will also be given to what might be some toward and away moves as a supervisor.

• Psychologists' attitudes toward money: Use of cognitive behavioral theory to explain how we perpetuate our financial abuse.  

Lori Eickleberry, Ph.D., ABPP, Nova Southeastern University
Laurel Marco, M.S., Nova Southeastern University

Based on a literature review conducted in the area of compensation in mental health, this satirical presentation discusses the income disparity that exists between mental health professionals and other health professionals and seeks to explain how thoughts, feelings, and behaviors of mental health professionals serve to perpetuate compensation disparity. Examples will use cognitive, behavioral, and relational frame theory to explain the cyclic nature of difficulties, as well as propose a "treatment plan" to change our "abusive" social situation. This presentation hopes to ignite a dialogue that will spark change through greater awareness. Areas for future research and change are explored.

Please note: You must be logged in as an ACBS member in order to view the content below.

WC16 Posters

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: Place du Canada Ballroom

Wednesday, July 25, 2018, 7:30-8:30pm - Poster Session #1 

Wednesday, July 25, 2018, 8:30-9:30pm - Poster Session #2

Friday, July 27, 2018, 6:00-7:00pm - Poster Session #3

Friday, July 27, 2018, 7:00-8:00pm - Poster Session #4

Image denotes ACBS Junior Investigator Poster Award Recipients

Wednesday, July 25, 7:30-8:30pm - Poster Session #1

1. Investigation of the Relationship between the Cognition of the Concepts of "Engage" and "Escape" to the Evaluation of Work

Primary Topic: Assessment
Subtopic: IRAP
Daiki Furuya, M.A., Graduate school of humanities, Meisei University
Fumiki Haneda, Vocational Counselor, Startline Co.Ltd
Koji Takeuchi, Department of psychology, School of humanities, Meisei university

Background: People work while having various orientations towards work (finding value in personal growth, the contribution to the belonging organization etc.). This difference in values reveals itself as a difference in the positive or negative cognition of the concepts “Engage" and “Escape". In this research, we aimed to measure the cognition of the concepts of “Engage" and “Escape" using the Implicit Relational Assessment Procedure (IRAP) and then to investigate the correlation between the IRAP results and the values expressed in the work questionnaire. Method: There were 20 participants (9 males, 11 females; M age 34.2 years old). IRAP used “Engage" and “Escape" as label stimuli and positive and negative words as target stimuli. The questionnaire used was the Work Value Scale (Eguchi & Tokaji, 2008). Result: Seven persons who did not meet the criteria of the practice phase were excluded and 13 subjects were analyzed. The correlation between the average D-IRAP score for each of four trial types and the average score for each questionnaire subscale was calculated. As a result, "engage-positive word" and " personal growth" (r = .56, p =. 04) and "escape-negative word" and "contribution to the belonging organization" (r =. -52, p = .06) showed significant correlations. Discussion: It is suggested that those who have a strong stimulus relationship between "Engage" and positive words feel value in their personal growth, while those who have a strong stimulus relationship between "Escape" and negative words did not derive value from the contribution to the belonging organization.

2. Psyflex: Validation of a new psychological flexibility measure in a Greek-Cypriot sample

Primary Topic: Assessment Tools
Subtopic: Psychological Flexibility
Michaela Paraskeva-Siamata, M.Sc., University of Cyprus
Georgia Spyridou, B.Sc., University of Cyprus
Andrew Gloster, Ph.D., University of Basel
Maria Karekla, Ph.D., University of Cyprus

Psychological flexibility describes an individual’s ability to focus on the present moment and accept his/er difficult emotions and thoughts while acting in a valued manner (Biglan, Hayes & Pistorello, 2008). Psyflex (Gloster, 2017) is a 10-item newly developed tool which is suggested to measure psychological flexibility. This is the first adaptation of this measure. The aim of this study was to validate the Greek translation of Psyflex. A set of questionnaires including Psyflex, Mental Health Continuum Scale (MHC; Keyes, 2005), Acceptance and Action Questionnaire-II (AAQ-II; Bond et al., 2011) and Cognitive Fusion Questionnaire (CFQ; Gillanders et al., 2014) was administered to 95 Greek-Cypriot individuals (86.30% females; M age=21,92, SD=3.34). Principal Component Analysis was conducted with orthogonal rotation. Two components emerged and in combination explained 59.09% of the variance. The first factor accounted for 38.98% of the variance and the second for 20.11%. Internal consistency was good for the entire scale (Cronbach’s α=.84) and one of the sub-scales (Cronbach's α=.85), and adequate for the second sub-scale (Cronbach's α=.64). Regarding construct validity, Psyflex was significantly correlated with the three sub-scales of MHC (psychological well-being: r=.40; emotional well-being: r=.26; social well-being: r=.34, p<.05) and was negatively correlated with AAQ-II (r-.36, p<.001) and CFQ (r=-.49, p<.001). Psyflex showed adequate psychometric properties and it presents with promise as a measurement tool of psychological flexibility. Further studies need to be conducted to assess its psychometric properties, test-retest reliability, sensitivity to change, and examine its application in other populations and samples.

3. Assessing Heart Rate Variability, Acceptance, and Mindfulness in Healthy Young Adults as Predictors of Anxiety

Primary Topic: Behavioral medicine
Subtopic: Anxiety Assessment
Sarah-Nicole Bostan, M.A., Alliant International University, San Diego
Natasha Nemanim, B.A., Alliant International University, San Diego
Richard Gevirtz, BCB, Ph.D., Alliant International University, San Diego

Third-wave cognitive behavioral therapies propose psychological flexibility is a central feature of both clinical disorders and nonclinical populations experiencing challenges of daily living. Heart rate variability (HRV) is a notable alternative method for assessing stress and pathology related to autonomic activity. High HRV at rest indicates an individual’s ability to adapt to his or her environment in a physiologically flexible manner. This study provides preliminary evidence for the relationship between psychological flexibility and autonomic nervous system health as measured by HRV.
For this study, 32 healthy college students over age 18 in San Diego, California, completed the Serial 7s, a cognitive stress induction task previously associated with psychophysiological changes in cardiovascular, electrodermal, and electromyography signals. Participant’s HRV, skin conductance, and temperature was collected in real time across a 15-minute span. Participants completed measures of state and trait anxiety, mindful awareness, acceptance, and psychological flexibility. It is expected that aspects of psychological flexibility moderate HRV-related recovery from stress differentially in participants with varying levels of anxiety.
These findings suggest a birdirectional relationship between physiological and psychological flexibility. Heart rate variability may influence mental wellness and vice versa, with acceptance and mindfulness as critical intermediary pathways. For example, higher trait anxiety and reduced ability to adapt to external environmental stressors is related to poorer physiological health, even in healthy emerging adults. This has future implications for providing biomarkers in mental health, which has been a recent priority of the clinical research community in order to provide increasingly valid and reliable health information.

4. ACT with Chronic Illnesses

Primary Topic: Behavioral medicine
Subtopic: HIV, Cystic Fibrosis, Pancreatic Cancer
C. Virginia F. O’Hayer, Ph.D, Drexel University College of Medicine
Caitlin O’Loughlin, BA, Drexel University College of Medicine
Reina Aikens, BA, Drexel University College of Medicine
David Bennett, Ph.D., Drexel University College of Medicine

Background: ACT has proven successful in managing chronic pain (McCracken et al., 2006), smoking (Gifford et al., 2004), substance use (Hayes, et al., 2004), anxiety and depression (Ost, 2014), and somatic problems (A-Tjak et al, 2015). Recently, our team has applied a 6 week manualized ACT intervention to individuals living with HIV/AIDS (ACT with HIV), cystic fibrosis (ACT with CF), and a single case study of pancreatic cancer (ACT with PanCan).
Methods: This intervention was applied in the form of a randomized control trial to 54 patients with HIV/AIDS. It was also applied via telehealth (using HIPAA-compliant WebEx webcam) for 13 patients with CF, and in person for another 6 patients with CF. The ACT with PanCan case study was a less structured treatment, guided by our manual.
Results: ACT was associated with decreased depression, anxiety, shame, and increased engagement among all of these samples. Retention has been high, with nearly all patients requesting a continuation of ACT, beyond the 6 scheduled sessions.
Discussion: Applications of manualized ACT to other chronic illnesses are considered for future directions.

5. Engagement in Acceptance and Commitment Training Predicts Outcomes in Individuals with Neurofibromatosis 1 (NF1), Plexiform Neurofibroma tumors (PNs), and Chronic Pain
Sponsored by: Pain SIG
Primary Topic: Behavioral medicine
Subtopic: Chronic Pain
Mary Anne Toledo-Tamula, MA, Clinical Research Directorate/Clinical Monitoring Research Program, Leidos Biomedical Research, Inc.
Taryn Allen, PhD, 1Clinical Research Directorate/Clinical Monitoring Research Program, Leidos Biomedical Research, Inc.
Kari Struemph, PhD, National Cancer Institiute
Pamela Wolters, PhD, National Cancer Institute
Staci Martin, PhD, National Cancer Institute

Chronic pain is common in individuals with NF1 and PNs and associated with diminished quality of life and interference with everyday activities. Research supports the efficacy of ACT across pain populations, yet little is known about how adherence to ACT interventions relates to outcomes. We examined how home-based engagement in an ACT intervention related to post-intervention pain-related outcomes among individuals with NF1 and chronic pain.
Adolescents and adults with NF1, PNs, and chronic pain (n=44; Mage=27.410.64 years; 43.2% male) enrolled in a randomized controlled trial completed questionnaires assessing pain interference and pain-related inflexibility. After a 2-day (4-hour) in-person intervention supplemented by videochats and weekly emails, participants were instructed to practice newly-learned ACT skills (i.e., mindfulness, defusion, and values-consistent activity) at home for 8 weeks. Post-intervention, they completed the same questionnaires and reported how often they practiced these skills.
Greater engagement in mindfulness (r=-.31, p<.05) and defusion (r=-.38, p<.05) exercises, though not values-consistent activity (p>.05), were associated with less psychological inflexibility post-intervention. Bootstrapping procedures to examine a simple mediation model suggest that home-based ACT practice (ACT engagement composite score) has a significant indirect effect on pain interference reductions at follow-up, which is mediated by adaptive changes in pain inflexibility post-intervention (Path ab; F(2, 38)=5.60, p<0.01; 95% CI: -3.90 to -0.47).
Engagement in ACT practices at home had a direct and adaptive effect on pain inflexibility, which indirectly reduced pain interference. Thus, the capacity to decrease pain interference via ACT has the potential to improve QOL in patients with NF1.

6. Is Emotion Regulation Associated with Cancer-Related Psychological symptoms?

Primary Topic: Behavioral medicine
Subtopic: Health psychology (cancer)
Anne-Josée Guimond, M.A., École de Psychologie, Université Laval
Hans Ivers, Ph.D., École de Psychologie, Université Laval
Josée Savard, Ph.D., École de Psychologie, Université Laval

Background: Breast cancer patients frequently report a constellation of several psychological symptoms including anxiety, depression, fear of cancer recurrence (FCR), insomnia, fatigue, pain, and cognitive impairments. In the general population, emotion regulation (ER) is considered a central mechanism underlying the development of psychological disorders. However, the relationships between ER and cancer-related psychological symptoms have received little attention.
Objectives: To examine the cross-sectional and prospective relationships between subjective (experiential avoidance, cognitive reappraisal, and expressive suppression) and objective (high frequency heart rate variability [HF-HRV]) measures of ER and a set of psychological symptoms (anxiety, depression, FCR, insomnia, fatigue, pain, and cognitive impairments) among women receiving radiation therapy for breast cancer.
Method: Eighty-one participants completed self-report scales before (T1) and after (T2) radiotherapy. HF-HRV at rest was measured at T1.
Results: Canonical correlation analyses revealed that higher levels of experiential avoidance and expressive suppression were cross-sectionally associated with higher levels of all symptoms, except pain, at T1 (R = .72, p < .0001) and at T2 (R = .75, p < .0001). Higher levels of suppression and reappraisal at T1 were marginally associated with reduced FCR and with increased depression and fatigue between T1 and T2 (R = .56, p = .07). HF-HRV was not associated with symptoms cross-sectionally or prospectively. Conclusions. These results suggest that maladaptive ER strategies, assessed subjectively, may act as a transdiagnostic mechanism underlying several cancer-related psychological symptoms.  

7. Predicting Child and Adolescent Functioning One Year after Major Orthopedic Surgery - Poster Award Winner

Primary Topic: Behavioral medicine
Subtopic: Children/ Adolescents, Pain, Surgery
Brittany Rosenbloom, MSc MA, York University
Melanie Noel, PhD, University of Calgary
Gabrielle Page, PhD, Universite de Montreal
Lisa Isaac, The Hospital for Sick Children
Fiona Campbell, The Hospital for Sick Children
Jennifer Stinson, The Hospital for Sick Children
Joel Katz, York University

Background: 20-50% of children and adolescents who undergo major orthopedic surgery develop moderate to severe chronic pain and disability. In adults, pain psychological flexibility (PPF) has been shown to predict functional and valued based outcomes post-surgery. The aim of this study was to examine parental PPF and child/ adolescent factors and their role in pediatric functional disability one year after major orthopedic surgery.
Methods: A subgroup (57.78%) of patients and their parents/guardians from a larger prospective, longitudinal study were included in this analysis (i.e. parents who completed the PPF Questionnaire). Parents and patients (n=156; 35.7% male, mean age=14.3 years, SD=2.6) were recruited before surgery, followed daily while in hospital, and 6 and 12 months later. Data was collected by questionnaire and chart review.
Results: Multivariable regression showed that pre-surgical child pain intensity, pain catastrophizing, pain self-efficacy, fear of movement, chronic pain acceptance, and parent PPF, did not significantly predict child functional disability [Functional Disability Index (FDI)] 1-year after surgery. However, multivariable regression at one year showed that child chronic pain acceptance and pain self-efficacy were significantly related to 1-year functional disability, over and above 1-year pain intensity, pain catastrophizing, fear of movement, and parent PPF, F(6,8)=8.938, p=.003, R2=.870.
Discussion: Child/ adolescent measures of chronic pain acceptance and pain self-efficacy are associated with higher functioning one year after surgery. The development of a validated measure of child/ adolescent PPF, including pain-specific thriving, is needed for future studies to clarify its direct role in facilitating healthy and successful long-term adaptation to surgery.

8. Novel Use of ACT Techniques in a Home Physical Activity Intervention for Cognitive Late Effects in Children Treated with Radiation for Brain Tumors: Descriptive Feasibility Data from a Pilot Randomized Controlled Trial (RCT)

Primary Topic: Clinical Interventions and Interests
Subtopic: Children
Pamela L. Wolters, Ph.D., National Cancer Institute
Staci Martin, PhD, National Cancer Institute
Mary Anne Tamula, MA, Clinical Research Directorate/Clinical Monitoring Research Program, Leidos Biomedical Research, Inc., Frederick, Maryland
Cristina Abel, National Cancer Institute
Marie Claire Roderick, National Cancer Institute

Children treated with cranial radiation therapy (CRT) may develop cognitive late effects for which interventions are limited. Physical activity (PA) targets CRT-damaged brain mechanisms and cognitive functions. We conducted a pilot RCT to evaluate the feasibility of an innovative home PA program including Acceptance and Commitment Therapy (ACT) techniques to facilitate PA engagement in pediatric brain tumor survivors.
Eligible children 8-17 years, >two years post-CRT, with cognitive difficulties were randomized to the Intervention Group (IG) that followed a 12-week home program to increase moderate-to-vigorous PA (MVPA) using activity trackers/website, or the Control Group (CG) that monitored usual PA for 12 weeks followed by the PA program. The ACT component consisted of a 2-hour in-person session with the child/caregiver to teach/practice ACT principles, including PA-related values, goal-setting, committed action, mindfulness, and acceptance, supplemented by weekly emails and monthly calls. After post-intervention outcome evaluations, children/parents completed feasibility questionnaires (1-5 ratings/categories/comments).
Six children (mean age=13.8 years, 10-17; IG=3; CG=3) enrolled and completed the study. They reported enjoying the activity trackers (mean=3.8; worn 3-4 times/week to daily) and website (mean=3.7) but rated ACT sessions (mean=2.8) and emails (mean=2.5) lower. Half used ACT >1x/week; most utilized goal-setting (4/6); fewer used values/mindfulness (both 2/6). Parent ratings showed similar patterns. Participants liked the PA program (mean=4.1) and found it helpful (mean=4.0); 6/6 increased their weekly MVPA (total means from 41 to 130 minutes).
These pilot data suggest good feasibility of the home PA program, including some ACT procedures, but indicate aspects to revise for the full RCT.

9. Acceptance and commitment therapy for psychosis and trauma: Improvement in psychiatric symptoms, emotion regulation, and treatment compliance following a brief group intervention

Primary Topic: Clinical Interventions and Interests
Subtopic: Trauma; Psychosis
Alicia Spidel, Universite of Montreal
Taj Dhanoa, UBC
Geoff Michell, Fraser Heath
Tania Lecomte, Universite of Montreal

Objectives. Acceptance and Commitment Therapy (ACT) has shown effectiveness for individuals with psychosis and individuals with a history of childhood trauma, but has not been investigated with people with psychosis who also have a history of childhood trauma. This study aims at determining the efficacy of a mindfulness-based ACT with this clientele in diminishing psychiatric symptoms, trauma-related symptoms, as well as in improving treatment adherence.
Design and Methods. Fifty participants meeting our inclusion criteria were recruited and randomized to take part in either 10 sessions of ACT group, or Treatment as Usual (TAU).
Results. Using RCT it was found that symptom severity, for both overall symptoms (BPRS) and anxiety (GAD), decreased over the course of the treatment, and participants’ ability to regulate their emotional reactions (i.e., accept them) increased. The study also found that treatment engagement increased with regards to help-seeking for those in the ACT group, compared with the TAU controls.
Conclusions. Acceptance and Commitment Therapy offered in a group appears a promising treatment for those with psychosis and history of trauma.

10. Self-as-Context Scale reliability, factor structure, and convergent and divergent validity

Primary Topic: Clinical Interventions and Interests
Subtopic: Psychometric, quantitative measurement
Geoffrey S. Gold, M.A., Hofstra University
Charles A. Dill, Ph.D., Hofstra University

Background: The Acceptance and Commitment Therapy (ACT) literature has defined psychological flexibility in terms of six component processes. Currently, few studies have examined quantitative measures of self-as-context and its less flexible alternatives, self-as-content and self-as-process. A recent study has developed a brief self-report measure, the self-as-context scale (SACS), and found support for its validity and reliability (Gird et al., 2012). The SACS correlates with a general measure of psychological flexibility (AAQ-II).
Method: This study builds upon that work with an examination of the relationship between the SACS and other clinically relevant self-report measures. The study expands upon the work of Gird and colleagues to reexamine scale factors, test reliability, and demonstrate convergent and divergent validity with a battery of clinical assessment tools.
Results: These data suggest SACS is a reliable measure (Cronbach’s α = .85). Results of a factor analysis suggest two factors similar to those identified in earlier studies. SACS scores positively correlate with scores on ACT process measures and other theoretically related measures (AAQ-II; ATQ-F; ATQ-B; EQ; FFMQ; VLQ-I; VLQ-C; SCS) and negatively correlate with measures of emotional struggle (BAI, CES-D), demonstrating convergent and divergent validity.
Discussion: Using correlations and factor analysis models, the current study (N=140) attempts to elucidate the relationships between these measures so that the SACS can be used for clinical interventions and research. A 7-item factor may be a useful tool to assess self-as-context using quantitative self-report. Based on item content, previous findings, and theory, the authors further discuss this factor, described as transcending.

11. An Examination Between Family Stress and Psychological Flexibility - Poster Award Winner

Primary Topic: Clinical Interventions and Interests
Subtopic: Family Stress
Michael Thorn, University of Mississippi
Gina Q. Boullion, University of Mississippi
Emmie R. Hebert, University of Mississippi
Karen Kate Kellum, University of Mississippi
Kelly G. Wilson, University of Mississippi

Family stress can have problematic effects including difficulty with relationships, depression, and social skills. But, some individuals can experience family stress without experiencing any negative impacts in other areas of their life. Understanding the differences between those who struggle during and after family stress and those who do not is important in identifying those who are at-risk, but little research has been conducted in this area. This study examined the relationship between psychological flexibility and perceived family stress. The researchers used a modified version of the Family Response to Stress Questionnaire Child Self Report Scale (RSQ) to measure perception of experienced family. The RSQ questions were modified to be appropriate to a college sample. The researchers measured psychological flexibility using the Acceptance and Action Questionnaire – II (AAQ-II) and the Multidimensional Psychological Flexibility Inventory (MPFI). We used two measures of psychological flexibility as the MPFI is relatively new, and used the AAQ-II to validate the results of the MPFI. Researchers distributed the survey to a sample of convenience through an on-line participant management system. Preliminary results indicate a relationship between some areas measured on the modified RSQ and the MPFI. The poster discusses implications and limitations of these findings.

12. Development of a Transdiagnostic Group Intervention for Pediatric Autonomic Dysfunction

Primary Topic: Clinical Interventions and Interests
Subtopic: Health Psychology
Clio E. Pitula, Ph.D., University of Colorado School of Medicine
Jessica Malmberg, Ph.D., University of Colorado School of Medicine
Sally Tarbell, Northwestern Feinberg School of Medicine/Ann & Robert H. Lurie Children's Hospital

Background: Pediatric autonomic dysfunction (AD) is associated with psychosocial and functional impairment. Psychological interventions may be important in promoting adaptive coping and reducing functional disability in this population. Acceptance and Commitment Therapy (ACT) approaches have been effective in promoting well-being among youth with chronic pain but a similar intervention has not been developed for AD. The present study aimed to develop a group intervention incorporating ACT principles to target modifiable transdiagnostic processes (e.g., experiential avoidance, cognitive flexibility) among youth with AD.
Method: A 10-week outpatient group protocol was developed based on published interventions for chronic pain and the authors’ clinical experience. ACT-based strategies included limits of control, focus on experience, values, mindfulness, cognitive defusion, and committed action. Psychoeducation, lifestyle change (e.g., sleep), and cognitive-behavioral principles (e.g., activity pacing) were integrated. 16 adolescents (15 females, M age=16.2 yrs) with AD and their parent(s) participated in this pilot study to evaluate acceptability (e.g., participant satisfaction) and feasibility (e.g., retention, attendance).
Results: At submission, 6 adolescents had completed the protocol and the remaining participants were in the 7th week. The protocol was revised as the intervention progressed to incorporate participants’ feedback and clinicians’ observations, resulting in a renewed focus on values-based action, clarification of acceptance/willingness, and the addition of motivational interviewing strategies. Preliminary results suggest this protocol was acceptable to families and feasible to implement in an outpatient setting.
Discussion: An ACT-based treatment approach targeting core transdiagnostic mechanisms has the potential to improve adjustment and reduce distress and disability among adolescents with AD.

13. Quality and Avoidance of Social Interactions and their Relation to Values in Depression, Social Phobia, and Controls: Preliminary Results

Primary Topic: Clinical Interventions and Interests
Subtopic: Social Interactions, Values
Jeanette Villanueva, University of Basel
Andrea H. Meyer, University of Basel
Marcel Miché, University of Basel
Hanna Wersebe, University of Basel
Thorsten Mikoteit, University of Basel, Psychiatric Hospital
Jürgen Hoyer, Technische Universität Dresden
Christian Imboden, Psychiatric Services Solothurn and University of Basel, Switzerland; Private Clinic Wyss, Muenchenbuchsee, Switzerland
Klaus Bader, University of Basel, Psychiatric Hospital
Martin Hatzinger, Psychiatric Services Solothurn and University of Basel, Switzerland
Roselind Lieb, University of Basel
Andrew T. Gloster, University of Basel

Social domains are consistently rated as more important in terms of valued behavior than non-social domains (Wersebe et al., 2017). At the same time, everyday social interactions (SIs) are often problematic in many psychological disorders, indicating a discrepancy between what we value and how we behave. In this study, we investigated aspects of SIs (frequency and quality of SIs) and aspects of currently having no SIs (longing/wishing for and avoiding SIs). 284 individuals (Major Depressive Disorder, MDD; Social Phobia, SP; Control Group, CG) were investigated via smartphones in an Ecological Momentary Assessment (EMA) paradigm for one week. Participants were asked in more than 10'000 instances about their feelings when they had SIs and when they had no SIs. Results show that the groups did not differ in terms of frequency of SIs and longing/wishing for a SI. However, MDD and SP reported a significantly lower quality of SIs and also avoided SIs significantly more often in comparison to the CG. Additional analyses will examine how these results relate to discrepancies of participants' social values and their social behavior. Understanding how social values relate to daily social behavior might help us gain more insight into mechanisms in clinical as well as non-clinical populations, therefore contributing to living a more meaningful life.

14. Can the ability to flexibly regulate emotions buffer against the effect of anticipated stress on sleep? – Preliminary results from an ESM Study

Primary Topic: Clinical Interventions and Interests
Subtopic: Sleep, Emotion Regulation
Victoria J. Firsching, M.Sc., University of Basel, Department for Clinical Psychology and Intervention Science
Andrea Meyer, Dr., Universität Basel, Department for Clinical Psychology and Intervention Science
Thorsten Mikoteit, University Psychiatric Clinics Basel
Jürgen Hoyer, Dresden University of Technology
Christian Imboden, Privat Psychiatric Clinik Wyss
Klaus Bader, University Psychiatric Clinics Basel
Andrew T. Gloster, Prof. Dr., University of Basel, Department for Clinical Psychology and Intervention Science
Martin Hatzinger, Psychiatric Services Solothurn and University of Basel, Switzerland

Background: In contrast to research on insomnia, less is known about the immediate influence of stress on sleep in populations without primary sleep disturbances. In addition, time sensitive analyses that examine how proximate stressors influence sleep quality and whether emotion regulation (flexible vs. rigid) can buffer the impact of stressors are lacking. In this study, the effect of a person’s anticipated stress for the next day (as measured at night before going to bed) on a person’s subsequent sleep quality is analyzed.
Method: In a quasi-experimental longitudinal design, participants completed questionnaires 6 times a day over one week, using the Experience Sampling Method (ESM) paradigm. In addition, they filled out a questionnaire battery at baseline.
Results: 284 participants with Major Depressive Disorder (n=118), Social Anxiety Disorder (n=47), and healthy controls (n=119) were included in the study. The mean age was 31.75 years (SD=11.52) and 189 (66.55%) were female. 93.16% of the prompts in the morning or evening were completed (n=3704 prompts). A time-dependent multi-level model using sleep parameters, psychological flexibility, expected stress, and the baseline scores of emotion regulation will be built. Variance in emotion regulation will be associated with anticipated stress and its impact on sleep quality.
Conclusion: The daily effects of anticipated stress on sleep can fill a gap in research and implicate improvements in the treatment of sleep difficulties. The role of emotion regulation can highlight the importance of interventions aimed thereat. Using a sample of both clinical and healthy participants offers generalizability across different populations.

15. Experiential Avoidance and Attachment Anxiety: A Transdiagnostic Model of Social Problem Solving Skills

Primary Topic: Clinical Interventions and Interests
Subtopic: Social problem solving
Dana Goetz, M.A., Western Michigan University
Amy Naugle, Ph.D., Western Michigan University
Caitlin Rae Turgeon, Western Michigan University
Jessica Good, Western Michigan University
Lilly Mazzone, Western Michigan University

Interpersonal dysfunction is generally considered a transdiagnostic process in the empirical literature as the criteria for virtually every disorder in the Diagnostic and Statistical Manual 5 stipulate that symptoms must impact interpersonal functioning. Thus, a deeper understanding of the development and maintenance of poor social problem-solving skills may come from studying variables that are transdiagnostic in nature, such as experiential avoidance and attachment anxiety (Agrawal, Gunderson, Holmes, & Lyons-Ruth, 2004; Berking, Neacsiu, Comtios, & Linehan, 2009). The present study tests a transdiagnostic model for the development of social problem-solving skills based on Gerhart and colleagues' 2014 model of interpersonal problems. The proposed model in this study will be tested in a convenience sample of undergraduate students. A moderated mediation model will be estimated using the bootstrapping approach as put forth by Preacher, Rucker, and Hayes (2007), hypothesizing that the indirect effect of experiential avoidance on poor social problem-solving skills will be accounted for by including attachment anxiety in the model. We further hypothesized that the strength of relationship between attachment anxiety and social problem solving skills will depend on the level of experiential avoidance. To target social problem-solving skills in a more contextual manner, the means-ends problem-solving test procedure (MEPS; Platt & Spivack, 1975) will be use. The MEPS is a "state like" measure of social problem solving and that includes interpersonal scenarios one may encounter in real-life. Findings will be discussed, with implications proposed for understanding the development and maintenance of interpersonal dysfunction from a transdiagnostic framework.

16. Psychometric Properties of the Cognitive Fusion Questionnaire (CFQ) in a Greek-Cypriot Sample of University Students
Sponsored by: Greek-Cyprus ACBS chapter
Primary Topic: Clinical Interventions and Interests
Subtopic: Cognitive Fusion
Marianna Zacharia, M.Sc., ACThealthy laboratory, University of Cyprus, Nicosia, Cyprus
Artemis Theofanous, B.A., ACThealthy laboratory, University of Cyprus, Nicosia, Cyprus
Maria Karekla, Ph.D., ACThealthy laboratory, University of Cyprus, Nicosia, Cyprus

The Cognitive Fusion Questionnaire (CFQ) is a measure of cognitive fusion, which constitutes a fundamental construct in the psychopathology model underlying Acceptance and Commitment Therapy (ACT). Well-validated measures that assess cognitive fusion across various groups and populations are needed to be able to assess this construct and examine any changes in cognitive fusion as a result of treatment. The purpose of this paper is to examine the factor structure and psychometric properties of the CFQ in a Greek-speaking sample. The sample (N=105; 64.8% female, Mean age=22.44) was derived from undergraduate and postgraduate students of various programs of study from the University of Cyprus. Initially, an exploratory factor analysis (EFA) was conducted. Results supported a single-factor solution based on Kaiser’s criterion, explaining 79.64% of the total variance. The Eigenvalue of this factor was 5.58. This finding was consistent with the sudden change on the scree plot chart emerging following the first factor. Additionally, Parallel Analysis was employed to verify the factor structure. Parallel Analysis recommended a single-factor solution (only one factor with a Raw Data Eigenvalue=5.32 above the 95th Percentile Eigenvalue=.64), with the scree plot corroborating the uni-dimensional factor structure. Consistent with previous empirical studies, including the reported structure of the original English version, a single-factor solution appears to be suitable. G-CFQ exhibited good internal consistency (Cronbach’s α=.96). G-CFQ demonstrated significant correlations with similar and other constructs (i.e., CAMM, SSEQ), suggesting good convergent and discriminant validity. The G-CFQ shows good psychometric properties. Directions for future research and clinical implications are discussed.

17. Psychometric Properties of the Child and Adolescent Mindfulness Measure (CAMM) in a Sample of Greek-Cypriot Youth
Sponsored by: Greek-Cyprus ACBS chapter
Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness
Artemis Theofanous, B.A., ACThealthy laboratory, University of Cyprus, Nicosia, Cyprus
Marianna Zacharia, M.Sc., ACThealthy laboratory, University of Cyprus, Nicosia, Cyprus
Maria Karekla, Ph.D., ACThealthy laboratory, University of Cyprus, Nicosia, Cyprus

As mindfulness interventions become more popular, it is important to validate measures to assess mindfulness across various populations and groups, so as to enable the more rigorous examination of the construct and any resulting interventions.The 10-item Child and Adolescent Mindfulness Measure (CAMM), assesses present-moment awareness and nonjudgmental/non-avoidant responses to feelings and thoughts. The current study examined the factor structure and the validity of the Greek version of the CAMM. A sample (N=105) of youth was recruited from the University of Cyprus. An exploratory factor analysis (EFA) was employed without forcing factor extraction. Results indicated a two-factor solution, explaining a total variance of 62.18%. The Eigenvalues were: 4.71 (47.17%) for factor 1 and 1.50 (15.01%) for factor 2. However, Factor 2 consisted of only two items and the two-factor structure lacked conceptual meaning. Parallel analysis was also performed, showing a sudden change on the scree plot after the first factor and the difference between the Eigenvalues of the first factor and the second factor was large. Therefore, the single factor solution seems more appropriate. Subsequently, all 10 items were forced into a single factor solution using EFA, which explained 47.17% of the total variance. G-CAMM showed good internal consistency (Cronbach’s α= .86). Furthermore, G-CAMM showed good psychometric properties, with good internal consistency and high correlations with similar constructs (e.g., CFQ). Overall, results suggest that the G-CAMM is a valid and reliable measure of mindfulness for Greek speaking youth.

18. Parameters of psychological trauma and their distinct and concurrent relationships to the development of adolescent resilience
Sponsored by: Greek-Cyprus ACBS chapter
Primary Topic: Clinical Interventions and Interests
Subtopic: PTSD
Elena Frixou, University of Cyprus
Myria Ioannou, University of Cyprus
Stelios N. Georgiou, University of Cyprus
Panayiotis Stavrinides, University of Cyprus

Psychological trauma affects up to 70% of children and adolescents and a portion of the people exposed to trauma can develop post-traumatic stress disorder (PTSD). Resilience is a potential outcome after traumatic exposure, which refers to the ability to bounce back and adapt in the context of adversity (e.g., Sapienza & Masten, 2011). Existing research investigates the effects of particular types of trauma on resilience, without concurrently testing the objective and subjective dimensions of trauma (i.e., history of trauma, duration of trauma, closeness of trauma to self, traumatic reactions, centrality of traumatic event). The present study aims to test the parameters of traumatic exposure reported above, as characteristics that affect and moderate the relationship between traumatic experiences and resilience. A sample of 250 adolescents aged 12-18 years old will take part in this study and will complete the Traumatic Events Screening Inventory for Children self-report (TESI-C-SR; based on TESI-C by Ribbe, 1996), the Children’s Revised Impact of Event Scale (CRIES; Horowitz et al., 1979; Yule et al., 1997), the Centrality of Event Scale (CES; Berntsen & Rubin, 2006), the Child and Youth Resilience Measure -28 (CYRM-28; Ungar et al., 2008) and the Brief Resilience Scale (BRS; Smith et al., 2008). The data are currently being collected and will be analyzed using Structural Equation Modelling in AMOS version 24.0. The findings of the study will increase our understanding in terms of the trauma-related characteristics that affect resilience, and will assist with the individualization of interventions for post-traumatic stress.

19. Investigating the role of family resilience in the relationship between psychological trauma and individual resilience in adolescents
Sponsored by: Greek-Cyprus ACBS chapter
Primary Topic: Clinical Interventions and Interests
Subtopic: PTSD
Styliani Stavrou, University of Cyprus
Myria Ioannou, University of Cyprus
Stelios N. Georgiou,, University of Cyprus
Panayiotis Stavrinides, University of Cyprus

Previous research on resilience has led to the identification of separated protective characteristics concerning the individual (e.g. age, education) and the family (e.g. spirituality, financial management), but more interactive effects on resilience development are absent. It is not clear yet what is the congruency between family and individual resilience and what is the role of the family in the management of traumatic exposure and the development of resilience in adolescence. The present study aims to examine family resilience as a potential moderator in the relationship between psychological trauma and adolescent resilience. A sample of 300 adolescents aged 12-18 years old will take part in this study and will complete the Traumatic Events Screening Inventory for Children self-report (TESI-C-SR; based on TESI-C by Ribbe, 1996), the Children’s Revised Impact of Event Scale (CRIES; Horowitz et al., 1979; Yule et al., 1997), the Child and Youth Resilience Measure -28 (CYRM-28; Ungar et al., 2008) and the Brief Resilience Scale (BRS; Smith et al., 2008). The Family Resilience Assessment Scale (FRAS; Sixbey, 2005) and the parental form of TESI (Ribbe, 1996) will be completed by one of the parents of each participant. The data are being collected at the moment and will be analyzed using Structural Equation Modelling in AMOS version 24.0. The findings of the study will add in the theoretical model of adolescent trauma and resilience and will shed light on the theoretical interactions between family and individual resilience, with the aim to inform interventions for post-traumatic stress in adolescence.

20. A Single Case Study Investigating the Efficacy of an Acceptance and Commitment Therapy Intervention to Promote Well-Being and Mitigate the Deleterious Effects of Shame and Self-Stigma in Adults Experiencing Homelessness

Primary Topic: Clinical Interventions and Interests
Subtopic: Homelessness
Varsha Eswara Murthy, BA, MPsychSc, University College Dublin
Louise McHugh; MA, Ph.D, University College Dublin

Background: The reality of being homeless and the circumstance leading to experiencing homelessness render this population at risk of a multitude of mental and behavioural health disorders. Furthermore, the stigma associated with experiencing homelessness can lead to difficulties in obtaining employment, reduced access to housing, poor support for treatment, or interpersonal rejection. This often results in the individual self-stigmatising and experiencing intense shame, resulting in negative thoughts that emerge from identification with a stigmatised group and their resulting in negative psychological and behavioural consequences. The aim of this study is to evaluate the efficacy of a single one-to-one session Acceptance and Commitment Therapy intervention to promote well-being and mitigate the deleterious effects of shame and self-stigma for individuals experiencing homelessness.
Method: We will use a two-arm, randomised multiple-baseline design. Participants will be 12 adults experiencing homelessness in Inner City Dublin. Internalised shame, depression, anxiety, psychological, emotional and social well-being, cognitive fusion, psychological flexibility, valued action, and openness to experience will be measured at baseline, post-intervention, and at a 6-week follow up. Daily measures of self-reported shame and experiential avoidance will be collected via text. Qualitative interviews will also be conducted post-intervention and at follow up assessing impact and ease of application of the intervention strategies.
Results: It is hypothesised that the intervention will, improve; psychological flexibility, resilience, positive coping strategies, quality of life, meaning in life, self-esteem, self-compassion, and decrease; levels of anxiety, depression, shame, and self-stigma.

21. Five Case Studies Using ACT for College Students with Perfectionism
Sponsored by: Pennsylvania Chapter
Primary Topic: Clinical Interventions and Interests
Subtopic: Perfectionism, College Students, Anxiety
Steven Bisgaier, MA, BCB, Widener University Institute for Graduate Clinical Psychology
Frank Masterpasqua, Ph.D., Widener University Institute for Graduate Clinical Psychology

Background: Perfectionism is prevalent in a wide range of psychiatric disorders (e.g., depression, anxiety, disordered eating, OCD, PTSD) and physical health problems (e.g., chronic pain, migraine, asthma, fatigue). While ACT protocols have been developed to treat perfectionism, no studies have evaluated its effectiveness. This pilot study examined the effectiveness of ACT in treating perfectionism in five undergraduate students with perfectionism as a primary feature of either generalized anxiety disorder or depression.
Method: The study used a one-group pretest-posttest design. Individual treatment lasted between seven and twelve sessions and was administered flexibly (i.e., non-manualized).
Results: Acknowledging the small sample size, significant improvement with large effect sizes were found on measures of depression (p = .012, d = 1.98), general anxiety (p = .011, d = 2.01), social anxiety (p = .009, d = 2.11), general distress (p = .008, d = 2.17), frequency and awareness of thoughts related to perfectionism (p = .003, d = 3.00), psychological flexibility (p = .017, d = 1.76), cognitive fusion (p = .013, d = 1.89), and commitment to values-consistent action (p = .050, d = 1.24).
Discussion: These findings provide preliminary support for the effectiveness of ACT as a treatment for perfectionism and pave the way for a future RCT. The study suggests three primary mechanisms of change: reductions in experiential avoidance, increases in cognitive defusion, and clarification of personal values. The study adds to existing evidence showing that treating perfectionism directly and explicitly can provide remittance of symptoms of other mental health issues.

22. Pilot evaluation of an ACT group intervention for adolescents implemented in integrated primary care

Primary Topic: Clinical Interventions and Interests
Subtopic: Children and Adolescents
Sean M. O'Dell, Ph.D., Geisinger
Shelley Hosterman, PhD, Geisinger
Carrie E. Massura, PhD, Geisinger
Monica R. Whitehead, PhD, Geisinger
Rachel A. Petts, PhD, Geisinger

Background: Few investigations have explored Acceptance and Commitment Therapy (ACT) interventions for adolescents, particularly within real-world settings. This project examined feasibility and clinical outcomes of a nine-session, novel group-based ACT intervention for clinic-referred adolescents with internalizing disorders in integrated primary care.
Method: Sessions attended and therapeutic homework completion were used to examine feasibility. We also used logistic regression to test for demographic and clinical predictors of treatment completion. Clinical outcomes were evaluated using dependent samples t-tests of pre-post self-report ratings of psychological flexibility, anxiety and depression symptoms, and goal attainment scale ratings.
Results: Most participants were white (91.0%) and female (77.5%), and mean age was 15.13 (SD = 1.6). 49 of 111 completed the group and all outcome measures; the average participant attended 5.83 sessions and completed 25.6% of the homework. There were no significant improvements in depression symptoms; however, psychological flexibility (p = .026; d = .32), anxiety (p = .005; d = .42), and goal attainment scale (p < .001; d = 2.12) outcomes showed improvement. No demographic or baseline clinical scores predicted treatment completion.
Discussion: Improvements in psychological flexibility, anxiety, and goal attainment scores improved for those who completed treatment provide preliminary evidence of effectiveness. Treatment completion rates are comparable to other studies in real-world settings and treatment completion did not differ across demographic or baseline clinical characteristics, suggesting attrition is not related to these factors. Feasibility of number of sessions, utility of homework, and non-response for depression symptoms warrants further investigation in more rigorous studies.

23. Chinese International Students Unique Stressors Scale

Primary Topic: Clinical Interventions and Interests
Subtopic: mindfulness, diversity
Huanzhen Xu, Bowling Green State University
William O'Brien, Ph.D., Bowling Green State university
Yiwei Chen, Ph.D., Bowling Green State University

Background: China has become a leading source of international college students for Western countries. Given Chinese international students (CIS)’ increasingly large contribution to the college population to the host countries, their specific needs in mental health service should be addressed. Studies across different countries indicate that international students, relative to domestic students, experience higher levels of distress given the acculturative challenges. However, there is little research investigating the unique stressors experienced by CIS and their impact on wellbeing. In this study, a new measure of CIS acculturative stress was developed and evaluated for its psychometric properties.
Methods: Focus groups were conducted in Mandarin to promote more open and flexible communication. Audiotapes of the focus groups were evaluated by three independent Mandarin speaking raters who generated 94 initial statements. These initial statements were then broken down and classified using a card-sort approach which identified ten sub-scales. The final CIS Unique Stressor Inventory contains 103 items (inter-rater reliability=85.58%). A sample of 21 CIS attending a Midwestern university completed the new measure along with the Acceptance and Action Questionnaire, Cognitive Fusion Questionnaire, Depression, Anxiety and Stress Questionnaire, and Patient Health Questionnaire.
Results: An analysis of psychometric properties of the new measure indicates it has excellent overall internal consistency (Chronbach’s Alpha = 0.967). The measure was significantly correlated with AAQ-II, DASS-21, and CFQ-7.
Discussion: the high correlations between the new measure and measures of psychological distress and mindfulness implied that it is a useful indicator of CIS’s psychological well-being and psychological flexibility.

24. Predicting life satisfaction and functioning: Examining the role of experiential avoidance with neuroticism and affect

Primary Topic: Clinical Interventions and Interests
Subtopic: Experiential Avoidance, Personality, Life Satisfaction, Life Functioning, ACT
Catherine Rochefort, M.S., Southern Methodist University
Michael Chmielewski, PhD, Southern Methodist University

Previous research has indicated that experiential avoidance (EA) is a predictor of life satisfaction and functioning. However, in most studies, EA was assessed using the AAQ-II, which recent research suggests functions as an indicator of neuroticism and negative affect (N/NA) instead of experiential avoidance. We examined whether the AAQ-II and the MEAQ (another measure of EA) predict life satisfaction and functioning above the effects of N/NA. Adult participants (MTurk; N = 643) completed the AAQ-II and MEAQ online. They also completed measures of neuroticism (BFI-N), trait positive and negative affect (TAI), life satisfaction (SWLS), and functioning (WHODAS-2.0 and SF-36). Replicating previous findings, the AAQ-II functions as a measure of N (r = .71) /NA (mean r = .62). In contrast, the MEAQ was differentiated from N (r = .39) and NA (mean r = .44), and can be considered an indicator of EA. Contrary to hypotheses, the MEAQ (i.e., EA) demonstrated limited incremental validity above N/NA in predicting life satisfaction and functioning. The AAQ-II demonstrated incremental validity above N/NA. However, the magnitude of this association was similar to that provided by N/NA over each other. Although unexpected, the current results suggest EA may not influence life satisfaction or functioning, and that N/NA is the primary variable of interest. We are in the process of replicating these results in additional samples. It is important to acknowledge that the data were cross-sectional. This is because it is possible, perhaps even likely, that the negative effects of EA manifest over time.

25. Disney Princess' Influence on Dating

Primary Topic: Clinical Interventions and Interests
Subtopic: Healthy Relationships
Lauralee Davis, University of Mississippi
Gina Q. Boullion
Emily Jacobson
Karen Kate Kellum

Research has indicated that there is a correlation between perceived similarity and wishful identification with that of the subject's romantic relationship morals and beliefs (Griffin, 2014). There are many reasons why perceived similarity and wishful indentification of Disney princesses should be linked to romantic relationship beliefs, and more research is warranted to examine that connection. We are interested in further understanding the interplay of these variables. Participants were recruited through an online particiant management system. They completed a battery of self-report questionaires regarding viewing of Disney princess films, relationship satisfaction, psychological distress, drinking habits, and psychological flexibility. The researchers used a modified Romantic Beliefs Scale (Sprecher & Metts, 1989) to measure individual's romantic relationship satisfaction. The researchers measured reasons for watching various movie genres, including Disney movies, using the Rubin scale (1983). The researchers also used the Homophily scale (McCroskey, Richond, and Daly, 1975) to measure an individual's attitudes relating to their favorite Disney princess. The researchers measured the levels of wishful identification using the and the Eyal and Rubin scale (2003). Preliminary results indicate a relationship between some areas of movie and relationship satisfaction. The poster discusses implications and limitations of these findings.

26. Developing an ACT-based mobile app intervention for adults with a visible difference affected by appearance anxiety - Poster Award Winner

Primary Topic: Clinical Interventions and Interests
Subtopic: Body image
Fabio Zucchelli, MSc, University of the West of England, Bristol
Heidi Williamson, Prof Doc (Health Psych), University of the West of England, Bristol
Olivia Donnelly, ClinPsyD, North Bristol NHS Trust
The VTCT Foundation Research Team at the Centre for Appearance Research, UWE Bristol, University of the West of England, Bristol

Visible difference refers to any physical appearance deviating from the societal norm, typically caused by congenital (e.g. cleft lip/palate) or acquired conditions (e.g. psoriasis), injury (e.g. burns) or medical treatment (e.g. surgery). Evidence is growing for the application of Acceptance and Commitment Therapy (ACT) to common psychosocial challenges reported by some with visible differences, including social anxiety and isolation(1), body image dissatisfaction and self-stigma(2). Psychologists across Europe also report using ACT for patients affected by visible difference(3).
There is a need for greater access to specialist psychological treatment for individuals affected by appearance anxiety(4). A mobile app could offer widespread access to tailor-made self-help. ACT-based apps show promising efficacy in changing behaviour, including smoking cessation(5) and exercise/diet(6).
This poster will describe the design process undertaken for a mobile app intervention resulting in a full app demo, and will outline plans to develop a prototype fully-formed app. The process comprised: (a) forming a project team with suitable expertise (clinical, research, lived experience, software development, and user experience design); (b) constructing an initial overview of the app; (c) producing a screen-by-screen wireframe (blueprint); (d) building a clickable demo based on the wireframe; (e) engaging in public involvement (PI) via a design workshop with members of charities representing appearance-affecting conditions; and (f) redesigning the demo following PI.
This will offer delegates an example of developing ACT-based health apps from conception. We will focus on the iterative design model employed, integrating ongoing PI with user representatives. Details of the content will also be provided.

27. Applying ACT to a Functional Restoration Program for Veterans with Chronic Pain

Primary Topic: Clinical Interventions and Interests
Subtopic: Chronic Pain
Lauren Hollrah, Psy.D., Puget Sound Veterans Affairs Health Care System
Jonathon Moore, Ph.D., Puget Sound VAMC
Bernard Canlas, MD, Puget Sound VAMC

Background: Acceptance and Commitment Therapy has support for the treatment of chronic pain. Functional Restoration Programs are also supported by research in the treatment of chronic pain, though typically using a more CBT approach. The VA Puget Sound has adopted an ACT based FRP (across modalities of physical therapy, medicine and psychology) to improve self-management and treatment of veterans with chronic pain. The shift of using mindfulness based therapies, across disciplines, supports and reinforces treatment for chronic pain. The primary goal is to enhance thriving as it relates to pain. Combining ACT with FRP leads to a viable and effective treatment of chronic pain across disciplines.
Method: For this program, Veterans met with providers twice weekly for four hours for eight weeks, totaling 64 hours of physical therapy, psychology, and mind-body interventions. Measures were administered at pre and post course data points.
Results: The current study consists of an observational, non-experimental exploratory analysis of outpatient chronic pain treatment outcomes. Treatment recipients at a Veterans Affairs hospital who participated in the outpatient treatment completed numerous pain-related outcome measures. This ACT based modality demonstrated beneficial effects, and preliminary evidence suggested that the treatment provides positive outcomes.
Discussion: Moving forward, it would seem beneficial for chronic pain management programs, specifically functional restoration programs, to use ACT as the psychological treatment modality.

28. An experimental comparison of ACT Values Exercises to increase values-oriented behavior

Primary Topic: Clinical Interventions and Interests
Subtopic: Values
Jessica L. Engle, Ph.D., University of Nevada, Reno and William S. Middleton Memorial Veterans Hospital
Victoria M. Follette, Ph.D., Florida Institute of Technology

BACKGROUND: In Acceptance and Commitment Therapy (ACT), identifying values is believed to increase clients' values-oriented behaviors. Some values exercises add an additional step of asking clients to rate how closely their recent behaviors match their values, but the effectiveness of this step is unknown.
METHOD: This online study compared the effectiveness of two values exercises with a control condition. Participants (N = 314) were randomly assigned to one of three conditions: 1) basic values identification (Values), 2) Values plus rating one's values-behavior consistency (VBC), or 3) control condition. In both values exercises, participants wrote about a chosen value and then rated the importance of charity-related values (e.g., "I care about giving back"). In the VBC condition, participants additionally rated how closely their recent behavior matched their values. In the control condition, participants wrote about time management practices. All participants then had the opportunity to donate some of their study earnings to charities.
RESULTS: Both the Values and VBC conditions increased the likelihood participants would donate to charity compared to the control condition (b = .51, p = .02; and b = .55, p = .01). Values conditions were not significantly different in their overall influence on donation. However, in the VBC condition only, fusion to negative self-statements was positively associated with donation.
DISCUSSION: Findings offer further support for values as a component of ACT and highlight important research directions. Values identification alone may be sufficient to change behavior.

29. Flexibly And/Or Inflexibly Embracing Life: Identifying Fundamental Approaches to Life Within the Hexaflex Model

Primary Topic: Clinical Interventions and Interests
Subtopic: Flexibility in Non-Clinical Populations, flexibility across time
Oliver Stabbe, University of Rochester
Jaci Rolffs, M.A., University of Rochester
Ronald D Rogge, PhD, University of Rochester

BACKGROUND: The Hexaflex model highlights 6 dimensions of inflexible responses to life and 6 corresponding dimensions representing psychological flexibility. Building on over 180 studies demonstrating the effectiveness of ACT, a scale was recently developed to assess each of the 12 dimensions of the Hexaflex model (the Multidimensional Psychological Flexibility Inventory; MPFI; Rolffs, Rogge, & Wilson, 2016).
OBJECTIVES: The current study sought to identify fundamental classes of individuals based on their scores on the 12 dimensions of the MPFI, clarifying the fundamental ways that individuals tend to approach challenges within the Hexaflex framework.
METHODS: A sample of 2,668 respondents (60% female, 82% Caucasian, 18 to 77yo, M = 34.2yo) were recruited (28% Mechanical Turk, 55% ResearchMatch, 14% undergraduate subject pool) to complete an online survey. A subset of 970 respondents completed a 4-month follow-up survey.
RESULTS: Latent Profile Analyses on the MPFI scores suggested 6 basic classes of respondents, ranging from a highly flexible group (n = 424) to a highly inflexible group (n=361), and including a group marked by moderately high levels of both flexibility and inflexibility (n = 387). Individuals in groups marked by higher levels of inflexibility were 3-4 times more likely to be in therapy, reporting higher current depressive symptoms and physical illness. In contrast, individuals in groups marked by flexibility reported higher current vitality as well as increases in vitality over 4 months.
DISCUSSION: The current results highlight the importance of flexibility for all individuals, extending previous findings in clinical populations to non-clinical populations.

30. The nomological network of cognitive fusion among people living with HIV

Primary Topic: Clinical Interventions and Interests
Subtopic: Human immunodeficiency virus (HIV)
Caitlin O'Loughlin, B. A., Drexel University
C. Virginia O'Hayer, Drexel University
David Bennett, Ph.D., Drexel University

Introduction: Cognitive fusion refers to intense over-identification with one’s thoughts. The relationship between cognitive fusion, self-compassion, and the potentially related constructs of rumination, shame, and grit is largely unknown, as is their association with internalizing symptoms among people living with HIV (PLWH). The current study examines the interrelationship of these constructs among PLWH presenting for outpatient psychotherapy. Specifically, we hypothesize that cognitive fusion is associated with higher levels of rumination, shame, depressive symptoms, and anxiety symptoms, and with lower levels of self-compassion and grit.
Method: Participants (n=98), who were previously diagnosed with HIV/AIDS, presented for psychotherapy after screening high on depressive symptoms on the Beck Depression Inventory-II (BDI-II). Participants completed the Cognitive Fusion Questionnaire, Self-Compassion Scale Short Form, Internalized Shame Scale, HIV Related Shame Inventory, Beck Anxiety Inventory, Ruminative Response Scale, Grit Scale, and BDI-II. Relationships between all study variables were examined using Pearson correlations and Spearman’s rho.
Results: As hypothesized, cognitive fusion and self-compassion were negatively correlated (r= -.61, p<.001). Cognitive fusion was associated with greater rumination, shame, depressive symptoms, and anxiety symptoms, and with less grit. Conversely, self-compassion was associated with less rumination, shame, depressive symptoms, and anxiety symptoms, and with increased grit.
Discussion: These findings highlight the interrelatedness between cognitive fusion and self-compassion, as well as their respective relationships to rumination, shame, and internalizing symptoms. Further research is needed to examine whether Acceptance and Commitment Therapy, with its focus on cognitive defusion and acceptance, can positively affect self-compassion, shame, and rumination in decreasing internalizing symptoms among PLWH.

31. MAC: a mindfulness, acceptance and commitment based short intervention for patients with depression

Primary Topic: Clinical Interventions and Interests
Subtopic: depression
Peter Tonn, MD, Neuropsychiatric Center Hamburg
Silja C. Reuter, MD, Neuropsychiatric Center Hamburg
Nina Schulze, Dipl.-Psych., Neuropsychiatric Center Hamburg

Background: Practicing mindfulness improves self-awareness and self-care. The ability to accept unpleasant situations and emotions reduces suffering and emotional pain. We developed a new short intervention for patients with depression.
Methods: We are currently treating a small group of patients with this treatment. IT is our pilot study to see if the treatment is effective. If it is, we will conduct a RCT study with more patients. At the ACBS we want to present the results of our pilot group with n=16.
Discussion: Due to a structural reform in the german health care system, it has become a lot easier for therapists to offer short interventions up to twelve sessions. Therefore the goal of our study was not only to create and evaluate a new treatment, but also to develop a therapy manual in which the treatment is described in detail and which we can give to other therapists to spread the use of ACT based interventions in Germany.

32. The incremental validity of the Cognitive Fusion Questionnaire (CFQ) over a measure of automatic negative thoughts

Primary Topic: Clinical Interventions and Interests
Subtopic: Measurement
Jennifer Krafft, Utah State University
Michael E. Levin, Ph.D., Utah State University

Background: The Cognitive Fusion Questionnaire (CFQ; Gillanders et al., 2014) is a well-validated measure of cognitive fusion. However, it is unclear if the CFQ has incremental validity compared to measures of the frequency of difficult thoughts. Items on the CFQ include “My thoughts cause me distress or emotional pain" and “I get upset with myself for having certain thoughts." Responses to these items could be influenced not only by fusion but also by the frequency of difficult thoughts. Establishing the incremental validity of the CFQ over a measure of the frequency of difficult thoughts would help to clarify that the CFQ is measuring cognitive fusion specifically.
Method: This study examined the association between the CFQ and the Automatic Thoughts Questionnaire (ATQ; Hollon & Kendall, 1980) as well as the incremental validity of the CFQ in a student sample (n = 346).
Results: The CFQ and ATQ-F were highly correlated (r = 0.71, p < .001). However, the CFQ predicted additional variance in distress ( = 0.14, p < .05) , depression ( = 0.11, p < .05), and anxiety ( = 0.16, p < .01) in a series of longitudinal hierarchical regression models controlling for corresponding baseline symptoms and automatic negative thoughts. The CFQ did not predict significant additional variance in social anxiety, academic stress, social role problems, or student role problems.
Discussion: These results suggest that the CFQ measures cognitive fusion, not only the presence of difficult thoughts, but suggest limitations in its incremental validity in specific areas.

33. Turkish Version of Voices Acceptance and Action Questionnaire (VAAS): Preliminary Analysis of Reliability and Validity

Primary Topic: Clinical Interventions and Interests
Subtopic: Psychosis
Merve Terzioglu, Bakirkoy Research & Training Hospital for Psychiatry, Neurology and Neurosurgery
Kaasim Fatih Yavuz, Bakirkoy Research & Training Hospital for Psychiatry, Neurology and Neurosurgery

BACKGROUND: There has been growing evidence which shows effectiveness of psychotherapy in psychosis using acceptance and mindfulness methods. VAAS (Voices Acceptance and Action Scale) has been developed for assessing acceptance-based attitudes and actions regarding to auditory hallucinations. This study aims to examine psychometric properties of the Turkish version of VAAS.
METHOD:The study group consisted of 50 psychotic patients with auditory hallucinations. The scale was translated by two independent person and then corrected by the authors. A socio-demographic data form, Turkish version of VAAS (TVAAS) , Acceptance and Action Questionnaire-II (AAQ-II), Scale for the Assessment of Positive Symptoms, Quality of Life Scale for Schizophrenic Patients, revised Beliefs About Voices Questionnaire (BAVQ-R), Psychotic Symptom Rating Scale Auditory Hallucinations were administered. Internal consistency and split-half analyses were performed to evaluate the reliability. Validity analyses were also conducted.
RESULTS:Reliability analysis using corrected item total statistics led 4 items to be removed from the scale. Cronbach’s Alpha coefficient was calculated as 0.855 for total scale. Acceptance and action subscales have also showed good internal consistency with Cronbach’s Alpha coefficient of 0.70 and 0.818. Split-half reliability of the scale was 0.85. TVAAS correlated in the expected direction with AAQ-II and Quality of Life Scale and showed good convergent validity (r=351, r=256). As expected, it didin’t correlate with symptom measurements and BAVQ-R.
DISCUSSION:VAAS has been found to be a reliable and valid measure to assess the psychological impact of voices in Turkish psychotic patients. Also it can be said that TVAAS assess different processes according to BAVQ-R.

34. Demonization, desecration, and the 2016 U.S. presidential election: The role of negative spiritual appraisals on post-election psychological adjustment

Primary Topic: Clinical Interventions and Interests
Subtopic: Spirituality and Religion
Serena Wong, M.A., M.E., Bowling Green State University
Tabitha Waite, M.A., Bowling Green State University
Rachel Wasson, B.A., Bowling Green State University
Augustus Artschwager, B.A., Bowling Green State University
Kenneth I. Pargament, Ph.D., Bowling Green State University
William H. O'Brien, Ph.D., Bowling Green State University

Demonization and desecration are negative spiritual appraisals associated with psychological maladjustment across political and relational contexts (Krumrei, Pargament, & Mahoney, 2011; Mahoney et al., 2002; Pargament et al., 2005). To what extent do people perceive the election of President Trump as the work of evil forces or a violation of the sacred? Using a cross-sectional online sample of 252 Americans, the authors examined the prevalence and role of negative spiritual appraisals of the 2016 U.S. presidential election on psychological adjustment. Approximately one-third of participants endorsed some level of such appraisals. Desecration and demonization also predicted maladjustment above and beyond vote and voter demographics. Moreover, the interactive effect between vote and negative spiritual appraisals accounted for unique variance in maladjustment. At higher levels of demonization and desecration, those who voted for President Trump reported greater difficulties with emotion regulation than those who voted against President Trump. Negative spiritual appraisals also moderated the relationship between vote and thought suppression, antagonism, openness to new information, and perceived negative impact of the election. Implications for mental health and psychospiritual interventions are discussed.

35. A Preliminary look at the Efficacy of Acceptance and Commitment Therapy (ACT) in a Transdiagnostic Group of Adolescents in Singapore

Primary Topic: Clinical Interventions and Interests
Subtopic: Adolescents, Anxiety, Depression, Transdiagnostic
Leong Yeok JANG, Institute of Mental Health, Singapore
LIEW Wei Lun Kenny, Institute of Mental Health, Singapore

Background: Anxiety and Depression contribute to a significant proportion of disease burden in youths, impacting their academic, vocational, and psychosocial outcomes. There is growing evidence that ACT can be a viable treatment option for adolescents with anxiety and/ or depression. A protocol for group-based ACT was adapted for adolescents presenting to an outpatient mental health clinic in Singapore. To our knowledge, the current study is the first to investigate intervention with an Asian adolescent sample.
Method: Eleven adolescents (4 males) aged 13 to 17 years (M = 15.8, SD = 1.5) with clinical diagnosis of anxiety disorders and/or depression enrolled in the intervention. Adolescents with comorbidity of Autism Spectrum Disorder, Schizophrenia, and/or intellectual disabilities were excluded. The efficacy of the group-based intervention was evaluated using four standardized instruments at pre-treatment, post-treatment, and at 3-months post-treatment: (a) Depression, Anxiety, Stress Scales short version (DASS21; Lovibond & Lovibond, 1993), (b) Child and Adolescent Mindfulness Measure (CAMM; Greco, Baer & Smith, 2011), (c) Acceptance and Fusion Questionnaire for Youth (AFQ-Y; Greco, Murrell, & Coyne, 2005), and (d) Valued Living Questionnaire (VLQ, Wilson, Sandoz, Kitchens, et al. 2010). Participants were required to attend the 8-session intervention, followed by a booster session 3 months later.
Results & Discussion: At post-treatment, most participants reported reduced levels of depression, anxiety and/or stress. They reported being more mindful as well as endorsed lowered experiential avoidance and cognitive fusion. Preliminary results may suggest that ACT is a promising transdiagnostic treatment option for adolescents in Singapore experiencing anxiety and/or depression.

36. Evaluation of the effectiveness of a brief intervention based on Acceptance and Commitment Therapy for Irritable Bowel Syndrome non-patients
Sponsored by: ACBS Japan Chapter
Primary Topic: Clinical Interventions and Interests
Subtopic: ACT, irritable bowel syndrome, brief intervention,
Masataka Ito, M.A., Graduate school of psychology, Doshisha University
Takashi Muto, Ph.D., Doshisha University

Background: Irritable Bowel Syndrome (IBS) is one of the most common functional disorders, and psychological treatment has been proven to be effective for IBS patients. However, a majority of IBS patients have experienced IBS as non-patients for a period, but intervention for these non-patients has rarely been investigated. The current study examined the efficacy of Acceptance and Commitment Therapy (ACT) for IBS non-patients.
Methods: A screening survey was administered to recruit undergraduates, and those who scored above the clinical cutoff on the IBS severity index were inducted into this study as IBS non-patients. A total of 26 non-patients who could participate in the ACT program were randomly assigned to either an intervention group or a waiting list group. Self-reported data assessing IBS symptom severity, quality of life, psychological distress, and psychological flexibility were collected at both pre- and post-intervention. Participants assigned to the intervention group completed the ACT program following the protocol listed on the ACBS website under “ACT for Irritable Bowel Syndrome." They were also offered the workbook titled “Get Out of Your Mind and Into Your Life."
Results: In the post-intervention assessment, the intervention group showed marginally significant improvement in symptom severity. In contrast, the waiting list group did not exhibit any improvement. Moreover, their depression score worsened. Other components did not demonstrate any significant change.
Discussion: The results showed that the ACT program is a promising approach for improving the condition of IBS non-patients because this program lessened IBS severity and prevented the participants from becoming depressed.

37. Brief Group-Based Acceptance and Commitment Therapy: A Pilot Study on Singaporean Adolescents

Primary Topic: Clinical Interventions and Interests
Subtopic: Adolescents
Amerie Baeg, MClinPsy, KK Women's and Children's Hospital (Singapore)
Siobhan Kelly, DClinPsy/MSc, KK Women's and Children's Hospital (Singapore

Background: A significant number of adolescent patients do not respond to current first-line treatment for anxiety and depression (i.e., Cognitive Behavioral Therapy). Moreover, an increasing demand for therapeutic services in clinical settings has increased wait time for adolescents seeking help in Singapore. There is hence an urgent need to develop brief, adjunctive/ alternative interventions to address current gaps.
Method: This study examined pre-post treatment changes in a pilot sample of adolescents (N=4) who underwent 4 sessions of ACT in a group setting. Each session lasted 2 hours, and was conducted weekly over a month. Sessions were adapted from an existing group protocol (ACT for Adolescents; Turrell and Bell, 2016).
Results: Preliminary results based on self-report measures are promising. In particular, pre-post comparisons revealed a reduction in depressive symptoms, experiential avoidance and cognitive fusion. Participants also reported an increase in self-compassion, and 3 of 4 participants endorsed a further increase in mindfulness. Collection of 3-month post-treatment results is ongoing. Data collection from current group participants is also underway.
Discussion: There is preliminary evidence for the utility of a brief ACT group intervention for adolescents. This supports current plans to conduct these groups at more regular intervals to enhance treatment for adolescent patients.

38. Acceptance and Commitment Therapy (ACT) for Addiction: A Systematic Review of Randomized Controlled Trials

Primary Topic: Clinical Interventions and Interests
Subtopic: Addiction
Euihyeon Na, M.D., Addiction Treatment Center, Maeumsarang Hospital, Republic of Korea
Cheol rae Jo, M.D., Maumgonggam Psychiatric clinic, Republic of Korea
Woon Jin Jeong, M.D., Department of Psychiatry, Maeumsarang Hospital, Republic of Korea

Background: Addiction is a chronic, relapsing disease that is often driven by experiential avoidance. In this context, Acceptance and Commitment Therapy (ACT) is proposed as a novel therapeutic approach with a possible added value over traditional addiction treatments using awareness, acceptance and being in ‘here and now’ instead of arguing and avoiding internal experiences. The objective of this systematic review is to summarize the current evidence for the effectiveness of ACT in patients with addictive disorder, in comparison with traditional therapies for addiction.
Methods: We identified relevant articles through electronic searches of the MEDLINE, Embase, Cochrane library, and by hand-searching reference lists. We searched for randomized controlled trials of ACT in people with addiction. Two review authors independently extracted and assessed data from studies that corresponded to the predefined inclusion criteria for methodological quality using PRISMA guidelines. A third review author was responsible for conflict resolution when required.
Results and Discussion: The systematic review identified 11 articles, including nicotine (n=6), opiates (n=2), methamphetamine (n=1), and various substance dependence (n=2). Though limitations such as small sample size and risk of reporting bias, qualitative data suggested that when measured, ACT improved objective abstinence rate compared to traditionally treated groups or control groups. In addition, ACT alleviated psychological distress occurred by withdrawal symptoms and co-occurring mood symptoms. Further study is needed to develop and validate a more structured treatment program, as well as an assessment tool tailored to the ACT treatment for patients suffering from addiction.

39. Grieving with Love and Compassion: Promoting Acceptance in Grief Workshops
Sponsored by: Social Work and ACT SIG
Primary Topic: Clinical Interventions and Interests
Subtopic: Grief
Sarah Cheney, Columbia University

Grief is a natural response to death, trauma, loss, and major life transitions. It is one of the most difficult and universal life experiences; however, people, including mental health professionals, know relatively little about grief. Consequently, we often feel unprepared for the painful and distressing experience and inadequate to support others in grief. An impersonal healthcare system, family separation, and fear and avoidance of death contribute to our inexperience with grief and can impede psychological growth. Contemporary grief experts emphasize a loving, relationship-focused perspective of grief by focusing on the physiologic effects of love (Shear, 2017) and how family and friends affect feelings of safety and confidence (Bowlby, 1980). People seeking grief support are ideal candidates for the non-judgmental, non-pathological, and compassionate approach of acceptance and commitment therapy (ACT). This mixed methods study examines whether a supportive grief workshop intervention using ACT and grief psychoeducation improves the grief experience. Participants are recruited from a 2-hour grief workshop and complete a pre- and post-workshop Acceptance and Action Questionnaire (AAQ-II). In addition, participants are asked to participate in a post-intervention and semi-structured interview to assess adaptation to loss, contact with grieving, and restoration of hope. Quantitative and qualitative analyses will determine whether ACT and grief psychoeducation contribute to improved psychological flexibility. Implications for refining the workshop and future research will be discussed.

40. Experiential Approach as a moderator to Film Induction

Primary Topic: Clinical Interventions and Interests
Subtopic: Experiential Control
Jeffrey Swails, M.A., Wichita State University
Robert Zettle, Ph.D., Wichita State University
Thiên Vū, Wichita State University
Aja Molinar, Wichita State University

On a conceptual level efforts to control private events can be broadly parsed into experiential avoidance and experiential approach. Experiential approach is one term used to refer to efforts to contact, sustain or maintain positive emotions and feelings. Preliminary analyses of a recently developed scale to measure this concept, experiential approach scale, reveal two factors that are correlated differently with measures of wellbeing and psychopathology. One factor, Anxious clinging is positively correlated with measures of psychopathology and negatively correlated with measures of wellbeing. While the other factor, experience prolonging is inert in its correlations with psychopathology and positively, but mildly, correlated with measures of wellbeing. This study explores the predictive power of these factors on people's reactions to short films that induced happiness and boredom. One hundred and thirty-six participants were randomly assigned to the two emotional film conditions. Results indicated that people who engage in relatively few strategies to control positive emotions experienced more positive emotions in both the happy and boring film than their more controlling counterparts. Furthermore, people that were high in anxious clinging had an increased desire to discontinue their current state after the boring film relative to their counterparts lower in anxious clinging. These findings provide some support for apriori hypotheses that attempting to control emotions, even positive ones, can have paradoxical impacts on emotion. Limitations regarding insensitivity to discrete emotions and implications for clinical application and future research are unpacked further.

41. A Pilot Study of TiES: Teaching Interventions to Empower and Strengthen Families

Primary Topic: Clinical Interventions and Interests
Subtopic: Childhood Behavioral Problems
Brandon Hollie, M.A., Syracuse University
Jacob Christenson, Ph.D., LMFT, Mount Mercy University
Molly Lamb, Southern Illinois University

Teaching Interventions to Empower and Strengthen Families is an early intervention program based on the Regional Intervention Program, which is a community-based, family-centered service for parents of children, aged 6 years and under experiencing behavioral problems. The purpose of this article is to evaluate the effectiveness of TIES and add to the current parenting program literature. ANOVA results of 41 participants showed there was a significant main effect following the TIES interventions for aggression, hyperactivity, social skills, and depression. Results of MLR also showed a negative correlation between social skills and parental stress levels.

42. The Role of Common Physical Properties and Augmental Functions in Metaphor Effect: A Replication Study

Primary Topic: Clinical Interventions and Interests
Subtopic: Metaphor
Beatriz Galli, Mackenzie Presbyterian University
Cassia Roberta da Cunha Thomaz, Mackenzie Presbyterian University

Metaphor is a tool frequently used in psychotherapy such as Acceptance and Commitment Therapy (ACT), a contextual behavioral model of psychological intervention rooted in an approach to human language and cognition known as Relational Frame Theory (RFT). This experimental study aimed to replicate the study "The Role of Common Physical Properties and Augmental Functions in Metaphor Effect" (Sierra MA, Ruiz FJ, Flórez, CL, Riaño-Hernandez D, & Luciano C, 2016) 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 specification of appetitive augmental functions in the metaphor content. A 2x2 factorial design was implemented where the presence/absence of the above-mentioned variables was manipulated. Eighty-two participants were exposed to a cold-pressor task at pretest. Afterwards, participants were randomly assigned to four experimental protocols consisting of a metaphor that included: (a) common physical properties and augmental functions, (b) only common physical properties, (c) only augmental functions, and (d) none of these variables. Then, participants were re-exposed to the cold-pressor task (posttest). The results showed that even though both variables had a statistically relevant effect on the pain tolerance induced by the cold-pressor task, the most significant effect was generated when only augmental functions were present.

43. To blend or not to blend? Can an app enhance the efficiency and the efficacy of an ACT treatment?

Primary Topic: Clinical Interventions and Interests
Subtopic: Technologie
Ellen Excelmans, De Braam private practice

This poster describes the results of a Belgian government sponsored project run in a private practice of psychologists where the added value of the app Learn2ACT in a psychological treatment was examined. The purpose of the app is to provide support outside the therapy sessions. We excepted that treatments would be more efficient and effective. Thanks to the app we could allow more time between the sessions and limit the number of sessions per client and, consequently, reduce our waiting list. Also, because of the extra data provided by the app we could detect problems faster and intervene when necessary.
Learn2ACT was received positively. Almost all the clients were willing to use the app (N = 85). The compliance was very high. The therapists, on the other hand, were somewhat more reserved and needed some training and support to integrate this new method into their work. Nevertheless, all of them would recommend the app to their colleagues.
Results from surveys (ease of use, efficient use of therapy sessions, feedback on the therapy process, commitment, self-efficacy, crisis-management) will be presented here. Blending ACT with an app didn’t have an effect on the effectiveness of the treatment, but did increase the efficiency of the treatment. Our average number of sessions per client declined with 1 during the project (compared with the same period the year before). This means that we can reach more people. Given the long waiting lists in mental health care, this is an important argument for stimulating blended therapy.

44. Palestinian parents’ attitudes towards sex education program: a cultural perspective

Primary Topic: Educational settings
Subtopic: cultural assessment
Ahlam Rahal, McGill University
Khawal Abu Baker, Prof., Al-Qasimi Academic College of Education

Sex education (SE) is a process of acquiring sex-related information, building sexual health, and forming values regarding identity, relationships and intimacy. This process is fundamental for healthy human development. Palestinian schools lack sex education (SE) programs. This lack was explained by schools boards’ concerns about parents’ negative reactions. This study aimed to examine Palestinian parents’ attitudes towards SE in school, and attitudes relationships with parents’ demographic characteristics. The study included 206 Palestinian parents (150 mothers, 56 fathers), with average age of 39.35 (SD=8.10), where 127 were aged below 40 and 123 were academics. The Participants filled categorical questionnaires which were examined by Chi-Square test. Findings indicated that the majority of parents (88.8%) supported SE as mandatory; however, they supported postponing SE to later ages. Parents also restricted discussing some contents, such as: intimacy, homosexuality, pregnancy and contraceptives, and preferred discussing contents that prevent premarital sex. Demographic characteristics differences showed that mothers, non-academics and younger parents held more conservative attitudes towards SE compared to fathers, academics and older parents. These innovative findings highlighted cultural aspects, suggesting that Palestinian parents perceive SE as an Abstinence-only education rather than comprehensive, and see it as an additional monitor for children’s sexual behavior. The findings also shed light on gender social roles, academic and age influence on attitudes. This study contributes to schools educators in their decision-making concerning SE; it provides comprehensive information for professionals, and may assist them in identifying “mistaken" attitudes towards sex issues. Limitation concerning study population and instrument was also discussed.

Wednesday, July 25, 8:30-9:30pm - Poster Session #2

1. Measuring Psychological Flexibility in a Context Sensitive Manner: Development and Preliminary Psychometric Properties of a Short and Accessible Questionnaire

Primary Topic: Clinical Interventions and Interests
Subtopic: Clinical Measure Validation
Victoria J. Firsching, M.Sc., University of Basel, Department for Clinical Psychology and Intervention Science
Jeanette Villanueva, M.Sc., Universität Basel, Department for Clinical Psychology and Intervention Science
Marcia Rinner, M.Sc., University of Basel, Department for Clinical Psychology and Intervention Science
Charles Benoy, University Psychiatric Clinics Basel
Veronika Kuhweide, University Psychiatric Clinics Basel
Sandra Brogli, University Psychiatric Clinics Basel
Andrew T. Gloster, Prof. Dr., University of Basel, Department for Clinical Psychology and Intervention Science
Mark Walter, University Psychiatric Clinics Basel
Klaus Bader, University Psychiatric Clinics Basel

Background: Psychological Flexibility (PF) is a functional-contextual concept. Among other things, this suggests that the skills that comprise PF may benefit an individual more in some situations than others. For example, pursuing valued directions can foster vitality, unless it is used as avoidance. Towards this end we developed a short questionnaire targeting each of the six PF skills in a context-dependent manner. For example, “If need be, I can let unpleasant thoughts and experiences happen without having to get rid of them immediately." The items used simple, every-day language to facilitate use across various education levels. Further, in order to increase its treatment sensitivity and to avoid eliciting trait-like responses from respondents, items refer to the past seven days.
Method: Items were chosen from a pool, tested on a small sample of clinical and healthy subjects, then narrowed down to the most informative ones. The resulting “Psyflex" questionnaire was administered to clinical and non-clinical populations simultaneously with measures of convergent and divergent constructs.
Results: The sample consists of n=441 participants (n=308 normative sample; n=133 clinical sample). The mean age was 33.73 years and 62.36% were female. Preliminary analyses show good internal consistency and correlations in predicted patterns with convergent and divergent measures. Factor structure and sample invariance will be tested.
Conclusion: The Psyflex is a state measurement of PF. It can be a valuable addition to existing measurements because of its context sensitivity, every-day language, and brevity while still covering all core skills targeted in ACT.

2. A Self-help Intervention to Reduce the Risk of Depression in Healthy People
Sponsored by: ACBS Japan
Primary Topic: Clinical Interventions and Interests
Subtopic: Depression, Productivity, Anxiety, ACT, mindfulness
Ryosuke ISHII, Graduate School of System Design and Management, Keio University, Japan Institute of Cognitive Science
Shogo Shimura, Medical School, Keio University
Hiroaki Kumano, M.D., Waseda University
Takashi Maeno, Ph.D, Graduate School of System Design and Management, Keio University

Objective: To reduce the prevalence of depression and to increase productivity and contentment in schools and workplaces, a set of worksheets was developed to enable healthy individuals to build psychological flexibility through a self-help intervention.
Method: A self-help intervention was conducted once with 141 Japanese individuals. Data were collected using the Japanese versions of the State-Trait Anxiety Inventory, the Beck Depression Inventory II, and the Acceptance and Action Questionnaire II about one week before the intervention; just before and after the intervention; and follow-up assessments were conducted 1 week, 1 month, 3 months, and 6 months later.
Results: At 1-month follow-up, significant improvements were shown in state anxiety, depression, and experiential avoidance. At 6-months follow-up, significant improvements in depression and experiential avoidance were still evident.
Conclusion: This pilot study demonstrated that a self-help approach combining methodical procedures with self-directed work that targets a fixed set of results is possible.

3. An Evaluation of Psychometric Properties of the Weight Concerns Scale in a Greek-Cypriot Sample
Sponsored by: Greek-Cyprus ACBS chapter
Primary Topic: Clinical Interventions and Interests
Subtopic: Eating Concerns
Danae Papageorgiou, MSc, University of Cyprus
Marianna Zacharia, MSc, University of Cyprus
Maria Karekla, PhD, University of Cyprus

Background: The Weight Concerns Scale (WCS) examines worries regarding weight, which are related to body image and can impact an individuals’ wellbeing. The current study aims to examine the psychometric properties of the WCS in Greek. In the drive to improve eating disorders’ and related mental health disorders treatment, validation of such measurements can be key given limited availability of scales capturing concerns with weight in the Greek language.
Method: The forward and backward method was first employed to translate the questionnaire into Greek. One hundred and seventy-three Greek-speaking university students (M=21.51, SD=.19) then completed the Greek version of the WCS. Data was analysed using an exploratory factor analysis (EFA).
Results: Results indicated a single factor solution based on Kaiser’s criterion with eigenvalue greater than one (3.03), explaining a satisfactory amount of the total variance (60.68%). The scree plot was in agreement, justifying retention of one factor. Parallel analysis also indicated one factor based on original eigenvalues (raw data=2.51) and subsequently comparison with the 95th percentile (.37). Cronbach’s alpha (α=.78) showed that WCS had good internal consistency. Additionally, results indicated good convergent validity with similar measures, including Body Image Acceptance and Action Questionnaire (BI-AAQ) and Questionnaire for Eating Disorder Diagnoses (Q-EDD), and discriminant validity with other measures (e.g. Depression Anxiety Stress Scale [DASS]).
Discussion: The current study showed good psychometric properties of the WCS in Greek. Clinical and research implications for these findings are discussed.

4. Psychometric properties of the Self-Compassion Scale (SCS) in a sample of Greek-Cypriot Youth
Sponsored by: Greek-Cyprus ACBS chapter
Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness
Despoina Iosif, ACThealthy laboratory, University of Cyprus, Nicosia, Cyprus
Myria Ioannou, University of Cyprus
Artemis Theofanous, ACThealthy laboratory, University of Cyprus, Nicosia, Cyprus
Patrisia Nikolaou, ACThealthy laboratory, University of Cyprus, Nicosia, Cyprus
Maria Karekla, ACThealthy laboratory, University of Cyprus, Nicosia, Cyprus

Self-compassion refers to the meaning of being kind and understanding to yourself rather than being harshly self-critical, in occasions of failure. The topic of self-compassion also entails the ability to perceive one’s experience as part of the larger human experience and face painful thoughts and feelings with mindfulness. Self-compassion becomes more widespread nowadays as it is significantly correlated with positive mental health. For this reason it is important to validate measures to assess self-compassion across different populations. The 26-item self-compassion scale (SCS), assesses Self-kindness, Common Humanity, Mindfulness, Self-judgment, Isolation and Over-identification. This study examined the factor structure and the validity of the Greek version of the SCS. Participants were 167 university of Cyprus students (139 female; Mage=21.52, SD=2.73). Confirmatory factor analyses (CFA) using AMOS 24.0 showed excellent fit for all the six subscales and all the items had statistically significant estimates on the six factors. The CFA of the whole scale showed that high correlations existed between the latent factors of isolation, self-judgment and over-identification and the same stood for mindfulness, common humanity and self-kindness. This suggested the existence of two second-order factors, representing negative aspect and self-compassion. The second-order CFA had acceptable fit, with χ2(282)= 491.477 (p<.001), CFI= .908, RMSEA= .067 (90% CI .057, .077), SRMR= .084. Furthermore, G-SCS showed good psychometric properties, with good internal consistency (Cronbach’s α=.84). Overall, the G-SCS is a valid and reliable measure of self-compassion for Greek speaking youth.

5. Thriving in Pediatric Inflammatory Bowel Disease: Preliminary Health Care Provider Perspectives

Primary Topic: Clinical Interventions and Interests
Subtopic: children, resilience, chronic disease
Sara Ahola Kohut, Ph.D., CPsych, Hospital for Sick Children
Natalie Weiser, MA, Hospital for Sick Children
Paula Forgeron, RN, PhD, University of Ottawa
C. Meghan McMurtry, PhD, CPsych, University of Guelph
Jennifer Stinson, RN, PhD, Hospital for Sick Children

Background: Inflammatory Bowel Disease (IBD) in youth can negatively impact all aspects of quality of life. However, some youth demonstrate resilience and successfully adjust to living with IBD. Research suggests that resilience is encompassed by three main factors: positive individual factors (e.g., optimism), family support, and supportive environments. However, it is unclear what characteristics are most important to mitigate the negative effects of living with IBD. The aims of this study are to explore specific characteristics from the perspective of health care providers (HCP) that bolster resilience.
Methods: A qualitative descriptive study using semi-structured interviews was completed to capture HCP perspectives on resilience in youth with IBD. English speaking HCPs with a minimum of 1-year experience working with this population were recruited from one tertiary pediatric hospital. Data were analyzed using inductive and deductive content analysis.
Results: Twelve HCPs with 7.88±4.49 years of clinical experience were interviewed. HCPs included gastroenterologists, nurses, dieticians, social workers, and child life specialists. Inductive analysis identified higher level themes transcending the three main factors found in the literature. Themes included openness about and acceptance of IBD, IBD not defining self-identity, trust of the medical team, and optimism for the future.
Discussion: This is the first study to show HCP identified individual, parent, and environmental factors that may be targeted for brief interventions aimed at bolstering resilience in youth with IBD. By bolstering resilience, targeted interventions may also prevent co-morbid risk trajectories (e.g., depression and anxiety stemming from poor adaptation to IBD).

6. Understanding Change in Therapy with the MPFI: A Hexaflex Measure of Psychological Flexibility

Primary Topic: Clinical Interventions and Interests
Subtopic: Flexibility
Ronald D. Rogge, Ph.D., University of Rochester
Brooke Dubler, M.A., University of Rochester
Jaci L. Rolffs, M.A., University of Rochester
Oliver K. Stabbe, University of Rochester

BACKGROUND: A scale was recently developed to assess each of the 12 dimensions of the Hexaflex model (the Multidimensional Psychological Flexibility Inventory; MPFI; Rolffs, Rogge, & Wilson, 2016). Building on a small set of studies examining moderators of ACT, the current study examined how levels of flexibility and inflexibility might predict response to ACT interventions over 2 months when given by community therapists trained in ACT.
OBJECTIVES: The current study sought to identify the dimensions of flexibility and inflexibility that were most strongly linked to increases or decreases in individual functioning over time within a population of individuals being treated with ACT.
METHODS: Twenty eight clients currently being treated with ACT (54% female, 75% Caucasian, 18 to 65yo, M = 39yo) have been enrolled in the study by their therapists and have completed a baseline assessment. Fifteen of those clients have now completed an 8-week follow-up assessment. Data collection is ongoing.
RESULTS: Preliminary regressions predicting residual change over time from treatment (conducted in the first 15 clients to complete the follow-up) suggested that higher levels of defusion at the initial assessment significantly predict drops in depressive symptoms (assessed with the PHQ-9) whereas fusion and self-as-content each predict increases in depressive symptoms over 2 months. Self-as-content at the initial assessment also predicted drops in vitality over 2 months of treatment.
DISCUSSION: The current results highlight that certain dimensions of flexibility and inflexibility might be more strongly tied to global outcomes in the context of ACT treatment. Implications will be discussed.

7. The “Carpet-Matrix": A tool to facilitate therapeutic work with children and adolescents

Sponsored by: ACT Italia
Primary Topic: Clinical Interventions and Interests
Subtopic: Children, ACT, Anxiety disorders, Matrix
Alessandra Chiarelli, Psychologist, IESCUM, ACT Italia, ASCCO (Parma)
Margherita Gurrieri, PsyD, IESCUM, ACT Italia
Giovambattista Presti, PhD, KORE University, IESCUM, ACT Italia
Francesca Pergolizzi, PhD, IESCUM, ACT Italia, ASCCO (Parma)
Paolo Moderato, PhD, IESCUM, ACT Italia, ASCCO (Parma

In ACT therapies one of the commonly used tools is the Matrix (Schoendorff & Polk, 2016). The matrix helps a client focusing in his behavioral directionality, acting towards appetitive goals or avoiding aversive conditions, while acknowledging barriers to value driven behaviors and using values right to help overcoming them. Though developed for adults matrix can be used in ACT sessions with children and adolescents help them making meaningful choices for their own life even in presence emotional or cognitive obstacles. However the Matrix metaphor could be too much sophisticated for the verbal skills of this population, so other ways than the usual presented in papers and manuals should be elaborated an used. The case of a 12 years old young girl, diagnosed with anxiety disorder, will be presented as an example of such a work. Therapy sessions were focused on trying to increase emotional awareness and decrease behaviors governed by rigid rules. After increasing emotion and thoughts recognition and identifying values and goals a carpet with a matrix was created in order to develop psychological flexibility. The girl was invited to move from one quadrant to another of the carpet matrix and post notes on the various quadrants in order to facilitate the process of discrimination of her own experiences. The steps that brought the young client to have a more flexible attitude towards internal and other contextual events and ultimately contributed to the reduction of anxiety related symptoms and a valued living pattern will be described.

8. Exploratory Analysis of Baseline Predictors of Engagement with Theory-based Modules of an ACT Smoking Cessation App for People with SMI

Primary Topic: Clinical Interventions and Interests
Subtopic: Serious mental illness, nicotine addiction, mHealth, process analysis
Paige Palenski, B.A., Duke University
Javier Rizo, B.A., Duke University
Matthew Small, B.A., Duke University
Roger Vilardaga, Ph.D., Duke University

Smoking among people with serious mental illness (SMI) remains a critical issue in the field of public health, emphasizing the need for more easily-disseminated smoking cessation interventions in this population, such as mHealth apps. Examining individual characteristics predictive of user engagement with targeted theory-based modules of ACT mHealth interventions is key to understanding the receptivity of mHealth ACT technology in this population. Learn to Quit is an ACT-based smoking cessation app that contains 28 theory-based modules designed and adapted for individuals with SMI. In this exploratory analysis, we will examine the association between participants’ baseline characteristics and engagement with key theoretical processes of the Learn to Quit app: Psychological Acceptance, Openness to Experience, and Values-based Activation. Baseline measures such as psychiatric diagnosis and functioning, experiential avoidance, perspective-taking, cognitive functioning, and general demographics were collected from 10 participants randomized to the Learn to Quit arm of a pilot randomized controlled trial evaluating the feasibility of our intervention in our target population. These measures were collected using diagnostic interviews and self-reported measures. User engagement with Learn to Quit at 1 Month Follow-up was objectively gathered using Google Analytics. User engagement metrics included number of app openings, duration of app use, interactions within the app, and number of times a “lesson" implicating an ACT component was completed. Identifying which baseline characteristics predict increased engagement with the active ingredients of ACT-based smoking cessation interventions can inform further development of ACT-based apps for other health behaviors in this population.

9. Effects of a Mindfulness intervention on the symbolic generalization of aversive function

Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness, Anxiety, Avoidance, Stimulus equivalence
Denise C. P. O. Marcondes, Centro Paradigma
William Ferreira Perez, Ph.D., Centro Paradigma

Anxiety has one of the highest incidences of all psychiatric disorders in the population. Findings in recent research on the equivalence of stimuli provide explanations for how fear and avoidance can be learned indirectly by transfer of function. Mindfulness strategies have been used as interventions for anxiety responses. However, no studies were found that analyze mindfulness interventions in comparison to other treatments already validated in a protocol of symbolic generalization of avoidance responses in controlled contexts. Thus, the present study used a protocol of symbolic generalization of aversive functions to evaluate the effects of a mindfulness intervention in comparison to a control group. The procedure, in both interventions, contained 6 phases: (1) Establishment of equivalence classes; (2) Aversive conditioning and avoidance training with stimuli of equivalence classes; (3) Transfer of function test (Pre); (4) Intervention; (5) Transfer of function test (Post); (6) Debriefing. No pre-post differences were found between groups regarding avoidance responses; however, the mindfulness group showed pre-post reduction on US expectancy, valence and negative semantic functions, while the control group did not.

10. Psychological flexibility, social connection and an interest in liposuction among women with lipedema

Primary Topic: Clinical Interventions and Interests
Subtopic: chronic illness
Joanna Dudek, Ph.D., SWPS University of Social Sciences and Humanities
Wojciech Białaszek, Ph.D., SWPS University of Social Sciences and Humanities
Pawel Ostaszewski, Ph.D, SWPS University of Social Sciences and Humanities
Przemysław Marcowski, M.Sc, SWPS University of Social Sciences and Humanities
Tilly Smidt

Background: Lipedema is a chronic and progressive disorder of subcutaneous tissue that affects mainly women. Its main symptom is the accumulation of adipose tissue on the extremities, with associated pain and swelling. This adipose tissue is resistant to standard low caloric diet or intense physical activity. Due to unknown etiology, available treatment is primarily focused on symptoms reduction. So far, liposuction has proven to be most effective, however it raises a number of concerns due to its costs and unknown long-term consequences.
Methods: We conducted an online cross-sectional study involving 328 women with lipedema, involving individuals from USA, Canada, Australia, UK, Netherlands, Sweden, Germany, and other European countries. We aimed to determine if women expressing an interest in liposuction or not differed in psychological flexibility and social connection scores.
Findings: We found that women who expressed interest in liposuction differed in levels of both psychological flexibility and social connection. In both cases, lower levels were observed in women who were interested in liposuction rather than not, while controlling for differences in individual body max index.
Discussion: Our results suggest that women who express interest in liposuction, are less psychologically flexible and feel less connected with others. We will discuss the results obtained as well as further research directions.

11. The role of self-compassion in women with lipedema

Primary Topic: Clinical Interventions and Interests
Subtopic: chronic illness, self-compassion
Joanna Dudek, Ph.D., SWPS University of Social Sciences and Humanities

Background: Self-compassion has been linked to higher levels of psychological well-being, lower level of body image dissatisfaction and lower eating psychopathology. However, its role was never investigated among women with lipedema.
Lipedema is a chronic, progressive subcutaneous adipose tissue disorder of unknown etiology that affects mainly women. It manifests itself with accumulation of the fat in the extremities, associated oedema and pain. Lipedemic fat tissue is resistant to standard low caloric diet or intense physical activity. Progressive and uncontrollable accumulation of lipedemic fat tissue on legs and arms results in visible difference in appearance that may be subject of stigmatization and lead to self-stigmatization.
Method: We conducted on online cross-sectional study with 120 women mostly from the USA, the UK and the Australia to investigate the role of self-compassion in various aspects of psychological functioning and quality of life among women with lipedema.
Results: Statistical analyses showed week positive correlation between self-compassion and quality of life, and moderate negative correlations with disordered eating and body image dissatisfaction. Interestingly, we obtained strong positive correlation between self-compassion and body image flexibility.
Discussion: Our results suggest that women who were more able to treat themselves kindly in times of distress, reported lower body image dissatisfaction, lower levels of eating psychopathology and higher quality of life. Additionally, higher level of self-compassion was related to higher flexibility around thoughts and feelings related to body image. We will discuss results obtained and implications for further research directions.

12. The Effective Role of ACT in the Control of Depression and Smoking

Primary Topic: ACT
Subtopic: Women, Depression, Smoking
Tahereh Seghatoleslam, University of Malaya Centre of Addiction Sciences (UMCAS), Malaysia
Hussain Habil, Mahsa University, Malaysia
Rusdi Abd Rashid, University of Malaya Centre of Addiction Sciences (UMCAS), Malaysia

Aim: The aim of the present study is to evaluate the effective of ACT in the control of depression and decrease the number of cigarettes smoked per day.
Method: This interventional study by using ACT was carried out on 34 women (Mean=39,Sd=6.6) who were depressed and as current smokers, used on an average of 25 cigarettes per day. Subjects were randomly selected and divided into two groups. The instruments were: 1) a questionnaire that contained personal, family, and smoking information, and 2), The Beck Depression Inventory (BDI). Participants received six week sessions of using (ACT) and decrease the number of cigarettes smoked per day.
Results: Measured the effect of ACT through a pre-test and two post-tests. Showed that there were significant decreases in depression with a reduction in the number of cigarettes smoked per day.
Conclusion: The results suggested that the effect of ACT has the main role in decreasing depression and provided special benefits for women who smoke and suffer from depression.

13. Psychological Flexibility and Quality of Life in Inflammatory Bowel Diseases

Primary Topic: Clinical Interventions and Interests
Subtopic: gastroenterological disease with somatic/psychological features
Hasan Turan Karatepe, Asist Prof., Medeniyet University Psychiatry Department
Rümeysa Yeni Elbay, Asist Prof, Medeniyet University Psychiatry Department
Celal Ulaşoğlu, Assoc.Prof., Medeniyet University Gastroenterology Department

Background: It is known that psychological factors affect the quality of life (QoL) as well as severity of lesions and disease process in inflammatory bowel diseases (IBD). This study aims to explore the difference of psychological flexibility (PF) between the (IBD) patients and healthy controls. We also try to investigate the impact of psychological flexibility on anxiety and depressive symptoms and quality of life in IBD.
Method: Participants include 100 IBD patients with a mean age of 45.79 (SD = 14.52) and 100 healthy control (HC) with a mean age of 42.09 (SD= 12.77) that completed Acceptance and action Questionnaire (AAQ-II), hospital anxiety and depression scale (HAD), Freiburg mindfulness ınventory (FMI) and WHO quality of life scale-BREF.
Results: Our findings suggest that: AAQ-II scores, depression and anxiety scores are higher in IBD than HCs. But we didn’t find any differences at FMI scores between the groups. %39 of IBD patients were in active and %61 of them were in remission phase. Patients in the active phase showed higher anxiety and depression scores and higher AAQ-II scores compared with patients in remission. There was a significant difference in QoL between the remission and active disease groups in BID. The level of QoL in patient with higher AAQ-II scores was significantly lower than patients wit lower scores of AAQ-II.
Discussion: Psychological flexibility of patients with inflammatory bowel disease is lower than the control group and the lower psychological flexibility negatively affects the quality of life in IBD.

14. Autism and psychological flexibility: An ACT-based protocol

Primary Topic: Clinical Interventions and Interests
Subtopic: Autism
Melissa Scagnelli, Ph.D., IESCUM, Milan
Arianna Ristallo, Ph.D., IESCUM, Milan
Cristina Copelli, Ph.D., IESCUM, Milan
Chiara Campo, M.A., IESCUM, Milan
Francesca Pergolizzi, Psy.D, IESCUM, Milan

Psychological flexibility is a fundamental ability to promote effective interactions in the natural environment; children with autism often lack this ability, in fact many of them show deficits in flexibly managing social interactions, coping with unexpected events and changing in daily routines.
Research shows that ACT-based interventions are effective in reducing discomfort and emotional distress and in promoting the emission of prosocial behaviors for people with autism (Hayes et al, 2012; Eiler and Hayes, 2015).
This study presents an ACT-oriented intervention for an 8 years old autistic child aimed at enhancing psychological flexibility.
Specific procedures, such as natural environmental teaching and manipulation of motivating operation, were implemented to promote the emergence of the target behavior listed above. Mindfulness sessions were applied thought playful activities and the six processes of the Hexaflex were trained thought different experiential exercises. The intervention also involved caregivers and teachers to promote the generalization of these abilities in all the significant contexts for the child. Data will be presented.

15. The role of body image-related cognitive fusion in a pervasive path towards binge eating in two different countries: A path analysis and multigroup invariance study

Primary Topic: Clinical Interventions and Interests
Subtopic: Binge eating, adults, women, obesity
Paola Lucena-Santos, MSc., Ph.D. Student., University of Coimbra - Portugal
José Pinto-Gouveia, MSc., Ph.D., University of Coimbra - Portugal
Renata Klein Zancan, MSc., Ph.D. Student, Pontifical Catholic University of Rio Grande do Sul - Brazil
Ana Carolina Maciel Cancian, MSc., Pontifical Catholic University of Rio Grande do Sul - Brazil
Margareth Silva Oliveira, MSc., Ph.D., Pontifical Catholic University of Rio Grande do Sul - Brazil

Introduction: This study aims: (1) to test whether body image-related cognitive fusion mediated the effects of drive for thinness and stress symptomatology on binge eating psychopathology; and (2) to test the model’s transcultural invariance.
Method: This was a transversal and transcultural study, conducted in women with overweight or obesity (BMI ≥25) currently in treatment for weight loss (Brazilian sample: n= 197; Portuguese sample: n= 100).
Results: There was not significant differences regarding age between countries (t(295)= -1.555; p = .090), while there was significant differences regarding the BMI (t(295)= 5.435; p < .001) and years of education (t(244)= -3.520; p = .001). The hypothesized model explained 49% of binge eating psychopathology, where the body image-related cognitive fusion emerged as a partial and significant mediator of the effect of drive for thinness (β=.184; 95% CI= ].126; .231]; p=.010) and stress (β=.159; 95% CI= ].109; .215]; p=.010) on the criterion variable. Furthermore, no differences between countries were found in terms of weights (ΔX2(3)=2.341; p= .505) or covariances (ΔX2(2)=1.053; p= .591).
Discussion: Despite all the existent sociocultural differences between Brazil and Portugal and between the samples of this study (i.e., BMI and years of education), the model was robust enough to keep its invariance. A significant portion of the effect of well-known predictors of binge eating only occurs in the presence of cognitive fusion related to body image. This was the first study to show the clinical importance of this emotional regulation process on eating psychopathology in more than one country simultaneously.

16. Further investigation on the psychometric properties of the Cognitive Fusion Questionnaire: Measurement Invariance across clinical and non-clinical populations

Primary Topic: Clinical Interventions and Interests
Subtopic: Psychometrics
Joel Gagnon, Ph.D.(c), Université du Québec à Trois-Rivières
Frédérick Dionne, Ph.D., Université du Québec à Trois-Rivières
Josée Rhéaume, Ph.D., Unité de Thérapie Cognitive-Comportementale, Hôtel-Dieu de Lévis
Valérie Tremblay, D.Psy, Unité de Thérapie Cognitive-Comportementale, Hôtel-Dieu de Lévis
Patrick Gosselin, Ph.D., Université de Sherbrooke
Frédéric Langlois, Ph.D., Université du Québec à Trois-Rivières

The Cognitive Fusion Questionnaire (CFQ; Gillanders et al., 2014) has been found to have good psychometric properties across both clinical and non-clinical populations. To date, no study has investigated the measurement invariance of the CFQ among different populations and cutoff scores for clinical purposes are yet to be recommended. The first aim of this study was to test for measurement invariance of the CFQ across three independent population. The second aim of this study was to recommend cutoff scores for clinicians and researchers working with the CFQ. The samples of this study were comprised of 971 participants from the general population; 694 participants living with chronic pain; and 170 participants suffering from mental health problems. Regarding the first aim, results from multigroup confirmatory factor analyses revealed that partial scalar invariance was achieved: χ2/df = 9.32; CFI = .96; TLI = .954; SRMR = .040; RMSEA = .117, [.108, .126]. Based on this result, it is possible to conclude that the score on the CFQ has the same meaning across clinical and non-clinical populations which further support the CFQ as a valid tool to assess cognitive fusion. Regarding the second aim, mean scores for each sample were calculated and compared using ANOVA. Results revealed that the score of the mental health sample was significantly higher than those of the general population and the chronic pain samples. The mean scores were then compared with the scores obtained in Gillanders et al., 2014 and cutoffs scores for clinicians and researchers are proposed.

17. Yoga-based ACT for Anxiety: Development of a 10-week group protocol, and findings from a pilot study

Primary Topic: Clinical Interventions and Interests
Subtopic: Yoga
Jan Fleming, MD, FRCPC, The Mindfulness Clinic, Toronto
Nancy Kocovski, PhD, Wilfrid Laurier University

Background-There is considerable evidence for the effectiveness of ACT for a wide range of anxiety problems, and growing evidence for the effectiveness of yoga for anxiety. The poster will summarize the development of a 10-week protocol for a yoga-based ACT group for anxiety and present findings from a small pilot study which examined the feasibility, acceptability and initial effectiveness of the protocol. Method-Seven participants were recruited from a community-based mental health clinic. The group was facilitated by the first author (JF) who is a psychiatrist and certified yoga instructor. ACT concepts were introduced in each 90-minute session during an opening guided meditation and included observer perspective, values, goals, defusion, acceptance, self compassion and mindfulness. Those concepts were then repeated and practiced during the yoga postures. Self-report measures of anxiety, depression, self-compassion and mindfulness were completed pre-, mid- and post-group. Results-Two subjects dropped out of the group and there was excellent attendance by the remaining five participants. Acceptability was demonstrated in positive ratings and comments on a feedback questionnaire. Initial effectiveness was demonstrated by reduced anxiety and depression scores, and increased self-compassion and mindfulness ratings. Discussion-Anxiety disorders are under treated despite the existence of effective treatments. Stigma around seeking treatment, and poor availability of effective treatments may contribute to under treatment of anxiety. Yoga-based ACT has the potential to be an effective, non-stigmatizing approach that could be made widely available to individuals struggling with anxiety. Larger, controlled studies of this approach are required.

18. The role of intuitive eating to buffer the negative effects of external shame and body dissatisfaction on binge eating psychopathology: A mediational and transcultural study

Primary Topic: Clinical Interventions and Interests
Subtopic: Obesity, adults, women, binge eating, intuitive eating, transcultural studies
Paola Lucena-Santos, MSc., Ph.D. Student., University of Coimbra - Portugal
Margareth Silva Oliveira, MSc., Ph.D., Pontifical Catholic University of Rio Grande do Sul - Brazil
Renata Klein Zancan, MSc., Ph.D. Student, Pontifical Catholic University of Rio Grande do Sul - Brazil
Ana Carolina Maciel Cancian, MSc., Pontifical Catholic University of Rio Grande do Sul - Brazil
José Pinto-Gouveia, MSc., Ph.D., University of Coimbra - Portugal

Introduction: The present study aims: (1) to explore if intuitive eating emerged as a mediator of the effects of body dissatisfaction and external shame on binge eating; and (2) to test the model’s transcultural invariance. Method: This was a transcultural (Brazil and Portugal) and transversal study, conducted in convenience samples of women with overweight or obesity (BMI ≥25) currently undergoing treatment to weight loss. Results: There were significant differences regarding the BMI (t(295)= 5.435; p < .001) and years of education (t(244)= -3.520; p = .001) between countries (Brazilian sample: n= 197; Portuguese sample: n= 100), but no differences were found regarding age (t(295)= -1.555; p = .090). Results showed a negative and significant indirect effect (through intuitive eating) of external shame and body dissatisfaction on the dependent variable, while the standardized direct effect of both variables on binge eating still positive and significant in the presence of the mediator. Regarding the model’s invariance, no differences between countries were found in terms of weights (ΔX2(3)=2.346; p= .504) or covariances (ΔX2(2)=1.579; p= .454). Discussion: Intuitive eating emerged as a partial mediator and seems to buffer the negative effects of external shame and body dissatisfaction on binge eating. This conceptual model was robust enough to keep its invariance simultaneously in Brazil and Portugal despite all sociocultural differences and even despite the differences between the samples themselves (i.e., BMI and years of education). This was the first study to highlight the transcultural relevance of intuitive eating on binge eating severity.

19. The Effectiveness of a Group Therapy Program for Adolescents

Primary Topic: Clinical Interventions and Interests
Subtopic: Adolescence
Aja M. Meyer, Ph.D., Johns Hopkins All Children's Hospital
Robert Mason Burdine, M.Ed.

Background‎: Although ACT applies to adolescents in numerous ways, concepts and methods that consider developmental stages were needed, leading to the development of the DNA-v model by Hayes and Ciarrochi. This model was designed to help young people strengthen advisor, noticer, and discoverer skills and identify values, in order to improve psychological flexibility (Hayes & Ciarrochi, 2015). Rayner, Hayes, and Ciarrochi (2017) developed a program entitled “Write your own DNA: A group program to help young people live with vitality and strength" that uses this model. As there have been few studies that have examined the effectiveness of ACT with adolescents in a group format, this study aims to assess improvements in the core processes of ACT with adolescents.
Method: Nine groups of adolescents will participate in the Write your own DNA protocol. Participants will be administered the Child Acceptance and Mindfulness Measure (CAMM) and the Avoidance and Fusion Questionnaire for Youth (AFQ-Y8) at pre-treatment and post-treatment. We hypothesize that participants will report an increased awareness and acceptance of internal processes (assessed with the CAMM) and decreases in cognitive fusion and experiential avoidance (assessed by the AFQ-Y8).
Results: Potential Results. After completing the group, it is expected that there will be a decrease in cognitive fusion and experiential avoidance. It is also expected that there will be an increase in self-awareness, mindfulness, and acceptance without judgment.
Discussion: We hypothesize that the Write your own DNA program will be an effective treatment that will assist young people in improving psychological flexibility.

20. Evaluation of a Two-Session ACT Training for Parents of Adolescents and Young Adults with Autism Spectrum Disorder

Primary Topic: Clinical Interventions and Interests
Subtopic: Acceptance and Commitment Therapy
Molly Lamb, B.A., Southern Illinois University
William B. Root, M.S., Southern Illinois University
Ruth Anne Rehfeldt, Ph.D., Southern Illinois University
India Hertel, B.S., Southern Illinois University

Research consistently shows parents of children diagnosed with autism spectrum disorder (ASD) experience more parental stress than parents with children in any other developmental category (Baker et al., 1997; Hauser-Cram et al., 2001; Hayes & Watson, 2013). Previous research has begun investigating the use of ACT protocols as an intervention to increase psychological flexibility and reduce stress among this population (Dixon and Palilunas, 2018). Due to evidence provided in the literature demonstrating ACT as an effective intervention for parents of individuals with ASD, the current study conducted an evaluation of a brief ACT training in comparison with a traditional parent support group for this population. Participants of the study were twenty parents and grandparents who identified as caregivers of an individual ranging from ages three to twenty-eight diagnosed with ASD. Each intervention consisted of two, two-hour sessions. Participants were provided with the Acceptance and Action Questionnaire-II and Parental Stress Scale pre and post intervention. Independent t-tests were ran in order to determine if mean change scores differed on the questionnaires across the ACT and TAU groups. Open-ended questionnaires were also provided to participants in order to collect data on the participants’ verbal behavior when discussing their experiences as parents of individuals diagnosed with ASD. Clinical implications are offered.

21. Exploring The Relationship Between Psychological Flexibility and Consequences of Substance Use in Juvenile Offenders: The Predictive Validity of Defused Acceptance

Primary Topic: Clinical Interventions and Interests
Subtopic: Substance Use
Jules C. Martowski, M.S., Baylor University
Samuel Stork, B.A., Baylor University
Jacqueline E. Hapenny, M.S., Baylor University
Brittany Sherrill, B.A., Baylor University
Laurie Russell, M.S., Baylor University
Sara L. Dolan, Ph.D., Baylor University

Research has found that juvenile offenders exhibit high rates of psychopathology (anxiety, behavior problems, etc.) and comorbid substance use problems, which in turn relate to increased recidivism. While psychological flexibility (PF) has been shown to negatively correlate with mood and behavioral problems in non-justice involved youth, its relationship with substance use consequences in incarcerated adolescents has not been assessed and thus it may provide further insight for addressing recidivism. The present study examined interrelations between substance-use related PF and consequences from illicit substance use in a juvenile offender sample. Seventy-four of 102 incarcerated juvenile offenders endorsed consequences from substance use in the past six months. Participants had a mean age of 15.2 years (SD = 1.11), were predominantly male (93.2%), and identified as non-Hispanic (51.4%) and African-American (37.8%).
Psychological flexibility (AAQ-SA) negatively correlated with substance use consequences (r = -.40, p < .01) and an examination of the two factors on this scale revealed a strong relationship with Defused Acceptance (r = -.46, p < .01) but not Values Commitment (r = -.19, ns). Hierarchical linear regression analyses found that Defused Acceptance accounted for a significant amount of unique variance in substance use consequences (ΔR2 = .06, partial r = -.30, p < .05) above the influence of general internalizing and externalizing symptoms, whereas Values Commitment did not (ΔR2 = .01, partial r = - .10, ns). Findings suggest that treatments targeting PF may be suitable for reducing recidivism in juvenile offenders who have comorbid psychopathology and substance use problems.

22. Perspectives on culturally relevant Acceptance and Commitment Therapy-based smoking cessation intervention among Latino smokers with depression or anxiety symptoms

Primary Topic: Clinical Interventions and Interests
Subtopic: Latino smoking
Virmarie Correa-Fernandez, Ph.D., University of Houston
Amanda Broyles, BA, University of Houston
Niloofar Tavakoli, BS, University of Houston
Erica Cantu, MPH, University of Texas
Melanie Gallego, University of Houston

Background: Acceptance and Commitment Therapy (ACT) has demonstrated promise as an efficacious treatment for smoking cessation, depression and anxiety separately, but more research is needed to consider ACT an evidence-based intervention for the co-occurrence of smoking and depression and anxiety, particularly among Latinos. The extent to which this intervention should be culturally-tailored to Latino population and how to incorporate cultural considerations in treatment remains to be determined. Method: This exploratory mixed-method study aims to examine the perspectives of Latino smokers with depression and anxiety on: 1) cultural factors that should be integrated in a smoking cessation intervention, and 2) the perceived utility of an ACT-based cessation intervention targeting this population. Participants will complete a brief online questionnaire about demographics, tobacco use, depression, anxiety and psychological traits relevant to ACT. Four focus groups (FG; 2 females and 2 males) with a maximum of 12 participants per group (N=48) will be conducted. FG guide inquire about the participants’ perspectives with respect to several commonly used metaphors in ACT and their application to smoking behavior and negative mood. Recommendations for cultural adaptations is also explored. Results: Study is in the recruitment phase. A pilot run-through of the study demonstrated the acceptability of the FG guide and the feasibility of conducting the study. Recommendations to present the metaphors were provided. Conclusion: After study completion, it is expected that findings from the focus groups will contribute to informing the development of the treatment protocol that is culturally relevant for Latino smokers with depression and anxiety.

23. Psychometric properties of the Body-Image Acceptance and Action Questionnaire (BI-AAQ) and its relationship with depression symptoms and emotional eating behaviour in a general sample of Mexican population

Primary Topic: Clinical Interventions and Interests
Subtopic: Psychological flexibility
Fresia Paloma Hernandez Moreno, Ph.D., Tecnologico de Monterrey
Andrea Morales Carrillo, Tecnologico de Monterrey
Mariel Gonzalez Knoell, Tecnologico de Monterrey
Gabriela Aurora Martinez Ramirez, Tecnologico de Monterrey

The objective of this study was to explore the psychometric properties of the Spanish translations of the Body-Image Acceptance and Action Question aire (BI-AAQ), and its relationship with depression symptoms and emotional eating behavior in a general sample of the Mexican population. Back translation procedure was used in order to achieve a conceptual equivalence of the scale. The study consisted in a non-randomized sample of 312 participants from different countries of the country. Results indicate a factorial structure of one factor, composed of 11 items explaining the 54.85% of the variance, with a .91 value of Cronbach’s alpha. There was also found a relationship between depression symptoms and body image inflexibility (rs= .341, p= .001), between body image inflexibility and emotional eating behavior (rs= .704, p= .001), and between depression symptoms and emotional eating behavior (rs= .349, p= .001). We conclude that the BI-AAQ has excellent psychometric properties, however, we recommend further studies in clinical population.

24. FOMO, or fear of missing out, and the use of mindfulness and values-based interventions to mitigate its potentially negative effects in an international population in the United Arab Emirates

Primary Topic: Clinical Interventions and Interests
Subtopic: FOMO, MIndfulness, Values, Cell Phone Overusage
Chasity O'Connell, American University of Sharjah & Human Relations Institute and Clinics (Dubai)

FOMO, or fear of missing out, is a phenomenon in which individuals experience an “uneasy and sometimes all-consuming feeling that you’re missing out—that your peers are doing, in the know about, or in possession of more or something better than you" (JWT, 2012). Research on FOMO suggests that those struggling with FOMO may experience increased depressive and anxiety symptoms (Baker, Kreiger, & LeRoy, 2016), increased stress, reduced psychological well-being (including social relationships and engagement in life) (Przybylski, Murayama, DeHaan, & Gladwell, 2013; Baker, Kreiger, & LeRoy, 2016; Elhai, Levine, Dvorak, & Hall, 2016)), increased risk of psychopathology (Lee, Kim, Choi, Lee, & Yook, 2014), increased risk of “addictive technological behaviors" (Schou, Billieux, Griffiths, Kuss, Demetrovics, & Pallesen, 2016), and increased risk of dangerous behaviors such as texting and driving (Steinmetz, 2015; Lee, Champagne, & Francescutti, 2013; Dossey, 2014). This paper will explore FOMO within the context of Self-Determination Theory (Przybylski et al.) and the mechanisms that influence its occurrence specifically within the highly-diverse population of the United Arab Emirates (UAE). This paper will also investigate the prevalence of FOMO in the UAE, explore its relationship with psychological distress and well-being, and provide the preliminary data results of an intervention wherein participants (comprised of university students and adults in the community) partake in a six-week, group-based intervention focusing on learning practical mindfulness skills and values-exploration exercises (based on Acceptance and Commitment Therapy).

25. An ACT intensive group therapy for adults who stutter: Results from a pilot study

Primary Topic: Clinical Interventions and Interests
Subtopic: Stuttering
Frédérick Dionne Ph.D., Université du Québec à Trois-Rivières
Marie-Eve Caty PhD, Université du Québec à Trois-Rivières
Nancy Blanchette, CIUSS MCQ

Adult stutterers regularly have speech-related fears, anxieties, depression and high level of avoidance. With the exception of the the work of Beilby, Byrnes and Yaruss (2012), there are very few studies or protocols using Acceptance and Commitment Therapy (ACT) with adults who stutter. This study aims to introduce an intensive group therapy combining ACT with Cambridge support for adults who stutter (n=3). The two three-day weekends program took place at a student university clinic. This is a onegroup pretest posttest design. The three participants completed self-reported questionnaires before and after the intensive therapy and at 1 month, 3 months and 6 months post-therapy. The frequency of stuttered syllables were also assessed for each of the time points. The results show significant improvements in psychosocial functioning, mindfulness skills, psychological flexibility, and overall speech fluency. Implications of this study are discussed in terms of future developments.

26. Northern Uganda: Trauma History/Clinical Trauma Work Experiences Using Interventions Developed on Principles of Behavioral Science

Primary Topic: Clinical Interventions and Interests
Subtopic: PTSD, DEPRESSION, ANXIETY
Kizito Wamala, Center for Victims of Torture (CVT)

Northern Uganda experienced war by the LRA from 1986 - 2006. That war left hundreds of thousands dead, millions traumatized and hundreds of thousands exiled. Among the survivors, that war left very serious mental health suffering. Currently in Northern Uganda, the PTSD and depression prevalence is very high, most recent researches indicating rates as high as 30% in the general population for both conditions. This makes trauma treatment very necessary and requires very effective approaches by the very meager numbers of qualified and specialized counselors in Northern Uganda.
The author's interventions are based on group and individual models/settings of counseling. The group model is conducted using a protocol developed on principles of CBT, ACT, NET and somatic exercises. The individual model is based specifically on ACT. For enrollment into the services, all clients are screened and assessed: (intake; pre-treatment and follow-up; post-treatment) using the Questionnaire of the Harvard Refugee Trauma Program in the areas of Physiological Functioning, Depression, Anxiety, PTSD and Behavioral Functioning.
The two models have led to very high results of improvement and general functioning. Remission of symptoms and improvement in general behavioral functioning is shown to be a high as 93% and 97%, respectively. More consistent results showing improvements are seen among individual clients treated specifically using ACT.
ACT is highly effective in the treatment of PTSD and related disorders using the individual counseling model in Northern Uganda implying that ACT might be very effective in group treatment and will target a bigger number of clients.

27. Evaluating the implementation of an intervention based on acceptance and commitment therapy in postsecondary institutions

Primary Topic: Educational settings
Subtopic: Implementation
Alexandra Nedelcu, Psy.D., University of Sherbrooke

BACKGROUND: Although many effective programs exist for reducing psychological distress in postsecondary students, few have been implemented and tested in community settings. The aim of this mixed-method study was to evaluate the implementation of an intervention based on Acceptance and Commitment Therapy (ACT) used to reduce psychological distress in postsecondary students. Its first goal was to describe the factors that may have facilitated or hindered the implementation of the intervention in nine Quebec postsecondary institutions, as perceived by the stakeholders who offered it. Its second goal was to document the fidelity of implementation according to four different components of adherence (content, frequency, duration and coverage).
METHOD: Twenty-two (N = 22) counsellors (e.g. psychologists) who offered the workshops were recruited. They first participated in a semi-structured interview and then answered a questionnaire assessing implementation fidelity.
RESULTS: The results indicate that the factors facilitating the implementation of the workshops were mainly related to 1) support from managers and colleagues, 2) effective promotion and recruitment methods, and 3) working with a co-counsellor. Conversely, implementation was hindered by obstacles such as 1) the length of the intervention, and 2) the difficulty of choosing an adequate time to offer it during the semester. In regard to implementation fidelity, most stakeholders reported having followed the suggested protocol.
DISCUSSION: This study provides a better understanding of what facilitates the accessibility and sustainability of ACT-based interventions in postsecondary settings and offers recommendations to facilitate the implementation of this type of intervention.

28. Exploring the relations between discrimination, psychosocial outcomes, and psychological inflexibility among college students

Primary Topic: Educational settings
Subtopic: Discrimination, psychological inflexibility, college students, psychological symptoms, social functioning
Woolee An, M.S., Utah State University
Aryn M. Dotterer, Ph.D., Utah State University
Su Jung Park, Utah State University
Michael E. Levin, Ph.D., Utah State University

Approximately seven in 10 adults in the United States experience some form of discrimination (American Psychological Association, 2016), broadly defined as the experience of unfair treatment by individuals and social institutions based on personal characteristics such as, race, age, gender, sexual orientation, physical disability, religion, education/income, ancestry or national origins, or physical appearance (Gonzales et al., 2016; Williams & Mohammed, 2009). Multiple studies have found that perceived discrimination is associated with various negative physical and psychological outcomes (Kressin, Raymond, & Manze, 2008; Paradies, 2006; Pascoe & Smart Richman, 2009; Williams & Mohammed, 2009). From an ACT perspective, psychological inflexibility plays an important role in a broad range of psychological problems (Bluett, Homan, Morrison, Levin, & Twohig, 2014; Hayes et al., 2006; Ruiz, 2010). Therefore, this study examined the role of psychological inflexibility in the associations between discrimination and psychosocial outcomes among college students. Using a short-term longitudinal design, 354 college students completed assessments of psychological symptoms and social functioning at two-time points. Path analyses were performed to examine the direct and indirect effects among psychological inflexibility, psychological symptoms, and social functioning. The results indicated that psychological inflexibility mediates the relation between perceived discrimination and psychosocial outcomes. These findings suggest that targeting psychological inflexibility may be clinically useful and effective particularly for college populations.

29. Teaching summarization strategies among fifth graders with learning disabilities: an application of Chinese dialogue-based intelligent tutoring system

Primary Topic: Educational settings
Subtopic: Children with learning disabilities
Chen-huei Liao, Professor, National Taichung University of Education
Wan-Shan Tsai, M.S., National Taichung University of Education
Kai-Chih Pai, Ph.D. candidate, National Taichung University of Education

The present study aims at exploring the pedagogical effectiveness of summarization strategies among five graders with learning disabilities by Chinese dialogue-based intelligent tutoring system. The teaching strategies are developed based on human tutor that simulated teacher’s teaching interaction and strategies. Students interacted with a computer tutor to learn summarization strategies by typing texts and choosing correct answers. The Chinese dialogue-based intelligent tutoring system gives different feedback immediately based on the students’ responses and assesses whether they are correct, incorrect or if there are any misconceptions. This process helps students to understand the concepts of the course that they should learn, and also rectify their misconceptions.
The single subject experimental design was employed with teaching summarization strategies by Chinese dialogue-based intelligent tutoring system as an independent variable, and students’ summarization writing ability was the dependent variable. Three students with learning disabilities and three non-disabled students were participated during the baseline, intervention, and maintenance, and analyzed using visual analysis and interviews.
These findings indicated that the proposed summarization strategies are effective for students. The teaching strategies had immediate and maintaining effects on all students with learning disabilities and non-disabled students. Only one student with learning disabilities showed poor efficiency in maintaining. Moreover, students with learning disabilities acquired more interactions and feedbacks than non-disabled students. Students also showed positive affirmation to the proposed summarization strategies.

30. Preliminary results of a guided vs. unguided Web-based ACT program on procrastination among university students

Primary Topic: Educational settings
Subtopic: ACT
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
Frédérick Dionne, Ph.D., Université du Québec à Trois-Rivières

Background: Academic procrastination is an ubiquitous problem among university students yet, effective interventions are lacking. Past studies have found Acceptance and Commitment Therapy (ACT) delivered via the Web to be efficacious for a variety of problematics. On the other hand, guidance has been shown as beneficial concerning adherence to treatment in Web-based programs. The purpose of this study was to test the efficacy of a guided vs unguided Web-based ACT program to decrease procrastination and increase psychological flexibility.
Method: The 8-weeks program comprised of a (1) Web platform, (2) videos, (3) exercises to complete each week, (4) weekly emails and (5) a forum. It was offered to students from two Canadian universities during Fall 2017. Participants were randomly assigned to one of two groups: unguided and guided. Questionnaires were completed before and after the 8-weeks program.
Participants: The final sample was comprised of 20 Canadian university students (85% women).
Results: Concerning procrastination, a significant main effect on time was found: F(1,18) = 6.74, p = .02, η2 = .10. Regarding psychological flexibility, results also revealed a significant main effect of time: F(1,18) = 10.34, p < .001, η2 = .10.
Discussion: Results highlight the potential effectiveness of a Web-based ACT program to decrease academic procrastination and increase psychological flexibility. The guided vs unguided condition had no effect on the results. We discuss aspects that could be improved for future developments to enhance the quality of the program and increase students’ engagement.

31. The impact of intensive intervention in Acceptance and Commitment Therapy and Psychoeducation comparision group in overweight and obese individuals: A Brazilian randomized study

Primary Topic: Functional contextual approaches in related disciplines
Subtopic: Obesity and Overweight
Ana Carolina Maciel Cancian, M.Sc, Pontifical Catholic University of Rio Grande do Sul
Igor da Rosa Finger, Pontifical Catholic University of Rio Grande do Sul
Patrícia Ariane Guedes, Pontifical Catholic University of Rio Grande do Sul
Renata Klein Zancan, Pontifical Catholic University of Rio Grande do Sul
Margareth da Silva Oliveira, Pontifical Catholic University of Rio Grande do Sul

Background: Overweight and obesity are related with several physical and mental problems and is a major concern worldwide. Acceptance and Commitment Therapy (ACT focuses on the clarification of personal values, intrinsically leading to reinforcing life directions, actions and goals. To achieve behavioral goals, an individual must have strategies to deal with emotional avoidance and cognitive fusion.
Methods: This study investigated the impact of an ACT one day workshop intervention compared to one day of Psychoeducation comparison group. A sample of 72 overweight and obese individuals were randomized (ACT: n = 39) and (Psychoeducation: n = 33). Weight, Body Mass Index (BMI), cognitive fusion, mindful eating and binge eating, using the Cognitive Fusion Questionnaire (CFQ), Mindful Eating Questionnaire (MEQ) and Binge Eating Scale (BES). The measures were assed at posttest and 5-month follow up.
Results: Significant differences were found in the ACT group in cognitive fusion at posttest and follow up (CFQ: F = 3.35, p = 0.04). Weight, BMI, mindful eating and binge eating showed differences after time (Weight: F = 10.89, p = 0.002; BMI: F = 12.06, p = 0.001; MEQ: F = 29.24, p = 0.001; BES: F36.32, p = 0.001) but no significant differences were found between the groups.
Discussion: Results indicate that a brief ACT intervention can clarify the function of eating behaviors, and help obese and overweight individuals to be less fused with thoughts. It is warranted that more studies investigate if ACT longer intervention can impact more than psychoeducation in other variables.

32. Yes Minister! An exploration of the experience of organisational politics in the UK Senior Civil Service with reference to psychological flexibility

Primary Topic: Organizational behavior management
Subtopic: Leadership
Ross McIntosh, City University of London

There is a scarcity of qualitative research exploring the key constructs of organisational politics (perceptions of politics, political skill and political will) and none has been located with participants from the UK Senior Civil Service (SCS). This qualitative study is an in depth exploration of the experience and management of organisational politics in the SCS. It also explores the hypothesis of a novel interaction between the constructs of organisational politics and the processes of psychological flexibility, which has been identified as a key factor in understanding psychological health, as it captures the multiple opposing forces that are experienced in the social environment.
17 members of the SCS from a range of Civil Service Departments and agencies were interviewed (10 female, 7 male; 12 Deputy Directors (DDs), 5 Directors). A Template Analysis was conducted to produce a thematic framework to represent the data.
An integrative theme was derived from the data which permeated the accounts from all participants. This integrative theme was made up of 3 sub-themes, all strongly related to values led behaviour in the workplace. This integrative theme also showed an interaction between psychological flexibility and the constructs of organisational politics. No claims are made about the nature of this potential interaction; it is suggested that it could form the basis for further research. Practical implications are considered and research limitations discussed.

33. The Validation Study of a Korean Version of Valuing Questionnaire(K-VQ)

Primary Topic: Other
Subtopic: Validation study
Choonja Yoo, Ph.D., Seoul Women's University Graduate School of Professional Therapeutic Technology in Korea
Kyung Park, Ph.D., Seoul Women's University Graduate School of Professional Therapeutic Technology in Korea

Introduction : In this study, a validation study of the Korean version of Valuing Questionnaire(K-VQ) was conducted as an appropriate evaluation tool to reliably measure the ‘value’ of ACT therapy.
Method: Participants : 390 Korean university students of both gender(112 males, 278 females)
Measurements :Korean version of Valuing Questionnaire(Yoo, 2017)
Data Analysis : Technology Analysis, Reliability Analysis, Correlation Analysis, Factor Analysis, Hierarchical Multiple Regression Analysis
Results: Factor 1(Progress) reflects value practice and includes a clear perception and patience about what is personally important. Factor 2(Obstruction) showed the same result as Smout et al.(2014), indicating avoidance of unwanted experiences and indifference to values.
Confirmatory Factor Analysis : The correlation coefficient between the items and the total score was .31 ~ .62, indicating a reasonable correlation coefficient in all items when adopting the correlation as a acceptable criterion.

34. Stigma toward Drug Users: Strategies of Acceptance and Commitment Training (ACT) for Healthcare Providers

Primary Topic: Performance-enhancing interventions
Subtopic: AOD stigma
Joanna Gonçalves de Andrade Tostes, Ph.D. Student, Federal University of Juiz de Fora (UFJF), Brazil
Pollyanna Santos da Silveira, Ph.D., Catholic University of Petrópolis (UCP), Brazil
Telmo Mota Ronzani, Federal University of Juiz de Fora (UFJF), Brazil

Background: Drug use is considered one of the most stigmatizing health conditions. Evidences have shown that it is associated with several impairments as poor access to health care, low education levels and unemployment. Stigma toward drug users is also found among healthcare providers. Besides the poor availability of services, many people who might benefit from treatment do not seek it or leave it prematurely to avoid stigmatization.
Method: We have developed and adapted a new Brazilian protocol based on international recommendations about interventions to reduce stigma, the Key Ingredients of Anti-Stigma Programs for Health Care Providers, and especially on the Acceptance and Commitment Training (ACT). We will conduct two sessions of workshop with a one week break. Each one will last six hours. The pretest-posttest nonequivalent control group design will be used. We will select a quota sampling of 100 healthcare providers, from specialized and non-specialized public services, to compose the Experimental Group (EG) and the Control Group (CG). To evaluate this intervention, we will use the follow Brazilian validated measures: Marlowe-Crowne Social Desirability Scale, Attribution Questionnaire-adapted to addicts, Opening Minds Scale for Health Care Providers-adapted to addicts, Cognitive Fusion Questionnaire, and Acceptance and Action Questionnaire.
Results: Now we are piloting it and in a few months we will have the preliminary results of feasibility and effectiveness indicators to fully present them.
Discussion: We need to move forward by implementing evidenced-based strategies to reduce professional stigma indicators, as the Acceptance and Commitment Training (ACT), and evaluating their effectiveness.

35. The Matrix for Sports Performance

Primary Topic: Performance-enhancing interventions
Subtopic: Sports Performance
Sebastian G. Kaplan, PhD, Wake Forest University School of Medicine
Laura Sudano, PhD, University of California San Diego

Background: Athletes experience a variety of performance impairing internal experiences, such as fear of failure, muscle tension during competitions, and thoughts about predicted failures. Athletes often work with mental performance specialists on strategies for overcoming such barriers to success, which frequently take form of relaxation exercises, thought stopping, or other methods to address unwanted thoughts, feelings, or physical sensations. Coaches may also employ such strategies to help their athletes succeed. While many athletes find these methods helpful, many will also experience continued worsening of their performance as these internal experiences further deplete their focus and energy. Acceptance-based methods have also become effective strategies in the world of sport performance. The matrix (Polk and Schoendorff, 2014) is a recently developed visual framework for applying acceptance-based intervention principles in clinical settings.
Methods: The presenters, in their roles as mental health and performance professionals integrated in a college sports medicine clinic, have used the matrix with several athletes. This presentation describes the application of the matrix with a baseball pitcher experiencing significant performance challenges.
Results: Thus far, the athlete has understood the matrix from a conceptual standpoint and has begun to implement new practice strategies. We will continue to gather clinical information relevant for this presentation in the coming months.
Discussion: Acceptance-based methods are not new in the world of sports performance. However, novel applications of acceptance-based methods are needed in order to provide mental performance professionals with an array of strategies that could prove effective with the diverse population of competitive athletes.

36. An Intervention Study of Mindfulness-Acceptance-Commitment on Sports Performance and Psychological Benefits among College Students

Primary Topic: Performance-enhancing interventions
Subtopic: Performance Enhancement
Shousen Xu, Ph.D., Capital University of Physical Education and Sports
Jingcheng Li, Ph.D., Capital University of Physical Education and Sports
Xia Zhao, Baidu Union

Objective: The purpose of present pretest-posttest control group design was to examine the intervention effects of Mindfulness-Acceptance-Commitment (MAC) on sport performance and psychological benefits.
Methods: Totally, 51 participants were recruited from golf elective course in PE college and were assigned to MAC group (n=33) and control group (n=18). Participants were asked to record hole-in scores using putter, and to assess the Five Facet Mindfulness Questionnaire (FFMQ), the Acceptance and Action Questionnaire-Second Edition (AAQ-Ⅱ), and the Competitive State Activity Inventory-2 (SCAI-2) at pre-, posttreatment (70minutes, 6 weeks) through self-report.
Results: The results of repeated measures analysis of variance indicated that, (1) The scores of posttest in both MAC group and control group were significant higher than the scores of the pretest in both big hole and small hole. Meanwhile, the improvement effect of MAC group in small hole-in score was significantly higher than that of control group. (2) MAC intervention improved the mindfulness trait of participants significantly. (3) MAC intervention decreased the level of experimental avoidance significantly. (4) On the Competitive State Activity Inventory-2, MAC intervention was able to decrease the level of cognitive anxiety, and increase the level of state confidence, however, MAC resulted in increase in physical anxiety.
Conclusion: Mindfulness-Acceptance-Commitment intervention improved sport performance and psychological benefits of college students, and could be applied to the college students in the formation stage of motor skill.

37. 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 Hatipoğlu 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). 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 614 college students from a public university in Turkey.Emotional Abuse and Neglect Subscale of Childhood Trauma Questionnaire and Anger Expression Styles Inventory were used to collect data.Correlation analysis 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),and negative for anger-control(r=-.15,p<.01).
Findings of the study revealed that college students who experienced emotional abuse 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. The theoretical and practical implications and recommendations for future research were presented.

38. Sense of coherence as a protective factor from PTSD, depression and anxiety: A Belgian study based on the terrorist attacks of March 22, 2016

Primary Topic: Prevention and Community-Based Interventions
Subtopic: PTSD
Ilios Kotsou, Ph.D., Chaire Mindfulness, Bien-Etre au travail et Paix économique, Grenoble Ecole de Management & Université Libre de Bruxelles
Christophe Leys, Ph.D., Faculty of Psychology, Université Libre de Bruxelles
Pierre Fossion, Brugmann Hospital, Université Libre de Bruxelles, Brussels, Belgium

Background: On Tuesday March 22, 2016, three suicide bombings occurred in Brussels, Belgium: two at the Brussels International Airport and one in Maalbeek subway station. Thirty-two civilians were killed and more than 300 people were injured. Islamic State of Iraq claimed responsibility for the attacks. Two days following these attacks, our research team started a prospective study about the psychological consequences of this collective trauma.
Aim: The authors conducted a prospective study aiming at observing the evolution of Post-traumatic Stress Disorder (PTSD) and depressive and anxiety disorders symptoms (DAD) and the protective role of Sense of Coherence (SOC) after the Brussels March 2016 terrorist attacks.
Method: They collected data on a non-clinical sample of 464 participants through an on-line questionnaire, two days (time 1) and three months (time 2) after the attacks. They measured the level of PTSD, DAD and SOC at time 1 and 2.
Results: They observed a negative relationship between SOC and both DAD and PTSD symptoms. A high level of SOC enable individuals to overcome DAD symptoms faster than individuals with lower level of SOC. This effect is not present regarding the evolution of PTSD symptoms.
Conclusions: Results confirm the protective function of SOC and the relevance of the current separation of PTSD from anxiety disorders. Authors propose an interpretation of this relevance taking into account the cognitive distortion observed in PTSD. At a clinical level, PTSD and DAD should benefit from different therapeutic interventions after trauma exposure.

39. The effect of Acceptance and Commitment Therapy intervention on implicit and explicit stigma towards mental illness
Sponsored by: ACBS Japan Chapter
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Mental illness stigma
Natsumi Tsuda, Doshisha University
Takashi Muto, Doshisha University

Background: The purpose of this study is to explore the effect of interventions on reducing stigma towards mental illness. According to Masuda et al. (2007), in students with low psychological flexibility, Acceptance and Commitment Therapy (ACT) intervention was more effective than educational intervention. Although the study used only explicit methods, it is not clear whether stigma was correctly measured. This study made use of ACT and educational intervention to reduce stigma and measured the effect by using implicit methods. Method: Participants were psychology students (N=79) divided into 4groups (2 (psychological flexibility: high or low)×2 (intervention: ACT or educational)). As Masuda et al.’s (2007) interventions were originally in English, the experimenter translated programs into Japanese. Measures were taken before and after the intervention and at a 1-month follow-up. 1) Implicit stigma, 2) explicit stigma, 3) psychological flexibility were measured. Results: 1) There was only a significant effect for time (explicit stigma: F(2, 124)=12.59, p<.01; implicit stigma: F(2, 124)=11.93, p<.01), 2) there was no correlation between the change scores of psychological flexibility and stigma towards mental illness (both implicit and explicit). Discussion: This research demonstrated educational and ACT interventions significantly reducing stigma toward mental illness. However, there was no relationship between psychological flexibility and mental illness stigma (both implicit and explicit). These results differ from those of previous studies (e.g. Masuda et al., 2007). There were some needs to study more about the relationship between mental illness stigma and psychological flexibility by using implicit and explicit stigma.

40. Psychological Flexibility in the Family Context: Evidence From A Sample Of Greek-Speaking Parents Of Younger Children With Externalizing Problems

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Family Context, Parenting, Behavior Problems, Psychological Flexibility
Anthi Loutsiou, PsyD, University of Cyprus
Andri Anastasiou, MA, University of Cyprus

This study tests the usefulness and ecological validity of a standardized measure of Psychological Flexibility in the parenting role (PR). It also tests the relationship between psychological flexibility-PR with other parenting variables and child behavior outcomes. A community sample of parents (N=206) (N=173 mothers) of children with externalizing behavior problems (Age= 2-8 years old) was recruited through open announcements to participate in the clinical trials of a parent training program. Parents completed a larger packet of self-administered questionnaires adapted in Greek and data was collected at baseline prior to any interventions. A measure of Psychological Flexibility-PR was developed in Greek based on the Parenting version of the 15-item AAQ (PAAQ). Reliability analyses suggest strong internal consistency of the measure. Preliminary factorial analyses support the original two subscales of psychological flexibility-PR (Inaction and Unwillingness) and a total score. Correlational analyses show that the parents’ psychological flexibility is negatively correlated to parenting stress. Further analyses will be conducted to assess the degree to which aspects of psychological flexibility-PR predict the variance in the child’s behavior problems. This study adds to the existing literature suggesting that psychological flexibility-PR is an important variable within the family context and appears to relate to outcomes of both the parents and the children. Implications for both research and practice with families of younger children will be discussed.

41. The use of acceptance and commitment therapy as a preventive and promotional program for mental health: A systematic review

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Depression
Ching Yee Lam, MPhil, MN, The Open University of Hong Kong, The Hong Kong Polytechnic University
Yim Wah Mak, PhD, The Hong Kong Polytechnic University
Sau Fong Leung, PhD, The Hong Kong Polytechnic University

Background: Mental health is essential to everyone as well as the community that prevention and promotion in mental health is imperative. ACT has been found as an empirically effective psychological intervention. It encourages people to accept unpleasant feelings hence increasing an individual’s psychological flexibility, and to move toward valued behavior. With an increasing use of ACT in preventing mental illness and promoting mental wellness, this review evaluate the effectiveness of ACT on psychological outcomes in non-clinical samples at primary level.
Method: A systematic search of relevant English language peer-reviewed journal was conducted in five computerized databases (PubMed, Medline, PsycINFO, CINAHL, and Embase) using keywords “acceptance and commitment therapy" AND (“prevent*" OR “promot*") dated until March 2018.
Result: Seventeen studies were included in this review. ACT has been used as a universal prevention, selective prevention, and promotional program in the past decade. It was delivered in a format of face-to-face, web-based, smartphone applications, bibliotherapy, or group therapy. Study participants were mostly recruited from schools, workplace or community in developed Western countries. The efficacy of ACT was examined independently and was compared with health education, usual practice or wait-list control group. Improvement in mental wellness and symptom reductions was reported in 14 universal/selective prevention program and promotional programs.
Discussion: ACT appeared to be applicable to general public in a non-therapy approach. This presentation reports efficacy of ACT in different delivery format for prevention and promotion in mental health, and to identify implications for practice or future research relating ACT and mental health.

42. ACTeen: a pilot Acceptance and Commitment Training for adolescents

Primary Topic: Prevention and Community-Based Interventions
Subtopic: ACT, Adolescents, Mindfulness, Groups
Emanuele Rossi, Psy.D., APC, SPC - AISCC
Natalia Glauser, Psy.D., APC, SPC - AISCC
Antea D'Andrea, Psy.D., APC, SPC - AISCC
Erica Curzi, Psy.D., APC, SPC - AISCC
Elena Cucchiari, Psy.D., APC, SPC - AISCC

Childhood and adolescence are characterized by difficulties ascribed to several issues that differ significantly from those observed in adults. Therefore, the application of procedures mainly focused on developmental needs was necessary in clinical practice. Recently an increase of studies and textbooks concerning this age has been observed in literature, and subsequently also in the ACT framework.
In the present study we propose an Acceptance and Commitment Training in a cohort of children and adolescents, achieved by adjusting the group setting instructions included in “ACT for Adolescent" (Turrell and Bell, 2016).
The Acceptance and Commitment Training for Adolescents was organized in a well-defined number of sessions, encouraging the ACT core processes using metaphors, mindfulness exercises and teen-friendly experiences.

43. Psychological First Aid Plus Matrix

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Psychological First Aid and Matrix
Naomi Johnstance, PARSA Trainer

NRC( Norqegian Refugee Council) provides legal support for regfugee from Iran, Pakistan and Internal displacement from war. So most of these placements have mental health issues, but legal staff can't do anything for these emotional concerns. Thus NRC with cooperation of PARSA organization develop a manual to cover this issue in the field. PARSA and NRC develop a new manual based on WHO(World Health Organization) Psychological First Aid and NRC protection guide lines which is fit into context of Afghanistan to support these legal counselors in dealing with their beneficaries.
The powerful tool the legal counselor use with beneficaries is Matrix, and they legal Counselor also use as self care him or her self. because Matrix is more practical, quickly emopwer beneficaries and easy for the beneficaries and legal counselor to use it to daily work and life. Further more immediately show beneficaries that you behavior, is not consist with values that you define for your self.
Right now I and My colleague Dr.Norman are delivering this training across the regions of Afghanistan.

44. An Interpretative Phenomenological Exploration of Group-Based Acceptance and Commitment Therapy with Adolescents

Sponsored by: Ontario ACBS Chapter
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Adolescents, Group Treatment, Anxiety, Depression, Transdiagnostic intervention, Qualitative
Tajinder Uppal Dhariwal, Ph.D., OISE/University of Toronto
Sheri Turrell, Ph.D., Trillium Health Partners

Acceptance and commitment therapy (ACT) is a transdiagnostic therapeutic approach that has proven effective for a wide range of psychiatric disorders with adults. There is limited evidence suggesting the effectiveness of group-based ACT with adolescents. An open trial was conducted using quantitative methodology to explore the effectiveness of group-based ACT with adolescents (n = 72) experiencing heterogeneous symptoms of anxiety and/or depression in a community hospital outpatient program (Uppal Dhariwal et al., in preparation). Results revealed significant reductions in symptoms of anxiety and depression from pre to post, and further significant reductions in symptoms post to three months follow-up (3MFU). Due to the exploratory nature of this investigation and lack of control or comparison group, a qualitative study was also conducted concurrently to explore adolescents’ experience, better understand the utility of group-based ACT, and corroborate the quantitative study findings. A subset of 10 adolescents participated in semi-structured interviews at post and 3MFU. Interpretative phenomenological analysis revealed themes of usefulness of treatment, improvements attributed to ACT, non-ACT factors, barriers to treatment use, and treatment within a group context. Each of the participants reported that ACT helped them to make values based behavioral changes. Several participants indicated that factors other than ACT contributed to their improvements. Overall, the qualitative results provided support for the utility of group-based ACT as a transdiagnostic treatment with adolescents. Future research is warranted comparing group-based ACT to control groups and alternative therapies with populations across multiple contexts before firm conclusions can be drawn.

Friday, July 27, 6:00-7:00pm - Poster Session #3

1. ACT for Cancer Survivors with Clinically Significant Fear of Recurrence: Results of a 3-Arm Randomized Pilot

Primary Topic: Behavioral medicine
Subtopic: Cancer
Shelley A. Johns, PsyD, ABPP, Indiana University School of Medicine
Kathleen Beck-Coon, MD, Indiana University School of Medicine
Linda F. Brown, PhD, HSPP, Indiana University
Michelle LaPradd, MS, Indiana University School of Medicine
Patrick O. Monahan, PhD, Indiana University School of Medicine

Background: Fear of cancer recurrence (FCR) is a prevalent and persistent source of distress for survivors. Few empirically-supported treatments for FCR exist. The objective of this 3-arm pilot was to assess feasibility and preliminary efficacy of ACT in reducing FCR and cancer-related avoidant coping (C-RAC) compared to survivorship education (SE) and enhanced usual care (EUC).
Methods: Post-treatment breast cancer survivors (BCS; n=91) with clinically-significant FCR were randomized to ACT, SE, or EUC. ACT and SE groups met 2 hours/week for 6 weeks; EUC was self-administered with survivorship readings. Feasibility was assessed with percentage of eligible BCS who enrolled, trial retention, and attendance (ACT; SE). Intent-to-treat ANCOVA was used to calculate pair-wise Cohen’s d effect sizes between the 3 arms on FCR and C-RAC post-intervention (T2) and 6-months later (T3) controlling for baseline (T1) scores and covariates.
Results: Of eligible BCS, 61.7% enrolled in the trial. Retention was 94.5% through T3, and attendance was ACT=5.0 sessions and SE=5.2 sessions, with no significant between-group difference (p=0.47). ACT was superior to SE in reducing FCR at T2 (d=0.69, p<0.05) and T3 (d=0.73, p<0.001). ACT was also superior to SE in reducing C-RAC at T2 (d=0.66, p<0.05) and T3 (d=0.97, p<0.001). ACT was superior to EUC in reducing FCR at T3 (d=0.42, p<0.05) and in reducing C-RAC at T2 (d=0.68, p<0.05) and T3 (d=0.80, p<0.001). No significant differences between SE and EUC emerged at any point.
Discussion: ACT is a promising intervention for BCS with FCR that warrants a fully powered efficacy trial.

2. Emotion Regulation Deficits and Impaired Working Memory as Correlates of Emotional Eating

Primary Topic: Behavioral medicine
Subtopic: Emotion Regulation
Tanya S. Watford, M.S., Bowling Green State University
Abby Braden, Ph.D., Bowling Green State University
Emily Ferrell, B.S., Bowling Green State University

Emotional eating (EE), or eating in response to emotions, is related to depression, binge eating, and weight gain. Poor emotion regulation (ER) is a risk factor for EE. Low working memory (WM) may also be a risk factor for EE, as WM is an important cognitive factor in emotion regulation (ER). Aims of the current study were to: 1) examine whether the relationship between ER and EE is stronger when WM is impaired and to 2) examine whether the relationship between WM and EE is stronger when ER is poor. A college student sample (n = 77; BMI = 26.84 + 6.79; age = 20.25 + 2.49; 79.2% female) completed measures of EE in response to depression, boredom, and anger/anxiety (Emotional Eating Scale), ER (Difficulties in Emotion Regulation scale) and a WM task (AOSPAN). Moderated regression analyses were conducted. Results showed that WM moderated the relationship between ER and boredom EE, ΔR2 = .12, p = 0.02, and depression EE, ΔR2 = .12, p = 0.03, such that poorer WM strengthened the relationship between poor ER and greater boredom and depression EE. Results showed that ER moderated the relationship between WM and boredom EE, ΔR2 = .04, p = 0.05, such that poorer ER strengthened the impaired WM/greater boredom EE relationship. Findings suggest that the mechanisms of boredom and depression EE may be different than anxiety/anger EE. Additionally, individuals with low WM and poor ER may be at increased risk for boredom and depression EE.

3. Predictors and mediators of outcome in cognitive behavioral therapy for chronic pain: The contributions of psychological flexibility

Primary Topic: Behavioral medicine
Subtopic: Chronic pain
Sophia Åkerblom, MSc, Lund University
Sean Perrin, PhD, Lund University
Marcelo Rivano Fischer, PhD, Skåne University Hospital
Lance M McCracken, PhD, King's College London

Background: To our knowledge, no previous studies have investigated whether psychological flexibility predict outcomes in CBT for chronic pain, or whether components from the psychological flexibility model besides acceptance mediate such outcomes. One aim of this study is to evaluate a range of possible predictors of outcome in CBT for chronic pain, including psychological inflexibility. Another aim of this study is to investigate psychological inflexibility, acceptance, committed action, cognitive fusion and values-based action as mediators of treatment outcome.
Methods: 232 participants took part in a multidisciplinary CBT treatment program for chronic pain with assessments at pre-treatment, post-treatment and at 12-month follow-up. Treatment outcome was indexed by pain intensity, pain interference, and depression.
Results: Higher levels of psychological inflexibility at baseline predicted worse pain interference and depression, lower levels of committed action predicted worse depression, at 12-month follow-up. Psychological inflexibility, acceptance, committed action, values-based action, and cognitive fusion all (separately) mediated treatment outcomes. Multivariate mediation analyses revealed that acceptance, committed action, and values-based action appeared to play the largest roles in the multivariate analyses, among those sub-processes available from the psychological flexibility model.
Discussion: The results from this study support the notion that the processes from the psychological flexibility model are general, transdiagnostic and trans-situational as they appear to operate within a traditional CBT-oriented treatment approach, as well as within contextual forms of CBT, and for a population with diverse problems cutting across diagnostic categories, including both somatic and psychiatric complaints. More precise targeting of these processes may yield better outcomes.

4. A Health Self-Management Support Intervention for Individuals with Serious Mental Illness: Exploring the ACT Therapeutic Stance with Peer Support Specialists
Sponsored by: Contextual Medicine SIG
Primary Topic: Clinical Interventions and Interests
Subtopic: Psychosis
Adrienne Lapidos, Ph.D., University of Michigan

Background: Scientist- and consumer-driven conceptualizations of metal health recovery have historically diverged, and mental health intervention development can benefit from inclusion of a community voice.
Method: A team of clinicians, university investigators, and mental healthcare consumers serving as Certified Peer Support Specialists (CPSSs) created a partnership to develop and test a CPSS-led physical health self-management intervention that would meet a Community Mental Health Agency’s needs. The Acceptance and Commitment Therapy (ACT) therapeutic stance was used as a foundation.
Results: Consumers (N=7) completed pre- and post-intervention questionnaires. Consumers reported high satisfaction with the intervention, and CPSSs (N=2) found personal and professional enrichment in learning ACT. Yet staff turnover proved to be an insurmountable barrier to sustainability.
Discussion: Throughout the project, CPSSs were valuable research partners, possessing “insider" (consumer) and “outsider" (provider) identities, and conveying consumer-driven notions of recovery. They reported that ACT felt deeply resonant with their work as Peer Support Specialists. Chief implementation barriers related to inner and outer setting.

5. Pathways to Pleasure: Flexibility as a Route to Sexual Pleasure as Women Age

Primary Topic: Clinical Interventions and Interests
Subtopic: Sex therapy
Kate Morrissey Stahl, LCSW, PhD, CST, University of Georgia
Jerry Gale, PhD, MFT, University of Georgia
Denise Lewis, PhD, University of Georgia
Doug Kleiber, PhD, University of Georgia

Older adult women make up a growing part of the population, and yet literature on the sexual activity over their life spans is lacking. This qualitative interview study explored the experience of 16 women aged 57–91 to better understand sexual pleasure over a lifetime. The participants described having to challenge cultural rules to create a supportive environment for sexual expression. Having access to Novel contexts in which to learn, cultivating Intimacy with partners and with oneself, being Creative with sexual activities, and Extending one’s sense of sexual possibility into advanced age (NICE) supported sexual pleasure as women aged. Overall, this supports the application of psychological flexibility to sexual behavior in older adult women.

6. Turkish Version of BAVQ-R: Preliminary Analysis of Reliability and Validity

Primary Topic: Clinical Interventions and Interests
Subtopic: Psychosis
Zülal ÇELİK, Bakirkoy Research & Training Hospital for Psychiatry, Neurology and Neurosurgery
Merve TERZİOGLU, Bakirkoy Research & Training Hospital for Psychiatry, Neurology and Neurosurgery
K.Fatih YAVUZ, Bakirkoy Research & Training Hospital for Psychiatry, Neurology and Neurosurgery

BACKGROUND: While hallucinations also exist in non-psychotic individuals, leads significant distress especially in psychotic individuals. The most common hallucinations are known to be of auditory type. Beliefs About Voices Questionnaire (BAVQ-R) is a self-report scale which has been developed for assessing how people understand and respond to their voices. This research investigates the reliability and validity analysis of Turkish version of BAVQ-R.
METHOD: The study group consisted of 50 psychotic patients with auditory hallucinations. The scale was translated by two independent person and then corrected by the authors. A socio-demographic data form, Voices acceptance and action scale (VAAS), Acceptance and Action Questionnaire-II (AAQ-II), Scale for the Assessment of Positive Symptoms (SAPS), Quality of Life Scale for Schizophrenic Patients, revised Beliefs About Voices Questionnaire (BAVQ-R), Psychotic Symptom Rating Scale Auditory Hallucinations were administered. Internal consistency and split-half analyses were performed to evaluate the reliability. Validity analyses were also conducted.
RESULTS: TBAVQ-R showed good internal consistency (Cronbach’s alpha values for each sub-scale, Resistance: 0.659; Engagement: 0.893; Malevolence: 0.82; Benevolence: 0.908; Omnipotence: 0.721). Split-half reliability of scale was 0.791. Significant correlations found between TBAVQ-R sub-scales (from r= .429 to .624). As expected subscales other than Omnipotence was not correlated with VAAS. SAPS scale was correlated with Malovolence, Resistance and Benevolence subscales (r=.281, r=.384, r=.-381).There were also significant correlations found between Malevolance, Resistance, Omnipotance subscales and AAQ-II (r=.447, r=.354, r=.598 respectively).
DISCUSSION: It can be proposed that TBAVQ-R is a reliable and valid measure for the assessment of individuals' attitudes to auditory hallucinations.

7. The effect of ACT-enhanced DANCE treatment for reducing burden of caring in Japanese family caregivers of dementia: A single-case experimental design

Primary Topic: Clinical Interventions and Interests
Subtopic: Dementia
Takashi Muto, Ph. D., Doshisha

McCurry (2006) proposed that a contextual behavioral treatment model of DANCE which is an acronym for five core principles for family caregivers of dementia. However, the DANCE treatment has had little evidence and reports applied in non-western country. The purpose of this study was to evaluate the effects of ACT-enhanced DANCE treatment for reducing burden of caring in Japanese family caregivers of dementia. In this study, 5 Japanese family caregivers of dementia were treated 6-12 weekly or biweekly sessions of treatment. The effects of ACT-DANCE for reducing distress were assessed using a multiple baseline design across participants. After treatment, three of five participants showed significant decrease in self-reported score of burden of caring for family with dementia. When implementing statistically combined Tau-U analysis of all 5 participants were significant decrease in this score (Tau-U = -0.56, 95％ CI [-0.9008, -0.2260]) , p = .0028). These findings suggest that might be also an effective for reducing distress of Japanese family caregivers of dementia.

8. Difficulties in Emotion Regulation: A Transdiagnostic Predictor of Adolescent Depression and Anxiety

Primary Topic: Clinical Interventions and Interests
Subtopic: Emotion Regulation and Psychopathology
Marissa D. Sbrilli, B.A., Children’s Hospital of Philadelphia
Jason D. Jones, Ph.D., Children’s Hospital of Philadelphia
Jami F. Young, Ph.D., Children’s Hospital of Philadelphia

Background: Emotion regulation (ER) is a multi-dimensional construct important in the development and maintenance of psychopathology (Sloan et al., 2017). Most research on ER has been cross-sectional (Compas et al., 2017) and has included limited examination of ER’s multiple dimensions (D’Agostino et al., 2017). This study examines the concurrent and longitudinal associations between ER dimensions and adolescents’ depression and anxiety symptoms.
Method: Adolescents completed measures at baseline (n=74) and 9 months later (n=57). A brief version of the Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004) measured overall ER as well as six dimensions of ER. The Children’s Depression Inventory (CDI; Kovacs, 2003) and the Multidimensional Anxiety Scale for Children (MASC; March et al., 1997) measured depression and anxiety symptoms. We used hierarchical regression to examine the association between ER and symptoms of depression and anxiety at baseline and 9 months later, after adjusting for demographic covariates and baseline symptoms (9-month model).
Results: The DERS total score and several subscale scores were significantly correlated with depression and anxiety symptoms. Greater ER difficulties were associated with more severe depression symptoms in the baseline model (β=.51, p<.05) and in the 9-month model (β=.41, p<.05). Greater ER difficulties were associated with more severe anxiety symptoms in the baseline model (β=.44, p<.05) and in the 9-month model (β=.28, p<.05).
Discussion: ER difficulties were found to significantly predict depression and anxiety symptoms concurrently and longitudinally, over and above variance accounted for by demographic covariates and baseline symptoms. Clinical implications will be discussed.

9. The relationship between experiential avoidance and its short-term consequences: Using ecological momentary assessment

Primary Topic: Clinical Interventions and Interests
Subtopic: Experiential avoidance
Taiki Shima, Doshisha University
Kazuya Inoue, Waseda University
Junichi Saito, Waseda University
Hiroaki Kumano, Waseda University

Introduction: To measure experiential avoidance (EA) in daily life, ecological momentary assessment (EMA; Stone & Shiffman, 1994) is employed (e.g., Machell et al., 2015). Previous studies have demonstrated EA acts as a predictor of negative states. However, few studies have focused on the relationship between EA and the short-term consequences of each behavior. In this study, we investigate EA and the consequences of each episode of behavior.
Methods: Participants: 22 students (F = 18, mean age 18.82 ± 0.80). Procedure: Participants were instructed to complete the form when they received a cue e-mail (four times per day) or observed an unpleasant experience. Items: Three EA items and eight state items (regret, excited, weary, fulfilling, irritated, pleasant, satisfied, and concentration levels) were measured during each report. Analysis: A correlation analysis was performed.
Results: The mean score of the EA items were significantly correlated positively with the mean scores for regret, excited, weary, irritated, and pleasant states (ρ = .76, .44, .75, .67, 61 respectively). They also significantly correlated negatively with the mean score for concentration level during the behavior (ρ = -.53).
Discussion: Almost all of these results were in line with previous studies. We found that the relationship between EA and negative states were especially robust. Although most results supported our hypothesis, some relationships (EA × excited and pleasant states) were inconsistent with our hypothesis. Measuring methods that use EMA may have room for improvement. This work was supported by JSPS KAKENHI (grant number 17J10709).

10. Social trust as a moderator of the relationship between stigma-related acceptance and self-reported prejudice

Primary Topic: Clinical Interventions and Interests
Subtopic: Prejudice
Leah M. Bogusch, M.A., Bowling Green State University
Mary T. Moeller, M.A., Bowling Green State University
Tabitha C. Waite, M.A., Bowling Green State University
William H. O'Brien, Ph.D., Bowling Green State University

Background: Increasing psychological flexibility has been identified as a potential intervention point for reductions in bias toward minorities (Levin et al., 2016). The present study examined social trust as a potential moderator for the relationship between stigma-related psychological flexibility and ratings of prejudice toward minorities.
Method: An online sample (n = 315) of US citizens completed the Acceptance and Action Questionnaire-Stigma, General Trust Scale, and ratings of prejudice toward minorities as part of a larger study following the 2016 presidential election.
Results: A hierarchical multiple regression was conducted. In the first step, two variables were included: psychological flexibility and social trust. These variables accounted for a significant amount of variance in ratings of prejudice, R2 = 0.21 F(4, 310) = 20.56, p < .0001. The interaction effect of social trust as a moderator was added to the model, which accounted for a significant amount of the variance in self-reported prejudice, ΔR2 = 0.03 F(1, 310) = 11.25, p = .0009, b = .27, t(310) = 3.35, p = .0009. A review of the interaction plot showed that as psychological flexibility and social trust increased, self-reported prejudice decreased.
Discussion: This study provides additional evidence for the relationship between psychological flexibility and lower self-reported prejudice. The role of social trust as a moderator for reductions in prejudice indicates that increasing social trust may reduce outgroup bias and reduce desire for group-based hierarchies (Cargile, 2017).

11. Convergent and Known-Groups Validity of the Self-as-Context Scale

Primary Topic: Clinical Interventions and Interests
Subtopic: Contextual self
Robert D. Zettle, Wichita State University
Kyle Rexer, Wichita State University
Jeffrey Swails, Wichita Sate Universitry
Suzanne R. Gird, Wichita State University<

The validity of a newly developed Self-as-Context Scale (SACS) with Centering and Transcending subscales was evaluated by administering it to nonclinical and clinical samples. Among college students (N = 360), strong correlations of total and subscale scores with those of the Self Expressions Questionnaire (SEQ), another recent measure of the contextual self, supported the convergent validity of the SACS. An exploratory factor analysis of pooled items from both instruments indicated that those from the Centering subscale of the SACS and the SEQ loaded on the first two factors. Transcending items alone loaded on a third factor, suggesting that the contextual self is a multifaceted construct with a dimension not fully captured by either the Self as Distinction or Self as Observer subscales of the SEQ. The validity of the SACS was further supported via the results of a known group comparison with a diagnostically diverse group of psychiatric outpatients (N = 54). Given the contribution that self-as-context is thought to make to psychological flexibility, this clinical sample as expected endorsed each of the SACS items to a significantly lesser degree than our group of college students. The overall results suggest that the SACS predictably overlaps with the SEQ, but not to the extent that they are indistinguishable from each other at least when administered to nonclinical populations.

12. Centering-Focused Protocols vs. Two Control Groups in Coping with Induced Pain

Primary Topic: Clinical Interventions and Interests
Subtopic: Contextual self, mindfulness
Robert D. Zettle, Wichita State University
Eric Richardson, Wichita State University
Yvonne Chaw, Wichita Sate Universitry
Suzanne R. Gird, Wichita State University
Charles Hayes, Wichita State University
Lucas Cylke, Wichita State University

Increased present-moment awareness and self-as-context have been viewed as constituting a centered response style that enhances psychological flexibility. A self-as-context (SAC)-based protocol that showed promise in increasing tolerance to acute pain when contextualized to that experience (Carrasquillo & Zettle, 2014) was further evaluated by comparing it to another centering-focused protocol and two control groups. In between presentations of the cold pressor, college students were randomly assigned to listen to a 20 min CD specific to one of the following four conditions: (a) the SAC-based protocol, (b) a mindfulness-based protocol contextualized to pain, (c) information about pain that served as an attention-placebo control group, or (d) an historical overview of the university that served as a no-treatment control group. The most powerful finding was that the no-treatment control group at best had no effect in improving pain tolerance and even resulted in a significant increase in pain intensity. By contrast, the two centering-focused protocols significantly decreased the level of pain experienced, while the attention-placebo condition had no effect. Of the two centering-focused conditions, any comparative differences favored the SAC-based protocol. It was the only one to display large effect size improvements across all measures derived from the cold pressor, compared to no significant increase in pain threshold and only a medium effect size on pain intensity for the mindfulness-based protocol. The overall results suggest that even an attention-placebo condition improves the ability to cope with induced pain, but that additional benefits accrue when a centered response style is encouraged.

13. Comparison Between CBT and ACT for Public Speaking Performance

Primary Topic: Clinical Interventions and Interests
Subtopic: Social Anxiety Disorder
Soultana Mpoulkoura, B.A., Minnesota State University, Mankato
Jeffrey Buchanan, Ph.D., Minnesota State University, Mankato

Background: Public speaking anxiety affects many people in the general population. Traditional Cognitive Behavioral Therapy aims to reduce distress by altering maladaptive schemas (Rapee & Heimberg 1997), but this approach is not always successful. Recent research has shown ambiguous support for cognitive restructuring as a mechanism of change. Therefore, further research is needed to discover effective treatments. Acceptance and Commitment Therapy, emphasizes psychological flexibility and values rather controlling negative thoughts (Hayes, 2006). Acceptance based approaches have been tentatively shown to be successful for increasing performance. Both treatments have shown to decrease anxiety, and possibly performance may be the key differentiator of these two treatments. The current study compared brief acceptance and cognitive control based interventions for increasing performance on a public speaking task. It was hypothesized that participants in CBT and ACT conditions will exhibit greater reduction of anxiety following the speech task compared to the psychoeducational control group. It was also hypothesized that the acceptance based intervention will lead to greater increases in performance compared to other two protocols.
Methods: Participants were college students at a Midwestern public university and were then randomized to receive an acceptance, cognitive-control, or psychoeducational-based protocol. Participants then prepared and gave 5 minute autobiographical speech in front of an audience of two research assistants.
Results: Data collection is ongoing with results expected by May 2018.
Discussion: By developing effective interventions we aim to help people with public speaking anxiety to perform better in public speaking scenarios, thus improving their overall quality of life.

14. ACT on Life group: A Pilot Study of ACT with Adolescents in Outpatient Mental Health Clinics

Primary Topic: Clinical Interventions and Interests
Subtopic: Adolescent, group therapy, anxiety, depression
Amber M. Johnston, Ph.D., IWK Health Centre
Susie McAfee, Ph.D., Dalhousie University
Michelle Tougas, MSc, Dalhousie University

Acceptance and Commitment Therapy (ACT) is a third wave Cognitive Behavioural Therapy. ACT focuses on increasing psychological flexibility through building mindfulness-based skills to support the exploration of values and willingness to move toward creating a life full of vitality. Sixteen adolescents between the ages of 15-19 years who identified as struggling with symptoms of anxiety, low mood, and/or chronic stress participated in 10, 90-minute ACT group sessions in outpatient mental health clinics and an additional 3-month follow up. Two, 2-hour ACT group sessions were offered to parents. Traditional CBT group protocols previously offered in this setting often resulted in high dropout rates and subsequently longer wait times for the families who returned seeking individual psychotherapy. The goals of this pilot project were to: increase psychological flexibility, increase retention, and decrease service utilization post group. Repeated measures ANOVA from pre-post group measures revealed: significant decrease in frequency and believability in automatic thoughts (ATQ), avoidance and fusion (AFQ-Y), emotional symptoms (SDQ-EE), depressive symptoms (CDI2), anxiety symptoms (MASC), as well as an increase in valued living (VQ). Gains were maintained at 3-month follow up. Compared to the traditional CBT group, the ACT group had higher retention (65% versus 39%), and lower utilization of services post-group (38% versus 29%). These findings suggest that the ACT on Life group is a feasible treatment option in an outpatient mental health setting.

15. The impact of a gratitude journal intervention on values-behavior congruence and subjective well-being

Primary Topic: Clinical Interventions and Interests
Subtopic: values; subjective well-being; gratitude
Robin Grumet, M.A., McGill University
Marilyn Fitzpatrick, Ph.D., McGill University
Gentiana Sadikaj, Ph.D., McGill University

Background. The positive impact of gratitude interventions on subjective well-being (SWB) is well established (Davis et al., 2016), however the mechanisms underlying this relationship are less understood. Research also supports a positive association between values-behavior congruence (VBC) and SWB (e.g., Lundgren, Dahl, & Hayes, 2008). Although research has yet to directly examine the relationship between gratitude and VBC, gratitude may promote self-improvement motivation (Armenta, Fritz, & Lyubomirsky, 2016) and facilitate goal progress (Emmons & Mishra, 2011). The current study utilized a randomized controlled trial design to examine the impact of a gratitude intervention on VBC, as well as the potential mediating role of VBC in the positive relationship between gratitude and SWB. Methods. North American participants recruited from Mechanical Turk participated in a bi-weekly gratitude journaling intervention (Emmons & McCullough, 2003) or control intervention (“The Life details exercise"; Sheldon & Lyubomirsky, 2006) over four weeks. They completed baseline, mid-point, and post-test questionnaires. The Valuing Questionnaire (Smout et al., 2016), Satisfaction with Life Scale (Diener, Emmons, Larsen, & Griffin, 1985), Positive and Negative Affect Schedule (Watson, Clark, & Tellegen, 1988), and Gratitude Questionnaire (McCullough, Emmons, & Tsang, 2002) assessed changes in VBC, SWB, and gratitude respectively. Results. Mediation analyses will explore whether the impact of the gratitude intervention on SWB was mediated by changes in VBC. Discussion. Results are discussed in the context of the ACT model and clinical implications are offered.

16. Acceptance and Commitment Therapy for the Treatment of PTSD: A Meta-Analysis of Treatment Outcome Studies

Primary Topic: Clinical Interventions and Interests
Subtopic: PTSD, ACT
Aniko Viktoria Varga, B.A., Bowling Green State University
Jennifer T. Grant, B.S., Bowling Green State University
Joel Engelman, B.A., Bowling Green State University
William H. O'Brien, Ph.D., Bowling Green State University

Background: Acceptance and Commitment Therapy (ACT) has been shown to be effective in treating various psychological disorders, including anxiety, depression, and psychosis. The current meta-analysis examined the effectiveness of ACT in the treatment of Post-Traumatic Stress Disorder (PTSD).
Method: A comprehensive literature search was conducted, and six relevant treatment outcome studies were located. These studies primarily tested PTSD symptom reduction after an ACT-based intervention. Additionally, three studies compared ACT to another active treatment such as Cognitive Behavioral Therapy, or a Treatment as Usual intervention. ACT versus alternative treatment at post-treatment and pre-treatment versus post-treatment Cohen’s d effect sizes were calculated.
Results: The ACT treatment versus alternative treatment effect size was .06 (p = .5436, 95% CI [-.14, .27]). The pre-treatment versus post-treatment effect size for ACT was 0.96 (p = .005, 95% CI [0.50, 1.42]), After removing outlier studies due to heterogeneity the effect size was .67 (p < .001, 95% CI [0.29, 1.06]). The pre-treatment versus post-treatment effect size for alternative treatment was .56 (p = .055, 95% CI [-0.01, 1.14]).
Discussion: These results suggest that ACT did not differ from alternative treatments in reducing PTSD symptoms. However, ACT had a moderate to large effect in reducing PTSD symptoms at post-treatment. Nonetheless, control treatments did not have a significant effect on PTSD symptoms from pre- to post-treatment. It is suggested that future research should focus on psychological flexibility processes to better understand the outcomes and processes targeted in ACT.

17. Flexibility between the Lines: Psychological Flexibility through Language Analysis, a Pilot Study

Primary Topic: Clinical Interventions and Interests
Subtopic: Language - psychological flexibility
Melissa Miller, University of Louisiana
Emily Sandoz, University of Louisiana

Psychological flexibility has been identified as an important dimension of human functioning across a number of domains. As psychological flexibility involves flexible, sensitive responding in the presence of aversive private events, assessment has been nearly entirely limited to self-report questionnaires (e.g., the Acceptance and Action Questionnaire and variations). These self-report data, however, are subject to significant disadvantages that may impact the validity of the assessment. Another approach to assessment of psychological flexibiltiy might involve soliciting a sample of verbal behavior that can be directly assessed in terms of psychological flexibility. Linguistic Analysis allows for quantification of unstructured verbal responses. The Linguistic Inquiry Word Count (LIWC) program is one such program that has been used to assess emotion regulation, mindfulness and meditation, and experiential avoidance. This paper will present pilot data examining the convergence between self-report questionnaires of psychological flexibility at 3 time points, and semi-structured journal entries. Implications for the continued use of linguistic analysis to assess psychological flexibility will be discussed.

18. Psychological Flexibility, Pain Characteristics, and Risk of Opioid Misuse in Noncancerous Chronic Pain Patients

Primary Topic: Clinical Interventions and Interests
Subtopic: Chronic Pain
Amanda Rhodes, M.A., Kean University
Donald Marks, Psy.D., Kean University
Jennifer Block-Lerner, PhD, Kean University
Timothy Lomauro, PhD, VA New Jersey Health Care System

Opioids are a leading prescription medication for persistent and recurrent pain, which affects 10% - 35% of the US population annually. To our knowledge, this is the first study exploring psychological flexibility and its association with pain severity, pain interference, early aversive histories and risk of opioid misuse in chronic pain patients. Data were collected at two outpatient pain clinics in the northeastern United States. Adults (N = 99) completed a cross-sectional survey with validated measures. Findings suggest that pain severity, pain interference and early aversive history each uniquely predict risk of opioid misuse. Psychological flexibility mediated the individual pathways between pain severity and pain interference, with risk of opioid misuse. Further, pain severity predicted pain interference, mediated by psychological flexibility. Implications of findings are discussed in terms of future psychological and medical assessments and interventions for chronic pain. One’s willingness to be open, centered and engaged with the world, psychological flexibility, appears to play a significant role in the experience of and coping strategies for physical pain.

19. ACT and DBT: a practical integrative approach for beginner and intermediate therapists working with multi-problematic clients

Primary Topic: Clinical Interventions and Interests
Subtopic: ACT and DBT
Loureiro Lucia, private practice
Principi Carolina, private practice

As therapists trained in both Acceptance and Commitment Therapy and Dialectical Behavioral Therapy, we usually use techniques from both models when working with our clients, specially those with multiple problems. We surveyed a small sample of therapists trained in ACT and DBT to gather data about the clinical situations in which they integrate these approaches, and the therapeutic interventions they use.
In this poster, we´ll summarize the most common patterns clinicians follow when trying to combine both models. We believe there are limitations in these attempts of integration: • They don´t integrate processes from both models: generally they include specific techniques from one model into a case conceptualized from the other; • They´re intuitive, instead of previously planned, and they usually respond to limitations the clinicians find in each model. • There´s a lack of clarity regarding the case conceptualization, both for client and therapist.
In this presentation, we aim to suggest a practical and simple way of integrating ACT and DBT considering the limitations beginner and intermediate therapists find in their daily practice. We suggest integrating both models from the beginning of treatment, designing a case conceptualization that includes elements of both DBT and ACT put together in an organized and coherent fashion.
Finally we propose an integration of models in terms of therapist´s skills, considering that the work with multiproblematic clients can be enhanced by the use of the specific clinical competencies of each approach.

20. Shaping Social Skills in Context: Social Fitness Club

Primary Topic: Functional contextual approaches in related disciplines
Subtopic: Children and Adolescents
Sally Lohs, M.D., Medical College of Wisconsin
John Parkhurst, Ph.D., Children's Hospital of Wisconsin
William Massey, Ph.D., Oregon State University

Social competence is essential to the development of social relationships. Additionally, limited social competence results in increased rates of school failure and adult psychopathology (Moffitt, Caspi, Harrington, & Milne, 2002; Kilma & Repetti, 2008). The skills underlying social competence, broadly referred to as social skills, are often taught to children and adolescents to promote positive outcomes and remediate social deficits. Meta-analytic reviews of social skills training programs for individuals with social-behavioral difficulties suggest moderate positive effects of social skill training interventions (Gresham, 2015).
Social Fitness Club (SFC) is a novel social skills training group that utilizes both modeling and positive reinforcement to shape contextually-dependent social skills in a fitness-type environment. SFC aims to increase flexible engagement and reduce avoidance in adolescents (12-17 years old) with emotional/behavioral concerns and poor social awareness. Participants completed eight (90 minute) social skills training sessions and were compared against multi-informant measures of their pre-intervention pro-social and self-efficacy behaviors.
Researchers will report on change in social behaviors, as measured by the Social Skills Improvement System (Gresham & Elliott, 2008), the Test of Adolescent Social Skill Knowledge (Laugeson & Frankel, 2006), and the Self-Efficacy for Social Situations Scale (Gaudiano & Herbert, 2003).
In addition to presenting social skills data, the researchers will discuss how behavioral skills programs, like SFC, can be used in novel settings to shape contextually-dependent social skills. The researchers will also discuss ways to effectively engage community providers in behavioral skills programs and ways to improve utilization of such programs in the future.

21. Integrating ACT and Behavior Analytic practices into an athletic coaching business model

Primary Topic: Functional contextual approaches in related disciplines
Subtopic: Athletics, Coaching
Christopher Hebein, University of Nevada, Reno
Patrick Smith, University of Nevada, Reno
Steven C Hayes, Ph.D., University of Nevada, Reno

In the world of athletic competition, the individual who applies targeted stress and rest at the correct time leading up to a competition ends up being the most physically capable of the competition. But many athletes mistakenly value the stress over the rest and end up overtrained or injured and thus not competitive. Additionally, strict rule-governed behavior can produce short-term improvements but long-term adverse outcomes for both athlete and coach. This poster outlines a number of processes within a coach-athlete business interaction that can incorporate ACT and Behavior Analytic consistent practices such as reinforcement, values clarification, and mindfulness in order to increase the likelihood of more sustainable behaviors and prepare athletes for probable long-term outcomes beyond the sport. Single case study data for some of these practices will be presented.

22. The Anti-ACT: How Organizations Sustain Systems of Psychological Inflexibility

Primary Topic: Organizational behavior management
Subtopic: Behavior Systems Analysis
Christopher Hebein, University of Nevada Reno
Ali Molaie, University of Nevada Reno
Neal Falletta-Cowden, University of Nevada Reno
Michelle Forman, University of Nevada Reno
Lauren Brown, University of Nevada Reno

Background: Research supports the use of the Acceptance and Commitment Therapy (ACT) model in addressing challenges within organizations including stress and health management, safety, and job satisfaction. However, few reports examine how organizations (political groups, cults, etc.) engage in practices that promote or support psychological inflexibility in their members. Deliberate or not, organizational rigidity, excessive rule governance and value conflicts may disrupt the functioning of individual flexibility. We provide case and descriptive analysis of the psychological inflexibility processes implicated in political groups, cults, social justice movements, and related organizations that may lead to deleterious psychological outcomes for individual members even while promoting organizational goals.
Methods: A literature review on psychological flexibility processes, rigidity and rule governance applied to organizations and groups will be followed by a conceptual analysis on the organization as a systemic source of psychological inflexibility that interfere with ACT core processes.
Results and Discussion: In order to achieve organizational goals (e.g. profit, influence), groups may foster psychological inflexibility via structuring environments that promote fusion with rules, specifically with regard to strengthening or defending the conceptualized self from perceived threats; experiential avoidance of painful realities that contradict notions of the conceptualized self; and committed action toward values that do not comport with a perspective-taking sense of self. Organizations may inadvertently establish even efficient behavioral systems that lead to psychological inflexibility in individual members. A conceptual analysis emphasizes that individual flexibility may be less effective if the existing behavior systems increase measures of rigidity.

24. Enjoy translating TED talks from the ACBS world!

Primary Topic: Prevention and Community-Based Interventions
Subtopic: ACBS, TED
Emanuele Rossi, Psy.D., APC, SPC -

TED talks are powerful talks of brief duration which have the function of spreading ideas. In the last few years they increased their efficacy and today we can hear talks about almost all topics translated in more than 100 languages. At the same time the international community of TEDx organizes events at a local level elevating them to a global level.
AMARA is the official award winning system that TED uses for translation and transcription. Amara is a subtitle editor designed to be easy to use and understand in order to transcript and translate video and make it more globally accessible.
Recently the ACBS community is making extensive use of TED Talks and AMARA system, sharing around the world its mission to alleviate human suffering and advance in human well-being.
This poster illustrates how to enjoy TED and AMARA communities. You will learn how to sign up and start the translation process and then move forward with the subtitling and the sharing. There are few clear rules to follow in order to accomplish the mission and spread the ideas in an effective way. By enjoying the community of volunteers and translators you will contribute to spread word of ACBS TED talks worldwide.

25. Meta-analysis of Acceptance and Commitment Therapy for Weight-loss, Physical Activity, and Other Weight-related Outcomes

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Weight
Sallie A. Mack, B.S., Utah State University
Jason Lillis, Ph.D., Brown University
Michael E. Levin, Ph.D., Utah State University

Obesity is a major public health concern linked to a host of negative physical and psychological health outcomes. Standard behavioral treatments (SBTs), typically composed of behavioral techniques such as controlling food intake, managing food cravings, and increasing physical activity, are the gold standard in weight loss. However, studies have failed to show long-term effectiveness of SBTs for weight loss, with participants commonly regaining all weight lost. Additionally, there is increasing emphasis on the health benefits of weight-associated behaviors such as increased physical activity and diet, independent of weight loss, and studies have begun evaluating interventions that target these behaviors as primary outcomes.
More recently, Acceptance and Commitment Therapy (ACT) has been adapted and applied to weight loss and weight-related behaviors, such as physical activity and diet. ACT-based interventions have shown promising effects in addressing weight loss, increased exercise, emotional eating, body dissatisfaction, weight-self stigma, and binge eating. The efficacy of ACT-based interventions targeting weight-related outcomes has been evaluated in a variety of samples, including college students, employees and general community samples. However, despite the number of trials evaluating ACT for weight-related issues, there are no meta-analyses currently summarizing this efficacy data.
This poster will present a preliminary meta-analysis of 14 randomized controlled trials testing the efficacy of ACT-based interventions as compared to SBTs. Specific outcomes that will be reviewed include weight loss and weight regain prevention, physical activity promotion, diet change, and attitudes towards weight and eating.

26. Mindfulness, psychological flexibility and wellbeing in a sample of Italian adolescents

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Adolescents, Psychological Flexibility, Mindfulness, Wellbeing
Emanuele Rossi, Psy.D., APC, SPC - AISCC
Antea D'Andrea, Psy.D., APC, SPC - AISCC
Erica Curzi, Psy.D., APC, SPC - AISCC
Elena Cucchiari, Psy.D., APC, SPC - AISCC
Natalia Glauser, Psy.D., APC, SPC - AISCC

Mindfulness can be defined as an awareness that is open-hearted, moment-to-moment and non-judgmental (Kabat-Zinn; 2005). Psychological flexibility can be defined as the ability to fully contact the present moment without defense as a conscious human being and to act in accordance with one's chosen values (Hayes et al., 2006). The main aim of this poster is to analyze and compare correlation between mindfulness, psychological flexibility and psychological wellbeing in a large group of Italian adolescents. Results will include descriptive data and correlation analyses between the ACT core processes of psychological flexibility, mindfulness and wellbeing.

27. Web system for ACT: About development and utilization situation of ACT-online

Primary Topic: Professional Development
Subtopic: Vocational Rehabiritation
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. Currently, 54 companies use satellite office services, and about 350 people with disabilities (about 60% are mental or developmental disorders) are working there every day. Currently, ACT is carried out in the initial training for disabled people who are using satellite office and training for improvement of employability to persons with disabilities using employment transition support agencies(EIT;Employability Improvement Training). Support of these ACTs is provided according to individual needs by using ACT-online system which can carry out ACT on the Web developed by us. At present, about 140 disabled people register with ACT-online and use support such as ACT exercise. ACT-online is like a big bowl that registers and manages various ACT exercises. Administrators of this Web system can independently create and introduce various contents using several types of fixed formats. Currently, ACT-online developed by us includes about 100 Japanese original contents. In our EIT, ACT support such as psychological education, implementation of daily ACT exercise, etc. are carried out during 9 days training period. In order to examine the effect of these ACT support, we are evaluating questionnaire by FFMQ, CFQ, AAQ -Ⅱ and IRAP at the start and end of training. In this presentation we will introduce development including ACT-online original content and ACT effect in EIT. And as a future task I would like to think about the extensibility of ACT-online.

28. Does psychological flexibility influence liking?

Primary Topic: Psychological flexibility
Subtopic:
Silvia Berkner, University of Leipzig, Germany
Sascha Krause, University of Leipzig, Germany

Psychologically flexible behavior (being present and aware of your feelings and emotions, taking your thoughts not too seriously and watch feelings and thoughts from a step back - perspective, being aware of your values and acting accordingly) was hypothesized to lead to a "compassionate style of communication that is attractive and desirable to other people" (Kashdan, 2010). In the present study participants (N = 139) not acquainted with each other, were assigned to groups of 4 to 6 (same sex) members. They had a short introductory meeting, rated how much they liked each other (round robin design), then had a 5 min conversation (free choice of topic) and afterwards again rated how much they liked each other. The 5 min dyadic interactions (N = 618) were videotaped and rated by observers concerning psychological flexibility. The analyses of interpersonal perceptions were based on the Social Relations Modell (SRM, Back and Kenny, 2010) to separate perceiver/target, actor/partner, and relationship effects. A significant correlation (r = .32, p < 0.01) was found between observed psychological flexibility and the target effect of liking after the conversations. The results indicate that psychologically flexible behavior increases liking after a dyadic interaction. Problems encountered are discussed, as how to operationalize psychological flexibility for behavior observation and how to improve interrater reliability.

29. Validation de la version française abrégée du Multidimensional Psychological Flexibility Inventory (MPFI)

Primary Topic: Questionnaire validation
Subtopic: Psychological flexibility
Simon Grégoire, Ph.D., Université du Québec à Montréal
Joel Gagnon, Université du Québec à Trois-Rivières
Cloé Fortin, Université du Québec à Montréal
Rebecca Shankland, Université Grenoble Alpes
Frédéric Dionne, Université du Québec à Trois-Rivières
Ilios Kotsou, École de management de Grenoble
Jean-Louis Monestès, Université Grenoble Alpes

Cette affiche présente les propriétés psychométriques de la version française abrégée (24 items) du Multidimensional Psychological Flexibility Inventory (MPFI) (Rolffs, Rogge, & Wilson, 2016). Une première étude a été menée auprès d’étudiants universitaires français (n = 282) et québécois (n = 360) afin d’évaluer la structure factorielle de l’échelle, l’invariance de mesure, la validité convergente, la cohérence interne et la stabilité temporelle. Une seconde étude été réalisée auprès de 479 salariés en Europe (n = 264) et au Québec (n = 215) afin de répliquer les résultats de l’étude 1. Les résultats indiquent qu’un modèle à 12 facteurs (6 facteurs de flexibilité et 6 facteurs de rigidité) s’ajuste le mieux aux données. Les corrélations entre les facteurs du MPFI varient entre 0,34 et 0,79 (flexibilité) et entre 0,10 et 0,79 (inflexibilité). De plus, une invariance de mesure forte entre l’occupation (étudiants vs travailleurs), le pays d’origine (Québec vs France) et le genre (femme vs homme) a été obtenue. Ces résultats supportent la validité de construit du MPFI. Le patron de corrélations entre les sous-échelles du MPFI et différentes échelles de flexibilité psychologique (p.ex., AAQ II) supporte la validité convergente de l’outil. Finalement, le MPFI démontre de bons coefficients alpha (0,83 à 0,92) et test-retest (0,71 à 0,76) (2 semaines). En somme, cette version française abrégée possède de bonnes qualités psychométriques et peut être utilisée auprès de différentes populations francophones, tant en recherche qu’en intervention.

30. Concurrent transfer of suppression and escape functions of pain-related verbal stimuli via same and opposite relations
Sponsored by: ACBS Dutch-speaking Chapter
Primary Topic: Relational Frame Theory
Subtopic: Thought suppression, RFT
Roy Thewissen, Ph.D., Maastricht University
Ian Steward, Ph.D., National University of Ireland
Ann Meulders, Ph.D., Catholic University of Leuven

Thought suppression is a strategy often used to manage pain, but research indicates that it can be counterproductive (Wegner et al., 1987). Previous RFT studies have revealed a 'transfer' of thought suppression functions via multiple derived relations ('same' and 'opposite')(Stewart et al. 2015). The current work extended the latter by investigating transfer of thought suppression alongside transformation of escape functions in the context of a pain-related verbal stimulus.
At first, participants were given training and testing of same and opposite relational responding in a five-member relational network. During a subsequent conditioned fear-of-movement task, participants learned to associate an aversive electrocutaneous stimulus with a verbal stimulus (Exp 1: 100 % and Exp 2: 75% contingency). Next, they were randomly assigned to engage in either a suppression task or control task. During final testing, in which they continued with their assigned task, they could choose to remove various visually presented verbal stimuli.
Experiment 1 revealed a weak but significant 'transfer' of suppression functions via 'same' as well as 'opposite' relations in the suppression condition, though not an expected transformation of escape functions via 'same' and 'opposite' relations in the control condition. Experiment 2 showed a significant 'transfer' of suppression functions via 'same' and a weak but significant transfer of suppression functions via 'opposite' relations in the suppression condition, and a transformation of escape functions via 'same' and 'opposite' relations in the control condition. Possible concurrent influence of escape versus suppression functions, depending on contingency rate, when suppressing pain-related verbal stimuli is discussed.

31. Assessment of Derived Relational Responding for Preschoolers
Sponsored by: ACBS China Chapter
Primary Topic: Relational Frame Theory
Subtopic: Preschoolers
Fen-Fen Wang, M.S, Institute of Psychology, Chinese Academy of Sciences
Zhuo-Hong Zhu, Ph.D, Institute of Psychology, Chinese Academy of Sciences
Yue Chen, M.S, Institute of Psychology, Chinese Academy of Sciences

Background: The current research focused on relational frame theory, which suggests that arbitrary applicable relational responding is the foundation of language and cognition. The research attempted to discover new evidences regarding the development of the ability of preschoolers’ language and cognition based on behavioral analysis.
Method: In this study, 230 Chinese preschoolers from 2 to 7 years of age participated completely with 554 children signed up at first. Each child completed an assessment included following types of relational responding: coordination, opposition, comparison, hierarchical relation, temporal relation, spatial relation and metaphor reasoning. Participants all individually finished the assessment in a quiet room and data were collected on the percentage of correct response to each item.
Results: Participants were divided into different groups by age, which shows that (1) for all types of relational responding, there were significant difference among ages (p<0.000); (2) for different age groups, the relational responding accuracy of participants had significant difference in all types of relational responding(p<0.000); (3) no significant gender difference existed.
Discussion: The result reveals that (1) with the growth of children, the ability of preschoolers’ relational responding is improved gradually; (2) different types of relational responding lead to different tendency of development. Coordination, opposition and comparison were developed earliest, temporal and spatial relation were taken the second place, and hierarchical relation and metaphor reasoning came the last; (3)The age of four is most likely to be the turning point of the development of derived relational responding.

32. Using Relational Frame Theory to increase cognitive skills in children with autism: The case for metaphors

Primary Topic: Relational Frame Theory
Subtopic: Autism
Maria Jose Sireci, IESCUM, University Kore Enna
Laura Visentin, IESCUM
Francesca Mongelli, University Kore Enna
Giovambattista Presti, IESCUM, University Kore Enna

Autistic individuals often experience difficulties with higher order language patterns, such as metaphors or deceptions; metaphors are a form of figurative speech and their comprehension is fundamental for social functioning. Using and understanding metaphorical language require the complex ability to understand one term in comparison to another one: according to RFT, such complex human behaviors can be conceptualized as responding to derived relations. From an RFT perspective, that ability is based on three relational frames: coordination, hierarchy and distinction. To understand a metaphor, it is necessary to relate an item to its properties (hierarchy) and then identify properties that are similar (coordination) and dissimilar (distinction). Following Persicke et al. (2012) protocol we developed 46 short stories, 10 in baseline and 36 for training: each story (in baseline and in training as well) included three features relevant to metaphors. A visual cue with two columns in which participants had to list the features of each target and identify the shared ones, was used in order to facilitate transfer of function to target. 8 children ranging from 5 to 11 years and with a diagnosis of autism except for one with an X-fragile syndrome were trained to respond to three metaphors per story. Each session included 4 stories (12 metaphors per session), 2 new and 2 from the previous sessions. The first session included only 2 stories. Baseline stories were used to test derived responses and generalization after the training. Preliminary results confirm and extend Persicke et al. (2012) to other languages.

33. Fostering Meaning and Motivation - Poster Award Winner

Primary Topic: Relational Frame Theory
Subtopic: Public Speaking Anxiety
Ana Gallego, University of Jyväskylä
Raimo Lappalainen, University of Jyväskylä
Matthieu Villatte, Evidence-based institute of Seattle
Louise McHugh, University Colleague Dublin

Background: Based on Relational Frame Theory, the present study aimed to analyze the comparative effect of two self-based interventions (“Hierarchical Self" and “Distinction Self"). Previous studies highly the superiority of hierarchical, rather than distinction, deictic relations in terms of reducing distress.
Method: Using a between-subjects design, the participants (n= 90) were randomly assigned to one of the three groups: Group 1 (Hierarchical Self), Group 2 (Distinction Self), Group 3 (Control group, expose alone). The primary outcome dependent variable was public speaking anxiety 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 general psychological flexibility and defusion skills.
Results: Our preliminary analyses suggested that the two RFT-based interventions (“Hierarchical Self" and “Distinction Self") had larger impact on defusion skills compared to the control group. More precisely, the difference was medium size (d=0.56) in favor the “Hierarchical Self" compared to the control, and small (d=0.37) in favor for the “Distinction Self" compared to control. However, all three interventions had equal impact on public speaking anxiety and general flexibility skills.
Discussion: Our findings indicate that adding very brief self-based exercises to public speaking skills training (e.g. when giving presentations) might change positively students’ cognitive strategies. The implications of the findings for clinical practice are discussed.

34. Assessing a Derived Transfer of Functions Using the Implicit Relational Assessment Procedure Under Three Motivative Conditions

Primary Topic: Relational Frame Theory
Subtopic: IRAP
Cainã Gomes, Paradigma – Centro de Ciências do Comportamento
William F. Perez, Paradigma – Centro de Ciências do Comportamento
João Henrique de Almeida, Universidade Federal de São Carlos
Arthur Costa e Silva, Paradigma – Centro de Ciências do Comportamento
Júlio C. de Rose, Universidade Federal de São Carlos
Dermot Barnes-Holmes, Ghent University

Some behavior analytic researchers have argued that the derived transfer of functions provides a functional-analytic model of symbolic control. One issue that arises in assessing the derived transfer of functions is determining how “strong" those functions might be. This was the primary purpose of the current study, which investigated the effects of motivative conditions on derived transfer of function. First, two equivalence classes were established: A1-B1-C1-D1 and A2-B2-C2-D2. These classes comprised nonsense forms and two meaningful stimuli: a picture of a glass full of water (A1) and a neutral picture (A2). Derived transfer of function from the meaningful stimuli to two nonsense forms (D1 and D2) was then assessed by means of a semantic differential and an IRAP. Before assessment, participants were divided in three groups: the first had water intake; the second had pepper; the third had pepper before the semantic differential, followed by an extra dose before the IRAP testing blocks. Results suggest that the motivative conditions progressively affected both measures. Regarding the semantic differential, D1 (water) and D2 (neutral) stimuli were close to neutrality for the Water group; for the Pepper and Double Pepper group, however, the D1 (water) stimulus had a positive valence while D2 (neutral) was neutral. In the IRAP, both the Water and Pepper group evaluated D1 as positive; nonetheless, for the Double Pepper group, IRAP scores revealed that D1 was even more positive compared to the other groups. Implications for the IRAP literature and conceptual issues regarding motivative operations are discussed.

35. The Relationship Between Psychological Inflexibility, Cognitive Fusion, Gender Role Conflict, and Normative Male Alexithymia in a Sample of Cisgender Males

Primary Topic: Theoretical and philosophical foundations
Subtopic: Psychological Inflexibility and Masculine Gender Norms
Michael McGlenn, M. A., Alliant International University, California School of Professional Psychology
Jill Stoddard, Ph.D., Alliant International University, California School of Professional Psychology

Extensive literature illustrates the negative consequences men experience when they deviate from socially prescribed masculine beliefs, expectations, and behaviors (i.e., gender role conflict; GRC). Researchers also propose that societal pressures for males to restrict emotional expression may contribute to difficulties with identifying, describing, and expressing affective experiences (i.e., normative male alexithymia; NMA). While the negative outcomes of GRC and NMA have been well documented, little is known about the underlying psychological mechanisms that prompt men to adhere to these social norms even when they come at great personal cost. Psychological inflexibility (PI), or the persistent use of behavioral strategies to avoid unwanted internal experinces at the expense of deeply held values, may help explain the negative consequences men experience when they adhere to socially prescribed behavior. The current study seeks to understand the relationship between NMA, GRC, PI, and cognitive fusion (CF). At least 77 cis-gendered males will complete online assessments that measure these constructs. It is hypothesized that NMA, GRC, PI, and CF will positively correlate with each other, and that CF, PI, and NMA will be significant predictors of GRC. The current study also hypothesizes that either PI or CF individually, or a PI/CF combined factor will mediate the relationship between NMA and GRC, with PI/CF together expected to demonstrate the strongest mediation effect. Data collection is ongoing and expected to be completed by May.

36. Effect of social contingency on rule-following among people with high and low depressive symptoms

Primary Topic: Theoretical and philosophical foundations
Subtopic: Depression
Kazuki HASHIGUCHI, Graduate School of Psychology, Doshisha University
Shin-ichi ISHIKAWA, Ph.D., Faculty of Psychology, Doshisha University
Takashi MUTO, Ph.D., Faculty of Psychology, Doshisha University

Objects: This study aimed to investigate whether adolescents who self-reported high or low levels of depressive symptoms would exhibit differential sensitivity to changing contingencies due to tracking or pliance instructions.
Method: Following a screening procedure, 23 high-depressive and 23 low-depressive students were selected. Participants were randomly assigned to one of two experimental conditions in which social contingency was either weakened by reading the instruction privately (tracking condition) or strengthened by reading it out loud to the experimenter and being monitored by the experimenter (pliance condition). Participants were instructed on how to respond during a simple learning task (four blocks, 40 trials each). The instructions in the first half of the study (blocks 1 and 2) were correct and those in the second half (blocks 3 and 4) were incorrect. The average number of correct responses was subjected to a 2 (Depressive symptoms: high vs. low) ×2 (Instruction-type: tracking vs. pliance) × 2 (Contingency: Block 3, Block4) repeated-measures ANOVA.
Results: The results revealed no significant interactions and main effect. However, a similar analysis by gender indicated that in the pliance condition, the average number of correct responses of high-depressive female students was significantly lower than that of low-depressive female students.
Conclusion: The results suggest that high-depressive women under social contingency exhibit less sensitivity to contingency in the environment.

37. Is ACT Efficient Buddhism?

Primary Topic: Theoretical and philosophical foundations
Subtopic: Buddhism, Mindfulness, Values
Stephanie Lin, B.A., San Jose State University
April Wentworth, B.S., San Jose State University
Jazmine Mauricio, B.A., San Jose State University
Megan Rauch, B.A., San Jose State University
Linette Villa, B.A. (as of May 2018), San Jose State University
Jennifer Gregg Ph.D, San Jose State University

Background: Mindfulness research and Buddhist practices emphasize the role of non-judgmental awareness and mindfulness related to the present moment over a targeted emphasis on living one’s personal values, as seen in Acceptance and Commitment Therapy (ACT). Mindfulness researchers, however, have assumed that the meaningfulness of mindfulness meditation comes, at least in part, from the role of more intentional behavior. The majority of the research on this subject suggests that mindfulness practices promote change through quiet observation of one’s thoughts, emotions, and bodily sensations as they come and go, instead of acting out on them (Hölzel, Lazar, Gard, Schuman-Olivier, Vago & Ott, 2011). ACT, on the other hand, as a psychological intervention, targets overt behavioral changes more explicitly through the clarification of and facilitated commitment to, personal values - chosen life directions that one can work towards moment by moment (Hayes, Luoma, Bond, Masuda, & Lillis, 2006).
Method: Participants (N= 195) completed an online survey via Amazon Turk. The HIT was restricted to workers in the United States who had at least a 95% task approval rate for their previous HITs. Participants completed a battery of questionnaires including the Five Facet Mindfulness Questionnaire (FFMQ), Meaning in Life Questionnaire (MLQ), and the Valued Living Questionnaire (VLQ).
Results: Results reveal a partial mediation of values in the relationship between mindfulness and meaning in life (Sobel = 4.46, p<.000).
Discussion: Results are discussed in terms of other recent findings comparing mindfulness alone and in conjunction with targeted values interventions.

38. How do children conceptualize the concept of mindfulness? Implications for future measures

Primary Topic: Interventions cliniques
Subtopic: Mindfulness, children, comprehension, measure, developmental considerations
Julie Beauregard, Université de Sherbrooke
Raphaëlle Beauregard-Lacroix, Université de Sherbrooke
Véronique Parent, Université de Sherbrooke
Fabienne Lagueux, Université de Sherbrooke

In the past 20 years, a growing interest in the concept of mindfulness and its application can be noted. However, it remains clear that this concept, given its multidimensional nature, is difficult to define. Moreover, most studies have been conducted with adult populations. For this reason, mindfulness-based interventions used amongst children stem directly from interventions intended for adults. The lack of developmental considerations in research on mindfulness is therefore clearly highlighted and is illustrated, namely, by the limited number of studies on this concept as it relates to youth and its measurement within this population. The purpose of this study is to better understand the concept of mindfulness as it is operationalized in children, while considering inherent developmental characteristics. Using a descriptive and exploratory perspective, children aged 8 to 12 years old (n = 14) participated in semi-structured interviews in order to explore how youth understand and describe the concept avec mindfulness in their own words. Results derived from a thematic analysis highlight the complexity of the concept of mindfulness and the difficulties children may experience in understanding this concept clearly. Although most participants understood some elements of what mindfulness is (for example, paying attention to the present moment by being aware of one’s surroundings and physical sensations), many wrongly associated this concept with other ideas, such as relaxation and thought suppression. Thereby, considering a developmental perspective when evaluating the concept of mindfulness with children would allow for the development of measures and interventions better suited for this clientele.

39. Feasibility Study of a Mindfulness-Based Educational Program (MBEP) for First Year High School Students in a Regular Classroom

Primary Topic: Éducation
Subtopic: Mindfulness in school settings
Linda Paquette, Ph.D., Université du Québec à Chicoutimi
Jacinthe Dion, Ph.D., Université du Québec à Chicoutimi
Nadia Fortin, BA, Université du Québec à Chicoutimi
Tommy Chevrette, Ph.D., Université du Québec à Chicoutimi

Many MBEPs are set up in schools to help adolescents cope with stress issues, sometimes with mitigated results. This study aims to test the feasibility of a program created for the Quebec school community. It is composed of 10 weekly sessions lasting one hour, followed by a second intervention consisting of five minutes of meditation per day over four weeks. The study was carried out using an experimental multiple n of 1 design of type A-B-A'-C-A '' with nine high school students in grade 1 (5 girls and 4 boys) aged between 11 and 12 years. In all, 29 measures of mindfulness capacity, anxiety, alexithymia (difficulty to identify emotions), and frequency of meditations were taken weekly at each of these phases: A (pre = 5 T); B (10 weeks intervention = 10 T); A' (post = 5 T); C (intervention 5 min X 4 weeks = 4 T) and A'' (post = 5 T). Visual analysis using the non-overlap percentage exceeding median (PEM) method (Ma, 2006) for group data indicates that mindfulness capacity and alexithymia improved at each phase. However, the anxiety score improved only during phases B and C and returned to baseline or above baseline levels in phases A' and A''. The frequency of meditations was very low during the 29 measurements. Individual results showed disparity between participants in the evolution of symptoms. These results suggest a possible interaction effect between alexithymia and anxiety, as well as a need for a post-intervention follow-up and an improvement of the program.

40. Functional analytic psychotherapy for older adults at risk for suicide: A conceptual rationale

Primary Topic: Clinical Interventions and Interests
Subtopic: Elderly, suicide, social connectedness, FAP
Ali Molaie, M.A., University of Nevada, Reno

Background: Adults aged 70 and older have the highest rates of suicide in many regions of the world. Findings from numerous theoretical and empirical reports support the role of social disconnectedness as a risk factor for suicidal behavior among older adults. Functional analytic psychotherapy (FAP) specifically targets functional classes of interpersonal behaviors that interfere with development and maintenance of social connectedness, and may thus provide a viable intervention option for elders at risk for suicide. This paper will examine the concordance between risk factors for suicide related to social disconnectedness in older adults, and functional classes targeted in FAP in order to provide an initial theoretical rationale for the empirical investigation of a novel application of FAP to elders at risk for suicide.
Method: Psychological literature databases were reviewed for theoretical and empirical reports that examined 1) markers of social disconnectedness associated with suicide-related outcomes in older adults (suicide ideation, attempts, and completion) and 2) functional classes targeted in FAP.
Results: Risk factors for suicide related to social disconnectedness in the elderly include: isolation, loneliness, family discord, low social support, perceived burdensomeness, impaired emotion recognition and social decision-making, and self-reported social problem-solving deficits and chronic interpersonal difficulties. The range and diversity of risk factors align with, and can be categorized within, the functional classes targeted in FAP.
Discussion: The results provide initial theoretical support for empirical investigation of the efficacy of FAP as a secondary intervention strategy to prevent the development of suicidal behavior in older adults experiencing social disconnectedness.

Friday, July 27, 7:00-8:00pm - Poster Session #4

1. Training perspective-taking skills by using A maze-instruction game: A case study

Primary Topic: Clinical Interventions and Interests
Subtopic: perspective-taking, spatial perspective-taking, down syndrome
Yu Horiuchi, Ritsumeikan-University graduate school of science for human service
Yuka Miyake, Ritsumeikan-University graduate school of science for human service
Yuka Hiramatsu, Ritsumeikan-University graduate school of science for human service
Taiki Minami, Ritsumeikan-University graduate school of science for human service
Shinji Tani, College of comprehensive psychology, Ritsumeikan-University

Background: The participant was a 15-year-old boy with Down syndrome who participated in ABA therapy, about once every two weeks. The participant will face increased numbers of social relationships in high school, so we attempted to provide training in perspective-taking, using a maze-instruction game, in which the participant instructs the therapist to move from a starting point to a goal point in a maze.
Method: The maze has a starting point and a goal point. The therapist–participant arrangement had four settings. Informed consent was gained from the participant’s mother. First, a maze was set up and printed on a sheet, and two chairs were arranged in front of the sheet. Therapist 1 and the participant sat on the chairs, while therapist 2(Koma) stood on the starting point of the maze sheet. The participant instructed Koma based on the motions that he desired the therapist to take direction. Based on the participant’s instructions, Koma moved on the maze. The participant and Koma wore the same wrist band sets as prompts. They wore red bands on their right wrists and blue on their left wrists. Results: When the participant and Koma were facing in the same direction, a correct response rate of BL was more than 96%. When the participant was facing Koma, the correct response rate(CRR) was 86%. After training in prompts, the CRR improved. However, although the CRR of face to face setting improved due to the prompt, the CRR when facing the same direction declined.

2. A preliminary evaluation of a brief ACT-intervention for women with vulvodynia

Primary Topic: Clinical Interventions and Interests
Subtopic: Pain (vulvovaginal pain)
Pernilla Maathz, MSc, Uppsala University
Thomas Parling, PhD, Karolinska Institutet & Stockholm Health Care Services
Johanna Ekdahl, PhD, Mittuniversitetet
JoAnne Dahl, Ph D, Uppsala University

Approximately one woman in ten women suffers from persistent, unexplained vulvar pain, e.g. vulvodynia. This type of pain is triggered by touch or pressure to the vulva and commonly occurs during sexual activity, often resulting in sexual dysfunction and distress. The impact of vulvar pain on sexual well-being differs depending on individual coping patterns. Women presenting with experiential avoidance, ie avoiding sexual activities in general or seeking ways to suppress pain in order to endure painful intercourse, experience the most negative effects. This study investigates if a brief intervention based on Acceptande and Commitment Therapy (ACT) can improve the sexual well-being among women with vulvodynia by helping them to find more helpful ways to respond to sex-related pain. The intervention was evaluated using a multiple baseline design with six women diagnosed with vulvodynia as participants. Preliminary analysis show that five out of six participants achieve reliable reductions in sexual distress and four women showed improvements in sexual function. All participants rated treatment acceptability as high. Daily measurements made during the baseline and intervention phases are currently under analysis, and the results of the analysis will be presented along with a discussion about study limitations and the implications of this research for the treatment of vulvovaginal pain.

3. The Exploration of Contextual Behavioral Variables for Sexual Minority Employees

Primary Topic: Clinical Interventions and Interests
Subtopic: Sexual minority research, Work place
A. Theodore Artschwager, B.A., Bowling Green State University
R. Sonia Singh, M.A., Bowling Green State University
William H. O'Brien, Ph.D., Bowling Green State University

People who identify as sexual minorities often experience harassment and incivility in the workplace (Sears & Mallory, 2011). Although it is important to combat discrimination on a global scale, due to the heterocentric structure of society, sexual minorities often experience invaliding and destructive internal and external events. These events imply a need to better understand sexual minority experiences. Bond and Lloyd (2016) provided suggestions for developing psychological flexibility at an individual level to build resilience. However, this chapter was primarily based on theory and there are no published investigations examining sexual minority individuals in the work place and constructs related to contextual behavioral science (e.g., psychological flexibility, mindfulness).
The current study assessed the relations among quality of life, psychological inflexibility, cognitive fusion, and mindfulness. Participants (n = 312) were employed adults who self-identified as sexual minorities. Participants completed the WHO Quality of Life Scale (WHO, 1998), Acceptance and Action Questionnaire-II (Bond et al., 2011), Cognitive Fusion Questionnaire (Gillanders et al, 2014), Mindful Attention Awareness Scale (Brown & Ryan, 2003).
A multiple linear regression was calculated with the three predictor variables of psychological flexibility, cognitive fusion, and mindfulness (R2=.45, F(3,306)=51.82, p<0.01). Psychological inflexibility (b = -0.33, p < 0.001) cognitive fusion (b = -0.31, p<0.01), and lower mindfulness were significantly associated with lower quality of life (b = 0.12, p < 0.05).
These results suggest that contextual behavioral constructs may be important targets in conceptualizing, understanding, and providing treatment to employees who identify as sexual minorities.

4. The Experience of Shame and Emotion Regulation Difficulties Related to the 2016 Election

Primary Topic: Clinical Interventions and Interests
Subtopic: Emotion Regulation, Shame, 2016 United States Presidential Election
Tanya S. Watford, M.S., Bowling Green State University
R. Sonia Singh, M.A., Bowling Green State University
Mary Moeller, M.A., Bowling Green State University
Aniko Viktoria Varga, B.A., Bowling Green State University
William H. O'Brien, Ph.D., Bowling Green State University

The election of President Donald Trump was greeted with substantial protest, feelings of distress, and thoughts of betrayal from those who opposed him (Rosa & Bonilla, 2017) and has been described by popular media and academic sources as a traumatic event to some. Specifically, people identifying of different minority identities have expressed feelings of otherness and not belonging as a result of the election. Shame is defined as a negative affective state towards characteristics of the self (Tangney, 1991) and is related to one’s personal identity. Further, this experience of shame may be related to difficulties in emotion regulation. The current study examined the relationships between trauma symptoms, shame, and emotion regulation in an adult sample in the United States (n = 162). It was hypothesized that trauma would have a significant indirect effect on emotion regulation through the construct of shame overall and as it relates to identities (e.g., gender, sexual orientation, race, and vote in the election). The Trauma Screening Questionnaire, the Personal Feelings Questionnaire–2 (PFQ-2), and the Difficulties with Emotion Regulation Scale were administered. The PFQ-2 was also administered for several different constructs of personal identity. Results indicated a significant indirect effect of trauma on emotion regulation through overall shame b = .102, BCa 95% CI [0.035, 0.221]. These results were replicated with analyses of identity-based constructs of shame. Results suggest that people may be experiencing difficulties with emotion regulation as a result of the 2016 election based on shame related to personal identities.

5. Acceptance and Commitment Therapy: What are the Benefits for University Students?

Primary Topic: Clinical Interventions and Interests
Subtopic: Acceptance and commitment therapy, psychological flexibility, university students, qualitative study
Laurence Morin, B. Sc., Université de Montréal
Lysa-Marie Hontoy, B. Sc., Université de Montréal
Karine Rondeau, Ph. D, Université du Québec à Montréal
Simon Grégoire, Ph. D, Université du Québec à Montréal

Studies conducted to date with post-secondary students have relied predominantly on quantitative and self-reported measures (e.g. Danitz, Suvak, & Orsillo, 2016; Grégoire, Lachance, Bouffard & Dionne, 2017; Räsänen, Lappalainen, Muotka, Tolvanen, & Lappalainen, 2016). Such studies did not succeed to capture the complexity of the process involved in ACT group interventions, and have not addressed the perceived benefits that students derive from this type of intervention. While qualitative studies allow for a more elaborate examination of the benefits that post-secondary students gain from interventions based on ACT (Patton, 2015), no studies of this nature, to date, have explored the topic. Hence, this qualitative study was conducted to explore the experience of students participating in the KORSA workshops, an intervention offered since 2013 in post-secondary institutions in Quebec (Grégoire, Lachance, Bouffard, Hontoy, & De Mondehare, 2016). One hundred and forty-six university students (N = 146) shared their impressions of the workshops in a written format. Thematic analysis of their testimonies revealed that the workshops resulted in the students: 1) perceiving their difficulties (e.g., thoughts or painful emotions) differently, 2) adopting new attitudes (e.g., acceptance) and behaviors (e.g. investing in different actions), and 3) experiencing a state of well-being, presence, and serenity. In addition, the nature and intensity of the benefits they derived from the workshops appeared to be influenced by context-specific characteristics in which the workshops were offered (e.g. university environment), as well as the attitudes of the facilitators (e.g. kindness, empathy).

6. Effectiveness of an Acceptance and Commitment Intervention on Values: a Randomized Controlled Trial

Primary Topic: Clinical Interventions and Interests
Subtopic: Values, Students
Lysa-Marie Hontoy, Université de Montréal
Laurence Morin, Université de Montréal
Simon Grégoire, Ph.D., Université du Québec à Montréal
Mireille Joussemet, Université de Montréal

The main purpose of ACT is to teach clients to accept and embrace necessary suffering in order to help them live in accordance with their chosen values (Hayes et al., 1999). However, to date, very few empirical studies examining the effectiveness of ACT have included a measure of valued living (Smout et al., 2014). In addition, little is known about what type of values may contribute to wellbeing. Self-determination theorists have distinguished the content of values as either intrinsic (e.g., affiliation) or extrinsic (e.g., financial success). A substantial body of research has demonstrated that prioritizing intrinsic over extrinsic values is associated with greater well-being (Kasser, 2002). The purpose of this study is to evaluate whether an ACT-based intervention will increase valued living and will encourage a shift in personal values from extrinsic to intrinsic. During the winter of 2018, 80 students were recruited in a Canadian university and randomly assigned to an experimental group (n=40) or a wait-list control group (n=40). Currently, students in the experimental group are taking part in five 2.5-hour workshops during a 5-week period and are asked to do exercises at home (e.g., meditation). All participants completed the pre-measurements in February and will complete the post-measurements in April. Wait-list students will then receive the intervention. We hypothesize that participants in the experimental group will report greater valued living and will prioritize intrinsic values over extrinsic ones when compared to the control group. Statistical analyses will be performed in May 2018, once the data has been collected.

7. The use of the ACT metaphor in an alcoholic rehabilitation department

Sponsored by: ACT Italia
Primary Topic: Clinical Interventions and Interests
Subtopic: metaphor
Alessia Medioli M.D., ACT Italia, ASCCO Parma, Fondazione Richiedei
Francesca Pergolizzi Ph.D., ACT italia ASCCO Parma
Luigina Scaglia M.D., Fondazione Richiedei
Nanni Presti M.D., ACT Italia, ASCCO Parma

Background: In a residential treatment (28 days) for alcoholic clients, metaphors were proposed as a creative expressive modality that the conversational interview often does not offer as already known in the literature (DèLutti1987).
Method: The study started in January 2017 and is still ongoing. The data refer to 195 clients, whose average age is 52 years and who are 70% male and 30% female, 32% are poly-consumers.
We have worked individually using metaphors tailored to the patient, which touch the processes of hesaflex. We used classical ACT metaphors with client-only groups:, leaves of the stream, demons on the boat, chessboard, , GPS navigator, bottle in the sea (modified for setting reasons). We used metaphors that led to the production of a three-dimensional object in groups made up of relatives and patients to discuss the concept of acceptance and sharing of values with the family.
Results: Thanks to the use of metaphors in RFT it is possible to break the traps of language and create new connections and new contexts, overcoming psychological suffering and building a life of value. (VVAA http: //contextualscience.org/
Discussion: This work, aligning itself with the international scientific literature ( Stoddard 2007) shows how the use of metaphor in ACT prospective becomes an effective and shared therapeutic tool, and how this in our experience takes place on an individual level, in groups of only clienta, and in mixed groups of clients and relatives and how to establish a new relationship with thoughts, in a simple and effective way.

8. Acceptance and Commitment Therapy for acceptance of aging self-stereotypes: A proof of concept study

Primary Topic: Clinical Interventions and Interests
Subtopic: Geriatric psychology
Mary Moeller, M.A., Bowling Green State University
Leah Bogusch, M.A., Bowling Green State University
Tabitha Waite, M.A., Bowling Green State University
William O'Brien, Ph.D., Bowling Green State University

Belief in stereotypes about the older adult population is related to many detrimental effects on memory, recovery from illness, and lifespan as individuals age. Nursing home residents may be particularly vulnerable to these types of stereotypes because they are consistently reinforced by the nursing home environment and staff. Acceptance and Commitment Therapy (ACT) is effective in targeting stereotypes, both about the self and about others, and in encouraging defusion from these thoughts. This study involved a four-week single subject study design with five nursing home residents in which participants attended an individual ACT session for an hour once per week. It was hypothesized that residents who participated in the intervention would report a) significantly more defusion from their belief in aging stereotypes, b) less daily distress, depression, and anxiety, and c) more meaningful interactions relative to baseline. Along with survey data, qualitative feedback on the protocol was collected from the participants and the therapists. Split middle trend estimation, percentage of non-overlapping data, and Swanson’s d were used to analyze the data. Results indicated overall improvements in acceptance of aging stereotypes, as well as individual improvements in depression, anxiety, and interactions. Future research should explore the benefits of putting more emphasis on experiential application of ACT techniques rather than psychoeducation, explore beginning the therapy with the values components to be used as a framework for flexibility and acceptance, and focus on addressing the ageism and constraints within the nursing home system as well as utilizing individual interventions for residents.

9. Multi-group invariance examination of the factor structure of the Cognitive Fusion Questionnaire (CFQ) in English and Spanish

Primary Topic: Clinical Interventions and Interests
Subtopic: Cognitive Fusion
Stephanie V Caldas, MS, University of North Texas
Sierra Kelly, University of North Texas
Cynthia Rivera, University of North Texas
Amy R. Murrell, PhD, University of North Texas

The Cognitive Fusion Questionnaire (CFQ; Gillanders et al., 2014) is a brief, self-report measure of cognitive fusion, a process of psychological flexibility targeted by Acceptance and Commitment Therapy (ACT) interventions. The CFQ has been translated in different languages, including Spanish (Romero-Moreno et al., 2014), and found to have sound psychometric properties. However, research that investigates whether distinct versions of the CFQ accurately capture the same underlying construct of cognitive fusion is needed. The establishment of measurement invariance is required to compare cognitive fusion across different lingual groups. Our study investigated the factor structure of the CFQ in two samples of Latinx individuals living in the United States who completed the CFQ in English (n = 220) and Spanish (n = 150). Confirmatory factor analyses with the entire sample (n = 370) indicated good fit (X2 = 38.54 (p <.001), CFI = .973, TLI = 956, SRMR = .026). Multi-group invariance testing indicated configural invariance and metric invariance (∆X2 = .525; ∆CFI = .004), suggesting that the CFQ structure and item meanings are equivalent across Spanish and English versions of the CFQ. However, findings indicated scalar inequivalence across groups (∆X2 =15.85; ∆CFI = .014), suggesting differential item functioning at the level of the response scale. Overall, our results demonstrate some support for the CFQ as an accurate and comparative measure of cognitive fusion across different lingual groups. However, the English and Spanish versions of the CFQ are not perfectly equivalent, and future research should investigate the source of measurement bias.

10. Our Bodies as Metaphor: Using Yoga to Foster Psychological Flexibility in the College Classroom

Primary Topic: Clinical Interventions and Interests
Subtopic: College students
Paola Ricardo, M.A., Kean University
Ashlyne Mullen, M.S., Kean Univeristy
Jennifer Block-Lerner, Ph.D., Kean University
Donald Marks, Psy.D., Kean University

Yoga involves the practice of being present with one’s mind and body, usually through movement, and accepting emotions and sensations as they are in each unfolding moment. Recent research has found yoga to be a beneficial treatment, leading to improvements in anxiety, depression, panic, sleep, and overall quality of life (Khalsa et al., 2015). Additionally, yoga has been shown to help develop mindfulness and decrease experiential avoidance (Dick et al., 2014). However, receptivity to yoga and other mindfulness practices has been mixed (Gaskins et al., 2015; Olano et al., 2015). The current study offers an alternative method of delivering yoga by incorporating postures and related practices in a curriculum-based workshop. Participants (N= 68) engaged in a one-session ACT workshop infused with yoga. The postures were used as a way to embody components of psychological flexibility and cultivate openness. Quantitative and qualitative data show that, on the whole, participants were receptive to the yoga exercises and able to connect the postures with acceptance, present moment, and values processes. Specifically, on an investigator-created receptivity questionnaire (α = .92), participants rated their interest in additional practice or resources at 3.95 out of 5. One participant spoke to the value of “learning how exercises and our (lives) were connected." Another spoke to a change in openness to the practice: “I initially thought yoga was for 'hippies' and vegans and unnecessary but this workshop changed (my) thoughts." Implications for enhancing receptivity to yoga and the integration of yoga in ACT interventions will be discussed.

11. Namaste in the classroom: Evaluating the effects of yoga integrated into an ACT curriculum-based workshop

Primary Topic: Clinical Interventions and Interests
Subtopic: College students
Ashlyne Mullen, M.S., Kean University
Paola Ricardo, M.A., Kean University
Jennifer Block-Lerner, Ph.D., Kean University
Donald Marks, Psy.D., Kean University

Research suggests that distress levels in today’s college students are much higher than those of previous generations (Galatzer-Levy, Burton, & Bonanno, 2012). One approach that has shown promising results within the college population is yoga. Recent research found that depressive, anxiety, and stress symptoms decreased from baseline to follow-up in students who participated in yoga groups (Falsafi, 2016). The current study is part of a larger project examining the effects of fuller bodily engagement through ACT workshops in a college classroom-based workshop (Mullen et al., under review). Two types of one-session ACT workshops were offered: one with a yoga component and one without. In addition, ecological momentary intervention was implemented following the workshops as a way to increase the dosage. Participants in the ACT workshops and in a no-treatment control condition completed the Identity Distress Scale (Berman, Montgomery, & Kurtines, 2004) at pre, post, and four-week follow-up points. For those in the no-treatment control condition, the measure was completed at the pre time point and five weeks later. Results indicate that those in the yoga group exhibited a significant decrease (p<.01) in reported discomfort related to various aspects of identity from pre to follow-up. Those in the ACT group exhibited a decrease in reported discomfort, however this did not reach the threshold for significance (p=.08). For those in the control group, the changes from pre to follow-up were not significant (p=.18). Limitations and implications for the usefulness of yoga-related activities with this population will be discussed.

12. Psychological flexibility in young adults with depression and anxiety

Primary Topic: Clinical Interventions and Interests
Subtopic: Young Adults, Partial Hospitalization
Rawya Aljabari, Ph.D., Rhode Island Hospital/Alpert Medical School of Brown University
Lauren Harris, Rhode Island Hospital/Alpert Medical School of Brown University
Olga Obraztosova, PhD, Rhode Island Hospital/Alpert Medical School of Brown University
Mark Zimmerman, MD, Rhode Island Hospital/Alpert Medical School of Brown University

Being a young adult poses many challenges in today’s society; one challenge being that up to 74% of first diagnosed mental health disorders occur before age 24 (Kessler et al, 2007). Depression and anxiety symptoms are especially common among young adults (Zivin et al, 2009). This in turn impacts one’s sense of self as young adulthood is a time of development and frequent changes in love, work, self-image, and worldviews (Erikson, 1968; Rindfuss, 1991). It is arguable that there is a connection between this developmental stage, psychological health, and psychological flexibility. Psychological flexibility refers to is an individual’s ability to fully connect with the present moment and to behave in ways consistent with one’s identified values (Hayes, Strosahl, & Wilson, 1999; 2012). The purpose of this study was to examine the influence of change in psychological flexibility and time in treatment on symptoms of depression and anxiety in young adults. A sample of 155 young adults in a partial hospital program completed self-report questionnaires measuring change in pre-and-post-treatment psychological flexibility, post-treatment depression symptoms, and post-treatment anxiety symptoms. Results suggest that change in psychological flexibility (M = -10.80, SD = 12.34) and time in treatment (M = 7.52, SD= 3.52) are significant predictors of final depression (R2 = 0.12, Adj R2 = 0.11, β= 0.28, p< 0.001) and anxiety symptoms (R2 = 0.09, Adj R2 = 0.08, β= 0.24, p < 0.01).Implications of the findings will be discussed, along with suggestions for future research.

13. The Role of Loneliness and Psychological Flexibility in the Pathway from Romantic Rejection to Depression

Primary Topic: Clinical Interventions and Interests
Subtopic: Depression
Im Fong Chan, Murray State University
Michael Bordieri, Murray State University

Romantic rejection has been linked to reduced psychological well-being and increased psychological distress (Field, Diego, Pelaez, Deeds, & Delgado, 2009). Emerging findings suggest that loneliness may play a role in this relationship (Wei, Shaffer, Young, & Zakalik, 2005), and psychological flexibility with regard to distressing memories has been extensively linked to psychopathology (Kashdan, 2010; Levin, Hildebrandt, Lillis, & Hayes, 2012). The aim of the current study was to examine the role of loneliness and psychological flexibility in the context of the relationship between romantic rejection and depression. Consistent with previous findings, results from 77 participants demonstrated that psychological flexibility and loneliness were positively associated with depression. In addition, the interactional effect of both psychological flexibility and loneliness moderated the relationship between breakup distress and depressed moods while controlling for covariates. These findings highlight the importance of psychological flexibility and loneliness as potential mechanisms underlying the breakup distress and the depression pathway. Implications of the current findings to self-compassion and acceptance- based-therapies are discussed.

14. Developing and testing a brief version of the CompACT

Primary Topic: Clinical Interventions and Interests
Subtopic: Measure development
Nima G Moghaddam, University of Lincoln
David L Dawson, University of Lincoln, UK

Commonly-used measures of psychological flexibility are somewhat narrow in scope, and have been critiqued in terms of their questionable precision. We have previously described the development and preliminary validation of a new broad-scope measure of psychological flexibility (the CompACT). In this poster, we will reveal a brief form of the CompACT that is more apt for repeated use in applied settings, developed from multiple data-sets (combined N = 733), and examine its reliability and validity in relation to the original measure. Moreover, we will draw on recent data from intervention studies to highlight that the CompACT (in brief and full formats) is sensitive to treatment effects and can out-perform the AAQ-II as a marker and mediator of treatment-related change in clinical outcomes.

15. Acceptance and Commitment Therapy for adults with head and neck cancer experiencing psychological distress: A hermeneutic single case efficacy design (HSCED) series - Poster Award Winner

Primary Topic: Clinical Interventions and Interests
Subtopic: cancer, anxiety, depression
Nicolle Morris, University of Nottingham, United Kingdom
Nima Golijani-Moghaddam, Lincoln University, United Kingdom
Sanchia Biswas, National Health Service, United Kingdom
Anna Tickle, University of Nottingham

Background: Individuals with head and neck cancer (HNC) are at risk of experiencing significant psychological distress (i.e. anxiety and depression).There is a need to test and refine psychotherapy interventions for this population.
Aim: The study examined change processes and outcomes for three adults with HNC who engaged with Acceptance and Commitment Therapy (ACT). Method: An adjudicated hermeneutic single-case efficacy design (HSCED) was used to enable a multi-level exploration of change. Rich case records (a matrix of quantitative and qualitative clinical evidence) were subject to critical analyses by three independent psychotherapy experts (‘judges’) who identified change processes, and determined the outcome for each client.
Results: Judges unanimously concluded that all clients showed good outcomes; specifically they progressed towards therapy goals and experienced reliable reductions in psychological distress. Judges systematically considered non-therapy factors and attributed client’s changes to their experience of therapy. ACT-specific processes and a strong therapeutic relationship at least partially mediated change for all clients; albeit to different degrees. Moderating client variables were identified.
Conclusions: Findings provide evidence that ACT can be an effective intervention for individuals with HNC experiencing psychological distress. Clinical and research implications are discussed.

16. Guided Acceptance and Commitment Therapy (ACT) self-help for clients on a waiting list for psychological therapy

Primary Topic: Clinical Interventions and Interests
Subtopic: Adult mental health
Kate French, University of Lincoln
Nima Golijani-Moghaddam, University of Lincoln
Thomas Schröder, University of Nottingham
Rebecca Blacker, Lincolnshire Partnership NHS Foundation Trust

Background: Waiting lists for clinical psychology services within the UK are long. A low-cost, transdiagnostic waiting-list intervention could improve experiences and initiate processes of psychotherapeutic change. Guided ACT self-help holds promise in this regard – with evidence supporting its efficacy in other contexts – but has not yet been tested as a waiting-list intervention. Moreover, research needs to explore underlying change-processes. Do changes follow the predictions of the Phase Model of Psychotherapeutic Outcome (PMPO), and are these changes mediated by psychological flexibility as posited by ACT?
Method: A multiple-baseline single-case experimental design was utilised to explore participant outcomes in psychological flexibility, wellbeing, symptomatology, and life functioning, during a 10-week phone-guided ACT self-help intervention. Participants then engaged in a post-intervention change interview to triangulate results.
Results: Three participants completed the full 10-week intervention: Two experienced improvements in psychological flexibility, wellbeing, and symptomatology, but no improvements in life functioning; the other participant experienced no significant changes in outcomes. Visual analysis of weekly outcomes did not support the temporal predictions of the PMPO. Links between psychological flexibility and outcomes were supported, but changes in psychological flexibility were not found to precede outcomes. Participants attributed outcomes to both life events and the intervention, and placed emphasis on the positive impact of the guiding phone calls. Feedback also indicated that the intervention requires adaptation to improve accessibility prior to future implementation.
Discussion: Future research should continue exploration into ACT processes, and consider whether phone calls alone could meet clinical need within waiting-list populations.

17. Effectiveness of Acceptance and Commitment Therapy self-help for carers of people with multiple sclerosis: A feasibility randomised controlled trial

Primary Topic: Clinical Interventions and Interests
Subtopic: Carers of people with Multiple Sclerosis
Kristy-Jane Martin, MSc BSc (Hons), Trent Doctorate in Clinical Psychology, University of Nottingham
Dr Nima Moghaddam, PhD, DClinPsy, Trent Doctorate in Clinical Psychology, University of Lincoln
Dr Nikos Evangelou, Division of Clinical Neurosciences, University of Nottingham
Prof. Roshan dasNair, Trent Doctorate in Clinical Psychology, University of Nottingham

Background: Acceptance and Commitment Therapy (ACT) may be a feasible intervention for carers of people with Multiple Sclerosis experiencing carer-related strain. This study assessed feasibility of an RCT of ACT self-help (SH), telephone-supported ACT self-help (SH+), compared to usual care (UC). Study objectives related primarily to feasibility and acceptability of study design and interventions.
Method: A mixed-method, parallel three-armed feasibility RCT. The SH group received an ACT self-help text, whereas the SH+ group additionally received weekly telephone support. All participants completed measures at baseline, three-month and six-month post-randomisation. Carer Strain was measured using Zarit Burden Interview (ZBI) and Modified Carer Strain Index (MCSI). A quality of life measure (CAREQOL-MS) alongside two ACT process measures (Acceptance and Action Questionnaire; AAQ-II and Comprehensive Assessment of Acceptance and Commitment Therapy; CompACT) were also completed and a sample of participants were interviewed.
Results: Twenty-four carers of PwMS were randomised. Participants found the design to be feasible, but highlighted difficulties with the self-help text and timing of the intervention. An exploratory, group-level analysis indicated effectiveness for the SH+ group on measures of carer strain (consistent across both follow-ups) but only one significant improvement for the SH group (on one outcome measure, at 6-month follow-up) and no reported qualitative changes.
Discussion: A full trial of ACT-based, telephone-supported self-help is warranted, further to significant changes to study design. Notably, the SH group was not deemed a feasible intervention. An internal pilot would be necessary to assess the feasibility of the study after the suggested changes are incorporated.

18. Academic assessment and psychological distress among medical students: How do they ACT?
Sponsored by: ACBS Dutch-speaking Chapter
Primary Topic: Educational settings
Subtopic: Psychological distress
Mrs. A.Smeets, MSc, Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
Mrs. Dr. M. Latijnhouwers, Radboud Health Academy, Radboud University Medical Center, Nijmegen, The Netherlands
Mr. Dr. M. Vorstenbosch, Department of Anatomy, Radboud University Medical Center, Nijmegen, The Netherlands
Prof. Dr. R. Laan, Radboud Health Academy, Radboud University Medical Center, Nijmegen, The Netherlands

(Background:)Assessment often invokes stress or anxiety. Multiple studies suggest a higher prevalence of psychological distress among medical students compared to the age-matched student population. In curriculum-development, there is an increasing emphasis for medical educators to consider the health and well-being of their students. This study aims to determine the perceived stress and subsequent stress-management techniques of students during a cumulative assessment program.
(Method:) In a focus-group interview setting, 2 homogeneous groups of medical students (n=7, n=5) discussed this topic on 4 different moments throughout their first year of college. The ‘ACT hexaflex’ was used as a framework for the interview guide. Special attention was given to ‘Acceptance’ and ‘Committed Action’. Interviews were analyzed qualitatively using Atlas-ti. The study was carried out at Radboud University, Nijmegen, The Netherlands.
(Results:)“A little stress is vital for an optimal performance – High stress levels are paralyzing – Planning may reduce feelings of anxiety – However, you never know when your preparation will suffice – Prior to the exam, my drinking and smoking levels increase massively. It helps me to forget."
(Discussion:)The interview-quotes illustrate, that students often experience assessment as a battlefield in which they hope to achieve victory. Experiential avoidance of anxiety came in different shapes and sizes. We hypothesize that a more committed and deliberate coping style – as used in ACT – could contribute to students’ well-being. In future research, we will explore, implement and evaluate the possibilities to enhance psychological flexibility of our students during periods of assessment.

19. Targeting Psychology Flexibility, Sleep Hygiene, and Physical Activity in High School Students using the DNA-V Model - Poster Award Winner

Primary Topic: Educational settings
Subtopic: DNA-V Model
Samuel Faulkner, M.A., East Carolina University
Sean O'Dell, Ph.D., Geisinger Medical Center
Jeannie Golden, Ph.D., East Carolina University

Background: Universal interventions in schools are an important component of mental health prevention, yet few. The DNA-V model explicitly targets psychological flexibility through similar processes used in ACT. The study assessed the feasibility and satisfaction of programming, impact of programming on psychological flexibility, sleep, and physical activity in adolescents, and potential moderators of treatment.
Method: 115 rural, mostly African American high school students participated. Students in the intervention condition (n = 71) received 6 weeks of DNA-V-consistent programming regarding sleep and physical activity. Outcome measures were collected pre-intervention, weekly, post-intervention, and at 1-year follow up. Implementation fidelity was collected at each session, and teacher and student satisfaction were collected post-treatment.
Results: Over 70% of students rated DNA-V components, handling private experiences, and overall satisfaction “somewhat useful" or “very useful". Teachers reported overall programming and students handling thoughts and feelings better “very useful." Programming demonstrated 98% fidelity. Preliminary analyses indicate mean improvement in sleep hygiene from pre- (M = 3.09) to post-intervention (M = 4.85) and mean reductions in psychological inflexibility (M = 15.13 to M = 14.83) for students in the intervention group.
Discussion: The present study seeks to fill gaps in the literature regarding SEL programming for high school students from a diverse, economically disadvantaged area. Results indicate universal programming targeting psychological flexibility can be feasibly conducted with satisfaction in a high school setting. Improvement in psychological flexibility and health-related outcomes provides initial justification for psychological flexibility as a target for SEL curricula.

20. Reciprocal relationships between experiential avoidance and depressive symptoms among Japanese adolescents: A one-year longitudinal study

Primary Topic: Educational settings
Subtopic: Children, Depression
Kenichiro Ishizu, Ph.D., University of Toyama
Yoshiyuki Shimoda, Ph.D., Saga University
Tomu Ohtuski,Ph,D., Waseda University

This study examined the relationship among experiential avoidance, psychological stressors, and depression in Japanese adolescents, through one-year prospective design, conducted in three waves with an interval of four month. Experiential avoidance is a construct that has been used in the context of acceptance and commitment therapy, and can be measured with the Avoidance and Fusion Questionnaire, designed for youth (Greco et al., 2008). Previous studies have shown that in adolescents, as well as in adults, experiential avoidance is correlated with various internalizing symptoms, but few studies have explored the longitudinal relationship between experiential avoidance and health related outcomes. To examine the longitudinal relationship between experiential avoidance and depressive symptoms, Japanese junior high school students (7th to 9th grade, N = 855) were requested to complete the questionnaires including experiential avoidance (AFQ-Y) and depression (DSRS-C). At the begging, we confirmed that depressive symptoms consisted of two factors; decreased activity and pleasure, and depressive mood. Then, a cross-lagged panel model revealed that experiential avoidance predicted subsequent depressive mood. In addition, we found decreased activity and pleasure and experiential avoidance related mutually.

21. Acceptance and Commitment Therapy (ACT) for K-12 Teachers in China

Primary Topic: Educational settings
Subtopic: Teacher, China, mental health, Interpersonal relationships
Hui Cao, Ph.D., Beijing Institute of Education, China

Teachers’ psychological status is important for their personal well-being and teaching quality. However, interventions focusing on teachers’ psychological well-being are underscored in schools of China. There is increasing literature suggesting that acceptance and commitment therapy (ACT) is effective in improving psychological well-being. In this research, we applied ACT training as an intervention and examined its effectiveness for Chinese K12 teachers. Participants were 100 volunteered primary and middle school teachers, who were randomly allocated into two groups: one waiting-list group as the control, and the other intervention group receiving a series of 3-hour ACT seminars once a week for 8 weeks. Teachers were assessed through online survey before and after the intervention. At last, 67 teachers finished the whole intervention and survey, whose data were included in this research. Our results showed that teachers of the intervention group benefited from ACT training in the following areas: 1. Cognitive process and coping strategies, including psychological flexibility, mindfulness, and self-compassion; 2. Mental health, including levels of flourishing, stress, anxiety and depression; 3. Interpersonal relationships, including active listening and trust; 4. Working behavior, including organizational citizen behaviors and anti-factory behaviors. The results suggested that ACT could serve as an effective method for the K12 teachers to improve their psychological well-being.

22. Middle School Students’ Perceptions of Mindfulness Workshops to Manage Academic-related Stress

Primary Topic: Educational settings
Subtopic: Mindfulness
Sarah E. Moran, B.A., Medical University of South Carolina
Rosaura Orengo-Aguayo, Ph.D., Medical University of South Carolina

Academic-related anxiety and stress levels are on the rise in children and adolescents (American Psychological Association, 2014). Mindfulness-based interventions (MBIs) have been shown to improve cognitive performance and resilience to stress (Zenner, Herrnleben-Kurz, & Walach, 2014); however, there is a research gap evaluating student perception of MBIs within an academic setting. The purpose of this study was to explore middle-school students’ perceptions of a brief mindfulness workshop targeting academic-related stress and identify specific components of the workshop that students found enjoyable and beneficial. One-hour mindfulness workshops were provided to three groups of seventh grade students (n=59) at a private middle school in the Southern region of the U.S. Students rated aspects of the workshop using a 5-point Likert-type scale (0=Strongly Disagree to 4=Strongly Agree). Students also responded to open-ended prompts, providing qualitative data on general feedback and aspects they liked and disliked about the presentation. Descriptive analysis indicate that students enjoyed the presentation, found the skills useful, desired more of these presentations in the future, and reported the presenter was knowledgeable and engaging; students neither agreed nor disagreed that these skills will be useful in everyday life. Overall satisfaction with the mindfulness workshop was positive (M=3.20, SD=0.67). Supporting this data, qualitative analysis of the open-ended questions indicated students found the interactive activities and metaphors beneficial and appealing. This study highlights the acceptability of mindfulness workshops by middle-school students in a school-based setting and has implications for early intervention within school-based settings targeting academic-related anxiety and stress for children and adolescents.

23. An Experimental Study on the Process of Creative Hopelessness: Changes in ACT-Specific Measures

Primary Topic: Performance-enhancing interventions
Subtopic: Creative Hopelessness
Madoka Takahashi, Waseda University
Wakana Maeda, Chubu-Rosai Hospital
Taiki Shima, Doshisha University
Kazuya Inoue, Waseda University
Junichi Saito, Waseda University
Hiroaki Kumano, Waseda University

Background: Creative Hopelessness (CH) has been an intervention to weaken Change Agenda and reduce Experiential Avoidance. The first purpose of this study was to summarize the process of CH. The second was to examine the process of CH in terms of the changes in ACT-specific measures, including: Change Agenda Questionnaire (CAQ), Acceptance and Action Questionnaire-II (AAQ-II), Mindfulness Rule Scale (MRS), and Acceptance Process Questionnaire (APQ).
Methods: We collected descriptions of CH from ACT-related books and classified them into five elements: reflection on control strategies, facing to Change Agenda, experience of unworkable control strategies, notice of unworkable control strategies, and challenging alternative strategies. Twenty-four students (F = 17, mean age 19.96 ± 1.24) were randomly assigned to either the experimental or control group. Each experienced two experimental days and one intervening week of homework. The experimental group received education on the first two processes on the first day and the last three processes on the second day. The control group received education on the importance of self-understanding and the solution strategy for unpleasantness. Both groups of participants completed ACT-specific measures.
Results: The 2 (group) × 4 (time) mixed-mode analysis of variance showed that CAQ-believability, MRS substance, and APQ subscale observed marginally significant interactions (F (2.48, 44.65) = 2.95, p < .10, F (3,54) = 2.64, p < .10, F (3,54) = 2.27, p < .10, respectively).
Discussion: The results suggest that, according to changes in ACT-specific measures, the process of CH was appropriate. Future studies should examine changes in behavioral indicators.

24. Effects of self-as-context/defusion intervention on behavioral assimilation to age stereotypes

Primary Topic: Performance-enhancing interventions
Subtopic: Defusion
Kohei Hashimoto, M. A., Graduate School of Doshisha University
Takashi Muto, ph.D., Doshisha Univeristy

Negative stereotypes about aging could impugn the performance of older adults. This phenomenon is called behavioral assimilation to age stereotypes (BAAS). An effective intervention for BAAS has not been previously demonstrated. In a prior research, we showed that individuals who are more cognitively fused with the conceptual self were more vulnerable to the age stereotype. In this study, we examined whether self-as-context and defusion intervention could mitigate the effect of BAAS. Community-living older adults were randomly assigned to an intervention group or a control group. Intervention was comprised “body scan," “observer exercise," and “word repeating." After the intervention or the controlling conversation, all participants were presented with negative stereotypes about aging and then worked on the cognitive task (Weschler Adult Intelligence Scale-III block design). We will report the differences of the task performance between the two groups and the moderation effects of the baseline tendency of cognitive fusion with the conceptualized self on the intervention.

25. The relationship between facets of mindfulness and implicit racial bias

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Mindfulness, Implicit bias
Elizabeth Tish Hicks, B. A., Utah State University
Kristin L. Jay, Ph. D., Marist College

While previous research has examined the effects of mindfulness interventions on implicit bias, the current study investigates whether, without a specific meditation intervention, higher baseline levels of mindfulness are significantly related to lower levels of implicit racial bias, which could offer new insight into how and why mindfulness practice reduces implicit bias. Method: Participants (92 undergraduates; mean age 18.99 ± 1.22 years) completed the Five Facet Mindfulness Questionnaire (FFMQ; Baer et al., 2006) and the “race attitude" Implicit Association Test (IAT; Nosek et al., 2007). Results: Pearson correlations were calculated between each of the five FFMQ sub-scales and IAT scores. A significant negative linear correlation was found between Observing sub-scale scores and IAT scores, r = -0.268, p < .01. A single linear regression model was then calculated to predict IAT based on Observing, F(1,90) = 6.946, p < .01, with R2 = .072. Discussion: Our results suggest that as levels of the Observing facet increase, levels of implicit racial bias decrease, and that levels of Observing can a predict 7% of the variance in IAT scores. It is interesting considering that of the five facets of mindfulness, Observing was the only facet significantly associated with implicit racial bias. These results suggest that decreases in implicit bias found previously may have occurred in part because the practice of mindfulness increased participants’ levels of Observing, which could have contributed to decreases in implicit bias. Understanding how mindfulness practice can reduce implicit bias can aid in promoting social equity and reducing discrimination.

26. ACT at work: Preventing workers’ burnout in the field of child welfare
Sponsored by: ACBS Japan Chapter
Primary Topic: Prevention and Community-Based Interventions
Subtopic: burnont
Tomu Ohtsuki, Waseda University
Aiko Kamada, Well Link co., ltd.

The present study explored the effect of the ACT based universal programs that aimed to prevent workers’ burnout and reduce their psychological stress responses in the field of child welfare. Participants were 20 child care workers. They were assigned to an ACT based intervention condition (N=10) and a control condition (N=10) randomly. Self-report measures which assess the tendency of psychological flexibility (Acceptance & Action Questionnaire-II: AAQ-II), values (Personal Values Questionnaire-II: PVQ-II), burnout (Maslach’s Burnout Inventory: MBI), mental health (General Health Questionnaire: GHQ28), anxiety (State-Trait Anxiety Inventory: STAI), and stress (Stressor Inventory for Child Care Worker: SICC) were collected at pre-intervention, post-intervention (1 week later), and follow-up (1 month later). The ACT based intervention which the authors developed was a 2 hours intensive session for enhancing their psychological flexibilities. The results showed that effects of the ACT intervention compared to the control for mediate measures were AAQ-II (between groups at pre-post Cohen’s d=1.32, at pre-follow up d=1.81) and PVQ-II (d=1.74, 1.73). For outcome measures were MBI (d=-1.70, -2.95), GHQ28 (d=-1.02, -2.26), STAI (d=-0.67, -2.00), and SICC (d=-1.04, -1.63). The ACT based intervention led to a significant increase in psychological flexibility and values, and decrease their burnout, mental health, anxiety, and stress. These results provide evidence for the efficacy of ACT based intervention program to prevent child care workers’ burnout.

27. Effectiveness of Interventions to Reduce Secondhand Smoke Exposure in the homes among Children in China: A Systematic Review

Primary Topic: Prevention and Community-Based Interventions
Subtopic: secondhand smoke exposure
Yan Hua Zhou, M.Sc., School of Nursing, The Zhejiang Chinese Medical University
Yim Wah Mak, Ph.D., School of Nursing, The Hong Kong Polytechnic University

Background: Secondhand smoke (SHS) exposure causes deaths from ischemic heart disease, lower respiratory infection, asthma and lung cancer. Worldwide, 40% of children were exposed to SHS. The corresponding figure was up to 66.7% in China. An increasing number of intervention studies have implemented to reduce SHS exposure. China is the largest country in tobacco consumption in the globe. This study assess the effectiveness of interventions for reducing tobacco smoke exposure at home among children in China.
Method: We obtained data from the conception till 2017 of various electronic databases: PubMed, MEDLINE, CINAHL, EMBase, Cochrane Central Register of Controlled Trials, CNKI, and Wanfang MED Online. Studies reported in English or Chinese that investigated the efficacy of interventions to reduce SHS exposure among Chinese children were selected.
Results: This review summerised findings of 13 relevant studies published in 2004-2017 for reducing SHS exposure among Chinese children. Most studies investigated the exposure among young healthy children (n=13) under 5 years old (n=8). Most studies have adopted individual, face-to-face approach to deliver the interventions. Various improvements were observed in all studies. The improvements included the reduction of SHS exposure among the children (n=4) and higher self-reported quit rate in five studies, one of them was confirmed by biochemical test.
Discussion: This review included all types of interventional studies published in Chinese or English. All reviewed interventions benefit the reduction of SHS exposure at home among Chinese children, but a sustaining effect is still lacking. Implications for clinical practices and future research will be discussed.

28. Effect of a workplace ACT intervention on psychological wellbeing, distress and flexibility: A randomized controlled trial using ecological momentary assessment

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Workplace ACT intervention, ecological momentary assessment
Laurence Morin, Université de Montréal
Laurence De Mondehare, M.Ps., Université du Québec à Montréal
Christophe Chénier, Université du Québec à Montréal
Simon Grégoire, Ph.D., Université du Québec à Montréal

Background: More than one fourth of Canadian workers reports high level of stress on a daily basis and 60% identify work as their main stress factor. Studies on workplace ACT interventions show that they help reduce symptoms of stress, anxiety, depression and burnout and improve satisfaction and psychological flexibility (ex. Flaxman, Bond et Livheim, 2013). However, the contribution of the different ACT processes is still unknown and rigorous studies (ex. randomized controlled trials with many time points) are scarce. Moreover, studies rely mostly on self-reported questionnaires despite the fact that many researchers suggest that psychological flexibility should be measured with instruments that have a better ecological validity. The goal of this study is to evaluate the effectiveness of an ACT-based intervention designed to help employees cope with stress and better understand the impact of the different ACT processes.
Method: Fifteen employees (N=15) from a college in Quebec participated in this project. The intervention consists of four 2-hour workshops. A randomized controlled trial with a wait-list control group combined with ecological momentary assessment (EMA) was used to assess changes in psychological wellbeing, distress, and flexibility over the course of the intervention. Data were collected with self-report questionnaires pre and post intervention as well as with daily questionnaires sent randomly to participants’ smartphones. Linear Mixed Model analyses will be performed on EMA data and analyses of variance on pre-post measures.
Results: Results to come since data are still being collected at the moment. The study is ending in mid-April.

29. Does perceived socioeconomic status predict receptivity to mindfulness practices and willingness to seek psychotherapeutic services?

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Mindfulness
Cristin Pontillo, M.A., Kean University
Arika Aggarwal, B.S., Kean University
Jared Hammond, M.A., Kean University
Brielle Tamburri, Kean University
Jennifer Block-Lerner, Ph.D., Kean University
Donald Marks, Psy.D., Kean University

Individuals of low SES are in need of mental healthcare at similar or higher rates than those in the middle-class (Reese et al., 2006). Higher levels of stigma surrounding mental healthcare are common among families with lower income, signifying a potential barrier for utilization (Golberstein et al., 2008). Higher SES has been associated with higher levels of receptivity to mindfulness and a greater willingness to seek psychotherapy (Barnes et al., 2008; Meyer et al., 2013); this may relate to stigma or a perception of limited availability of resources for those from lower SES backgrounds. Curriculum-based interventions may address stigma and increase access to services for individuals from the full range of backgrounds with regard to SES. However, it is important to determine the extent to which individuals are open to related practices. The purpose of this study is to examine associations between SES and: a) receptivity to mindfulness practices, and b) likelihood of seeking psychotherapeutic services in the context of curriculum-based mindfulness-focused workshops. Undergraduate students (current n=150) at a diverse state university in the northeastern US participated in a one-session curriculum-based experiential workshop emphasizing values, mindfulness, and community-building.
Participants reported their perceived income sufficiency and, after the workshop (and a subset at a one-month follow-up point), their interest in mindfulness-based practices (α = .92) and in seeking psychotherapy if needed. Research questions will be addressed via regression analyses; limitations and future directions related to developing and promoting services for individuals of lower SES and other vulnerable populations will be discussed.

30. Cultural Harmony: Examining the effects of exposure to music-based mindfulness practices on feelings of common humanity and openness to diversity

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Mindfulness and Spirituality
Neil Patel, M.A., Kean University, Nathan Weiss Graduate College
Paola Ricardo, M.A., Kean University: Nathan Weiss Graduate College
Jennifer Block-Lerner, Ph.D., Kean University: Nathan Weiss Graduate College
Donald Marks, Psy.D., Kean University: Nathan Weiss Graduate College
Cristin Pontillo, B.A., Kean University: Nathan Weiss Graduate College
Arika Aggarwal, B.A., Kean University: Nathan Weiss Graduate College

In a time of increasing divisiveness and hostility towards those perceived as other, where the term “identity politics" has begun to dominate public discourse, finding ways to see humanity in others and foster openness to diversity can help generate change in the way communities interact and relate to one another (Gilbert, 2009). Engagement with cultural expressions via music may allow individuals to connect with universal aspects of human experience, including feeling part of nature or a larger whole (Matsunobu, 2011). However, little research has examined the effects of exposure to music-based mindfulness practices on these processes. This study aims to investigate whether exposure to the documentary One Track Heart, which features the spiritual journey of Krishna Das and the performance of kirtan as a form of mindfulness practice, contributes to increased feelings of openness to diversity and a sense of common humanity. Undergraduate students enrolled in psychology courses have been randomly assigned to one of four conditions in a 2x2 independent groups factorial design. Currently, 126 students have participated (anticipated N = 150). Conditions are based on which film participants are exposed to (One Track Heart or a conference talk on spiritual diversity) and whether or not they are invited to participate in brief mindfulness practices prior to watching the film. Implications for the use of mindfulness-based practices like kirtan as ways of creating connection to shared aspects of the human experience will be discussed.

31. Using ACT to promote resilience and self-compassion among people living with or affected by HIV, mental illness and addiction

Primary Topic: Prevention and Community-Based Interventions
Subtopic: Stigma reduction and self-compassion
Josephine Pui-Hing Wong, PhD, Ryerson University
Alan Tai-Wai Li, Regent Park Community Health Centre
Alessandro Bisignano, Committee for Accessible AIDS Treatment

Background: Racialized immigrants, living with or affected by HIV, mental illness and/or addiction, experience myriad barriers in accessing relevant services and support. They also face complex, multi-layered stigma and discrimination. To address these barriers, the Committee for Accessible AIDS Treatment (CAAT) consulted affected individuals and service providers to identify strategies to address current program and service gaps for the affected communities.
Method: Acceptance and Commitment to Empowerment (ACE) is a program that applies Acceptance and Commitment Therapy (ACT) to: (1) promote psychological flexibility; (2) reduce stigma associated with HIV, addiction and mental health challenges; (3) increase self-compassion and self-care; and (4) consolidate mutual support and advocacy. ACE consists of 10 sessions of small group experiential learning and weekly follow-up at-home practice. Program topics focus on: mindfulness, defusion, acceptance, self-as-context, valued living and committed action. Participants participated in pre- and post- surveys and post-program focus groups.
Results: A total of 30 racialized immigrants living with or affected by HIV, and facing mental health/addiction challenges completed the ACE program. Evaluation results indicated that ACE was effective in promoting sustainable mindfulness, self-compassion, and collective resilience. This poster will showcase the ACE strategies and effects in: (1) promoting trust, mutual empathy and support; (2) enhancing embodiment of self-compassion and valued living; and (3) facilitating individual and group resilience.
Discussion: Multi-layered stigma and systemic barriers reinforce social isolation and suffering among individuals living with HIV, mental illness and/or addiction. The ACT model supports integrative strategies that address the holistic needs, reduce shame and promote self-compassion among affected individuals.

32. Decision-Making and BIRRs: investigating the propensity to buy functional food

Primary Topic: Relational Frame Theory
Subtopic: Functional Nutrition
Andrea Modica, University of Enna "Kore"
Valeria Squatrito, University of Enna "Kore"
Annalisa Oppo, Sigmund Freud Acadamey
Giovambattista Presti, University of Enna "Kore"
Paolo Moderato, IULM University

Consumers are paying more and more attention to particular types of food named functional foods. They are so called because of their putative effects on health, to prevent various diseases ranging from chronic cardiac conditions to cancer. To investigate how price and effects on health could influence the purchasing decision we compared self-reports and an IRAP (Implicit Relational Assessment Procedure) to test wether consumers respond faster to the expensive price-buy relation in the context of healthy or unhealthy food.
In the IRAP task two relational response options (Buy/Not Buy) were offered in the context of 6 words related to healthy and 6 words related to unhealthy food and two targets referring to expensive and cheap prices. Participants were asked to response consistently to two alternative instructions. The first was "answer as if you are willing to pay an expansive price for healthy food and cheap price for unhealthy food"; the second instruction asked to respond to the opposite.
In this exploratory study 35 university students were involved. Data analysis showed that participants evaluated the general characteristics of functional foods more positively than negatively (t(34)=37.06, p<.001). A positive implicit preference when products are expensive but healthy emerged and was significantly different than cheap-healthy or cheap-unhealthy (F(3,34)=6.58,p<001,=.162,97%statistical power). In summary IRAP data showed that participants implicitly choose to buy healthy food whether it is expensive or cheap, but would buy an unhealthy product only at a low price.

33. Assessing the Change Agenda Using the Implicit Relational Assessment Procedure

Primary Topic: Relational Frame Theory
Subtopic: IRAP, Change agenda, acceptance, creative hopelessness
Kazuya Inoue, Graduate school of human sciences, Waseda University
Taiki Shima, JSPS Research Fellow
Madoka Takahashi, Graduate school of human sciences, Waseda University
Hiroaki Kumano, Faculty of human Sciences, Waseda University

Background: In order for the acceptance intervention to be successful, it is important to letting go the change agenda (Sakai et al. 2014). In the current study, we compare the measurement of change agenda using Implicit Relational Assessment Procedure (IRAP) and explicit measurements.
Method: Seventeen undergraduate and graduate students were randomly assigned to either an acceptance group (N = 10, mean age = 22.5 ±3.04) or a control group (N = 7, mean age = 23.5 ±3.00).
Procedure: The participants completed the change agenda IRAP, change agenda questionnaire; CAQ (Shima et al., 2018), the AAQ-II Japanese version (Shima et al., 2013), and the cold pressor task before and after the intervention. Regarding intervention, the acceptance group received exercises, while the control group was asked to read a book for 10 minutes.
Results: The cold water tolerance time of the acceptance group increased after the intervention more than that of the control group. There was moderate negative correlation between rate of change the cold water tolerance time and change amount of change agenda D score, but not significant (ρ = −.48, ｐ= 0.16). On the other hand, no correlations were found between rate of change the cold water tolerance time and change amount of CAQ and AAQ-II (ρ = −.17, ｐ= 0.65, ρ = −.20, ｐ= 0.59, respectively).
Discussion: It may be concluded that the measurement of the change agenda using IRAP could predict change of acceptance behavior by an intervention rather than explicit questionnaire.

34. Food choice: analysis of implicit and elaborated relational responding to taste and price

Primary Topic: Relational Frame Theory
Subtopic: Decision-Making and food
Andrea Modica, University of Enna “Kore"
Valeria Squatrito, University of Enna “Kore"
Annalisa Oppo, Sigmund Freud Acadamey
Giovambattista Presti, University of Enna "Kore"
Paolo Moderato, IULM University

Psychology usually conceptualize human decision-making into two categories: highly conscious decisions, which are deliberate, and semi-conscious decisions, which are spontaneous and simplified. Research relates purchasing behavior of food more to the second category than the first one. The goal of this study was to analyze purchasing behavior related to two variables, taste and cheap price in the context of Brief Implicit Relational Respondings. We compared self-reports and an IRAP (Implicit Relational Assessment Procedure) testing on wether consumers respond faster to tasty-buy relation. In the task two relational response options (Buy/Not Buy) were offered in the context of 6 words related to “taste" and 6 words related to “cheap-food" and two targets “like" or “dislike". Fifty participants were asked to respond consistently to two alternative instructions: first "answer as if you are willing to pay an expensive price for healthy food and cheap price for unhealthy food"; the second instruction asked to respond to the opposite. Participants were 50 students. A within subject ANOVA of responses to questionnaires on the 6 adjectives related to price and the 6 related to taste revealed a statistically significant difference (p<.001) in favor of taste. However data of the IRAP task demonstrate that no significant bias emerged for either taste or price. An analysis of food choice in terms of BIRR’s and EERRs related to taste and price will be offered.

35. In Vino Veritas: An IRAP analysis of the propensity to buy wine after visiting a winery

Primary Topic: Relational Frame Theory
Subtopic: Decision-making and wine
Andrea Modica, University of Enna “Kore"
Valeria Squatrito, University of Enna "Kore"
Annalisa Oppo, Sigmund Freud Acadamey
Giovambattista Presti, University of Enna "Kore"
Paolo Moderato, IULM University

Context influences our behavior in many ways and relevant experiences can have an impact on purchase decision making. In Italy new marketing strategies have focused the experience of visiting wineries as a way to increase the propensity to buy wine. This study explores if purchase propensity after wine tasting is changed when visit a winery or not.
140 participants were recruited as part of a bigger study in wine tasting and purchasing behavior and divided into two groups: wine tasting (control) and wine tasting + visit to the winery (experimental group). Subjects were asked to blind taste three wines and label the best preferred with a green sticker and the less preferred with a red one. The red and green stickers were used as samples in the IRAP and put in relation with 12 adjectives, 6 referring to high price and 6 related to cheaper price. IRAP was administered to both groups at baseline, after the visit at the winery for the experimental group and after the same interval of time for the control group, and at a two week follow-up for both groups. After visiting the winery, the experimental group showed an increase an increase in the willingness to buy both the preferred wine and the wine not liked at the implicit cognition task.

36. The Impact of the 2016 Election: Predictors of Health Outcomes

Primary Topic: Theoretical and philosophical foundations
Subtopic: 2016 Election
Leah M. Bogusch, M.A., Bowling Green State University
Aniko Viktoria Varga, B.A., Bowling Green State University
Hannah R. Geis, M.A., Bowling Green State University
William H. O'Brien, Ph.D., Bowling Green State University

Background: The present study examined the relationship between the self-reported personal impact of the 2016 Presidential election and physical and mental health.
Method: A moderated mediation model was tested. Thought suppression and social trust were modeled as mediators and emotion regulation was modeled as a moderator. An online sample (n = 299) of United States citizens completed the Personal Impact of the Election Scale (PIES), White Bear Suppression Inventory, Social Trust Scale, and physical and mental health (SF-12).
Results: Results indicated that thought suppression mediated the relationship between PIES and the physical and mental health. Specifically, PIES was positively related to thought suppression (b = .07, p < .001), which in turn, was inversely related to physical and mental health (b = -1.32, p = .007; b = -2.94, p < .001). Social trust did not mediate these relationships. Emotion regulation was a significant moderator of the relationship between the PIES and mental health (b = -.84, p = .001), but not physical health, such that greater emotion regulation weakened the relationship between perceived impact of the election and poorer mental health.
Discussion: These results suggest that persons who experienced higher election impact and who reported higher levels of thought suppression tended to report more election-related physical and mental health symptoms.

37. Understanding Adolescent Substance Use: A Developmental-Contextual Theory Approach

Primary Topic: Theoretical and philosophical foundations
Subtopic: Adolescence, Substance Use, Affect Regulation
Korine Cabrera, Clark University
Kathleen Palm Reed, Clark University

Adolescence has been identified as a particularly vulnerable period of time for the development of substance use. Among Americans, lifetime substance use rates peak between the ages of 16 to 25 (NSDUH, 2014; SAMHSA, 2009) and substance abuse in adolescence is associated with a variety of adverse health, behavioral, and social consequences as well as a greater risk for substance problems and dependence later in life (King & Chassin, 2006). This developmental phase is uniquely characterized by heightened stress, emotional lability, and impulsivity. Several lines of research have theorized how affect regulation is a principal motive for substance misuse (Baker et al., 2004; Kober, 2014). Thus, considering the function of affect regulation is essential component of understanding the elevated rates of substance use during this time (Riediger & Klipker, 2014). Developmental contextual factors in adolescence, such as increasing autonomy, identity formation, social relationships, and neurobiological/hormonal changes, may particularly impact affect regulation difficulties that are associated with substance misuse (Schulenberg & Maggs, 2002). In the proposed poster, we will provide a conceptual analysis of adolescent substance use that is informed by a contextual behavior science lens. We will present a model of risk and protective factors for adolescent substance use that incorporates core factors relevant to this distinct developmental phase. Implications and suggestions for future research will be discussed.

38. The Relationship between Psychological Inflexibility and the Interpersonal Needs Underlying Suicidality in a Juvenile Offender Sample

Primary Topic: Theoretical and philosophical foundations
Subtopic: Children/Adolescents, Suicidality
Jacqueline E. Hapenny, M.S., Baylor University
Brittany N. Sherrill, Baylor University
Jules C. Martowski, M.S., Baylor University
Laurie H. Russell, M.S., Baylor University
Sara L. Dolan, Ph.D., Baylor University
Thomas A. Fergus, Ph.D., Baylor University

According to the interpersonal theory of suicide, thwarted belongingness and perceived burdensomeness are necessary components underlying suicidal desire (Van Orden et al., 2010). Theorists suggest that psychological inflexibility underlies psychopathology, including suicidal desire (Hayes et al., 2008). Though research has related components of psychological inflexibility to interpersonal needs within adult samples (e.g., Hapenny & Fergus, 2017), it remains unexamined how psychological inflexibility relates to interpersonal needs within a youth sample. As juvenile offenders are particularly vulnerable to suicide, examining this potential relationship within a juvenile offender sample may provide unique insight (Joshi & Billick, 2017).
The present study examined interrelations between psychological inflexibility and interpersonal needs. The sample consisted of 99 youths residing within a juvenile justice center in the state of Texas, with a mean age of 15.1 years (SD = 1.30, range 11-17). Participants were predominantly male (86.9%), with a slight majority identifying as non-Hispanic (54.5%) and African-American (36.4%). Participants completed self-report measures of the targeted variables (all Cronbach’s αs > .70).
As predicted, psychological inflexibility positively correlated with thwarted belongingness (r = .28, p < .01) and perceived burdensomeness (r = .46, p < .01). Hierarchical multiple linear regression analyses found that, beyond covariates of depression and hopelessness, psychological inflexibility accounted for a significant amount of unique variance in perceived burdensomeness (ΔR2 = .05, partial r = .26, p < .02), but not in thwarted belongingness. Overall, the present results indicate that psychological inflexibility may aid in better understanding perceived burdensomeness and suicidal desire in youth.

39. Défusion Cognitive en Réalité virtuelle

Primary Topic: Interventions cliniques
Subtopic: Médiation Instrumentale
Pichat Michael Ph.D. McU, Université Paris VIII
Shankland Rebecca Ph.D. McU, Université Grenoble Alpes
Béghin Gaëtan, Ecole de Psychologues Praticiens

En psychothérapie, la réalité virtuelle est souvent réduite à la simple exposition (désensibilisation), dans une logique comportementale (Paples-Keller, & al., 2017).
Dans une logique proprement cognitive, nous développement avec l'outil qu'est là réalité virtuelle une analogie du champ mentale où peuvent s'effectuer les opérations de défusion cognitive de manière "physique".
Objectif principal : - Développer la compétence de défusion cognitive grâce à l'exercice (médiation instrumentale, Vygotsky). - Développer l’insight du sentiment de compétence de défusion
Démarche : Inhiber non pas la pensée douloureuse initiale (peine de niveau un) mais le passage rumination qu’elle entraine (peine de niveau deux).
Protocole en 4 phases : 1. Paramétrage +Identification d'un thème de rumination à travailler 2. Génération d'un état de fusion en VR 3. génération de la défusion en VR 4. Contraste expérientiel fusion/défusion, génération de croyances alternatives + prescription
Posture du praticien : - Générer un vécu expérientiel fusion/défusion - Explicitation phénoménologique systématique du contraste vécu fusion/défusion - Empowerment : développer sentiment de compétence vis-à-vis de la VR Evaluation d'efficacité : pré/post-test sur deux échantillons : général et individus diagnostiqués avec un trouble des comportements alimentaires. (en cours)

40. Résilience des ex- combattants blessés de guerres en République Démocratique du Congo

Primary Topic: Interventions cliniques
Subtopic: Résilience
Jean-Pierre Birangui, Université de Lubumbashi

Depuis les deux guerres de 1996-1997 et 1998-2002 en République Démocratique du Congo à nos jours, nous avons constaté une recrudescence des violences et victimes de guerres. Parmi ces victimes, nous avons observé la présence de certains ex-combattants blessés de guerres, qui malgré les traumatismes psychiques et balistiques subis, leur éviction dans des centres hospitaliers en 2005 et 2009 survivent dans la ville de Lubumbashi. Cela étant, nous avons axé notre préoccupation sur la question suivante: quelles peuvent être les stratégies de survie de ces ex-combattants blessés de guerres à Lubumbashi en République Démocratique du Congo . Pour y répondre, nous nous servi de la méthode clinique, les techniques d 'entretien, d'observation, l analyse fonctionnelle auprès de huit ex- combattants blessés de guerres, tous de sexe masculin d' âge moyen de 34 ans entre 2010-2015.

41. Le programme d’intervention psychologique «Savoir Être Étudiant en pleine conscience» pour aider les étudiants universitaires: Données préliminaires de son efficacité et des processus associés à la pleine conscience

Primary Topic: Interventions cliniques
Subtopic: Pleine conscience
Catherine Gagnon, D.Ps(c), Université du Québec à Trois-Rivières
Michel dumont, M.Ps., Université Laval
Carmen Pedneault, M.Ps., Université Laval
Frédérick Dionne, Ph.D., Université du Québec à Trois-Rivières
Marie-Claude Blais, Ph.D., Université du Québec à Trois-Rivières

Les résultats de plusieurs recherches mettent en évidence une prévalence plus élevée de diverses problématiques de santé mentale et de détresse psychologique chez les étudiants universitaires, en comparaison à la population générale. Pour remédier à cette problématique, les universités mettent en place des services d’aide psychologique adaptés à la clientèle universitaire. Dans cette optique, des interventions psychothérapeutiques de groupe basées sur la pleine conscience ont commencé à voir le jour dans certaines universités canadiennes, dont l’Université Laval à Québec. Cette étude évalue les effets d’un programme d’intervention basé sur la pleine conscience, soit le programme « Savoir Être Étudiant en Pleine Conscience ». Un total de 24 étudiants ont participé à ce programme ont participé à l’étude en 2015-2016. Dans le cadre de ce projet de recherche, différents questionnaires ont été administrés aux participants avant et après le programme afin d’en évaluer l’impact sur les symptômes anxio-dépressifs et sur les processus associés à la pleine conscience. Les résultats suggèrent que le programme « Savoir Être Étudiant en Pleine Conscience » pourrait diminuer significativement les symptômes anxio-dépressifs. L’intervention tendrait également à améliorer de façon significative certains processus, tels que la défusion cognitive, l’évitement expérientiel ainsi que la capacité à être en pleine conscience. Ces processus pourraient expliquer l’effet de l’intervention sur les symptômes anxio-dépressifs. Ces résultats s’avèrent prometteurs, car ils corroborent la pertinence d’utiliser ces programmes qui étaient jusque-là présents dans les milieux hospitaliers et qui commencent à émerger dans les Centres d’Aide aux Étudiants des universités.

Thursday, July 26
Friday, July 27
Saturday, July 28
Sunday, July 29

Thursday, July 26

9. Using ACT in the Treatment of More Complex Forms of Depression: Examples in Three Clinical Settings
Symposium (10:35am-12:05pm)
Components: Original Data
Categories: Clinical Interventions and Interests, Depression
Target Audience: Beg., Interm., Adv.
Location: Rue Sainte-Catherine

Chair: Kristy Dalrymple, Ph.D., Rhode Island Hospital/Warren Alpert Medical School of Brown University
Discussant: Robert Zettle, Ph.D., Wichita State University

ACT has demonstrated efficacy for the treatment of depression and is listed as an empirically supported treatment. However, additional research is needed to examine the application of ACT in routine psychiatric settings in which clients present with more severe/complex forms of depression. ACT may be particularly helpful for those who experience more severe and functionally impairing depression, given its emphasis on improving quality of life (e.g., Berk et al., 2012; Bohlmeijer et al., 2011). The first presentation will review findings from a pilot randomized trial examining ACT for depression with comorbid social anxiety in clients recruited from an outpatient psychiatry practice. The second presentation will discuss outcomes and predictors of outcomes from an ongoing study of ACT for clients with depression at a partial hospital program. The third presentation will describe findings from a randomized controlled trial comparing ACT to CBT for depression in an outpatient practice. Finally, these findings will be reviewed in the context of the existing ACT for depression literature and suggestions will be provided for future research directions.

• Acceptance and Commitment Therapy for Depression with Comorbid Social Anxiety: Results From a Pilot Randomized Trial
Kristy Dalrymple, Ph.D., Rhode Island Hospital/Warren Alpert Medical School of Brown University
Emily Walsh, B.A., Columbia University
Lia Rosenstein, B.A., Pennsylvania State University
Mark Zimmerman, M.D., Rhode Island Hospital/Warren Alpert Medical School of Brown University

Depression often is complicated by comorbid social anxiety, resulting in greater functional impairment and poorer treatment outcomes. Given the transdiagnostic focus of ACT, it may be particularly helpful for this population. A prior open trial of ACT for depression and social anxiety showed significant improvement following 16 individual sessions (Dalrymple et al., 2014). The present study aimed to further examine its feasibility and acceptability in a pilot randomized controlled trial. Patients (n=26) with depression and social anxiety at a hospital-based outpatient psychiatry practice were recruited between July 2012 and January 2016. They were randomly assigned to medication as usual (MAU) or MAU plus ACT (MAU+ACT); patients in MAU+ACT received 16 weekly, individual sessions of ACT. Assessments were completed at pre-treatment, 8 weeks, and 16 weeks. Results showed medium between-groups Cohen’s d effect sizes at 16 weeks on depression symptoms (0.55), and medium-to-large effect size differences for social anxiety avoidance (0.69) and quality of life (0.67) favoring MAU+ACT. Additional results will be presented on outcome and process measures, such as psychological flexibility and behavioral activation.

• Treating Complex Presentations of Depression using Acceptance and Commitment Therapy
Theresa A. Morgan, Ph.D., Rhode Island Hospital/Warren Alpert Medical School of Brown University
Lauren Harris B.A., Rhode Island Hospital
Catherine D’Avanzato Ph.D., Rhode Island Hospital/Warren Alpert Medical School of Brown University
Sarah Zimage M.A., Rhode Island Hospital
Brian Pilecki Ph.D., Rhode Island Hospital/Warren Alpert Medical School of Brown University
Rawya Aljabari Ph.D., Rhode Island Hospital/Warren Alpert Medical School of Brown University
Olga Obraztsova Ph.D., Rhode Island Hospital/Warren Alpert Medical School of Brown University
Douglas Long Ph.D., Rhode Island Hospital/Warren Alpert Medical School of Brown University
Savannah McSheffrey, Ph.D., Rhode Island Hospital/Warren Alpert Medical School of Brown University
Adriana Hyams, Ph.D., Rhode Island Hospital/Warren Alpert Medical School of Brown University
Cerena Reid-Maynard, LICSW, Rhode Island Hospital/Warren Alpert Medical School of Brown University

In treatment settings, comorbidity in depression is the norm rather than the exception. It is also predictive of poorer outcomes, including symptom intensity/persistence, functional impairment, treatment utilization, and suicidality. Transdiagnostic therapies like ACT provide flexible models for treating complex patients with high acuity. The current study reports effectiveness of using ACT to treat depressed patients in acute crisis. Participants include 1035 partial hospital patients, 549 of whom met criteria for current MDD. Most common comorbid diagnoses included GAD (56%), social phobia (39%) and PTSD (34%). Results showed a 45% decrease in depression from intake to discharge (Cohen’s d =1.47). Functioning and quality of life improved by 23% and 22%, respectively. Changes to ACT processes were large (Cohen’s d from 0.94 to 1.24 for mindfulness, valuing, and flexibility). Best predictors of symptom change were number of comorbid diagnoses, SI at intake, education level, and presence of PTSD or BPD. In contrast, ACT process change was most related to age, current PTSD diagnosis, and education level. Discussion will include clinical issues when adapting ACT for this sample.

• ACT for Major Depressive Disorder: can it compare to evidence-based treatment and how does it work?
Jacqueline A-Tjak, Ph.D., PsyQ, Zaandam, the Netherlands and the University of Amsterdam, Amsterdam, the Netherlands

Worldwide, more than 300 million people are affected by depression. There has not yet been much research regarding if and how ACT can help improve the lives of those suffering from depressive disorders (although there is important research showing ACT can help cope with depressive symptoms). In this talk, we will share design and results from a Randomized Controlled Trial performed in the Netherlands in an outpatient facility with patients formally diagnosed with Major Depressive Disorder. We included 82 patients who received either ACT or CBT (both protocolized). We measured the impact on depressive symptoms, diagnosis and quality of life, from pre- to posttreatment, and at 6 and 12 months follow up. We also measured depressive symptoms and process measures at several time points during treatment, post treatment and at follow up. In this talk we will address how to understand the results from this RCT within the context of research on depression and depressive symptoms, focusing on ACT and CBT.

Educational Objectives:
1. Describe the feasibility, acceptability, and preliminary results from a pilot randomized trial examining the addition of ACT to medication as usual for patients experiencing depression and comorbid social anxiety in a routine outpatient psychiatry practice. 2. Describe outcomes, predictors of outcomes, and changes in processes for patients with depression and other comorbidities receiving ACT within a partial hospital program. 3. Explain the meaning of the results found in an RCT comparing ACT to CBT for patients with MDD, regarding both outcomes and processes.

 

11. Recent theoretical and methodological advances in Relational Frame Theory (RFT)
Symposium (10:35am-12:05pm)
Components: Conceptual analysis, Original data, Didactic presentation
Categories: Relational Frame Theory, Clinical Interventions and Interests, Educational settings, Functional contextual approaches in related disciplines, RFT, Coherence, Mental Health, Perspective Taking, IRAP, Children
Target Audience: Beg., Interm., Adv.
Location: Rue Crescent

Chair: Michael Bordieri, Ph.D., Murray State University

This symposium explores recent findings supporting the Relational Frame Theory (RFT) framework in the study of the self. The first paper reviews the concept of coherence from RFT and presents a paradigm that assesses coherence in a social context. The second paper empirically assesses the role of self-as-distinction and self-as-hierarchy on depression, stress, and anxiety. The third paper presents data supporting the relational triangulation framework of RFT in derived perspective taking and observational learning through social modeling. Finally, the fourth paper studies the influential role of negative and positive affect on verbal processes associated with wanting more or less based on the RFT perspective.

• Relational Coherence in a Social Context
Michael Bordieri, Ph.D., Murray State University
Jeremy Vargas, Murray State Univeristy

Recent theoretical advances in Relational Frame Theory (RFT) have placed increasing emphasis on coherence as a core dimension of relational responding (Barnes-Holmes, Barnes-Holmes, Luciano, & McEnteggart, 2017). This paper will briefly review empirical work that explores the appetitive properties of coherence before focusing on a paradigm that assesses coherence in a social context. The paradigm superimposes a conformity manipulation typically employed in social psychology (Asch, 1956; Smiowitz, Campton, & Flint, 1988) onto an established coherence reinforcer assessment (Bordieri, Kellum, Wilson, & Whiteman, 2016; Hughes & Bordieri, 2016). Results from 51 participants suggest that the reinforcing value of coherence can be manipulated by contextual factors such as social approval, but only to a limited extent. The obtained findings highlight the interaction of relational coherence with a competing source of reinforcement and highlight important limitations regarding the study of relational coherence in a convenience sample of undergraduate students. Implications for future research will be discussed, with particular attention placed on stimulus design and controlling for sequence effects.

• Distinction vs. Hierarchical Deictic Relating: Implications for Young People’s Mental Health
Orla Moran, Ph.D., University College Dublin
Louise McHugh, Ph.D., University College Dublin

Recent evidence from Contextual Behavioral Science indicates that 2 types of relating facilitate the experience of self-as-context- self-as-distinction and self-as-hierarchy. While the latter has been associated with better mental health outcomes relative to distinction, to date these types of relating have not been examined directly before any manipulation has occurred. The present study examined the relative contribution of each of these two types of self-as-context on depression, stress, and anxiety, while controlling for deictic ability and gender, using regression analyses in a sample of 102 young people. Mediation analysis was also used to examine the role of psychological flexibility. While self-as-hierarchy was significantly predictive of lower stress and depression, psychological flexibility was not found to mediate this relationship. Self-as-distinction did not emerge as a significant predictor of any outcome variable. Suggestions for future research on the basis of these findings are discussed.

• Social Modeling as Derived Perspective Taking via Relational Triangulation
Paul Guinther, Ph.D., Western Psychological and Counseling Services

The relational triangulation framework (Guinther, 2017) of Relational Frame Theory (Hayes, Barnes-Holmes, & Roche, 2001) posits that observational learning through social modeling (Bandura, 1977) is an instance of derived perspective taking. Empirical data supporting this contention has been collected using an operant match-to-sample relational triangulation perspective taking protocol (RT-PTP; Guinther, 2017). Participants were first directly trained to make deictic pointing responses to target locations relative to pointing origins of the self (A1) versus two others (A2 and A3) under the respective control of three contextual stimuli (i.e., X1:A1, X2:A2, X3:A3). Participants were then trained across trials to report the other-relative deictic orientations of a target (i.e., discriminating which varying side of the target was facing A2 versus A3, under the respective contextual control of X2 and X3). During a subsequent test for derived relational responding, participants spontaneously reported the self-relative deictic orientations of the target under X1, even though X1, A1, and A1's spatial position had never been directly conditioned to exert control over those responses. Thus, participants spontaneously transposed others' perspectives onto the self.

• An Examination of Generalised Implicit Biases Towards 'Wanting More' as a Proxy of Materialism: A Relational Frame Theory (RFT) Perspective
Brian Pennie, Trinity College Dublin, Ireland
Michelle Kelly, Ph.D., National College of Ireland

The research investigated the contextual effects of mood on implicit measures of ‘wanting more’ as a proxy of materialism and investigated the basic verbal processes underpinning this behaviour. Participants (n=60) were exposed to either a positive (n=21), negative (n=20) or neutral (n=19) mood induction procedure; an Implicit Relational Assessment Procedure (IRAP) examining biases towards wanting more or less; and questionnaires assessing life satisfaction, materialism, and positive and negative affect. On the IRAP, shorter mean response latencies across consistent (more-good/less-bad) compared to inconsistent (more-bad/less-good) trial-blocks were interpreted as an implicit bias towards ‘wanting more’. Compared to the neutral mood condition, participants in the positive mood condition demonstrated an increased bias towards ‘wanting less’ (p=.028). Several predicted associations were also observed. Of note, reduced levels of materialism were significantly correlated with an implicit bias towards wanting less (r=.579, p=.006). The findings provide preliminary support for the IRAP as a generalised implicit measure of ‘wanting more’ as a proxy of materialism; and suggest that changes in mood may influence this effect. Findings are discussed from an RFT perspective.

• Relational Framing in the Classroom. The Effects of Derived Relational Responding and Trained Augmentals on Instructional Control
Shari Daisy, Ed.S., The Chicago School of Professional Psychology, Los Angeles
Leslie Morrison, Ph.D., The Chicago School of Professional Psychology, Los Angeles
Eric Carlson, Ph.D., The Chicago School of Professional Psychology, Los Angeles
Jonathan Tarbox, Ph.D., University of Southern California

Instructional control is an important issue in education, impacting both teaching and learning. Although instructional control has been defined from several perspectives (Baron & Galizio, 1983; Glenn, 1987; Schlinger, 1993; Schlinger & Blakely, 1987; Skinner, 1969), Relational Frame Theory provides an explanation for how instructional control is established through the process of arbitrarily applicable relational responding, or derived relational responding (O'Hara & Barnes-Holmes, 2004). The current paper reviewed the literature in regards to instructional control and evaluated whether instructional control over student behavior could be established and reversed through the use of trained augmentals in a general education kindergarten classroom. First, coordination relations for a network of arbitrary stimuli were trained. Tests for derived frames of coordination then occurred. Next, augmental values for two arbitrary items - one of high value and one of minimal value - were established through training. Finally, reversal tests for instructional control over student behavior were conducted during group classroom activities with trained augmentals in place.

Educational Objectives:
1. Describe recent theoretical and empirical advances in the study of relational coherence. 2. Describe the relational triangulation framework 3. Discuss how augmentals establish and maintain instructional control over desired behaviors in the classroom setting.

 

13. Awareness, courage, and love: Clinical measurement, clinical analogue and clinical findings: FAP SIG Sponsored
Symposium (10:35am-12:05pm)
Components: Original Data
Categories: Clinical Interventions and Interests, Theoretical and philosophical foundations, Awareness, courage and love
Target Audience: Beg.
Location: Rue Saint-Paul

Chair: Jonathan W. Kanter, University of Washington
Discussant: Fabián O. Olaz, Centro Integral de Psicoterapias Contexuales

Although the terms awareness, courage, and love (ACL) were first introduced to describe qualities of therapist behavior while conducting Functional Analytic Psychotherapy (FAP), they have become frequent descriptions of therapy targets, especially when a client presents with problems related to intimacy. With the need for a functional and empirical basis for talking about client behavior in terms of ACL in mind, a contextual-behavioral, clinical model of ACL has been developed. This symposium presents important new empirical findings on this model with clinical-analogue and clinical samples. First, Katherine Manbeck presents results from a randomized lab-based clinical analogue experiment, in which the model was evaluated with a high fear-of-intimacy (FOI) participants, including measurement of heart-rate-variability (a marker of emotion regulation). Second, Adam Kuczynski presents results from a longitudinal study documenting relationships between ACL, quality of life, and psychopathology in therapy clients over the course of several months of ongoing therapy. Finally, Chad Wetterneck presents results documenting changes in ACL over the course of treatment for clients with PTSD, including the prediction of premature treatment termination.

• The intricacies of connecting with individuals who fear intimacy
Katherine E. Manbeck, University of Washington
Savannah M. Miller, University of Washington
Natalia M. Montes, University of Washington
Jonathan W. Kanter, University of Washington

In a lab-based, clinical analogue randomized experiment, 146 undergraduates oversampled for high fear of intimacy (FOI) engaged in "fast friends" interactions with research assistants trained to respond to participants' vulnerable disclosures with high responsiveness. Participant vulnerability is conceptualized as "courage" in the Awareness, Courage, and Love (ACL) model, while research assistant responsiveness is considered "love." Unlike previous experiments with undergraduates documenting that high responsiveness predicts closeness with the researcher up to two weeks later, the current results found an immediate effect which was not sustained over time (high responsiveness no longer predicted closeness after 48 hours). Furthermore, measurement of physiology before and after the interaction using heart rate (associated with anxiety) indicated that high responsiveness decreased anxiety for those in the normal range of fear of intimacy, but low responsiveness was more effective at decreasing anxiety in participants with highest FOI; high responsiveness did not decrease physiological arousal in high FOI participants. These data suggest important modifications to provision of therapeutic ACL that may need to occur in clinical interactions with certain client populations.

• Predictive Validity of Awareness, Courage, and Responsiveness (ACR) in a General Psychiatric Sample and Non-psychiatric Dyads
Adam Kuczynski, University of Washington
Jonathan W. Kanter, University of Washington

Social functioning deficits, including deficits in intimacy, are strong risk factors for psychological distress in general, physical health problems, and various psychopathologies in particular. Given that social functioning deficits, by definition, occur in a particular context, contextual-behavioral therapies are particularly equipped to target such deficits. The current study examines the predictive validity of a new measure of ACR - The Awareness, Courage, and Responsiveness Scale (ACRS) - using data from a longitudinal (followed over five months) general psychiatric sample (N = 50) and a non-clinical sample of romantic and non-romantic dyads (N = 70) taking part in a randomized controlled trial. Results indicated that the ACRS has strong internal reliability and is characterized by similarity in scores among dyads. The ACRS was a significant predictor of general psychiatric symptomatology and quality of life, however this relationship disappeared when loneliness was entered into the model. Treatment implications of these findings are discussed.

• Awareness, Courage, and Responding (ACR) in PTSD: Psychometrics, Predictive Validity, and Sensitivity to Change During Treatment
Chad T. Wetterneck, Rogers Memorial Hospital
Peter Grau, Marquette University
Sonia Singh, Bowling Green State University

PTSD has a pervasive impact on interpersonal intimacy, values-based behavior, and self-compassion. Most treatment models suggest cultivating interpersonal skills and emotion regulation to address avoidance and reduce trauma symptoms. Third-wave therapies fit with other evidence-based treatments to address these issues. However, validated instruments are needed to assess whether ACR constructs are reliable and valid, and if they impact outcomes. The current study examines a new ACR measure using data from 225 PTSD patients receiving third-wave enhanced exposure-based treatment in a PTSD specialty program. Results indicated that the ACR had good internal consistency, and convergent and divergent validity with admission measures. Machine learning analyses were used to predict treatment dropouts from admissions variables including psychological symptoms, therapeutic change processes, ACR, and interpersonal variables; the Courage scale was the top predictor of dropout. Individual ACR subscales demonstrated significant change over the course of treatment. A final machine learning analysis, yet to be completed, will determine whether ACR helps to predict treatment outcome. Future directions, including the use of the ACR in treatment planning, will be discussed.

Educational Objectives:
1. Demonstrate how to engage the awareness, courage, love model for use in clinical work and research. 2. List specific ACL measurement strategies. 3. Discuss how ACL predicts therapy progress and dropout for general and PTSD-specific samples.

 

15. Efficacy of brief RNT-focused ACT protocols in different settings
Symposium (10:35am-12:05pm)
Components: Original Data
Categories: Clinical Interventions and Interests, RFT, ACT, emotional disorders
Target Audience: Beg., Interm., Adv.
Location: Exclamation

Chair: Daniela Salazar-Torres, Fundación Universitaria Konrad Lorenz
Discussant: Carmen Luciano, Universidad de Almería, Madrid Institute of Contextual Psychology

Recent research on clinical RFT has identified repetitive negative thinking (RNT) as an especially counterproductive form of experiential avoidance because of its pervasiveness. RNT is usually the first response to aversive private events and some recent empirical analyses are showing that triggers of RNT are hierarchically related. This analysis has some clinical implications: (a) focusing the intervention on disrupting counterproductive patterns of RNT might be especially powerful and might produce rapid therapeutic gains; and (b) focusing therapeutic work on the triggers at the top of the hierarchy might promote greater generalization of the therapeutic outcomes due to how transformation of functions through hierarchical relations works. Some studies have been developed RNT-focused ACT protocols that have shown very promising outcomes. The current symposium will present new studies that are applying this type of protocols in different settings.

• Effect of a 2-session RNT-focused ACT protocol in emotional disorders: A randomized clinical trial
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz
María B. García-Martín, Fundación Universitaria Konrad Lorenz
Diana M. García-Beltrán, Fundación Universitaria Konrad Lorenz
Ángela Henao, Fundación Universitaria Konrad Lorenz
Andrea Monroy-Cifuentes, Fundación Universitaria Konrad Lorenz
Andrés Peña-Vargas, Fundación Universitaria Konrad Lorenz
Eduar S. Ramírez, Fundación Universitaria Konrad Lorenz

Previous preliminary studies with N=1 methodology have shown that very brief ACT interventions focused on disrupting repetitive negative thinking (RNT) can be very effective in treating emotional disorders such as depression and generalized anxiety disorder (GAD). The aim of the current study is to test the efficacy of a 2-session RNT-focused ACT protocol versus a waiting-list control in treating depression and/or GAD. The study is currently collecting data. One-hundred participants suffering from depression and/or GAD will be randomly allocated to one of the two experimental conditions. Outcome variables are emotional symptoms, whereas process outcomes are measures of experiential avoidance, cognitive fusion, values, and RNT. Pre-treatment level of symptoms and scores on other measures will be explored as potential moderator variables of the effect of the intervention. Results will be discussed in terms of the viability of this very brief ACT protocol in applied settings.

• Effect of an online RNT-focused ACT intervention on emotional disorders
Marco A. Sierra, Fundación Universitaria Konrad Lorenz
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz
Daniela Salazar-Torres, Fundación Universitaria Konrad Lorenz

Online psychological intervention is an emerging field that consists of the delivery of therapeutic assessment and treatment through information and communication technologies. Evidence suggests this might be a promising alternative to traditional psychotherapy. Online applications of third wave psychotherapy approaches have successfully decreased emotional symptomatology. The present study aims to analyze the efficacy of an online psychological intervention based on Acceptance and Commitment Therapy (ACT), which focused on undermining repetitive negative thinking (RNT) patterns. The treatment consisted of 3 modules that were delivered through one month of intervention and was based on previous protocols that showed the promising effect of RNT-focused ACT intervention. A multiple-baseline design was implemented in 30 participants suffering from moderate depression and/or generalized anxiety disorder. Data collection is currently in process. The results will be compared with the efficacy of brief RNT-focused ACT protocols.

• Effect of a brief RNT-focused ACT protocol in improving school adjustment of exceptionally gifted children
Yury A. Larrea-Rivera, Fundación Universitaria Konrad Lorenz
María B. García-Martín, Fundación Universitaria Konrad Lorenz
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz

An exceptionally gifted child stand out in general intelligence, easily learns contents of any domain, and demonstrate behavior more sophisticated than his/her reference group. However, a good number of exceptionally gifted children presents school maladjustment due to experiencing school tasks as low-demanding and boring. This usually leads to emotional difficulties and scholar failure. The current study describes the effect of a brief ACT intervention focused on disrupting rumination and procrastination, and increase valued actions in exceptionally gifted children. A multiple-baseline design across participants was used with 9 children experiencing significant levels of school maladjustment. All children were identified as exceptionally gifted by means of intelligence quotient and learning potential tests. Results are discussed in terms of how psychological flexibility can enhance the use of high-level cognitive abilities and put them at the service of valued behavioral directions.

Educational Objectives:
1. List three clinical applications of an RFT analysis of repetitive negative thinking. 2. Discuss the potential of RNT-focused ACT protocols. 3. Describe the efficacy of RNT-focused ACT protocols in different settings.

 

16. Optimizing Well-being among Individuals with Appearance Concerns
Symposium (10:35am-12:05pm)
Components: Literature review, Original Data, Case presentation
Categories: Clinical Interventions and Interests, Behavioral medicine, Appearance Concerns
Target Audience: Beg., Interm., Adv.
Location: Multiplication

Chair: Staci Martin, Ph.D., National Institutes of Health
Discussant: Joanna Dudek, Ph.D., SWPS University of Social Sciences and Humanities

Individuals with a broad array of appearance-related concerns, such as those associated with chronic illness, injury, or other body dissatisfaction, often report diminished well-being. In this symposium, three presenters engaged in research and clinical work on this diverse topic will discuss how ACT processes may be leveraged to optimize well-being among individuals with appearance concerns. The first presenter will provide an empirical background and theoretical application of ACT to the problem of appearance concerns/visible differences with case examples. The second presenter will present data on body image flexibility that support the use of the ACT model to address these issues in women with visible differences. The third presenter will present a specific application of ACT to appearance concerns, describing a novel ACT-based intervention for individuals with type 1 diabetes whose weight concerns impact management of their chronic illness. Finally, the discussant will offer thoughts on ways to move this work forward. This symposium is applicable to anyone who has a client struggling with appearance concerns or is interested in clinical research in this area.

• Context, Connection, and Compassion: Theoretical Applications of ACT for People with Appearance Concerns
Staci Martin, Ph.D., National Institutes of Health

Individuals with health 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 impair quality of life and prevent valued living. This presentation will explore how mental health professionals can employ ACT techniques to target the anxiety, depression, and low self-esteem that often accompany these visible signs of illness. We will show how people with visible differences can practice defusion from thoughts about how they “should” look along with acceptance of their appearance. We will present concrete techniques that practitioners can use to change the contextual cues, strengthen patients’ connections to others, and foster self-compassion among these individuals. Finally, connecting (or re-connecting) with values is of pivotal importance to guide patients away from a conceptual self that focuses exclusively on their illness or appearance. Through these objectives along with case examples, we aim to show how ACT can promote optimum functioning in people with appearance changes due to health conditions.

• Body image inflexibility, body appreciation and affect in women with a visible difference
Fabio Zucchelli, M.Sc., University of the West of England, Bristol, UK
P. White, Ph.D., University of the West of England, Bristol, UK
E Halliwell, DPhil, University of the West of England, Bristol, UK
H Jarman, M.Sc., University of the West of England, Bristol, UK
A Slater, Ph.D., University of the West of England, Bristol, UK
D Harcourt, Ph.D., University of the West of England, Bristol, UK

Background: The emotional experience of women with a visibly different appearance varies from anxiety and low self-esteem in some, to more positive descriptions in others. Affect in this population is likely influenced by individuals’ body image, but may also be determined by psychological flexibility towards one’s body image. Drawing from a larger cross-sectional study, this sub-study sought to test whether body image inflexibility predicts positive/negative affect beyond body image alone. Methods: 148 women aged 18-74, who self-identified as having a visible difference, completed measures of body image inflexibility, body appreciation (positive body image), and positive and negative affect. Results: Controlling for perceived noticeability of one’s visible difference, body image inflexibility statistically predicted negative affect over and beyond body appreciation. Although body image inflexibility significantly correlated with positive affect, only body appreciation uniquely predicted positive affect. Conclusion: Body image flexibility may protect against negative affect in women with visible difference, suggesting potential utility of Acceptance and Commitment Therapy for this group. The positive valence of body appreciation may account for its greater influence on positive affect.

• Dying to Control Weight (An ACT Intervention to Help Individuals Thrive with Type 1 Diabetes)
Rhonda Merwin, Ph.D., Duke University Medical Center
Ashley A. Moskovich, Ph.D., Duke University Medical Center
Lisa K. Honeycutt, MA, Duke University Medical Center

Many young women with type 1 diabetes (T1D) report taking less insulin than they should to lose weight(1,2) tripling their risk for early complications and premature death(3). Attempts to understand and treat this problem have focused on the way in which diabetes increases attention to food and body dissatisfaction(3,4). However, conventional eating disorder (ED) treatments that target these factors are less effective with T1D patients than their nondiabetic counterparts(5,6), and even when attitudes about eating/weight change, behavior may not(5). Our data suggest that EDs in T1D might be better understood by considering how confusion and distress related to T1D might turn individuals away from T1D management and toward the clear and concrete goal of weight loss. We will outline a functional-contextualistic model of EDs in T1D based on our research (5R01DK089329-03; PI: Merwin) and describe a novel, ACT-based intervention (1R21 DK106603-01; PI: Merwin). Key intervention strategies will be described as well as preliminary outcomes (n=16). Discussion will be relevant to other chronic illnesses that impact appearance, interoception or require arduous daily management.

Educational Objectives:
1. Describe three ACT-consistent techniques for helping people with appearance concerns. 2. Discuss the meaning of the term 'visible difference' and the role of body image and body image flexibility in determining positive and negative affect in people with a visible difference. 3. Describe a functional perspective to T1D patients focus on appearance, and the outcomes for a novel ACT intervention based on this formulation.

 

24. Conceptual, empirical and pragmatic innovations in the contextual behavioural science of thriving with a long-term health condition
Symposium (1:20-2:50pm)
Components: Conceptual analysis, Original Data, Case presentation
Categories: Clinical Interventions and Interests, Behavioral medicine, Persistent Health Conditions
Target Audience: Beg., Interm., Adv.
Location: Rue Sainte-Catherine

Chair: David Gillanders, DClinPsy, University of Edinburgh
Discussant: Graciela Rovner, Ph.D., Karolinska Institutet, Angered's Hospital & ACT Institute Gothenburg, Sweden.

One of the remarkable things about contextual behavioural science is the breadth of application of a small number of concepts to very diverse areas. This symposium brings together researchers and clinicians from the UK, Canada and Australia. The three presenters will outline innovative approaches to understanding and intervening in three different populations of people with health conditions: cancer survivors, people with cystic fibrosis and workers who have a long-term health problem. Two of the papers are primarily data driven, one of which is cross sectional and the other an intervention study. The third will present a novel conceptual framework with illustrative case examples. Together the papers illustrate novel data, new applications of theory and pragmatic innovations that help people to thrive within these challenging health contexts.

• Exploring the Impact of Psychological Flexibility on the Relationship between Fear of Cancer Recurrence and Adjustment in Cancer Survivors
Kate Randell, DClinPsychol, NHS Forth Valley
David Gillanders, DClinPsy, University of Edinburgh
Susie Porteous, DClinPsy, NHS Forth Valley

Fear of cancer recurrence (FOR) has been repeatedly identified as a concern for many cancer survivors. Consensus over conceptualisation and measurement of FOR is still emerging, and few interventions to reduce its impact have been tested. The current study explored the potential for psychological flexibility to mediate the relationship between severity of FOR and distress and quality of life (QOL). In a cross-sectional design, 75 post-treatment cancer survivors completed a battery of assessment measures. Relationships between predictor variables of FOR and psychological flexibility, and outcome variables of distress and QOL were explored, using multiple linear regression and Conditional Process Analysis. Severity of FOR was predictive of adjustment outcomes, and psychological flexibility mediated this relationship. Exploration of each distinct flexibility process highlighted valued living as the strongest predictor of QOL and depression, while fusion with thoughts was most predictive of levels of anxiety. Psychological flexibility and ACT may be useful in both the identification of patients at risk of poorer adjustment, and in guiding the development of interventions to reduce the impact of FOR.

• Why don't people do their treatments? A conceptual exploration of non-adherence in chronic illness using a contextual behavioural approach
Jennifer Kemp MPsych (Clinical), Royal Adelaide Hospital, Adelaide, Australia

Non-adherence to treatment is a significant problem across all areas of medicine, with estimates suggesting a non-adherence rate of about 50% for prescribed treatments (e.g. Sabaté, 2003). As a result, millions of people with chronic illness may be missing out on the potential benefits of adequate treatment. Research into adherence is scarce and inconsistent. Education alone is not sufficient, and despite the addition of motivational interviewing, on-line interventions, and various interpersonal strategies, reliable treatment adherence remains elusive. Contextual Behavioural Science opens up new opportunities for addressing treatment adherence and adds precision and richness to addressing individual barriers to adherence. By exploring the functions of non-adherence, the specific issues that undermine adherence can be identified, and treatment can be placed in a values-based context. In this conceptual paper, the presenter will provide a conceptual behavioural model for non-adherence. Using illustrative case studies of her own clients with Cystic Fibrosis, she will explore contextual behavioural approaches to address non-adherence that can help patients overcome barriers to treatment adherence, improve their health and achieve a fulfilling life.

• Helping workers with chronic health conditions: Results from an ACT based telephone coaching intervention
Dayna Lee-Baggley, Ph.D., R. Psych., Nova Scotia Health Authority
Area Day, Ph.D., St Mary's University, Halifax
Nicolle Vincent, Ph.D., R. Psych, Nova Scotia Health Authority

Many workers face personal health and wellbeing demands that create additional challenges in remaining healthy and productive at work. The negative work outcomes linked to chronic conditions are well established and include increased absences/disability (Pizzi et al., 2005), psychological symptoms (e.g., Velly & Mohit, 2017) and productivity loss (e.g., Gilmour, 2017). Yet, for many, including those with chronic conditions, working has positive effects, including social contact, structure, and meaning (e.g., Saunders & Nedelec, 2014). ACTion (Awareness & Commitment Training In Organizational Networks) is a 10-week phone-based, individual-focused coaching program that uses ACT interventions to support individuals with chronic conditions in the workplace. In particular the program focuses on providing ACT-based tools to deal with "what gets in the way" of engaging in self-care and making use of workplace resources. Aspects of the program including the participant manual and coaching techniques will be presented. In addition, results from a randomized (waitlist control) clinical trial will be presented including measures of functioning, wellbeing, engagement, and strain at pre-, post-, and 3 months post.

Educational Objectives:
1. Describe an empirically based psychological flexibility oriented approach to conceptualising fears of recurrence in cancer patients. 2. Describe a conceptual model for non-adherence to treatment and approaches to treatment using a functional contextual behavioural framework. 3. Describe an empirically based adaptation to ACT for long term health conditions for telephone delivery in organisational settings.

 

26. Exploring a past, present and future of broadening of behavioral horizons
Symposium (1:20-2:50pm)
Components: Conceptual analysis, Original Data, Didactic presentation
Categories: Theoretical and philosophical foundations, Statistical Methodology, Clinical Interventions and Interests, Educational settings, Functional contextual approaches in related disciplines, Behavioral Science, Mainstream, Data-analytic methodology
Target Audience: Beg., Interm.
Location: Rue Crescent

Chair: Michael Vriesman, M.S., Eastern Michigan University
Discussant: Michael Levin, Ph.D., Utah State University

Early behavior analysts had targets and interests that were ambitious and reflected a broad scope of practice with diverse populations and problems—often with relative success. However, a recent focus on validating tools and technologies, the rapid expansion of professionals, and current credentialing practices have presented the field of behavior analysis with challenges. Furthermore, the application of behavior analytic principles has become more limited to very specific populations. With the emergence (or re-emergence) of process-oriented assessments and interventions and expansions in the utility of behavioral health interventions, behavior analysis may again find itself poised as experts in many complex and important areas of human service and interest. This symposium will identify current barriers in the field and the potential for growth beyond scope of current mainstream practices.

• “Can someone tell me the four functions of behavior? I lost my white book.” Revisiting the Technical Drift in Applied Behavior Analysis
Stuart Law, M.A., University of Nevada, Reno

Current practices in ABA have been dominated by a focus on the standard functional analysis and the validation of evidence-based technologies. In their 1980 article, Hayes, Rincover, and Solnick attempted to capture this by applying a scoring system to articles in the JABA with respect to four dimensions of the field. The results indicated that behavior analysis was moving towards a science of validating and comparing technical efforts, in lieu of the application of conceptual principles. Today, this drift has continued and may be preventing BCBAs from being effective in the search for new and complex operants and their application. Behavioral constructs are at the heart of many important and broadly applicable ideas like Process-Based Interventions and mindfulness. However, training in understanding philosophical assumptions, and foundational concepts may be necessary to ensure behavioral professionals are able of being effective in areas outside of (and arguably even within) working with individuals with limited verbal repertoires. This discussion will revisit the idea technical drift in ABA, and explore the implications and potential future directions.

• Improving Integrated Behavioral Health Services: Capitalizing on the Similarities between Quality Improvement and Behavioral Science
Alexandros Maragakis, Ph.D., Eastern Michigan University

With the potential to improve access to behavioral health services, reduce healthcare costs, and improve overall health outcomes, the integration of behavioral and somatic healthcare services has gained much attention worldwide over the last decade. While integrated care systems are generally supported by both medical and behavioral providers, the method to integrate these services in the most efficient and effective manner remains an empirical question. The use of group designs, like randomly controlled trials, have the potential to provide insight on the overall impact of integrated care systems, but they provide minimal information on how specific processes within the system (e.g., scheduling same day appointments, utility of behavioral health screens) impact overall care. However, the use of quality improvement methods, which have become mandated in many healthcare settings, allow the clinical scientist to investigate the impact of specific processes on outcomes in a cost-efficient manner. This presentation will highlight the similarities between quality improvement and traditional behavioral methodologies, and present data-based and conceptual approaches on how behavioral science could rapidly improve integrated care services.

• Modeling ongoing acts-in-context from a contextual behavioral perspective: A network analysis approach
Adam M. Kuczynski, M.S., University of Washington
Jonathan W. Kanter, Ph.D., University of Washington

At the core of Contextual Behavioral Science (CBS) is the goal of predicting-and-influencing ongoing actions of individuals in context. Multiple methodological principles drive this goal, including the notion that research is a multi-dimensional, multi-level enterprise with precision, scope, and depth. Few data analytic techniques, however, converge at the intersection of these principles and as such, researchers are often forced to sacrifice one principle in exchange for another. In this talk, we discuss the limitations of current data analytic approaches to innovation within the CBS community and introduce network analysis as a solution to some of these issues. Network analysis is a statistical approach that allows for examination of probabilistic relations in a reticulated framework, and can be used to model the transactional relationship between environment and behavior both nomothetically and idiographically. Clinical and research implications are discussed, and practical instruction is provided.

Educational Objectives:
1. Describe the meaning of "technical drift" and how it has impacted the field of behavior analysis. 2. Apply behavior science to integrated care settings through quality improvement programs. 3. Expalin the utility of behavior science and RFT to early education.

 

28. Ecological Momentary Assessment as a CBS Tool: Empirical Applications of Ecological Momentary Assessment to Questions of Contextual Behavioral Science
Symposium (1:20-2:50pm)
Components: Original Data
Categories: Clinical Interventions and Interests, Clinical Interventions and Interests, Contextual Behavioral Methodology, Ecological Momentary Assessment
Target Audience: Interm., Adv.
Location: Rue Saint-Paul

Chair: Benjamin Pierce, M.S., Utah State University
Discussant: Andrew Gloster, Universität Basel

This symposium covers a range of applications of ecological momentary assessment (EMA) methods to various questions within Contextual Behavioral Science (CBS). We aim to demonstrate through this collection of papers the advantages of using EMA and associated analytic techniques to more deeply understand patterns of behavior in-context. The research questions cover a range of topics including the emergence and stimulus control of maladaptive eating behavior, the naturalistic effectiveness of coping responses to difficult thoughts, and the use of affective information to guide momentary behavior. Within each talk, we hope to illustrate the versatility of EMA to address the research questions as well as provide valuable information to inform the development and refinement of intervention techniques. We will therefore include a balance of methodological, theoretical, and applied implications for each topic, and hope to reach a breadth of audiences who may be interested in this exciting methodological approach.

• An ecological momentary assessment (EMA) investigation of cognitive processes for responding to difficult thoughts
Jennifer Krafft, M.S., Utah State University
Michael E. Levin, Utah State University

Research on the naturalistic use of cognitive processes for responding to difficult thoughts (i.e., defusion, reappraisal, and restructuring) in daily life has the potential to clarify theoretical questions on the consequences of these strategies and identify contextual factors that alter their effectiveness. We will report the results of an EMA study on cognitive processes in a sample of college students (expected n = 100). This presentation will provide answers to the following research questions: 1) Does momentary use of cognitive defusion, cognitive reappraisal, and/or cognitive restructuring predict momentary positive affect and values progress? 2) Are the effects of these strategies dependent upon characteristics of the thoughts targeted, such as self-relevance, importance, believability, and willingness? These results will help to provide clarity on whether these theoretically distinct processes have differential effects on well-being and values progress in the moment, and if their effects vary depending on characteristics of the thoughts addressed. Implications for clinical decision-making will be discussed, such as types of thoughts or outcomes for which specific cognitive strategies may be more effective.

• A Momentary Approach to Assessing and Treating Maladaptive Eating and Weight Control among Individuals with Type 1 Diabetes
Rhonda M. Merwin, Ph.D., Duke University Medical Center
Adhley A. Moskovich, Duke University Medical Center
Lisa K. Honeycutt, Duke University Medical Center

Individuals with type 1 diabetes (T1D) who intentionally omit insulin are at high risk for early and severe diabetes-related medical complications and premature death. Studies show 30-40% of young women with T1D omit insulin they know they need to manipulate their weight. Individuals with T1D do not fare as well in conventional eating disorder (ED) treatments, highlighting the need for innovative interventions. Studying ED behavior among individuals with T1D in the natural environment may elucidate the context in which these behaviors emerge and inform a momentary intervention strategy. We conducted an ecological momentary assessment study of individuals with T1D (5R01DK089329-03; PI: Merwin). We will present findings on the temporal patterns, situational factors and real-time precursors to ED behaviors among individuals with T1D, and describe how these data have informed the development of a novel ACT intervention that leverages mobile technology for momentary skill development (1R21 DK106603-01; PI: Merwin). Discussion will have broader implications for ecologically valid approaches to assessment and intervention of intractable behavior problems.

• Does momentary affect matter? An investigation of momentary affective discrimination and its relation to psychological flexibility processes
Benjamin Pierce, M.S., Utah State University
Michael E. Levin, Utah State University

Flexible responses to antecedent emotional states may be crucial for adaptive functioning in daily life. Past research suggests the ability to discriminate among a variety of emotional responses is important when using affective information to guide behavior and to cope with distress. However, little research has investigated the momentary associations between affective discrimination, experiential avoidance, and adaptive behavioral responses. Therefore, this paper examines the use of momentary affective information as predicted by experiential avoidance and as a predictor of adaptive behavior in a sample of 71 college students sampled over two weeks using Ecological Momentary Assessment (EMA) methods. A unique methodological strategy for studying momentary affective discrimination is described within a hierarchical linear modeling framework that distinguishes trait (between-persons) and state (within-persons) variability in this construct. The implications of the findings are discussed in relation to theoretical developments within contextual behavioral science (CBS) and to strategies for training effective discrimination of affective states in CBS-informed interventions.

Educational Objectives:
1. List ways that ecological momentary assessment strategies can address specific research questions within a contextual behavioral science perspective. 2. Describe some of the variety of statistical and analytic approaches available to interpret data from ecological momentary assessment research. 3. Explain how the findings of ecological momentary assessment research can be used to advance contextual behavior intervention practices and theory to address psychological problems.

 

30. Thriving with Medical Illness: Novel Acceptance and Mindfulness Interventions to Promote Psychological Flexibility in Adolescents and Adults
Symposium (1:20-2:50pm)
Components: Literature review, Original Data, Experiential exercises, Didactic presentation, Case presentation
Categories: Clinical Interventions and Interests, Adolescents, Physical illness, Mindfulness
Target Audience: Beg., Interm.
Location: Exclamation

Chair: Kathryn Birnie, Hospital for Sick Children
Discussant: Lilian Dindo, Baylor College of Medicine

This symposium will review three novel interventions for individuals living with chronic or recurrent pain (chronic pain, inflammatory bowel disease, opioid misuse disorder). First, an in-person 8 week mindfulness based group intervention for adolescents with chronic pain and inflammatory bowel disease will be reviewed and data presented on both child and parent outcomes. A comparison will be made with respect to adaptations needed between chronic vs relapsing pain conditions. Next, data from an ongoing pilot study of an online acceptance and mindfulness based intervention for adolescents with inflammatory bowel disease will be presented. This will include lessons learned from providing group therapy online. Lastly, a new ACT protocol for opioid weaning in adults with concurrent chronic pain and opioid misuse disorder will be presented. A clinical case series will be presented to demonstrate how ACT promotes opioid tapering in this population.

• From Development to Implementation: Adapting Mindfulness Programs for Adolescents with Chronic Pain and Adolescents with Inflammatory Bowel Disease – does one size fit all?
Danielle Ruskin, Hospital for Sick Children and York University

Research on the impact of mindfulness programs for adolescents has mainly focused on mindfulness in the schools, where mindfulness programs are delivered primarily to healthy children. Few studies document outcomes of mindfulness programs for adolescents with health conditions. Dr. Ruskin will report on a research program examining the development, effectiveness and implementation of a mindfulness program adapted for adolescents with health conditions (MBI-A). A review of the existent literature on mindfulness and acceptance approaches for adolescents with health conditions will be provided, followed by description of the MBI-A highlighting specific adaptations for youth with chronic disease. Quantitative data and findings from focus groups with adolescents will then be presented detailing feasibility, acceptability, and initial outcomes of delivery of the MBI-to two different populations: 1) Adolescents with chronic pain and 2) Adolescents with Inflammatory Bowel Disease. Discussion will include whether adolescents with chronic conditions (e.g., pain) versus relapsing/remitting conditions (e.g., IBD) respond differently to mindfulness programming. Initial findings from a concurrent parent workshop provided to parents of the adolescents in the MBI-A will be provided.

• The nuts and bolts of online mindfulness and ACT based treatment for youth with inflammatory bowel disease
Sara Ahola Kohut, Hospital for Sick Children and University of Toronto
Danielle Ruskin, Hospital for Sick Children and York University
Jennifer Stinson, Hospital for Sick Children and University of Toronto

The Internet has emerged as one of the top health information resources and modes of social communication for adolescents and is, therefore, ideally suited to the provision of online health care services. However, little research exists on online mindfulness and ACT based interventions for youth with chronic health conditions. In this talk, we will provide an overview of the literature on online mindfulness and ACT based interventions for young people with chronic health conditions. This will be followed by a description of a new online group therapy for adolescents with inflammatory bowel disease. Next, feasibility, acceptability and initial effectiveness outcomes of a pilot study of this online group will be presented. We will also show audio and video mindfulness and ACT based content that was developed in partnership with adolescents living with chronic pain, arthritis, and inflammatory bowel disease. Future directions for online mindfulness and ACT interventions in pediatric chronic disease populations will be discussed.

• ACT for Opioid Misuse and Opioid Tapering in Patients Living with Pain
Aliza Weinrib, Toronto General Hospital and York University
Philip Desormeau, University Health Network

Opioid overuse is an urgent public health crisis. Some people living with pain end up on long-term, high dose opioid therapy with elevated risk of side effects, addiction, and overdose. In more extreme cases, pain patients can develop opioid misuse disorder, and their clinical presentation includes pain and addiction components. ACT is an empirically supported treatment for both chronic pain and substance misuse, with an appropriately transdiagnostic approach. We will report on a pilot project to treat pain patients with opioid misuse disorder with a combination of ACT and buprenorphine/naloxone medication maintenance therapy. We will outline a series of case reports describing how we used ACT with these patients. A hexaflex model specifying how the key ACT processes are targeted in this population will be reviewed. We will present our published case study, as well as preliminary data from our outpatient clinic showing that ACT promotes opioid tapering. The patient perspective will be shared through patient videos. Finally, we will outline key features of our novel ACT protocol for opioid tapering in patients with pain.

Educational Objectives:
1. Describe a mindfulness program adapted for youth with chronic pain and IBD and identify differences in the wants and needs of teens from each of these populations. 2. Describe the benefits and challenges of providing mindfulness and ACT based interventions online to young people with chronic health conditions. 3. Describe how the transdiagnostic ACT approach can be applied with patients with comorbid pain and opioid abuse.

 

31. Advances in Relational Frame Theory Research of Applied Relevance
Symposium (1:20-2:50pm)
Components: Original Data, Experiential exercises
Categories: Relational Frame Theory, Clinical Interventions and Interests, Relating relations, children analogy, transference of function, avoidance, defusion, self-forgiveness, IRAP
Target Audience: Adv.
Location: Multiplication

Chair: Diana Bast, Federal University of São Carlos
Discussant: Ian Stewart, National University of Ireland Galway

The current symposium will include a number of talks in which RFT research of applied relevance will be presented. The first paper presents the effects of a commonly used ACT defusion exercise on transformation of functions through arbitrarily related stimuli. The second paper explores the effects of a hierarchy-defusion intervention on participants’ implicit (as assessed by the Implicit Relational Assessment Procedure; IRAP) and explicit self-forgiveness following perceived failure. The third paper presents a novel protocol for assessing and training the relating of relations (i.e., analogical relations) in young (3-7 year old) children. The fourth and final paper presents data on the relating of complex relational networks (i.e., analogical relations) based on same/opposite and bigger- than/smaller-than contextual cues in adults, interpreted via the Multi-Dimensional Multi-Level (MDML) model of relational framing.

• A preliminary measure of the effects of ACT metaphors on the transformation of function of arbitrarily related stimuli
Roberta Kovac, M.D., São Paulo University
William Perez, Nucleo Paradigma
Carmen Luciano, University of Almeria
Sonia Meyer, São Paulo University

This study aimed to measure the effects of an ACT metaphor delivered as a meditation exercise on the transformation of stimulus functions. After establishing two equivalence classes (A1B1C1D1, A2B2C2D2), one stimulus from each class was paired with distressing images and dissonant sound (A1) whereas another (A2) was paired with earning points. After pairing, participants also learned to produce avoidance and approach responses to these respective stimuli. Transfer of functions to equivalent stimuli (C1 and C2) was tested on the approach/avoidance task and by means of evaluative self-report measures (VAS, US Expectancy, Valence, Semantic Differential). The ACT metaphor “Leaves on the stream” was then delivered by earplug. Transfer of function tests were repeated after the intervention. Most participants emitted avoidance and approach responses to directly trained and derived stimuli. Pre/posttests results indicate no changes regarding avoidance responses and a slight reduction in the aversive function related to self-report measures.

• The Effect of Hierarchy-Defusion Intervention versus Control-Distraction on Implicit and Explicit Self-Forgiveness Following Perceived Failure
Diana Bast, Federal University of São Carlos
Jane Fitzpatrick, National University of Ireland Galway
Ian Stewart, National University of Ireland Galway

This study compared an hierarchy-defusion intervention and a control-distraction condition on participants’ implicit and explicit levels of self-forgiveness following perceived failure on an insoluble task. Participants (n=29) were first assessed for implicit and explicit self-forgiveness using the Implicit Relational Assessment Procedure (IRAP) and an explicit IRAP analogue measure respectively. They were then exposed to the insoluble task, after which they were asked to report their positive and negative feelings. They were subsequently assigned to hear either a defusion (n=14) or control-distraction (N=15) audio recording and were re-exposed to the implicit and explicit measures. Results showed a significantly positive change after the intervention on all IRAP trial-types for both groups, but a significant reduction of the negative bias for failure in the defusion condition. The (explicit) IRAP analogue measure showed no changes but there was an increase in both positive and negative feelings post-intervention for both groups. The results and the implications will be discussed.

• Assessing and Training Analogical Responding in Young Children
Elle Kirsten, National University of Ireland Galway
Ian Stewart, National University of Ireland Galway

Analogical (A:B::C:D) relational responding is a key repertoire in the development of verbal and intellectual repertoires. This paper will discuss the development and testing of a Relational Frame Theory based assessment of analogical relations in 3-7 year old children. The four stage protocol allows assessment/training of (i) non-arbitrary (physical) relations (ii) non-arbitrary analogy (relations between physical relations) (iii) arbitrary (abstract) relations and (iv) arbitrary analogical relations (relations between abstract relations). Correlational data on the performance in the analogical sections and the overall protocol, and performance on a standardized measure of language and cognition (Stanford-Binet 5) will be presented and discussed. The extent to which basic relational patterns provide the needed foundation for analogy, and training protocols to train weak or missing basic and analogical relations as identified by the assessment will also be discussed.

• Developing AARR: Relating relational networks
Cainã Gomes, Pontificia Universidade Católica de São Paulo
Dermot Barnes-Holmes, Gent University
Maria Eliza Mazzilli, Pontificia Universidade Catolica de São Paulo
William Perez, Nucleo Paradigma

This study aimed to extend previous research in relational responding. The main objective was to produce, in a bottom-up approach, relating complex relational networks based on same/opposite and bigger-than/smaller-than contextual cues. After the non-arbitrary pretraining of the aforementioned contextual cues, two four-member nonsense stimulus classes were established based on comparative (bigger-than/smaller-than) relations. Participants were trained to select stimuli on an array of eight options (all stimuli of both networks) based on a symbolic rule that established a relation (same or opposite) between two stimuli: one of network 1 and one of network 2. Training was done by relating the network 1 to network 2; and testing by relating network 2 to network 1. All participants reached the mastery criterion in the training stages and produced the predicted performances in the test. In a final stage, reinforcing and punishing consequences were varied systematically in the presence of two novel antecedent stimuli and antecedent control was observed for all seven participants. Results will be discussed in the light of the MDML framework and analogical responding.

Educational Objectives:
1. Describe recent RFT research of applied relevance. 2. Discuss RFT research on analogical networks in adults and children. 3. Discuss RFT research of clinical relevance (i.e., to ACT, self-forgiveness).

 

37. Open, aware, and engaged: ACTing and adapting across the video platform
Symposium (3:10-4:25pm)
Components: Conceptual analysis, Original Data, Experiential exercises
Categories: Clinical Interventions and Interests, Supervision, Training and Dissemination, Telehealth
Target Audience: Beg., Interm.
Location: Rue Sainte-Catherine

Chair: Erika M. Shearer, Ph.D., VA Puget Sound Health Care System
Discussant: Michael E. Levin, Ph.D., Utah State University

Clinical Video Telehealth (CVT) is a synchronous, internet-based, video teleconferencing technology to facilitate communication between providers and their patients. CVT appears to be an effective, well-accepted, and cost-effective modality to deliver evidence-based treatment to patients that may experience difficulties accessing such treatment. Despite the fact that CVT has been found to be feasible, effective, and satisfactory to both patients and providers, the overall adoption of CVT by providers has been slow. Providers, who act as gatekeepers of this modality, have an essential role in implementing CVT. The papers in this symposium seek to explore potential complexities specific to provision of Acceptance and Commitment Therapy (ACT) via CVT. The first paper in the symposium presents findings from a survey of Veterans Affairs (VA) providers related to barriers to ACT implementation via CVT. The second paper presents lessons learned from the implementation of “hybrid” ACT groups – groups that are facilitated both in-person and via CVT. The third paper presents qualitative data from the survey of VA providers as well as a process-oriented approach to ACT training.

• Taking ACTion across the computer screen: examining the clinician context
Erika M. Shearer, Ph.D., VA Puget Sound Health Care System
Alycia Zink, Ph.D., VA Puget Sound Health Care System
Lauren Hollrah, Psy.D., VA Puget Sound Health Care System

Despite research suggesting that Clinical Video Telehealth (CVT) produces results comparable to in-person mental health care with respect to assessment, treatment outcomes, therapeutic relationship, retention, and patient and provider satisfaction; this innovative modality of care remains underutilized. The current project sought to better understand barriers to providing ACT via CVT. Veterans Affairs providers who successfully completed ACT-D training were invited to complete an anonymous survey on their use of CVT and delivery of ACT via CVT. A total of 84 mental health staff completed the questionnaire. Roughly 42% of the sample endorsed using CVT; however, of that sample, less than half endorsed providing ACT via CVT. These findings point to an added layer of complexity related to provision of ACT via CVT. Potential barriers to CVT use were surveyed and challenges in implementing experiential work via CVT was the most frequently endorsed barrier followed by administrative burden and lack of training in CVT. This study extends the existing literature by determining barriers to CVT adoption with particular emphasis on the provision of ACT via CVT.

• The experience of facilitating a hybrid group: lessons learned
Lauren Hollrah, Psy.D., VA Puget Sound Health Care System
Kate L. Morrison, Ph.D., VA Puget Sound Health Care System
Lisa Glynn, Ph.D., VA Puget Sound Health Care System
Stacey M. Cherup-Leslie, Ph.D., VA Southern Nevada Health Care System
Sheeva Mostoufi, Ph.D., Behavior Therapy Center of Greater Washington
Erika M. Shearer, Ph.D., VA Puget Sound Health Care System

Acceptance and Commitment Therapy (ACT) has been well studied as an effective treatment to improve the lives of those with chronic pain. Chronic pain is a common health and mental health concern for Veterans seeking care in the Veteran Health Administration (VHA). While many Veterans suffering from chronic pain could benefit from ACT, they are often unable to access treatment due to rural locality, physical limitations, financial limitations, and conflicts with their schedule. Clinical video teleconferencing (CVT) is a modality that has been used to address these barriers. However, ACT may not be initially considered as an option to provide via CVT because of the experiential nature of the therapy. This presentation will describe the implementation of ACT groups for chronic pain using CVT through the chronic pain and primary care clinics in the VHA. The groups were offered in two formats: hybrid (in-person and CVT) and CVT alone. This presentation will summarize lessons learned from these groups and how to maintain fidelity to the ACT model through a novel platform.

• We are ACTing in a technology world: committing to a technology informed process
Alycia Zink, Ph.D., VA Puget Sound Health Care System
Erika M. Shearer, Ph.D., VA Puget Sound Health Care System
Lauren Hollrah, Psy.D., VA Puget Sound Health Care System

With a growing emphasis on video delivery for psychotherapy to increase access to mental health treatment (e.g. Telehealth or Clinical Video Telehealth) within the Veteran’s Hospital Administration (VHA), providers will likely need to develop a number of adaptations to existing evidence based treatments for use with this technology. In a recent poll, VHA clinicians who participated in the VHA’s Training and Dissemination Program for Acceptance and Commitment Therapy (ACT) reported limited use of this treatment via Telehealth and specifically identified difficulty adapting some of the techniques for use with video based platforms as a perceived barrier to implementation. Barriers identified included clinicians’ perception that the exercises would be too difficult to adapt to telehealth, while others opted for more visualization-based exercises. In rare instances, a few clinicians suggested theoretically sound modifications. This presentation will discuss the qualitative data obtained from this clinician poll as a basis for encouraging a “drop-down menu” approach, e.g., a process oriented approach, to implementation of ACT that would be more readily adaptable to video or web-based platforms.

Educational Objectives:
1. Describe provider-identified perceptions related to implementing ACT via video-based platforms. 2. Discuss considerations for adapting ACT to the telehealth modality. 3. List theoretically-driven adaptations to ACT for video-based platforms.

 

39. The Value of Health: Utilizing ACT to Promote Flexibility and Well-Being in Primary Care and Health-related Settings: ACT for Health SIG Sponsored
Symposium (3:10-4:25pm)
Components: Original Data
Categories: Clinical Interventions and Interests, Prevention and Community-Based Interventions, Behavioral medicine, Health, Primary Care Mental Health, Work Stress
Target Audience: Beg., Interm., Adv.
Location: Rue Crescent

Chair: R. Sonia singh, M.A., Bowling Green State University
Discussant: Dayna Lee-Baggley, Ph.D., Dalhousie University

Acceptance and Commitment Therapy (ACT) is a contextual behavioral therapy that utilizes several processes to promote psychological flexibility (Hayes et al., 1999). Four aspects of psychological flexibility are highly relevant to health including: (1) adapting to situational demands, (2) changing or shifting of perspective related to personal and social functioning, (c) finding balance when needs, desires, and demands of conflicts with life and (d) bold and meaningful committed action towards personal values (Kashdan & Rottenberg, 2010). ACT has been used to address health concerns, such as pain, chronic illness, and work stress (e.g., Flaxman & Bond, 2010, Luciano et al., 2014, Vowles et al., 2007). The current symposium builds upon this literature and synthesizes intervention research that evaluated the effects of ACT in pediatric primary care, women with breast cancer, and nurses and nurse aides in long-term care.

• Developing an Acceptance and Commitment Therapy (ACT)-Informed Evidence-Based Assessment Model to Guide Brief ACT-Intervention in an Integrated Pediatric Healthcare Clinic
Kimberly L. Gushanas, M.A., University of Texas

Brief ACT interventions have been utilized throughout integrated healthcare settings to address a wide array of medical and psychological needs (Strosahl, Robinson, & Gustavsson, 2012). As rates of chronic and co-occurring medical conditions continue to increase (Wu & Green, 2000), the need for flexible yet effective pediatric care models are becoming increasingly important (Dindo, Van Liew, & Arch, 2017). Although independent models exist for empirically-based screening, assessment, and intervention in integrated settings, literature is limited with regards to utilizing a comprehensive acceptance-based approach, especially within pediatric populations. This presentation will describe and outline the pilot implementation of an evidence-based screening and assessment protocol utilized within a specialized, integrated pediatric health clinic and designed to guide appropriate ACT-informed brief interventions. Two case examples will be reviewed, one highlighting the use of the protocol for an inpatient consultation, and another from outpatient tertiary care. Considerations for dissemination in pediatric settings will be discussed, as well as implications for research. Preliminary data regarding the outcomes of pilot implementation may be available at the time of presentation.

• Group ACT for breast cancer women: the usefulness of the Matrix method and Compassion based strategy
Giuseppe Deledda, Psy.D., “Sacro Cuore-Don Calabria” Hospital of Negrar

Introduce ACT protocol group intervention for women with breast cancer, with the Matrix method and Compassion based strategy. The intervention consisted of eight sessions every two weeks and two monthly follow-up sessions. In the group, patients have reflected on the suffering linked to oncological disease, the side effects of therapy, the pain and suffering in live it with the wig, and the bodily changes. The Matrix was used, in order to move patients to explore their thoughts and feelings, the behaviour strategies, the cognitive entanglement, attachment to a conceptualized self, loss of contact with the present (I-there-then), and the resulting failure in taking action related to values. The work of continuous discrimination on the I-here-now has been very useful to bring back and reinforce the work on values, even in the presence of recognized thoughts, emotions and sensations. Through the compassionate writing method, patients have had the opportunity to open up to their suffering, share the suffering of other women, and treat it with gentleness, respect, gratitude, admiration, and compassion.

• ACT for Nurses and Nurse Aides Experiencing Work Stress
Mary Moeller, M.A., Bowling Green State University
R. Sonia Singh, M.A., Bowling Green State University
Kristin A. Horan, M.A., University of Central Florida
Rachel S. Wasson, B.A., Bowling Green State University
Steve Jex, Ph.D., University of Central Florida
Clare Barratt, Ph.D., Bowling Green State University
Russell Matthews, Ph.D., University of Alabama
William H. O'Brien, Ph.D., Bowling Green State University

Nurses and nurse aides experience high rates of stress and burnout relative to other workplace populations (Levin, Hewitt, Misner, & Reynolds, 2003). Acceptance and Commitment Therapy (ACT) and other mindfulness-based therapies are becoming more widely researched as interventions for the negative appraisals and cognitive fusion that can lead to work stress and avoidance-based behaviors (Bond & Bruce, 2000; Brinkborg, Michanek, Hesser, & Berglund, 2011). The present study is a randomized controlled trial in which nurses and aides were randomly assigned to receive an ACT intervention or be put on a waiting list. The ACT intervention involved 2, two-hour sessions. The first session taught mindfulness, creative hopelessness, and that control strategies are often ineffective as a coping mechanism. The second session focused on cognitive defusion, letting go of the struggle, and values-based committed action. Intervention participants improved significantly in injury count and mindfulness. Mindfulness and acceptance mediated the effects of workplace stressors on aggression from residents, work-related frustration, and burnout. The results suggest that ACT may be an effective intervention for high-stress employees.

Educational Objectives:
1. Evaluate adaptive components and applications of an ACT-informed model of evidence-based assessment and intervention designed for specialized pediatric health settings. 2. Explain the value of a group-based ACT intervention for women living with breast cancer. 3. Describe a group-based ACT approach for work stress for nurses and nurse aides in long-term care settings.

 

40. Bringing ACT for Psychosis into the “Real World”: Recent Developments in Dissemination and Implementation: Psychosis SIG Sponsored
Symposium (3:10-4:25pm)
Components: Conceptual analysis, Literature review, Original Data, Didactic presentation
Categories: Clinical Interventions and Interests, Supervision, Training and Dissemination, Inpatient Hospitalization, Psychosis, Severe Mental Illness
Target Audience: Beg., Interm., Adv.
Location: Rue Mansfield / Rue Sherbrooke

Chair: Brandon A. Gaudiano, Ph.D., Alpert Medical School of Brown University & Butler Hospital
Discussant: Louise Johns, Oxford Health NHS Foundation Trust

ACT for psychosis (ACTp) is supported research showing that the treatment is effective at helping individuals cope with symptoms to decrease impairment and rehospitalizations. However, the dissemination of ACTp in typical community settings has lagged behind these efforts, and further work is needed to establish feasible and effective models of care for those being treated in real world settings. This symposium brings together three different research groups studying complementary ways of disseminating and implementing ACTp in inpatient and outpatient settings across different countries. The first paper will report results from a project to train routine hospital staff to integrate ACTp into the system of care in an acute-care psychiatric inpatient unit in the U.S. The second paper will describe effects on staff and patients when implementing a brief ACTp model on an inpatient unit in Sweden. The third paper will report on efforts to evaluate a group-based ACTp program for outpatients in Australia. Our discussant, Dr. Louise Johns, will comment on the current state of ACTp implementation efforts and crucial next steps.

• Researching the Effectiveness of Acceptance-based Coping during Hospitalization: Initial Results from the REACH Project
Brandon A. Gaudiano, Ph.D., Alpert Medical School of Brown University & Butler Hospital
Carter Davis, BFA, Butler Hospital
Gary Epstein-Lubow, M.D., Alpert Medical School of Brown University
Ivan W. Miller, Ph.D., Alpert Medical School of Brown University & Butler Hospital

ACT for psychosis (ACTp) has shown initial efficacy in randomized controlled trials for improving acute and post-discharge outcomes in patients with psychosis when studied in inpatient psychiatric hospitals in the U.S. However, the intervention has not been widely adopted in its current form because of its reliance on an individual-only format and delivery by doctoral-level research therapists with extensive prior experience using ACTp. The aim of the Researching the Effectiveness of Acceptance-based Coping during Hospitalization (REACH) Project is to adapt a promising acute-care psychosocial treatment for inpatients with psychosis, and to pilot test its effectiveness in a routine inpatient setting. More specifically, we describe initial results gained from: (a) modifying the ACTp treatment protocol for integration into the typical inpatient milieu; (b) completing an initial open trial to train staff and further refine the intervention based on stakeholder feedback; and (c) conducting a pilot randomized controlled trial to examine the effects of ACTp versus supportive therapy on rehospitalization rates and other clinical outcomes.

• Affecting the psychiatric ward milieu using a combination of individual treatment and staff behavior change
Mårten Tyrberg, Stockholm University & Hospital of Västmanland Västerås
Per Carlbring, Stockholm University
Tobias Lundgren, Stockholm University & Karolinska Institutet

Changing the context surrounding patients treated in psychiatric wards is a great challenge, with barriers in terms of the organization, work culture and clinical skill. We propose a model to influence the ward context by adding psychological treatment in both individual form and by teaching inpatient staff how to use a simplified ACT model to inform their daily interactions with patients. We further discuss difficulties in the implementation of psychological treatment in inpatient milieus. Results from three empirical studies in a naturalistic setting in Sweden form the basis of a model describing how access to evidence-based psychological treatment might be increased using limited extra resources. Data suggest that 1) an average of two individual ACT sessions might lessen the need for future inpatient care for psychosis patients, 2) inpatients as well as staff members themselves might benefit from staff learning and using a simplified ACT model, and 3) staff find the ACT model useful both in terms of helping patients handle psychiatric symptoms and in terms of handling their own work-related stress.

• Promoting recovery from psychosis using ACT groups in community mental health: Feasibility, acceptability and outcomes
Eric Morris, La Trobe University
John Farhall, La Trobe University & NorthWestern Mental Health
Jesse Gates, Melbourne Health
Jacinta Clemente, Melbourne Health
Eliot Goldstone, NorthWestern Mental Health

This paper will describe the ongoing evaluation of community-based Acceptance and Commitment Therapy groups for people recovering from psychosis at NorthWestern Mental Health in Melbourne, Australia. This 8-session group program has been adapted from the protocol described by O’Donoghue et al (2018), using the principles described by Butler et al (2015), and previously evaluated in the National Health Service in the United Kingdom. We will present preliminary findings of the effectiveness group ACT in helping consumers to recover, achieve improved wellbeing, and greater quality of life. Alongside these outcomes we will discuss the feasibility of running these groups in community health settings, and the qualitative feedback from participants of their group experiences. Group ACT shows promise as a low-intensity intervention to support the wellbeing and quality of life of people recovering from psychosis.

Educational Objectives:
1. Describe how routine hospital staff can be trained to adapt ACT for psychosis during inpatient care. 2. Apply the ACT model in simplified form to inpatient care. 3. Learn how to conduct feedback processes in ACT for psychosis groups and measure outcomes.

 

43. ACT processes and outcomes among high risk populations
Symposium (3:10-4:25pm)
Components: Literature review, Original Data, Didactic presentation
Categories: Clinical Interventions and Interests, Performance-enhancing interventions, Prevention and Community-Based Interventions, Supervision, Training and Dissemination, Suicide, Psychological flexibility, Youth, Inpatient care, Adolescent depression, Adolescent anxiety, Psychosis
Target Audience: Beg., Interm., Adv.
Location: Exclamation

Chair: John Donahue, Psy.D., University of Baltimore

This symposium explores ACT processes as well as ACT outcomes with high risk populations. This first presentation describes the results of two studies in which the relation between psychological flexibility and suicidal ideation (SI) was examined. In the first study, psychological flexibility predicted SI in a high risk population (i.e., individuals with Borderline Personality Disorder) over and above symptom severity. Findings of the second study are expected to reveal psychological flexibility longitudinally predicts SI in a general sample, even after controlling for relevant covariates. The second presentation provides outcome data from a randomized controlled trial of ACT for patients with psychosis conducted in Buenos Aires, Argentina. To date, ACT for patients with psychosis, an often high risk and difficult to treat population, has been ben implemented and found successful in several international settings. This current study will present the first outcome data from this region.

• Longitudinal Associations between Psychological Flexibility Processes and Suicidal Ideation
John Donahue, Psy.D., University of Baltimore
Rebecca Thompson, Ph.D., University of Baltimore
Katie Callahan, B.A., University of Baltimore

Suicide is the tenth leading cause of death in the US and the cross-national lifetime prevalence of suicidal ideation (SI) is 9.2% (Nock et al., 2008). While the psychological flexibility (PF) model of psychopathology has been examined across a range of problem domains, research in relation to SI is in its nascency (Bryan et al., 2015). We will report on two longitudinal studies examining PF processes as predictors of later SI. In a sample of 63 participants endorsing elevated Borderline Personality Disorder symptomology (study 1), the closed response style, measured using the Cognitive Fusion Questionnaire and Brief Experiential Avoidance Questionnaire, was significantly associated with SI nine months later (β = .35, p < .05), over and above baseline negative affect, depressive rumination, and suicidal desire (ΔR2 = .07). In study 2, 150 online participants will complete measures of PF (CompACT), anxious/depressive symptomology (DASS-21), and SI at baseline and three months later. We hypothesize PF will longitudinally predict SI after controlling for relevant covariates. The utility of the PF model in understanding SI will be discussed.

• Randomized controlled trial of acceptance and commitment therapy applied for psychotic patients in a public mental health hospital in Buenos Aires
Germán Teti, M.D., CATC - Hospital "Braulio Moyano"
Juan Pablo Coletti, CATC

Until now, several randomized clinical trials (RCTs) have shown that ACT is an effective treatment for the management of schizophrenias and other psychotic disorders. Bach and Hayes, applied 4 sessions of ACT to 40 psychotic patients, finding a decrease in the rehospitalization rates in the group that received the intervention. Gaudiano and Herbert, applied 3 sessions of ACT to a group of 20 psychotic patients, finding significant differences with respect to the group that received the usual treatment in relation to the discomfort caused by hallucinations. Finally, a recent RCT, published in 2017 in the British Journal of Psychiatry, randomized 53 patients to 8 sessions of ACT and 53 patients to 8 sessions of befriending, resulted in a significant difference in the ACT group in relation to the discomfort caused by the voices. The present study aims to evaluate the efficacy of ACT applied to this population of patients in a context not yet explored. The present study has been approved by the ethics and research committe of the “Braulio Moyano” hospital in Buenos Aires.

Educational Objectives:
1. Describe suicidal ideation and suicide within the context of the psychological flexibility model of psychopathology. 2. Assess the relationship between psychological flexibility processes and later suicidal ideation in comparison to other known risk factors. 3. Describe the protocol for the RCT using ACT in this study.

 

44. Metaphor Co-Creation: ACT as Practiced in Japan: Japan Chapter Sponsored
Symposium (3:10-4:25pm)
Components: Case presentation
Categories: Clinical Interventions and Interests, Clinical Interventions and Interests, co-creation of metaphor, The way of case presentation, ACT practice in various cultures, CARE Guideline, creating a metaphor
Target Audience: Interm.
Location: Multiplication

Chair: Takashi, Mitamura, Ph.D., Ritsumeikan University
Discussant: Shinji Tani, Ph.D., Ritsumeikan University

We show how ACT is practiced in Japan by focusing on metaphor co-creation and case presentation. Case research is very important for scientific progress. It helps clinicians find techniques and findings that have never been reported in a research design. An elaborate and well-designed case research consists of case formulation, the use of a single case design and an ongoing form of measurement. Case research can contribute to a strong research base (according to the CARE Guideline). The main objective of this presentation is to highlight how case research can translate to stronger evidence. The second objective is to give some examples of metaphor co-creation in Japanese and discuss cultural differences. Japanese language is said to be a contextually dependent language. A clinical conversation using a metaphor and an ACT exercise differs from English. All three speakers will: a) Give a case presentation respecting the CARE Guideline; b) Outline an intervention using a single case design; c) Give examples of metaphor co-creation; d) Demonstrate exercises which fit within Japanese culture.

• Co-creation of metaphor to observe and describe sufferings with curiosity - A case of a woman with fear of incontinence
Atsushi Seguchi, Inuyama hospital

This case report describes an intervention based on ACT for a 39-year-old woman who was unable to drive her car because of fear of incontinence, To verify the effectiveness of the intervention, AAQ-Ⅱwas administered, and the frequency of driving, the duration of driving, the number of palaces she could go to by car, and response latency until she came out of a bathroom were measured repeatedly. In the intervention phase, the client and therapist co-created a metaphor for her thoughts as “Bibili-Chan” which looks like a traditional Japanese ghost. A defusion exercise was practiced using the “ Bibili-Chan” metaphor to observe and describe the client’s thoughts with curiosity, and she underwent the exercise while driving. The therapist encouraged her to use the metaphor in difficult situations. The client then spontaneously created another metaphor for the sensation she felt in her urinary bladder and used it for accepting the unpleasant sensation. This intervention led to improvements in AAQ-Ⅱscores (from 32 to 16) and in every behavioral measurement.

• Co-creating metaphor for exploring lost values and activities: A case of a woman who had major depression due to marital troubles
Yusuke Shudo, Hiroshima International University

This case report details the treatment of a woman in her 30s who had major depression due to marital problems. A functional assessment revealed that the woman’s depressive behavior of staying in bed was maintained by avoidance of her husband or stimulus that was reminiscent of her husband. Therefore, it was necessary (1) to clarify her values and increase the frequency of behavior based on those values to make her commit to them and (2) to establish acceptance of unpleasant experiences. The first intervention was to clarify her values and schedule activities based on those values. In this phase, “exploring lost values and behavior cards” exercise was used to help her understand that having uncertain values can cause depression and that value-based activities are important in the treatment of depression. Subsequently, acceptance-based interventions were introduced. These interventions helped enforce her value-based behavior, which was not influenced by mood. Their effectiveness was confirmed through repeated measurements using standardized scales; her BDI score improved from 32 to 7 and AAQ-Ⅱ score improved from 46 to 26.

• Co-creating a metaphor for evoke curiosity about fear: A case of a woman with emetophobia
Takashi Mitamura, Ritsumeikan University

This is a case study of a woman with emetophobia or fear of vomiting. Clinical behavior analytic intervention was conducted, which consisted of 9 sessions (including some follow-up sessions). The STAI, Emetophobia-Scale, AAQ-II, and BADS were administered repeatedly to the client. The therapist conducted exposure-based intervention. Then, the therapist and the client, who is a swimming instructor, created the metaphor “searching for goldfishes in the pool” to willingly experience anxiety. This intervention proved to be effective and reduced the client’s phobia. Additionally, behavior activation-based interventions were carried out in the next phase. As the result, not only did her anxiety (STAI-State: from 64 to 24, STAI-Trait: from 63-30, and Emetophobia-Scale: from 266 to 155) and experiential avoidance (AAQ-II: from 41 to 18) reduce, but her activity levels also increased (BADS: from 18 to 49). In addition, her depression was alleviated (BDI-II: from 25 to 7) and her daily life showed improvement.

Educational Objectives:
1. Describe the checklist of the CARE Guidelines 2. Explain the important points to create a metaphor and exercise. 3. Discuss the way of ACT practice in various cultures.

 

Friday, July 27

56. Examining the Impact on ACT Processes of ACT and Exposure-Based Treatments for OCD and PTSD
Symposium (10:35am-12:05pm)
Components: Original Data, Didactic presentation
Categories: Clinical Interventions and Interests, Theoretical and philosophical foundations, OCD, PTSD, ACT, The Matrix, IBA
Target Audience: Interm.
Location: Rue Sainte-Catherine

Chair: Chad Wetterneck, Ph.D., Rogers Memorial Hospital, Marquette University
Discussant: John Forsyth, Ph.D., University at Albany, SUNY

Consistent with recent calls to move away from treatment protocols towards understanding broader, transdiagnostic processes of change (Hayes & Hofmann, 2017), the papers presented in this symposium discuss studies exploring the impact of ACT and exposure-based treatments on ACT processes. ACT has been called an exposure-based treatment, and it has been suggested that exposure may be used to strengthen any of the core ACT processes. (e.g., Luoma, Hayes, & Walser, 2017). The studies presented here offer novel methods for examining ACT-related mechanisms of change in applied settings, and they clarify the impact of ACT and exposure-based treatments for OCD and PTSD on ACT processes.

• Valued Living and Psychological Flexibility in an Exposure-based PTSD Program: Considerations for Treatment
Peter Grau, M.S., Marquette University, Rogers Memorial Hospital
Chad Wetterneck, Ph.D., Rogers Memorial Hospital, Marquette University
Michael Clark, M.Ed., University of Wisconsin-Milwaukee, Rogers Memorial Hospital

Exposure therapy for PTSD is efficient (Foa & Mclean, 2016) and effective (Eftekhari et al., 2013). However, evidence suggests holistic treatment for PTSD benefits from incorporating the pursuit of meaning and values (Bean et al., 2017; Donahue, Huggins, & Marrow, 2017; Orsillo & Batten, 2005). This study explores the impact of incorporating a focus on valued living and psychological flexibility in an exposure-based partial hospitalization PTSD treatment program. Participants (n=150) were in treatment and were mainly White (87%), heterosexual (80%), and female (80%), with an average age of 35.7 (SD=10.8). Valued Living was measured using the Valued Living Questionnaire, psychological inflexibility was measured using the Acceptance and Action Questionnaire, and PTSD symptomology was measured using the PTSD checklist for DSM-5. Initial results show that over the course of treatment, PTSD symptomology decreases while valued living and psychological flexibility increases. Secondary analyses will be conducted to see whether changes in valued living and psychological flexibility interact with changes in PTSD symptoms. This provides evidence supporting use of ACT and exposure therapy for PTSD.

• The Impact of ERP and ACT for OCD on ACT Processes: A Single Case Design Study
Brian Thompson, Ph.D., Portland Psychotherapy Clinic, Research, & Training Center

Recent research suggests ACT and ERP may work through a broader range of processes than predicted by the theories underlying each (Twohig et al., 2010). In a multiple baseline across participants single case design study, ACT processes were tracked across a combined ERP and ACT for OCD treatment protocol delivered in 45-sessions. All participants (N = 4) began with ERP. At a randomized point in treatment, ERP was suspended, and participants received 4 ACT sessions before returning to ERP. At treatment completion, changes in Y-BOCS scores indicated 3 of 4 participants were treatment responders (>35%), and 2 of 4 participants achieved symptom remission (<14; Farris et al., 2013). Visual inspection of graphed data indicated ERP effected shifts from change-focused strategies towards acceptance-based strategies (defusion; willingness), even before one participant began the ACT phase. Findings suggest exposure effects changes in ACT processes.

• Preliminary data of an ACT vs IBA RCT for OCD
Benjamin Schoendorff, M.A., M.Sc., Contextual Psychology Institute

The data of an RCT (N = 46) comparing ACT with the Inference Based Approach for OCD (IBA, O’Connor et al. 2005) will be presented. In addition to pre-post and 6-month follow-up data, an innovative analysis of mechanisms of change specific to ACT, IBA, Cognitive Therapy (CT) and Exposure with Response Prevention (ERP) will be described. The results of an analysis of the temporal evolution of the postulated mechanisms of change for each condition will be presented, evidencing the specificity or otherwise of the postulated mechanisms of change for ACT and IBA as compared with those postulated for CT and ERP.

Educational Objectives:
1. Describe the potential value in integrating ACT concepts into exposure therapy for PTSD. 2. Demonstrate how ACT and exposure may effect change in ACT processes in OCD treatment. 3. Describe the method of analyzing the temporal evolution of postulated mechanisms of change of both ACT and IBA.

 

58. A functional contextual approach to moral injury: Conceptualization, treatment, and implementation considerations
Symposium (10:35am-12:05pm)
Components: Conceptual analysis, Literature review, Original Data, Didactic presentation, Case presentation
Categories: Clinical Interventions and Interests, Theoretical and philosophical foundations, Moral Injury
Target Audience: Beg., Interm., Adv.
Location: Rue Crescent

Chair: Lauren M. Borges, Ph.D., Rocky Mountain MIRECC
Discussant: Sean M. Barnes, Ph.D., Rocky Mountain MIRECC

Exposure to morally injurious events (MIEs) is a transdiagnostic risk factor for the development and maintenance of a range of psychological symptoms and syndromes including PTSD, substance use, suicidal behavior, and depression. Relationship disconnection, spiritual disengagement, workplace difficulties, and self-care neglect often result as impaired facets of functioning. Given the prevalence of exposure to MIEs (Wisco et al., 2017) and its transdiagnostic consequences, models of conceptualization, treatment, and implementation that target the function of these symptoms over form are imperative. Three presenters will approach moral injury from a functional contextual perspective. First, Lauren Borges will present a conceptual model of moral injury and data from a qualitative study examining veterans’ perspectives about addressing moral injury in treatment. Consistent with this model, Robyn Walser will present Acceptance and Commitment Therapy for Moral Injury (ACT-MI) and will provide data supporting this intervention. Finally, Jason Nieuwsma will present data on chaplains’ engagement with moral injury and ACT. Each talk describes how in approaching moral pain, individuals can move towards finding meaning in their lives again.

• A conceptual model of moral injury and a qualitative exploration of standard moral injury treatment
Lauren M. Borges, Ph.D., Rocky Mountain MIRECC
Brooke Dorsey Holliman, Ph.D., Rocky Mountain MIRECC
Sean M. Barnes, Ph.D., Rocky Mountain MIRECC

Experiencing morally injurious events (MIEs) is increasingly recognized as a risk factor for psychopathology. Following exposure to MIEs, moral pain often results where dysphoric emotions and cognitions are experienced (Farnsworth et al., 2017). Moral pain can include both self-conscious emotions and cognitions (e.g., shame) and other-condemning emotions and cognitions (e.g., contempt). Moral injury arises when attempts to manage, control, or cope with moral pain leads to social, psychological and spiritual suffering. This conceptualization of moral injury will be presented, as will qualitative data from veterans identifying lifetime difficulties in functioning related to moral injury. Standard approaches to treating moral injury will be identified and barriers to discussing moral injury in therapy will be explored. Persistence of moral injury following standard care (often evidence based psychotherapies for PTSD) will be described. Data surrounding the perceived utility of standard interventions in treating moral injury will be presented, as will veterans’ perceptions about the importance of moral injury treatment. These data support the exploration of interventions explicitly targeting the moral pain that maintains moral injury.

• Thriving in the midst of moral pain: A presentation of pilot data supporting Acceptance and Commitment Therapy for Moral Injury (ACT-MI)
Robyn Walser, Ph.D., National Center for PTSD
Jacob Farnsworth, Ph.D., Denver VA Medical Center
Lauren M. Borges, Ph.D., Rocky Mountain MIRECC
Wyatt Evans, Ph.D., Strong Star PTSD Consortium
Kent Drescher, Ph.D., VA Palo Alto Health Care System

Acceptance and Commitment Therapy for Moral Injury (ACT-MI), was developed as a transdiagnostic psychotherapy to improve psychological functioning following exposure to morally injurious events by utilizing the social functions of moral emotions (Nieuwsma et al., 2015). Using group psychotherapy, moral pain is targeted in ACT-MI via social functionalism and functional contextualism. During ACT-MI, clients learn that moral emotions are indicators of important values; to observe their thoughts, emotions, and urges; and to practice engaging in values-consistent behavior even in the presence of moral pain. Using this conceptual model, ACT-MI will be discussed as an intervention that explicitly builds psychological flexibility related to moral pain. Data from ACT-MI pilot groups provide preliminary support for increased engagement in the present moment, improved observation of internal experiences, and increased values-consistent behavior. ACT-MI was found to be acceptable among warzone Veterans (Farnsworth et al., 2017). Data will be presented supporting the feasibility of ACT-MI. Treatment considerations for connecting individuals to meaning and purpose in their lives to promote thriving in the midst of moral pain will be explored.

• Utilizing Acceptance and Commitment Therapy to aid chaplains in addressing moral injury
Jason Nieuwsma, Ph.D., Duke University
Jennifer Wortmann, Ph.D., Visn 6 MIRECC, Durham VA Medical Center
Rebecca Morris, MDiv, Portland VA Medical Center
Jaimie Lusk, Ph.D., Portland VA Medical Center
Janet Hanson, Rev., Portland VA Medical Center
Keith Meador, M.D., Vanderbilt University

Moral injury inherently invites therapeutic attention from perceived moral authority figures, such as clinical chaplains, with prominent definitions of moral injury explicitly noting its characteristic “spiritual” impact (Litz et al., 2009). Aspects of moral injury may be particularly responsive to intervention with Acceptance and Commitment Therapy (ACT; Nieuwsma et al., 2015), a therapeutic modality that is especially synergistic with core commitments in clinical chaplaincy (Nieuwsma, Walser, & Hayes, 2016). To evidence the unique therapeutic potential for chaplains to utilize ACT in addressing moral injury, this presentation will draw on multiple data sources collected by the authors: a) a representative survey of 2,163 Veterans Affairs (VA) and military chaplains (62% response rate); b) longitudinal training outcomes from approximately 120 chaplains intensively trained and supervised in the application of ACT; and c) a two-part survey of VA chaplains’ moral injury practices (N = 109; N = 367). The presentation will also include an example from one site where chaplains are conducting an ACT for moral injury group. Clinical, research, and interdisciplinary implications will be discussed.

Educational Objectives:
1. Describe moral injury and moral pain from a functional contextual perspective and identify barriers to approaching moral injury in treatment. 2. Discuss the components of Acceptance and Commitment Therapy for Moral Injury and how these facets of treatment can empower individuals to move towards their values even in the presence of moral pain. 3) List the strengths of engaging chaplains in utilizing ACT to address moral injury.

 

59. Barriers and innovations in self-guided ACT interventions: ACTing with Technology SIG Sponsored
Symposium (10:35am-12:05pm)
Components: Original Data
Categories: Clinical Interventions and Interests, Behavioral medicine, Technology, Self-Help
Target Audience: Beg., Interm., Adv.
Location: Rue Mansfield / Rue Sherbrooke

Chair: Jennifer Krafft, Utah State University
Discussant: Ben Johnson, Ph.D., RICBT

One of the core therapist competencies required in face-to-face ACT is the ability to elicit, identify, and target psychological inflexibility processes flexibly, as they appear in the moment (i.e., dancing around the hexaflex; Luoma, Hayes, & Walser, 2007). This flexible, functional approach to behavior change is challenging to translate to self-guided interventions, which may by necessity be limited in their flexibility, if not completely static. The tension between the clinical emphasis on flexible delivery of ACT and the limitations of self-guided interventions raises major questions, such as: How do more static vs. dynamic interventions impact treatment outcomes, acceptability, and engagement? How are self-help treatment developers innovating to make self-help experiential and personally relevant? How can clinicians use self-help most effectively given its unique limitations and advantages? What should clinicians think about when integrating self-help with their practice? This symposium will present results from recent, innovative self-guided ACT interventions, with a focus on exploring these questions.

• Flexibly targeting ACT and integrating a web-delivered intervention for tobacco cessation into your practice: The WebQuit intervention
Jonathan Bricker, Ph.D., Fred Hutchinson Cancer Research Center

Up to 70% of people with mental health problems smoke cigarettes—which contributes their dying ten years sooner than those with mental health problems who don’t smoke (Tam et al., 2016). However, less than a third of mental health practitioners with clients who smoke assist with them with stopping smoking (Sharma et al., 2018). Common barriers include practitioners’ lack of skill, knowledge, time, and mechanisms for reimbursement. Fortunately, my research team has developed a free web-delivered intervention that any mental health practitioner can easily integrate into their practice without special training. WebQuit is a cigarette smoking cessation that flexibly applies the ACT model into simple four step process: 1. Make a Plan, 2. Be Aware, 3. Be Willing, and 4. Be Inspired. The largest randomized trial of ACT (N= 2637) recently showed that WebQuit has 24% quit smoking rates at 12-month follow-up—much more effective than the typical 9% found in web-delivered interventions (Bricker et al., 2018). I will demonstrate WebQuit.org and show how to flexibly integrate it into practice.

• Using mobile apps to tailor ACT skill training in-the-moment: Results from the ACT Daily app
Michael E. Levin, Ph.D., Utah State University
Jack Haeger, M.S., Utah State University
Cynthia Navarro, M.A., Utah State University
Rick Cruz, Ph.D., Utah State University

Mobile apps offer unique advantages in providing high frequency, low intensity interventions throughout people’s day, and to tailor interventions based on in-the-moment variables. This presentation will report the results of a series of trials evaluating the ACT Daily mobile app, which delivers check-in assessments throughout people's day and provides tailored skill suggestions based on responses. We will focus on results from a recently completed trial comparing 69 adults randomized to receive the tailored ACT daily app, a non-tailored version, or an assessment only version of the app (without skill coaching). This trial found the tailored app outperforms a non-tailored or assessment only version of the app on post intervention outcomes as well as in-the-moment app assessment data. We will also briefly review two other trials of ACT Daily, which found positive results when the app was used adjunctively with face-to-face therapy and as a support for clients on a therapy waiting list. We will discuss how these results may inform clinical decision making in therapy and the use of mobile apps with clients.

• Development and pilot-testing of storytelling video self-help program based on Acceptance and Commitment Therapy for depression
Lisa A. Uebelacker, Ph.D., Brown University, Butler Hospital
Brandon Gaudiano, Ph.D., Brown University, Butler Hospital
Carter H. Davis, Butler Hospital
Ivan W. Miller, Brown University, Butler Hospital

This study involved development and testing of a 4-episode video self-help intervention called LifeStories, which features real patients describing their use of coping strategies for depression based on Acceptance and Commitment Therapy. In the development process, we interviewed people with experiences of depression and ultimately selected twelve to be featured as storytellers in LifeStories. Once we created a working version and an accompanying workbook, we conducted a baseline-controlled open trial (AB design) with 11 depressed individuals. Participants reported high levels of satisfaction and transportation (i.e., engagement) after watching LifeStories. We did not observe significant changes during the 4-week baseline period in interviewer-rated depression severity (primary outcome), but we observed a significant and large effect at Week 8 post-intervention. Most participants (54.5%) showed a reliable and clinically significant posttreatment response. During the intervention period only, we observed significant improvements for self-reported depressive symptoms and aspects of mindfulness (nonreactivity). Based on participant interviews, we identified additional areas for intervention refinement. We used feedback to further refine Lifestories and are currently conducting a pilot randomized controlled trial.

Educational Objectives:
1. Demonstrate the integration of a smoking cessation app into clinical practice flexibly and effectively. 2. Explain the effects of tailoring in mobile app interventions and how tailoring is linked to clinical decision-making. 3. Describe the rationale for and impact of incorporating story-telling into a self-help intervention.

 

63. Social intimacy: A transdiagnostic target for CBS therapists
Symposium (10:35am-12:05pm)
Components: Original Data
Categories: Clinical Interventions and Interests, Clinical Interventions and Interests, psychophysiological, Functional Analytic Psychotherapy, Social relating, Heart Rate Variability
Target Audience: Interm.
Location: Multiplication

Chair: Lindsey Knott, Ph.D., Michael E. DeBakey VA Medical Center
Discussant: Michel A. Reyes Ortega, Ph.D., National Autonomus University of Mexico Faculty of Medicine

In recent years, social intimacy (intimacy) has become a key factor in research related to Functional Analytic Psychotherapy (FAP, Wetterneck & Hart, 2012; Maitland et al., 2017). While there is an emerging literature base exploring the theoretical role of intimacy in psychological distress and implementation of FAP, there continues to be a dearth of empirical investigations on the subject. In this symposium, researchers will present data-driven investigations of the role of fear of intimacy in mental and physical health, how fear of intimacy impacts committed action and behavioral activation, and how intimacy with client’s therapists affects the timing and magnitude of treatment outcomes in FAP. In these studies, intimacy will be assessed at different levels including behavioral observations, questionnaires, and physiological responses. At the conclusion of the talks, an expert in the field will discuss the larger implications of the finding and how this data can facilitate therapist, client, and treatment growth and development.

• Intimacy as a clinically relevant target: The role of intimacy in mental and physical health
Katherine E. Manbeck, M.S., University of Washington
Jonathan Kanter, Ph.D., University of Washington
Savannah Miller, University of Washington

Fear of intimacy is associated with briefer relationships and more loneliness. Lack of social support is a risk factor for a variety of physical and mental illnesses, including mortality, but the direct relationship between fear of intimacy and outcomes of interest has not been evaluated. In study 1, participants completed a battery of assessments in our research lab, and a researcher assessed their BMI and heart rate variability at baseline and during social stress (sharing vulnerably with a researcher). We examined the association between self-reported fear of intimacy and physical health, assessed using the World Health Organization self-report measure and physiological markers of health (BMI and heart rate variability). In study 2, participants completed an online battery of tests designed to capture mental health and social adjustment variables. We explored the relationship between self-reported fear of intimacy and self-reported mental health. We further examined relationship closeness as a mediator of the relationship between fear of intimacy and health outcomes. We found that fear of intimacy is a clinically relevant target that tangibly affects health.

• When relationships are the intersection of values and committed action: The role of intimacy in behavioral activation
Emily Munoz, Texas A&M University Corpus Christi
Daniel W. M. Maitland, Ph.D., Texas A&M University Corpus Christi

Committed action is sometimes defined as taking effective action guided by our values (Harris, 2009). One values domain frequently targeted in clinical practice and research is interpersonal relationships. While relationships, broadly defined, hold much importance to individuals, the exact reason that interpersonal connection or social support impacts subjective distress is not fully understood. Researchers have theorized that social intimacy may be a key variable in understanding the role of relationships in transdiagnostic distress (Wetterneck, 2012) and studies have found that intervening upon intimacy have led to significant improvement in subjective well-being (Maitland et al., 2016). Based on these and other similar findings, modalities of therapy such as Functional Analytic Psychotherapy have developed treatment models that focus primarily on interpersonal intimacy (The Awareness, Courage, and Love Model; Maitland, Kanter, Manbeck, & Kuczysnki, 2017). The current research investigates the role of approach behavior in interpersonal interactions that involve engaging in vulnerable self-disclosure (intimacy) and the impact that engaging in these behaviors has on creating an enriched environment and increased committed action that can help an individual thrive.

• Intimacy as a mechanism of change in Functional Analytic Psychotherapy
Daniel W. M. Maitland, Ph.D., Texas A&M University Corpus Christi
Amanda Murray, Texas A&M University Corpus Christi
Emily Munoz, Texas A&M University Corpus Christi

Functional Analytic Psychotherapy has shown promising initial findings as a treatment for enhancing social functioning (social intimacy) and reducing distress. However, no study has comprehensively assessed FAP’s proposed model. In FAP’s model of behavior change, first, a strong in-session relationship is developed, followed by enhanced social functioning outside of session, which finally results in decreased psychological distress. Despite the lack of a comprehensive evaluation of FAP’s mechanism, researchers have developed the tools and provided data supportive of FAP’s theoretical mechanism of change (e.g. Maitland & Gaynor, 2016, Maitland et al., 2016). This talk will present a study conducted using a multiple baseline design with individuals struggling with social functioning, that comprehensively evaluates FAP’s proposed model of change testing the following hypothesis: adherent and competent application of FAP increases client therapist intimacy and increased client therapist intimacy, in turn, increases out of session intimacy, which leads to reduced psychiatric distress.

Educational Objectives:
1. Discuss the role of intimacy in psychological distress. 2. List measurement techniques for social intimacy across a number of behavioral levels. 3. Explain the role of intimacy in Functional Analytic Psychotherapy.

 

64. Delivery of Brief, Group-Based ACT Interventions in Diverse Settings: Outcomes and Lessons Learned in Implementation
Symposium (10:35am-12:05pm)
Components: Literature review, Original Data
Categories: Clinical Interventions and Interests, Supervision, Training and Dissemination, Group Acceptance and Commitment Therapy
Target Audience: Beg., Interm., Adv.
Location: Arobase

Chair: Emily B. Kroska, M.A., University of Iowa; University of Kansas Medical Center
Discussant: Darrah Westrup, Ph.D., Indepedent Practice

The demand for psychotherapy services far exceeds the number of available therapists. Thus, group interventions have the potential to offer increased access and efficiency to care. Acceptance and Commitment Therapy (ACT) research has supported the efficacy of brief group interventions in the treatment of anxiety, depression, and health behaviors. At the same time, research examining the application of brief group ACT interventions in diverse settings and populations is growing. Because ACT is transdiagnostic, integration into medical and educational settings is not only possible, but also beneficial in reaching patients who may be unable to pursue traditional weekly psychotherapy (e.g., rural inhabitants, patients with physical disability). This symposium will discuss dissemination and implementation of brief group ACT interventions in in the context of medical centers, educational settings, and a residential treatment facility. Preliminary outcomes and lessons learned regarding implementation will be offered. The findings suggest that brief ACT is feasible and acceptable, applicable with a variety of populations, and potentially effective in predicting behavior or symptom change.

• Responding to Traumatic Stress Post Hurricane María in Puerto Rico: Brief ACT-Informed Group Intervention with School Personnel
Rosaura Orengo-Aguayo, Ph.D., Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences
Regan W. Stewart, Ph.D., Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences
Freddie A. Pastrana, M.A., Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences
Bianca Villalobos, Ph.D., Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences
Michael de Arellano, Ph.D., Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences
Joy Lynn Suárez-Kindy, Psy.D., Puerto Rico Department of Education; Carlos Albizu University
Julia Keleher, Ed.D., Puerto Rico Department of Education

Natural disasters can adversely impact children and adolescents’ emotional, behavioral, and social functioning. Schools provide an ideal setting in which to implement wide-reach interventions that can bolster resiliency and promote psychological wellness after a potentially traumatic event. Our team has established a partnership with the Puerto Rico Department of Education (PR-DE) to implement the Puerto Rico Psychological Relief Program (PRPRP). This is a multi-phase, trauma-focused intervention model designed to respond to the needs of PR-DE students, teachers, and staff at each phase of the post-disaster recovery process. This presentation will provide: 1) an overview of the PRPRP Project and its incorporation of ACT Core Processes in post disaster recovery; 2) results of Phase 1 group trainings [Psychological First Aid + ACT-informed exercises] conducted with over 500 PR-DE staff three weeks after Hurricane María devastated the island; and 3) lessons learned, including recommendations for how to incorporate brief ACT-informed interventions to aid in the post disaster recovery process.

• One-Day Behavioral Intervention for Patients with Inflammatory Bowel Disease and Co-Occurring Psychological Distress—A Pilot Study
Lilian Dindo, Ph.D., Michael Debakey Veterans Administration Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety, Houston, Texas; Baylor College of Medicine, Houston, Texas
Jason K. Hou, M.D., Michael Debakey Veterans Administration Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety, Houston, Texas; Baylor College of Medicine, Houston, Texas
Elyse R. Thakur, Ph.D., Michael Debakey Veterans Administration Health Services Research and Development Center for Innovations in Quality, Effectiveness and Safety, Houston, Texas; Baylor College of Medicine, Houston, Texas

Background: Depression and anxiety are common among patients with inflammatory bowel disease (IBD) and are associated with poor health related quality of life (HRQoL); however treatments targeting depression and anxiety for patients with IBD are lacking. In this study, we developed and tested a 1-day Acceptance and Commitment Training (ACT) plus IBD education workshop (ACT4IBD) for patients with IBD and comorbid depression and/or anxiety. Twenty patients with IBD and concomitant anxiety and/or depression attended the ACT4IBD workshop. Assessments of disease activity, HRQoL, mental health, and psychological flexibility, were completed at baseline and 3-months post-treatment. At the 3-month follow-up, patients exhibited improvements in disease activity, psychological flexibility, and distress. Qualitative feedback indicated that the intervention was valuable. This pilot study provides preliminary evidence that a 1-day workshop for patients with distress and IBD is feasible and potentially efficacious for the enhancement of quality of life and improvement in distress symptoms. A larger randomized controlled trial will provide the power needed to better assess the effects of the workshop.

• How Much is Enough in Brief Acceptance and Commitment Therapy in Treating Depressive Symptoms?
Emily B. Kroska, University of Iowa; University of Kansas Medical Center
Michael W. O'Hara, University of Iowa

The present study sought to answer how much ACT is enough to make an impact on depressive symptoms by comparing three single-session group ACT interventions that varied in length (90 minutes, 3 hours, or 6 hours). Participants completed measures of depression, social satisfaction, and key ACT processes before and after the intervention (1- and 3-months). Results indicated that depressive symptoms decreased between baseline and follow-up, and there were no differences between conditions. Expected change in avoidance and social satisfaction was observed over time, but there were no between-condition differences. Mindfulness did not change over time across groups, but differences in mindfulness were observed at 3-month follow-up between the 90-minute group and the 3- and 6-hour groups. The findings are important to consider in light of public health initiatives to increase access to mental health services. Several aspects of the current study are promising from a public health perspective: the single-session time commitment, delivery in groups, and brevity. Future research should examine the acceptability and feasibility of brief interventions compared to traditional courses of psychotherapy.

Educational Objectives:
1. Describe implementation of a brief, ACT-based group intervention, within an educational setting, after Hurricane María devastated Puerto Rico. 2. Apply ACT among patients with comorbid medical an psychological conditions. 3. Discuss the delivery of brief ACT groups in treating depressive symptoms.

 

71. Cultivating Self-Compassion and Its Relation to ACT Intervention Processes
Symposium (1:20-2:50pm)
Components: Conceptual analysis, Literature review, Original Data, Didactic presentation
Categories: Clinical Interventions and Interests, Supervision, Training and Dissemination, Self-compassion
Target Audience: Beg., Interm., Adv.
Location: Rue Sainte-Catherine

Chair: John P. Forsyth, Ph.D., University at Albany, SUNY
Discussant: Dennis Tirch, Ph.D., Director, The Center for Compassion Focused Therapy

Self-compassion (Gilbert, 2009; Neff, 2003) is increasingly making its way into evidence-based practice, both as transdiagnostic process and as an important intervention outcome (Neff & Tirch, 2013). How core ACT intervention processes, including psychological flexibility, interface with self-compassion is not well understood. Each of the data-based papers in this symposium highlights relations among core ACT intervention processes and self-compassion. The methods span experimental psychopathology work, exploring the acute impact of a brief mindfulness and self-compassion intervention on mood, to intervention studies evaluating mediational relations among self-compassion and ACT intervention processes (e.g., defusion, mindfulness, and psychological flexibility) and research exploring relations among self-compassion and psychological flexibility in the treatment of persons suffering with PTSD. Each of the studies offers novel insights into the unique and synergistic contribution of self-compassion on ACT change processes, along with practical insights and recommendations for future research and clinical practice.

• Love Yourself or Just Breathe?: The Acute Effects of Loving-Kindness Meditation vs. Traditional Mindfulness on Mood
Jamie R. Forsyth, Ph.D., Union College

A vast body of literature supports the notion that meditation can have important impacts on suffering and psychopathology; however, few studies have evaluated differential effects between various forms of meditation. This presentation will describe a study that aimed to: 1) determine if a brief meditation can have immediate effects on mood, 2) determine the validity of two different types of meditation (i.e., mindfulness and loving-kindness) and 3) evaluate the differential efficacy of the two types of meditation, specifically, whether one is more effective than the other. Undergraduate students (N = 179), who were mostly novice meditators, participated in the current study. Results demonstrated that both meditation practices were equally effective at decreasing anxiety and depressive cognitions after only one 15-minute meditation session. Additionally, both forms of meditation produced increases in self-reported self-compassion and mindfulness. Finally, it seems that breathing meditation may be more beneficial for novice meditators and that loving-kindness meditation may have the largest impact when taught after one has been introduced to a simple mindfulness practice.

• Clarifying Relations Among Self-Compassion and ACT Processes in the Treatment of Anxiety Disorders: A Test of Several Mediational Models
Eric D. Tifft, B.A., University at Albany, SUNY
Timothy R. Ritzert, Ph.D., Longwood University
John P. Forsyth, Ph.D., University at Albany, SUNY

Two RCTs, one face-to-face (Arch et al., 2012) and the other purely self-help (Ritzert et al., 2016), demonstrate that ACT is an efficacious and effective transdiagnostic intervention for anxiety disorders. Both protocols, in turn, target core ACT intervention processes and self-compassion (Neff, 2003). The purpose of this paper is to elucidate relations among self-compassion and ACT processes (i.e., mindfulness, psychological flexibility, and defusion) when each is evaluated as a mediator and as an outcome within a self-help RCT for anxiety disorders (N = 503). ACT processes and self-compassion were assessed pre and post intervention, and at 3 and 6 month follow-up. Using simple and multiple meditational models (Hayes, 2012), we will report on the relative contributions of ACT-relevant process as mediators of changes in self-compassion post-intervention, and conversely whether self-compassion mediated positive changes in ACT processes as outcomes. As will be seen, self-compassion and ACT processes are intimately intertwined. Discussion will highlight theoretical and practical considerations regarding the role of self-compassion, both as process and outcome, in relation to the ACT model of therapeutic change.

• An Analysis of the Relationship Between Self-Compassion, Psychological Inflexibility, and PTSD Severity in a Partial Hospitalization Program
Peter Grau, M.S., Marquette University, Rogers Memorial Hospital
Chad Wetterneck, Ph.D., Rogers Memorial Hospital, Marquette University

Seligowski, Miron, and Orcutt (2015) found that psychological inflexibility has a mediating effect on the impact of self-compassion of trauma symptom severity in a sample of trauma-exposed undergraduates. This study attempts to replicate and extend those results in a PTSD treatment program while using the two-factor model for the Self-Compassion Scale (Neff, 2003) and ACT-consistent measures of psychological well being (valued living and quality of life). Participants (N =147) were mainly White (87%), heterosexual (80%), and female (80%), with an average age of 35.7 (SD =10.8). Psychological inflexibility was measured using the Acceptance and Action Questionnaire and PTSD symptomology was measured using the PTSD checklist for DSM-5. Contrary to the previous findings, SEM results show that self-compassion predicts both PTSD symptoms and psychological wellbeing in the presence of psychological inflexibility. Additionally, psychological inflexibility predicts psychological health and PTSD symptom severity. This study provides evidence in support of targeting self-compassion and psychological inflexibility in PTSD treatment.

Educational Objectives:
1. Describe the importance of a single session meditation for novice meditators and the clinical implications for selecting an optimal mindfulness exercise when targeting self-compassion. 2. Describe empirical relations between self-compassion and ACT processes and the practical implications of this work for mental health practice. 3. Explain the potential benefits of cultivating self-compassion and targeting psychological inflexibility in PTSD treatment.

 

73. Importance of Values in Therapy: Empirical Evidence: Greek-Cypriot Chapter Sponsored
Symposium (1:20-2:50pm)
Components: Conceptual analysis, Literature review, Original Data
Categories: Clinical Interventions and Interests, Prevention and Community-Based Interventions, Values
Target Audience: Beg., Interm., Adv.
Location: Rue Crescent

Chair: Andrew Gloster, University of Basel
Discussant: Megan Kelly, Edith Nourse Rogers Memorial Veterans Hospital and University of Massachusetts Medical School

Values and valued action are a crucial aspect of the ACT model. Working on values during interventions can facilitate and enhance work on other components of the model. Clarifying values and building up patterns of reinforcing action can be emotionally intense, for both the client and therapist/trainer. Arguably, values are one of the key reasons the ACT model resonates with practitioners and leads to meaningful change in the clients we serve. Empirical verification of some these theoretical positions are lacking, however. This symposium will empirically examine how and in what way values impact interventions and in turn are changed during interventions. The presentations in this symposium will present data from studies that both do and do not directly target values (i.e., ACT & CBT) as well data from studies that assessed values during technological interventions. Data will be discussed with respect to possible theoretical and clinical refinements.

• Values, value conflicts, and change
Juergen Hoyer, Technische Universitaet Dresden, Institute for Clinical Psychology and Psychotherapy
Jasmin Čolić, Technische Universitaet Dresden, Institute for Clinical Psychology and Psychotherapy
Gerd Gruebler, Technische Universitaet Dresden, Institute for Philosophy
Andrew Gloster, University of Basel, Clinical Psychology and Epidemiology

We investigated a) which domains of living psychotherapy patients value and b) to what extent valued action changes during psychotherapy. Furthermore, we examined the degree to which valued domains were experienced as compatible (“conflicted”) with one another. In Study 1, we applied the Valued Living Questionnaire (VLQ; German version) pre- and post-treatment and at 6 month follow-up in over 500 patients at a university CBT outpatient clinic, all reliably diagnosed with standardized interviews. In Study 2, a study with N = 104 philosophy students, we explored how values included in the VLQ (e.g., family, friendship, work, physical self-care) interrelate and form consonant vs dissonant relationships. Data show that value-oriented action increased through therapy, but only in the magnitude of a small effect. Study 2 demonstrated that while some values are well in harmony (e.g., family and physical self-care) others are not (e.g., parenting and work). Integrating these findings we will emphasize the idea that an increase in valued action in some areas can either be helpful or bring about new challenges in other areas.

• How Daily Engagement in Values Impacts Outcomes and Prosocial Activities
Andrew Gloster, Ph.D., University of Basel
Marcia Rinner, University of Basel
Andrea Meyer, University of Basel

Values are behaviors and as such are constantly changing in response to numerous contextual factors. Retrospective recall of non-static behaviors is susceptible to numerous biases. Research on values needs to account for their dynamic nature in part by collecting data in the environment (ESM) and more frequently than pre-post treatment. In this presentation, we will present data from two studies with repeated measures data that inform on how values function. In study one, weekly assessments collected from n = 51 treatment-resistant patients will be presented. Analyses will examine the temporal progression of change for values in relation to other variables (e.g., symptoms, avoidance). In study two, daily assessments (i.e., every three hours) collected from n = 118 participants with Major Depression, n = 47 participants with social phobia, and n = 119 controls will be presented. Analyses will test whether participants’ daily engagement in personally defined valued actions is associated with increased mood and prosocial behaviors. Together, these studies will provide information about the conditions that increase and decrease the impact of daily valued behaviors.

• Valued living: How an ACT intervention for chronic pain affects chronic pain patients' values-consistent living?
Michaela Paraskeva-Siamata, University of Cyprus
Maria Karekla, University of Cyprus
Vasilis Vasileiou, University of Cyprus
Evaggelos Karademas, University of Crete
Savvas Papacostas, Cyprus Institute of Neurology and Genetics

Chronic pain is a health condition, related to numerous negative consequences for the life of patients, their families and the health care system. Acceptance and Commitment Therapy (ACT) is considered an effective intervention to deal with chronic pain. As values-consistent living is one of the main targets of ACT, the present study aims to examine the effectiveness of an 8-week group ACT intervention for chronic pain on valued-living. Specifically, it will examine session by session changes in values-consistent living, associating it with changes in other ACT model components and changes. Fifty-eight Greek and Greek-Cypriot chronic pain patients (80.80% women, age M=52) received the group intervention and completed a set of questionnaires including the Bull's Eye measure of values-consistent living in every session. Statistical analyses will help us understand how the specific intervention affected participants' values-consistent living through the intervention and afterwards, and which ACT components produced the maximum change in valued-living.

Educational Objectives:
1. Explain how and in what way values impact interventions and in turn are changed during interventions. 2. Describe session by session changes in values-consistent living, associating it with changes in other ACT model components and changes. 3. Evaluate possible theoretical and clinical refinements in values work.

 

77. Using ACT to enhance performance and well-being
Symposium (1:20-2:50pm)
Components: Conceptual analysis, Original Data, Didactic presentation, Case presentation
Categories: Performance-enhancing interventions, Clinical Interventions and Interests, Clinical Interventions and Interests, Prevention and Community-Based Interventions, Performance-enhancing interventions, Educational settings, Organizational behavior management, Functional contextual approaches in related disciplines, Applied psychology, space psychology, mindfulness, ACT, perormance psychology, group cohesion, stress, isolation, music performance anxiety, performance enhancement, imposter syndrome
Target Audience: Beg., Interm., Adv.
Location: Exclamation

Chair: David Juncos, Psy.D., Horstein, Platt & Associates (private practice in Philadelphia, PA)

This symposium presents the utility of ACT to help enhance performance and well-being in various contexts. The first paper explores the psychological human factors involved in human space exploration, describes findings from Mars analogue mission simulations and discusses how contextual behavioural science may be beneficial in this context. The second paper presents results of a study comparing efficacy of an ACT intervention and a solutions problems skills protocol intervention for improving academic perormance in university students. The third paper presents results of three studies in which ACT was used to treat music performance anxiety and discusses how the results relate to larger discussions on ACT’s proposed mechanisms of change. Finally, the fourth paper describes the relationship between Impostor Phenomemon and Burnout, and how these relate to experiential avoidance, while presenting study results assessing these variables among psychology students.

• Contextual Behavioural Science for Building Cohesive Groups and Maintaining the Productivity and Well-being of Astronauts and the Mission Support for Long-duration Space Missions
Karoly Schlosser, Ph.D. researcher in psychology, Institute of management Studies, Goldsmiths, University of London
Frank Bond, Director, Institute of Mangement Studies, Goldsmiths, University of London

Applied psychology in space exploration is becoming vital (Vakoch, 2011) as humans are preparing to take the next leap to explore space and establish colonies on the Moon and Mars. The endeavours of becoming inter-planetary species will require significantly longer missions and so it is crucial for astronauts and mission support to perform outstandingly, whilst maintaining their psychological well-being and performance in situations that have not yet been fully examined. In order to successfully accomplish mission outcome in such extreme and isolated environments astronauts and their team need to remain psychologically flexible in supporting each other and addressing unexpected issues. We believe that contextual behavioural science underpinned by over two decades of empirical research, is well placed to improve the psychological and behavioural skills needed for such demanding missions; research clearly shows that acceptance and commitment based trainings improve mental health, productivity, prosocial behaviour and innovation by increasing people’s psychological flexibility, even among high performance groups.

• Comparison of a Solutions Problems Skills protocol vs Psychological Flexibility protocol in improving academic performance in university students
María Belén García-Martín, Fundación Universitaria Konrad Lorenz
Cindy Bermúdez, Fundación Universitaria Konrad Lorenz
Diana C. Riaño, Fundación Universitaria Konrad Lorenz
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz

The academic performance has been widely studied, explaining it as the quantity and quality of knowledge reflected in the grades obtained by a student. There are multiple factors that can influence this performance, as sociocultural, economic, contextual and psychological factors. Recent investigations show that emotional intelligence is a component that has relation in the academic results, even more than the intellectual quotient than the students. There are also some studies that show that psychological flexibility has a relevant role in academic performance and intervention that promote them can have an effect on it. The aim of the present study is to compare the effect of two interventions for improving academic performance: one intervention based on increasing problem solving skills and one intervention based on acceptance and commitment therapy. An experimental design with a waiting-list control group was implemented. The results will be discussed according to the differences found in the efficacy of both interventions.

• Acceptance and Commitment Therapy as a clinical performance anxiety treatment and enhancement program for musicians
David Juncos, Psy.D., Horstein, Platt & Associates (private practice in Philadelphia, PA)

Acceptance and commitment therapy shows promise as a treatment for music performance anxiety (MPA) and as a potential performance enhancement (PE) program for musicians with MPA. In this paper the results of three studies in which ACT was used to treat MPA will be discussed: 1) a single-case design with a professional rock/pop drummer (Juncos et al., 2014), 2) a single-case design with a student violinist (Juncos & Markman, 2015), 3) and a pilot study with seven vocal students (Juncos et al., 2017). How the results of these studies relate to larger discussions of ACT's proposed mechanisms of change (e.g., Ciarrochi et al., 2010) will also be discussed, namely, that increases in psychological flexibility are thought to be due to acceptance of unwanted symptoms, increased cognitive defusion, reduction of experientially avoidant behaviors, and increased valued action. Future directions for this line of research will be mentioned.

• ”I don’t want to be an impostor and it’s burning me out!”
Andreas Larsson, Ph.D., Stockholm University
Tord Ohlsson, Stockholm University

Burnout is work-related sudden loss of energy, to the point where work is often no longer possible. Oftentimes family and personal life suffering greatly and individual suffering is huge. This a rising problem in the western world. Mental health providers are amongst the most at risk. A common stressor for burnout is impostor phenomenon (IP) - the experience of not being good enough, knowledgeable enough or productive enough despite evidence of the contrary. In this study it was hypothesized that Experiential avoidance (EA) could be seen as a contender for describing the relationship between the two or even behind both of them. Psychology students were asked to complete measures of IP, Burnout and EA and results provided supported the hypothesis that IP predicted Burnout but when including EA it is a better predictor of both. This paper will describe the research and give implication for treatment.

Educational Objectives:
1. Describe our findings in Mars analogue mission simulations and discuss how contextual behavioural science may be benefitial in this extraordinary context. 2. Describe two interventions to promote academic performance 3. Explain possible mechanisms by which ACT may effectively treat music performance anxiety and possibly enhance performance skills.

 

78. Shame, Stigma, and Stress: Barriers to Thriving for Gender and Sexual Minorities: Gender and Sexual Diversity SIG Sponsored
Symposium (1:20-2:50pm)
Components: Original Data
Categories: Clinical Interventions and Interests, Prevention and Community-Based Interventions, Barriers to treatment, gender and sexual minorities
Target Audience: Beg., Interm., Adv.
Location: Multiplication

Chair: R. Sonia Singh, M.A., Bowling Green State University
Discussant: Matthew Skinta, Ph.D., Palo Alto University

Minority stress is defined as the model of psychological stressors experienced by people who identify as a part of marginalized and stigmatized groups (Meyers, 1995). Gender and sexual minorities are defined as individuals experiencing minority stress due to living in a heterocentric, cisgender society. Minority stress studies have consistently and reliably found that sexual minority individuals experience higher rates of depression, anxiety, suicidal ideation, self-injurious behavior, substance abuse, and stigmatization than heterosexual individuals (as cited in Skinta & Curtin, 2016). Further, gender and sexual minority individuals are less likely to seek treatment due to their experiences of discrimination and minority stress. Given this experience of minority stress, there has recently been a push towards addressing and understanding contextual behavioral variables when working with gender and sexual minority clients (Skinta & Curtin, 2016). This symposium will synthesize basic research related to the impact of shame, stigma, and stress on gender and sexual minority individuals, as well as the importance of addressing these variables from a contextual behavioral perspective and implications for treatment.

• Thriving at the intersections: Minority stress and coping in sexual minority Latinxs in the U.S.A.
Néstor Noyola, B.S., Clark University
Esteban Cardemil, Ph.D., Clark University

Sexual minority Latinxs (SMLs) experience the intersections of multiple systems of oppression (e.g., racism and heterosexism), and thus face unique minority stress. Given the dearth in the literature, we conducted a qualitative study using an intersectionality framework to explore SMLs’ experiences of minority stress and coping responses. Semi-structured interviews were conducted with 17 self-identified sexual minority Latinx adults (Mdnage = 25) recruited online. There was diversity in sexual orientation (24% identified as lesbian, 29% as bisexual, 12% as pansexual, 29% as gay and 6% as queer), with most identifying as female (58%). Approximately half identified as immigrants. Preliminary thematic analyses suggest that anticipating family rejection, internalizing heterosexism and racism, and experiencing discrimination/microaggressions represent main areas of minority stress for SMLs. In the face of these stressors, coping entailed separating private life from public life, focusing on the future, and understanding the impermanence of the present. Implications for ACT processes (e.g., present-moment awareness, psychological openness, and values-based action) will be discussed.

• Substance Use and Fear of Stigma Among Gender and Sexual Minority Individuals
Madeline Benz, M.S., Clark University
Kathleen Palm Reed, Ph.D., Clark University

Experiences of everyday discrimination and stigma may influence substance use severity and treatment-seeking behaviors among gender/sexual minority (GSM) young adults. Fear of stigma, rather than the anticipation or experience of stigma, may predict these outcomes . Further, fear of stigma may be particularly relevant among individuals who experience intersecting marginalized identities. Thus, the present study used an anonymous online survey to examine these associations among a national sample of 67 individuals who identified as a GSM and endorsed substance use problems. There were significant linear correlations between severity of alcohol use problems and both anticipated and fear of minority-related stigma (ps<.05), as well as between fear of minority-related stigma and past help-seeking behavior (p=.02). Preliminary regression analyses indicate that fear of minority-related stigma predicts increased severity of alcohol use problems (β=.38, p<.01). Additionally, reported fear of minority-related stigma is associated with a higher likelihood of having received substance use treatment in the past (Expβ=1.08, p=.01). Additional analyses and implications regarding directions for prevention and intervention will be discussed from a contextual behavioral perspective.

• Sexual Minority Work Stress: Barriers and Potential Solutions
R. Sonia Singh, M.A., Bowling Green State University
William H. O'Brien, Ph.D., Bowling Green State University

Sexual minority individuals often experience harassment, incivility, and discrimination in the workplace (Sears & Mallory, 2011). Although it is important to fight discrimination, it is also important that sexual minorities have resiliency to live in a heterocentric world. Bond and Lloyd (2016) provided suggestions for developing psychological flexibility and related constructs at an individual level to build resilience. The authors discuss the importance of safe disclosure as being important to safety and resilience in the work place. Some potential barriers to disclosure may be intrapersonal (e.g., shame) or environmental (e.g., workplace climate). The current study (n = 312) examined variables that may act as barriers to resiliency. Regression analysis was used to test whether shame significantly predicted fear of disclosure at work when controlling for work place climate. The results of the regression with two predictors was significant, (R2 =0.55, F(2,263)=108.72, p<.001). It was also found that shame predicted fear of disclosure independent from LGBT workplace climate (β = .27, p<.001). Implications of these findings for intervention with sexual minority work stress will be discussed.

Educational Objectives:
1. Discuss how racism and heterosexism intersect to influence the minority stress that sexual minority Latinxs experience in their day-to-day lives. 2. Describe how the fear of stigma associated with everyday discrimination influences symptom severity and treatment-seeking among individuals who identify as a gender or sexual minority and endorse substance use problems. 3. Describe how shame can prevent disclosure and safety in the work place and discuss how this relates to psychological flexibility and work stress in sexual minorities.

 

84. It is time to discuss race and politics: Applying CBS to address social divisions
Symposium (3:10-4:25pm)
Components: Original Data
Categories: Educational settings, Clinical Interventions and Interests, Racism, politics
Target Audience: Beg.
Location: Rue Crescent

Chair: Mariah D. Corey, University of Washington
Discussant: Akihiko Masuda, University of Hawaii at Manoa

In today's challenging cultural and political context, it is more important than ever that CBS is actively engaged in generating solutions that reduce distress experienced by those who are exposed to discrimination and oppression, that we empower well-intentioned individuals to engage in values-guided committed actions, and that we improve empathy, facilitate rationale dialogues, and seek human connections across social divisions. This symposium presents results of 3 randomized studies documenting the benefits of contextual-behavioral science approaches to improve outcomes on these hot-button issues. In the first paper, results are presented from a randomized trial of a workshop-style intervention that improved White medical providers' empathy and emotional rapport towards Black patients in racially charged medical interactions. The second paper presents a randomized trial of a workshop-style intervention to reduce racial bias and improve connections among Black and White undergraduates on college campuses and the third paper presents an intervention to reduce political polarization and improve empathy among conservative and liberal undergraduates. Across these settings, results are encouraging and future work in these crucial areas is needed.

• A contextual-behavioral intervention to improve provider empathy and emotional rapport in racially charged interactions: A randomized trial
Daniel C. Rosen, Bastyr Univesity
Jonathan W. Kanter, University of Washington
Katherine Manbeck, University of Washington
Heather Branstetter, Bastyr University
Mariah D. Corey, University of Washington
Monnica T. Williams, University of Connecticut

This report presents results of a randomized controlled trial of a contextual-behavioral, workshop-style intervention that aimed to address racial biases that lead to disparities in health care and health outcomes by improving medical provider's empathy and emotional rapport towards Black patients in racially charged interactions. The intervention integrated experiential exercises from Acceptance and Commitment Therapy (ACT) and Functional Analytic Psychotherapy (FAP) to help providers practice acceptance of aversive emotions and connecting with patients in moments of heightened emotion. The sample comprised 25 medical students and early professionals, an important population to study as medical biases and behaviors become increasingly entrenched over time. Using objective coding of provider behavior in interactions with standardized Black patients who specifically disclosed racially charged information and presented in ways that might trigger negative stereotypes to the provider, we found support for positive behavior changes in intervention providers compared to a control sample of providers. Limitations, future research directions, and clinical implications for helping providers overcome bias are discussed.

• Facilitating racial harmony on college campuses: A randomized trial
Jonathan W. Kanter, University of Washington
Monnica T. Williams, University of Connecticut

This paper presents results of a contextual-behavioral, workshop-style intervention that brought 44 Black and White undergraduate students together on a college campus to decrease White student's racial bias and tendencies to microaggress, strengthen Black student's ethnic identity, and increase closeness and connection among all participants. The workshop included a didactic/discussion component and experiential exercises from Acceptance and Commitment Therapy (ACT) and Functional Analytic Psychotherapy (FAP) designed to increase acceptance and willingness in the presence of inter-racial anxiety and to facilitate closeness and connection. Compared to an active comparison condition, intervention participants demonstrated significant benefits including decreased tendencies to microaggress (White students), improved ethnic identity (Black students), and increased closeness and connection between workshop participants. Most results remained significant at a one-month follow-up. Limitations, future research directions, and pragmatic implications for improving diversity training are discussed.

• Improving relations and decreasing polarization between conservatives and liberals on a college campus: A preliminary trial
Katherine E. Manbeck, University of Washington
Adam Kuczynski, University of Washington
Daniel W. M. Maitland, Texas A&M University at Corpus Christi
Lauren Fine, University of Washington
Mariah D. Corey, University of Washington

The US has never been more divided politically. This limits consideration of alternatives, causes discord, and increases stress. This may be particularly problematic on college campuses, where conservative students are outnumbered and often feel marginalized. In this study, we examined the effectiveness of a half-day workshop to decrease polarization and improve closeness between conservatives and liberals. Informed by findings from political psychology, the intervention employed experiential exercises from Acceptance and Commitment Therapy (ACT) and Functional Analytic Psychotherapy (FAP) to encourage identification of core values and engage in vulnerable discussions of deeper reasons for core political beliefs. We collected data from 2 groups: one group of conservatives and liberals, and one of all liberals (groups did not know political composition). We found improvements in general attitudes and hostility towards outgroup members from pre- to post-workshop in both groups, and improvements in attitudes toward outgroup workshop participants that were maintained at 1-month follow up. Participants also reported arguing less than expected. Results indicated that this workshop improves connectedness between workshop participants and is acceptable to participants.

Educational Objectives:
1. Demonstrate brief experiential exercises used in interventions to decrease racism and improve political dialogue. 2. Describe primary benefits of CBS approaches to racism and political dialogue. 3. Discuss obstacles to engaging in connections across racial and political differences from a contextual-behavioral lens.

 

88. ACT for People with Pain: What We Still Have to Learn: Pain SIG Sponsored
Symposium (3:10-4:25pm)
Components: Original Data, Didactic presentation
Categories: Behavioral medicine, Clinical Interventions and Interests, Chronic Pain
Target Audience: Beg., Interm., Adv.
Location: Exclamation

Chair: Steve Hull, M.D., Mercy Pain Center
Discussant: David Gillanders, DClinPsy, University of Edinburgh, School of Health in Social Science

Chronic pain is one of the areas where ACT interventions have had the most impact (e.g., Wicksell et al, 2013; Hughes et al., 2017). However, there is still much to learn about the best way to assess ACT-related processes, the most effective delivery format for interventions, and the factors that predict negative outcomes such as opioid misuse. This symposium brings together clinical researchers who aim to broaden our knowledge base in these areas. The first presenter will describe the development of the ACTiveAssessment algorithm as a means of grouping patients by pain acceptance levels and thus individualizing rehabilitation programs. The second presenter will describe results from a mixed-methods (in-person and online) ACT intervention for individuals with a genetic syndrome and chronic pain. Our third presenter will address factors predicting risk of opioid misuse in chronic pain patients and will describe the role of psychological flexibility in these individuals. Finally, our discussant will integrate these findings and discuss how they fill some of the existing knowledge gaps as well as the directions for future research.

• ACTiveAssessment: Profiling patients’ way to manage their pain and their responsiveness using CPAQ-8 (Chronic Pain Acceptance Questionnaire-8)
Graciela Rovner, Ph.D., ACT Institutet Sweden; Karolinska Institutet; Pain Services, Angered Hospital
Fredrik Johansson, Medical Library, Danderyd University Hospital
David Gillanders, DClinPsy, University of Edinburgh, School of Health in Social Science

ACT-based programs for chronic pain yield medium to low effect sizes, leading many to search for ways to identify who responds to what kinds of treatment. Grouping patients by their pain acceptance (using the CPAQ-8) offers an understanding of their shared behavioral patterns and rehabilitation needs, in turn guiding the modularization of the rehab program. This study describes the development of the ACTiveAssessment algorithm, a clinical cut off for pain acceptance clustering. LCA replication (N=1775) confirmed the four-cluster solution found in previous research. ROC analysis showed that clinical cluster membership could predict LCA cluster membership with excellent sensitivity (.87 to .97), and specificity (.01 - .08) (AUC between 89.3%- 96.6%). The ACTiveAssessment algorithm allows clinicians to use clustering in their assessment and triage decisions, enhancing the potential for further progress in principle-driven tailoring and modularizing rehabilitation programs in a stepped care model.

• A Mixed Methods ACT Intervention for Individuals with Chronic Pain from Neurofibromatosis Type 1 (NF1): Results from a Randomized Controlled Trial (RCT)
Staci Martin, Ph.D., National Institutes of Health
Taryn Allen, Ph.D., Clinical Research Directorate/Clinical Monitoring Research Program, Leidos Biomedical Research Inc.
Kari Struemph, Ph.D., National Institutes of Health
Mary Anne Tamula, MA, Clinical Research Directorate/Clinical Monitoring Research Program, Leidos Biomedical Research Inc.
Andrea Baldwin, CRNP, National Institutes of Health
Pamela Wolters, Ph.D., National Institutes of Health
Brigitte Widemann, MD, National Institutes of Health

NF1 is a genetic syndrome associated with painful symptoms, including plexiform neurofibroma (PN) tumors that grow along the nerves. We conducted a RCT to determine effects of a mixed-methods ACT intervention among individuals with NF1, PNs, and pain. Forty-one participants were randomized to the ACT intervention or a Wait List. The intervention involved two, 2-hour in-person sessions and 8 weeks of weekly email assignments and biweekly video chats. The trainer taught mindfulness, acceptance, and values-consistent coping strategies. Questionnaires assessed pain interference, pain intensity, pain acceptance, inflexibility, and emotional wellbeing. Twenty-one ACT participants (M age=27.6 years) and 20 Wait List participants (M age=27.8 years) were included. In the ACT group, mean pain interference and pain intensity scores decreased from baseline to post-intervention (ps<.01); Wait List differences were nonsignificant. Repeated measures analyses of these variables were not significant. However, the group X time interaction for pain acceptance (CPAQ) scores was significant (F=11.45, p<.01), suggesting that the ACT intervention increased pain acceptance after just four hours of in-person treatment. More research with larger samples is needed.

• Psychological Flexibility, Pain Characteristics, and Risk of Opioid Misuse in Noncancerous Chronic Pain Patients
Amanda Rhodes, M.A., Kean University
Donald Marks, Psy.D., Kean University
Jennifer Block-Lerner, Ph.D., Kean University
Timothy Lomauro, Ph.D., VA New Jersey Health Care System

Opioids are a leading prescription medication for persistent and recurrent pain, which affects 10% - 35% of the US population annually. To our knowledge, this is the first study exploring psychological flexibility and its association with pain severity, pain interference, early aversive histories and risk of opioid misuse in chronic pain patients. Data were collected at two outpatient pain clinics in the northeastern United States. Adults (N = 99) completed a cross-sectional survey with validated measures. Findings suggest that pain severity, pain interference and early aversive history each uniquely predict risk of opioid misuse. Psychological flexibility mediated the individual pathways between pain severity and pain interference, with risk of opioid misuse. Further, pain severity predicted pain interference, mediated by psychological flexibility. Implications of findings are discussed in terms of future psychological and medical assessments and interventions for chronic pain. One’s willingness to be open, centered and engaged with the world, psychological flexibility, appears to play a significant role in the experience of and coping strategies for physical pain.

Educational Objectives:
1. Describe how algorithms based on pain acceptance scores can be used to individualize rehabilitation programs. 2. List an example of how mixed-methods ACT interventions using online components can be used for treating patients with pain. 3. Demonstrate an understanding of the role of psychological flexibility in people with pain who mis-use opioids.

 

89. Empirically evaluating smartphone app technology effectiveness in delivering and evaluating ACT interventions
Symposium (3:10-4:25pm)
Components: Original Data
Categories: Clinical Interventions and Interests, Behavioral medicine, Contextual assessment, ACT, technology, mobile devices
Target Audience: Beg., Interm.
Location: Multiplication

Chair: Javier Rizo, B.A., Duke University, Psychiatry and Behavioral Sciences
Discussant: Michael Levin, Ph.D., Utah State University, Logan, UT

Smartphones, a mobile technology device with many computer functionalities, are a ubiquitous presence in many societies around the world. As people increasingly embed these devices in their daily lives for all sorts of purposes, clinicians and researchers are turning smartphones into a healthcare tool. Smartphones can remotely deliver contextual behavioral interventions such as ACT and evaluate their effects, or remotely evaluate the effects of in-person interventions. This symposium presents the varying uses for smartphones in ACT interventions and discusses how effective smartphones are as instruments of treatment delivery and treatment assessment.

• Analyzing longitudinal user engagement data of an ACT smoking cessation app for those with serious mental illness to examine outcomes of psychological flexibility and smoking behaviors
Javier Rizo, B.A., Duke University, Psychiatry and Behavioral Sciences
Paige Palenski, B.S., Duke University, Psychiatry and Behavioral Sciences
Roger Vilardaga, Ph.D., Duke University, Psychiatry and Behavioral Sciences

Cigarettes cause 1,300 worldwide deaths per day, with tobacco use being the top preventable cause of death amongst those with serious mental illness. Smartphone apps increasingly deliver treatments for nicotine addiction. Therefore understanding user engagement patterns with these apps and its effects on smoking outcomes is critical. We will present longitudinal background analytics data from 23 participants diagnosed with serious mental illness who enrolled in a randomized controlled trial, assigned to use a smoking cessation app for 4 months. In this ongoing trial, participants are being randomized to either Learn to Quit (n=10), an ACT app designed for people with serious mental illness, or NCI QuitGuide (n=13), an app designed for the general population. Participants provide measures of smoking abstinence, app usability, and experiential avoidance. We will conduct an exploratory analysis of longitudinal engagement patterns between the two apps, examining their association with smoking outcomes and self-reported levels of experiential avoidance. The results of this study may improve our understanding of users’ engagement with mobile health apps and inform future app development efforts.

• ACT for a transdiagnostic treatment-resistant patients: Evidence from event sampling methodology and process assessments
Andrew Gloster, Ph.D., University of Basel, Division of Clinical Psychology and Intervention Science
Charles Benoy, University Psychiatric Clinics of Basel
Veronika Kuhweide, University Psychiatric Clinics of Basel
Katrin Pinhard, University Psychiatric Clinics of Basel
Klaus Bader, University Psychiatric Clinics of Basel

Therapy non-response is a common occurrence in both clinical trials and with individual practitioners. Few studies have tested whether psychotherapy is a viable option for treatment-resistant patients in general and less information is known about the processes of change vs. continued non-response. This study examined whether Acceptance and Commitment Therapy (ACT) would be helpful for a transdiagnostic group of patients with non-response to previous treatments. ACT was administered in a specialized inpatient unit via a multidisciplinary team in which patients received both group and individual therapy. Patients were given smartphones for a one-week event sampling methodology (ESM) at the beginning and end of treatment. In addition, patients completed weekly process assessments. Pilot data showed large decrease in symptoms (d = 0.9) and medium increase in meaning in life (d = 0.5). Data will be presented on compliance with the ESM, weekly process, and discuss how these factors relate to treatment outcomes.

• Examining a prototype mobile app for self-critical thoughts: A clinical component test of cognitive defusion and cognitive restructuring
Jack Haeger, M.S., Utah State University, Logan, UT
Michael Levin, Ph.D., Utah State University, Logan, UT
Woolee An, M.S., Utah State University, Logan, UT
Michael Twohig, Ph.D., Utah State University

Cognitive behavioral therapies have continued to evolve since their inception, leading to a growing field of increasingly diverse treatment approaches and components. It is important to examine the differing active effects and processes of change among treatment components, as this will aid in fostering a more precise understanding of the therapeutic methods common in today’s evidence-based practices. Mobile apps offer a promising method for conducting such clinical component tests by providing greater experimental control and a higher dosage of treatment that can be deployed in-context. This study compared the components of cognitive restructuring and cognitive defusion delivered via a mobile app. A sample of 87 adults high in self-criticism were randomized to a defusion app, a restructuring app, or waitlist condition for two weeks. Overall, results indicated that although mobile apps providing defusion and restructuring strategies are equally effective at reducing self-criticism, they appear to work through distinct processes of change. Additional key findings will be presented including: secondary outcomes, mediators of change, consistency of effects, user engagement/satisfaction, and future implications.

Educational Objectives:
1. Describe how users with serious mental illness engage with smartphone app interventions and its effects on treatment outcomes. 2. Explain how ESM is used by patients and inform about treatment processes. 3. Describe the diverging clinical impact and processes of change associated with cognitive defusion and restructuring delivered via a mobile app.

 

90. Recent Research on Verbal Processes Involved in Components of ACT and RFT
Symposium (3:10-4:25pm)
Components: Conceptual analysis, Original Data, Didactic presentation
Categories: Theoretical and philosophical foundations, Clinical Interventions and Interests, Prevention and Community-Based Interventions, RFT, Autism, perspective taking, adolescents, adults, defusion, theory of mind
Target Audience: Beg., Interm., Adv.
Location: Arobase

Chair: Natalia Baires, Southern Illinois University, Carbondale
Discussant: Jonathan Tarbox, Ph.D., BCBA-D, University of Southern California

During Acceptance and Commitment Therapy (ACT) and Relational Frame Theory (RFT), various verbal processes are observed, such as self-as-content and self-as-context statements. Furthermore, perspective taking (PT) plays a key role during said processes. In the current symposium, three studies utilizing ACT or RFT in conjunction with verbal processes are discussed. The first study, which evaluates the effects of a defusion exercise and PT interactions based on RFT, aims to alter negative statements about the self through training of deictic frames in adolescents with autism. The second study focuses on evaluating the efficacy of ACT with adolescents and adults with autism to increase self-as-context statements and decrease self-as-content statements. Moreover, data from physiological measures were obtained and subsequently stabilized while discussing negative thoughts after receiving ACT, suggesting that ACT has an effect on physiological responses. Finally, a third study will discuss how a RFT-based protocol assists in expanding PT skills in adults with autism. In combination, all three studies provide diverse insight into the role verbal processes play when components of ACT and RFT are included.

• Effects of Defusion and Deictic Frame Interactions on the Development of Self-As-Context in Individuals with Autism
Sebastián García-Zambrano, Southern Illinois University, Carbondale
Ruth Anne Rehfeldt, Ph.D., BCBA-D, Southern Illinois University, Carbondale
India Pauly Hertel, B.S., Southern Illinois University, Carbondale

The aim of this study is to evaluate the effects of a defusion exercise in combination with perspective-taking interactions protocol based on Relational Frame Theory (RFT). The protocol is designed to alter verbal statements about the self through training deictic frames (e.g., I-YOU, HERE-THERE, AND NOW-THEN) in conjunction with a defusion exercise. A pre-post design with a control group is implemented to evaluate the effects of the protocol on the probability of self-as-context and self-as-content statements. Adolescents with autism are assigned to each group based on the frequency of self-as-content statements. Each participant is interviewed individually through a structured interview aimed at identifying deictic frames and negative statements. Participants in the treatment group receive the protocol of defusion and deictic frames individually, and participants in the control group receive a Behavioral Skills Training session individually. Finally, participants are interviewed using an interview based on the identification of deictic relationships and negative statements about the self. Preliminary results showed an increase in the probability of occurrence of the self-as-context statements after the implementation of the protocol.

• Effects of Acceptance and Defusion on Verbal Self-Statements and Physiological Measures in Individuals with Autism Spectrum Disorder
Jessica Hinman, B.A., Southern Illinois University, Carbondale

The purpose of this study is to evaluate the efficacy of using Acceptance and Commitment Training (ACT) with adolescents and young adults with autism to change the function of verbal statements made about the self while talking about a negative thought. Throughout the study, participants will wear an Empatica wristband measuring physiological responses. Participants will determine a negative thought they have about themselves and discuss why they believe the thought is true, followed by a version of ACT to talk about the same negative thought. Verbal statements about the self and physiological measures before and after ACT will be compared. Preliminary anecdotal results for three typically developing adults suggest that ACT was effective in increasing self-as-context statements, and decreasing self-as-content and reason giving statements. Additionally, the physiological data show stabilization while discussing the negative thought after receiving ACT, suggesting that ACT can change the function of verbal statements and affect physiological responses. Preliminary and expected results suggest a clinical utility of ACT to improve the way individuals with autism interact with their thoughts.

• Perspective-Taking and Multiple Exemplars in Adults with Autism Spectrum Disorder
Natalia Baires, M.S., BCBA, Southern Illinois University, Carbondale
Jessica Hinman, B.A., Southern Illinois University, Carbondale
Ruth Anne Rehfeldt, Ph.D., BCBA-D, Southern Illinois University, Carbondale

Perspective-taking (PT) encompasses skills individuals require to take on perspectives of others. While this skill is frequently absent in repertoires of children with autism, adults with autism also lack key components for strong PT skills. The term "advanced theory of mind" was devised to account for the subtlety in social information and difficulty in interpreting such information, which is encountered on a daily basis. Existing literature on PT yields limited studies focusing on adults with autism, which indicates a need for such treatments. In the current study, participants, consisting of adults with autism, will complete five theory of mind (ToM) tasks. As part of exclusion criterion, participants possess an intelligence quotient of at least 90. Using a Relational Frame Theory and Acceptance and Commitment Therapy perspective, participants will expand their PT skills if low performance is demonstrated. Preliminary data obtained from typically developing adults demonstrate high scores. It is hypothesized that participants' scores on ToM tasks will improve in the post-test phase and their skills will generalize to a novel ToM task.

Educational Objectives:
1. Discuss the effectiveness of a defusion exercise and perspective taking interactions based on RFT to alter negative statements about the self. 2. Describe the efficacy of ACT on increasing self-as-context statements and decreasing self-as-content statements in conjunction with its effects on physiological responses. 3. Discuss how a protocol based on RFT can assist in increasing perspective taking skills in adults with autism.

 

Saturday, July 28

100. SMART (Strengthening Mental Abilities through Relational Training) interventions across the lifespan: Enhanced outcomes across a variety of valued indicators for school-aged children, adults with learning difficulties, and Alzheimer's patients
Symposium (10:35am-12:05pm)
Components: Conceptual analysis, Original Data
Categories: Performance-enhancing interventions, RFT, Education, Alzheimer's, Adult Learning Disability
Target Audience: Beg.
Location: Rue Sainte-Catherine

Chair: Ian Tyndall, Ph.D., University of Chichester, UK
Discussant: Robert Whelan, Ph.D., Trinity College Dublin, Ireland

This symposium showcases one of the most exciting and dynamic developments in the contextual behavioural science mission (Hayes, Barnes-Holmes, Wilson, 2012). Relational Frame Theory proposes that relational framing skills are at the core of what we understand by language and cognition, or intelligent behaviour more generally. More specifically, the symposium presents three papers that utilise the SMART (Strengthening Mental Abilities through Relational Training) online training programme to improve scores on standardised psychometric tests of intelligence, cognition, and aptitude, and also non-cognitive tests such as self-esteem and motivation to learn. Firstly, Dr. Ian Tyndall, University of Chichester, UK, presents research on the effects of SMART intervention in three schools in Ireland, one primary, and two secondary on educational attainment, self-efficacy, and motivation to learn. Secondly, Dr. Sarah Cassidy, Maynooth University, Ireland, will describe a study using SMART with adults with learning disabilities resulting in enhanced literacy and self-esteem. Thirdly, Dr. Nanni Presti, Kore University, Sicily, highlights fascinating findings of the application of SMART training with Alzheimer’s patients, with promising data that goes well beyond pharmacological treatment-as-usual.

• Critical tests of capacity of relational training to enhance educational attainment self-efficacy: Randomised control trials of the SMART (Strengthening Mental Abilities through Relational Training) online intervention program in three Irish schools
Shae McLoughlin, University of Chichester, UK
Ian Tyndall, Ph.D., University of Chichester, UK
Antonina Pereira, Ph.D., University of Chichester, UK
Teresa Mulhern, University of Chester
Sue Bentham, University of Chichester, UK

The general factor of intelligence is the best predictor of academic outcomes offered by the field of psychology. We sought to provide the first randomized controlled trials (RCTs) to test the efficacy of relational frame training for improving cognitive ability and the scholastic outcomes they predict. Study 1: Using a crossover RCT design, we assessed the effects of relational frame training on young children’s (n = 40; age 7-9) IQ, attitudes to learning, and standardised tests of their national curriculum. Study 2: Using a stepped-wedge RCT design, we assessed the effects of relational frame training on secondary school students’ (n = 170; age 13-14) IQ and summer examination results across six subject areas, controlling for baseline personality factors. Study 3: Using a crossover RCT design, we assessed the effects of relational frame training on secondary school students’ (n = 195; age 13-14) IQ, perceptual speed/attention, and summer exam results across six subject areas, controlling for baseline personality factors and gender. This paper will report on the progress of these studies to date.

• Testing the Impact of a Derived Relational Responding Intervention on Relational Skills, Full Scale IQ, literacy, attention and self esteem in adults returning to education
Sarah Cassidy, Ph.D., Maynooth University, Ireland
Bryan Roche, Ph.D., Maynooth University, Ireland
Steve Gannon, Ph.D., Maynooth University, Ireland

The current research aimed to replicate and extend a previous finding that “Relational Skills” training can lead to improvement in the general intelligence of children by testing its efficacy with adults with learning challenges, while also assessing its impact on attention and self-esteem. 12 adults returning to education at an adult literacy training initiative were first administered the Wechsler Adult Intelligence Scale, the Wechsler Individual Attainment Test, Rosenberg’s self-esteeM.Sc.ale, and the Achenbach attention scale. Group 1 participants (n=5) then began supervised online relational skills training in their adult training environment for several 30-60 minute sessions per week for several months while Group 2 (n=7) formed the waiting control group. Data trends show significant improvements in relational ability, literacy skills, attention skills and levels of self-esteem for Group 1, but not for Group 2. This research points the way towards on line educational interventions that can target not just cognitive ability, but also other skills that are critical in learning environments such as literacy, attention and self-esteem in adults with long standing learning difficulties.

• Does SMART training improve cognitive skills in Alzheimer’s patients undergoing AChI treatment? A 9-month follow-up clinical trial as an add-on intervention
Giovambattista 'Nanni' Presti, Ph.D., Kore University, Sicily
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
Annalisa Oppo, Sigmund Freud University, Milan, Italy
Bryan Roche, Maynooth University, Ireland

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 RFT training, as an add-on non-pharmacological intervention to cholinesterase inhibitors (ChEIs) to increase cognitive skills. Participants were exposed to SMART (Strengthening Mental Abilities with Relational Training) via 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 a 3- and 6-month follow-up (FU) using MODA (Milan Overall Dementia Assessment), Coloured Progressive (CPM) and attentive matrices, respectively. 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 at the end of training. Results were maintained at 3-month FU for MODA. 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.

Educational Objectives:
1. List key relational frames applied to enhance educational attainment. 2. Describe protocols for adapting relational frame theory to Alzheimer's patients. 3. Demonstrate utility of SMART training for adults with poor literacy skills.

 

102. Innovation and evaluation in ACT training: Steps towards a science of dissemination
Symposium (10:35am-12:05pm)
Components: Conceptual analysis, Original Data, Didactic presentation
Categories: Supervision, Training and Dissemination, Clinical Interventions and Interests, Supervision, Training and Dissemination, Professional Development, Training for trainers, Science of training, Novice therapists
Target Audience: Beg., Interm., Adv.
Location: Rue Crescent

Chair: David Gillanders, DClinPsy, University of Edinburgh
Discussant: Jacqueline A-Tjak, ACTCursus, Netherlands

The contextual behavioural science community is thriving. One of the practical engines of its growth is the availability of training, particularly in ACT. A great deal of international effort is focussed on delivering training, making training more accessible, and developing innovations in both the content of training and how to train people. In contrast to the vigorous and thriving activity in this area, very little is known about the actual impact of such efforts. Empirical evidence of the personal, professional and clinical impact of ACT training is limited to less than 15 peer reviewed articles. In this symposium, ACBS peer-reviewed ACT trainers present data from two novel studies, and give an overview of an innovative approach to 'training the trainers'. These papers will give delegates new data on the impact of online ACT training, new tools to evaluate ACT training, and new methods for enhancing the continuing professional development of those already giving trainings. The symposium will encourage delegates to reflect on the potential (and pitfalls) of further developing a science of training.

• The perceived impact of an online third wave CBT training among postgraduate students and mental health professionals
Frédérick Dionne, Ph.D., Université du Québec à Trois-Rivières
Luc Bourrassa, D.Ps. (c), Université du Québec à Trois-Rivières
Nadia L'Espérance, Ph.D., CIUSSS de la Mauricie-et-du-Centre-du-Québec, Université du Québec à Trois-Rivières

Despite the growing dissemination of the third-wave of cognitive and behavioral therapy (CBT) and the desire from mental health professionals and students to receive training in this approach, there are few studies evaluating its perceived benefits at a personal level. The main objective of this study is to better understand the perceived impact of a third wave CBT online university course. A Content analysis of 48 written assignments which reflect what students have learned from the course were analyzed with the use of a Nvivo software. The average age of participants is 36.6 years (σ: 11.1 years). The results are articulated around four general themes: 1) personal improvements on the therapeutic processes (e.g., acceptance, present moment); 2) the alleviation of symptoms (ex: stress, burnout); 3) increased positive experiences and quality of life (e.g, well-being, personal growth); 4) negative experiences lived through the course of the training (e.g, unpleasant emotions, difficulty with the software). The authors discuss the implications of this study as well as its limitations and suggest future research directions.

• Development and initial validation of the Mindful Healthcare Scale - a new measure of psychological flexibility for helping professionals
Gillian Kidney, DClinPsychol, NHS Grampian
David Gillanders, DClinPsy, University of Edinburgh
Lene Forrester, Ph.D., BMI Healthcare, UK

Research shows that psychological flexibility (PF) is useful to helping professionals, for both skill development, and personal wellbeing. Whilst studies have used general measures of PF, context specific measures are often more precise and sensitive to interventions. This paper describes the initial development of a new measure of PF in helping professionals: The Mindful Healthcare Scale (MHS). Exploratory and confirmatory factor analysis, plus reliability and convergent validity analyses, across two samples of helping professionals (n = 480 and n = 196) led to scale refinement. The final scale had 13 items and an excellent fitting factor structure, with 3 sub-factors corresponding to engagement, awareness, and defusion, and a higher order factor representing overall psychological flexibility in professional helping. Cronbach's alpha were .74 (engaged), .71 (awareness), .74 (defusion), and .79 (overall flexibility). The MHS correlated in the expected directions with measures of burnout (r=-.62), self-compassion (r=.58), negative reactions to other's distress (r=-.52) and general psychological flexibility (r=.68). The potential uses of the MHS for evaluating ACT training and recommendations for future research will be presented.

• ACT Training Lab - a blueprint for bespoke CPD events for ACT trainers and advanced practitioners
Graciela Rovner, Ph.D., Karolinska Institutet, Angered's Hospital & ACT Institute Gothenburg, Sweden.
Joseph Oliver, Ph.D., Contextual Consulting
Jacqueline A-Tjak, ACTcursus, Zaandam, Netherlands
Louise McHugh, Ph.D., University College Dublin, Ireland
David Gillanders, DClinPsychol, University of Edinburgh

Training for trainers is crucial to the growth of our CBS community. Delivering impactful training can be challenging, but can be made easier by working together to facilitate co-operation, connectivity and resource sharing. To this end, a small group of peer reviewed trainers met in January 2018 for a two-day retreat. This training took a skills-sharing and experimentation format, akin to a 'Training Lab'. Some outcomes of this retreat included: new developments in training people how to work with the 'self', methods to link clinical assessment and treatment decisions in more empirically based ways developing ways to incorporate movement and body awareness into trainings, new approaches for balancing the experiential and skills development elements of training consideration of ways to evaluate training. In this presentation we will share relevant materials, and you will hear an outline of the retreat format, the outcomes, impacts on trainer practice, potential uses and pitfalls encountered, in an effort to encourage other practitioners to use the Training Lab format as a model for life long education.

• Skills of Acceptance and Commitment Therapy (ACT) among novice therapists are associated with changes in depression symptoms in a brief ACT intervention
Katariina Keinonen, M.S., University of Jyväskylä
Heidi Kyllönen, M.S., University of Jyväskylä
Piia Astikainen, Ph.D., University of Jyväskylä
Raimo Lappalainen, Ph.D., University of Jyväskylä

Objective: The aim of this study was to explore whether early sudden gain (clinically significant change within two sessions) was associated with therapists’ skills of ACT when providing a brief six-session intervention for diagnosed depression. Method: A total of 37 novice therapists (students of psychology) were evaluated for process-specific skill level and global competence and adherence using the ACT Adherence Scale. Two randomly selected sessions were included in the sample (n = 74 sessions). The ratings were then analyzed in relation to the treatment results on the level of depressive symptoms. Results: Overall competence and adherence in ACT (r=0.36, p=0.030 and r=0.38, p=0.021, respectively) and especially process-specific skill levels (i.e. r=0.45, p=0.005 for defusion and r=0.48, p=0.003 for values based actions) were associated with change of depression symptoms. However, the competence level was not associated with early sudden gain. Conclusions: Our preliminary data suggested that among novice therapists, the basic skills of ACT were connected the outcome of the whole treatment, but not to early sudden gains observed after two sessions.

Educational Objectives:
1. Evaluate the perceived impact of a third wave online training on a personal level among university students and mental health professionals. 2. Critically evaluate approaches and tools for the empirical evaluation of ACT training and health staff well-being interventions. 3. Discuss the level of therapist competence and adherence in a brief ACT based intervention for diagnosed depression using novice therapists and the association between competence and outcome.

 

106. The impact of identity on thriving: Examining self-as-content in multiple contexts: Student SIG Sponsored
Symposium (10:35am-12:05pm)
Components: Original Data
Categories: Clinical Interventions and Interests, Behavioral medicine, Theoretical and philosophical foundations, RFT, Self-as-content, Identity, Psychopathology
Target Audience: Beg., Interm., Adv.
Location: Exclamation

Chair: Madeline B. Benz, M.S., Clark University
Discussant: Jason B. Luoma, Ph.D., Portland Psychotherapy Clinic, Research, & Training Center, PC

The ability to consider oneself in changing environmental contingencies without excessive attachment to experiences promotes psychological flexibility and general well-being. This concept, known as self-as-context, is associated with the processes of acceptance and mindfulness fostered in Acceptance and Commitment Therapy. In contrast, self-as-content, defined as a rigid over-identification with a personal label (e.g. “addict” or “victim”), can negatively impact psychological and behavioral functioning. Through a series of quantitative research presentations, this symposium will explore the impact of self-as-content on thriving and mental health across multiple domains. First, Madeline Benz will examine how identification with a stigmatized group impacts treatment-seeking behavior among individuals who report substance use problems. Second, Lia Bishop will determine the ways in which rigid identification with trauma-based identities impacts post-trauma functioning in a community sample. Third, Peter Grau will discuss the relationship between event centrality and psychopathology in a clinical sample of trauma survivors. Last, Douglas Gazarian will explore how rigid identification with masculine norms influences psychopathology and treatment-seeking behavior in college-aged men.

• What does it mean to consider yourself an “addict”?: The impact of identity on treatment-seeking behaviors among individuals with substance use problems
Madeline Benz, M.S., Clark University
Kathleen Palm Reed, Ph.D., Clark University
Lia Bishop, Clark University

Individuals who identify with marginalized groups experience unique stressors and stigma that shape how they are viewed and treated. Identifying as an “addict” caries a mainstream connotation that the individual is blameworthy, which is a stigmatizing perspective that may serve as a barrier to treatment-seeking for young adults. Other studies have found certain types of stigma may facilitate treatment. Given research suggesting fear of stigma may be more salient than the experience of stigma for some marginalized groups, we examined treatment-seeking behaviors in a national sample of 171 young adults with a history of problematic substance use. Correlations indicated fear of substance-related stigma was associated with previous help-seeking behavior and intentions to seek treatment (ps<.001). When controlling for severity of alcohol use problems, fear of substance-related stigma predicted intentions to seek help beyond the anticipation/experience of stigma (β=.48, p<.001). These preliminary analyses suggest fear of substance-related stigma may contribute to increased treatment-seeking behavior among young adults with a history of substance use problems. Implications will be discussed using an ACT framework.

• “I’m a survivor”: Exploring the relationship between conceptualized identities and post-trauma functioning
Lia Bishop, M.A., Clark University
Kathleen Palm Reed, Ph.D., Clark University

Research suggests that individuals who build their identity around traumatic experiences (e.g. “I am a victim”) may be more likely to develop post-trauma psychopathology. Psychological inflexibility may underlie this relationship, such that individuals who attempt to control their thoughts and feelings are more likely to develop a static (e.g. “conceptualized”) identity. In a community sample of 193 trauma survivors, path analyses confirmed that individuals who endorsed more conceptualized identities also reported greater posttraumatic stress disorder (PTSD) and depression symptoms, and that psychological inflexibility partially explained these relationships (p < .001; p < .001 respectively). Psychological inflexibility accounted for 47.62% of the variance between identity conceptualization and PTSD, and 64.16% of the variance between identity conceptualization and depression. Qualitative analyses revealed that individuals who endorsed more conceptualized identities also tended to (1) use definitive identity language (e.g. survivor, victim), (2) report external standards of “normalcy” (e.g. “I will never be normal again”) and (3) endorse stark breaks between their pre- and post-trauma identities (e.g. “who I was died that night”). Implications and limitations will be discussed.

• De-centralizing the context of trauma: Exploring the relationship between PTSD symptoms, posttraumatic cognitions, and centrality of events in PTSD treatment
Peter Grau, M.S., Marquette University, Rogers Memorial Hospital
Chad Wetterneck, Rogers Memorial Hospital, Marquette University

Boals and Murrell (2016) conducted a clinical trial that demonstrated PTSD symptom severity is predicted by the centrality of a traumatic event. Conceptually, they found that centrality of a traumatic event is linked to rigid self-identification with that traumatic event, mapping onto the concept of self-as-context. Additionally, da Silva et al. (2016) found that centrality of events is related to both increased PTSD symptom severity and negative posttraumatic cognitions. Taken together, these studies provide evidence in favor of incorporating Acceptance and Commitment Therapy (ACT) into treatment with the intent of reducing event centrality and, as a result, PTSD symptom severity and negative posttraumatic cognitions. This study replicates and extends these results in a PTSD partial hospitalization program (PHP) that integrates ACT principles into an exposure-based model. Participants (n=150) were in treatment and mainly White, heterosexual, and female (mean age=35.7). Structural Equation Modeling will examine how centrality of events and posttraumatic cognitions affect PTSD symptom severity in treatment. Implications for clinical practice and PTSD conceptualization will be discussed.

• Masculine Self-Concept Rigidity and Psychological Distress
Douglas Gazarian, B.A., Clark University
Michael E. Addis, Ph.D., Clark University

Inflexible adherence to male gender expectations (e.g., emotional control) predicts depressive symptoms, aggressive behaviors, and reduced help-seeking. To our knowledge, no study has used the psychological flexibility model to conceptualize masculinity as a rigid self-process in some men. Further, how this changes by context is unknown. The present study investigates whether men with stronger self-attachments to traditional expectations about manhood show increased psychological distress, and whether receiving psychoeducational information changes this process. Undergraduate males completed a Masculine-Self Implicit Association Test alongside a self-report measure of masculinity-adherence. Participants in the experimental condition watched a video deconstructing male gender roles as emotionally restrictive. Participants in the control condition watched an unrelated video. Masculine self-concept was measured before and after the video manipulation, and again after a one-week interval. Data collection is ongoing; however, initial analyses reveal moderate effect sizes linking self-attachment to masculine norms and psychological distress (r = .40 - .60). Upcoming analyses will test the manipulation’s effect on self-concept malleability across time.

Educational Objectives:
1. Describe how the fear of stigma associated with identifying as an “addict” influences treatment-seeking among a national sample of young adults with a history of substance use problems. 2. List and explain how conceptualized identities manifest among trauma survivors, and influence post-trauma mental health; understand the functional impact of integrating a traumatic event into one’s identity on negative posttraumatic cognitions and PTSD symptom severity in a clinical sample. 3. Demonstrate recognition of masculine gender as relevant to many men’s conceptualized selves.

 

107. Understanding and targeting fear and rumination with RFT
Symposium (10:35am-12:05pm)
Components: Conceptual analysis, Original Data
Categories: RFT, Clinical Interventions and Interests, Fear, anxiety, generalization, conditioning, ACT, emotional disorders
Target Audience: Beg., Interm., Adv.
Location: Multiplication

Chair: Miguel Rodriguez-Valverde, University of Jaen, Spain

This symposium presents studies using experimental designs in the study of conditioned fear and the hierarchical organization of triggers of rumination. The first paper investigates the use of eye-blink startle as a psychophysiological measure on the derived transfer of fear. The second paper uses an aversive conditioning procedure to study the potentiation and attenuation of fear reactions to neutral stimuli. The third paper explores the effectiveness of defusion protocols to reduce rumination and worry strategies. The fourth paper study the role of hierarchical organizations of triggers of rumination and the impact of hierarchical framing to promote psychological flexibility.

• Transfer of conditioned fear-potentiated startle across equivalence classes
Miguel Rodriguez-Valverde, University of Jaen, Spain
Monica Hernandez-Lopez, University of Jaen, Spain
Miguel Angel Lopez-Medina, M.Sc.,, University of Jaen, Spain

Although research on the transfer of fear is key to understanding human fear and anxiety, there is a paucity of evidence about this phenomenon with physiological measures of arousal. The few published studies are based on skin conductance responses (SCRs) as the measure of fear. Current recommendations in psychophysiology research point to fear-potentiated blink startle as a more adequate measure of fear conditioning. However, all previous research from our lab has failed to find clear transfer-of-fear effects with this measure. The present study attempts to overcome the limitations of previous research by using task parameters that have proved useful in obtaining solid transfer effects with SCRs (Rodríguez-Valverde, Luciano, & Barnes-Holmes, 2009). Participants underwent an MTS procedure for the formation of two five-member equivalence classes. Two elements from each class were used in a differential aversive conditioning procedure (CS+1: B1; CS+2: C1; CS-1: B2; CS-2) with electric shock as the UCS. Transfer tests were presented with the remaining class elements. Acoustic eye-blink startle (EMG activity of the orbicularis oculi muscle) was the main dependent variable.

• Transformation of conditioned fear-potentiated startle in accordance with a relational frame of comparison
Miguel Rodriguez-Valverde, Ph.D., University of Jaen, Spain
Monica Hernandez-Lopez, University of Jaen, Spain
Maria Fontiverio-Maldonado, M.Sc., University of Jaén

This study analyzed the experimental interactions that are responsible for the potentiation and attenuation of fear reactions (fear-potentiated acoustic startle) to stimuli with no direct history of aversive conditioning. After establishing a series of symbolic (arbitrary) comparative relations (larger-than, smaller-than) between different visual stimuli, the "intermediate size" stimulus in the relational network was repeatedly paired with mild shock in an aversive conditioning procedure. Once conditioning was acquired, two other elements in the relational network were tested to see if they produced a modulation of acoustic startle reactions in accordance with the previously established arbitrary relations. A stimulus that was previously trained to be symbolically “smaller than” the CS should produce an attenuation of the startle reflex, while a stimulus previously trained to be symbolically “larger than” the CS should produce a potentiation of the startle reflex. Results were obtained in the absence of direct conditioning contingencies with either the “smaller-than” or the “larger-than” stimuli. Although symbolically different in “size”, the physical dimensions of all the stimuli in the experimental task were identical.

• Promoting Rumination and Analyzing the Differential Effect of Defusion Protocols on a Memory Task
Bárbara Gil-Luciano, Universidad de Almería, Madrid Institute of Contextual Psychology
Daniel S. Tovar, Fundación Universitaria Konrad Lorenz
Tatiana Calderón-Hurtado, Fundación Universitaria Konrad Lorenz
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz
Beatriz Sebastián, Universidad de Almería
Eduar S. Ramírez, Fundación Universitaria Konrad Lorenz

Psychological inflexibility is made of distinct reactions that are oriented to lessen distress. In this sense, worry and rumination (RNT) are strategies that seem to be common denominators in many psychological disorders. This study had two parts. Firstly, we explored such a hierarchical organization of thoughts with two ruminative induction procedures, analyzing their impact on a memory task. Secondly, we examined the differential effect of two defusion protocols that aimed to alter the discriminative avoidant functions of triggers for RNT. Results suggest that inducting RNT with stronger triggers (thoughts at the top of the hierarchy, or “big ones”, that symbolically contain or are inclusive of weaker thoughts or triggers) showed a more negative effect in the task performance than inducting RNT with less stronger triggers. Results also indicate that participants that were intervened with the defusion protocol that specifically contained hierarchical cues to reduce the discriminative avoidant functions of triggers for RNT showed a better performance at post-test, in comparison with participants that received a defusion protocol that only contained deictic cues.

• An RFT approach of the Hierarchical Organization of Triggers for Rumination
Bárbara Gil-Luciano, Universidad de Almería, Madrid Institute of Contextual Psychology
Tatiana Calderón-Hurtado, Fundación Universitaria Konrad Lorenz
Daniel Tovar, Fundación Universitaria Konrad Lorenz
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz
Beatriz Sebastián, Universidad de Almería
Andrés Peña-Vargas, Fundación Universitaria Konrad Lorenz

The present study analyzed the relational networks between private events (thoughts) that typically trigger rumination. Among a sample of 100 undergraduate students, participants went through several evaluation phases. Firstly, all participants responded to several questionnaires that broadly measured their current emotional health state. Secondly, participants were presented a list of thoughts that typically serve as triggers for rumination, and were asked to select a number of thoughts that they frequently had and to what extent they get entangled in them. Consequently, they were presented and explained three different types of diagrams as examples of how those thoughts could be organized: coordination, comparison and hierarchy. Finally, participants were asked to select the diagram that best fitted for them. Results were that 79% of participants organized their triggers for rumination in relations of hierarchy, while 19% of participants organized them in relations of comparison, and only 2% in relations of coordination. Conceptual and clinical implications of these findings are discussed.

Educational Objectives:
1. List the main psychophysiological measures used in research on the derived transfer of fear. 2. esign experimental research about the transfer of fear. 3. Discuss the clinical implications of the hierarchical organization of triggers of rumination.

 

115. ACT in the workplace: Understanding how ACT interventions improve employees' mental health
Symposium (1:20-2:50pm)
Components: Original Data
Categories: Occupational health, Professional Development, Mindfulness
Target Audience: Beg., Interm.
Location: Rue Sainte-Catherine

Chair: Paul Flaxman, Ph.D., City, University of London
Discussant: Frank Bond, Goldsmiths, University of London

There is growing interest in the use of ACT to help improve mental health in workplace settings. Previous studies have shown that ACT is effective in improving workplace well-being, and the beneficial effects are often mediated via increases on general measures of psychological flexibility. However few studies have offered more in-depth explorations of how ACT improves employees’ functioning. This symposium reports three intervention studies seeking to address this issue. The first paper is a mixed methods study, evaluating the effects of a 4-session ACT training programme on teachers’ mental health; 34 of these participants were interviewed to understand how ACT-based processes are manifesting in employees’ daily life. The second study explored various potential processes of change, including increases in positive affect, behavioural activation and cognitive defusion. The findings indicate the defusion is an influential process of change in these brief interventions. Finally, study 3 directly compares ACT and mindfulness training in a workplace setting. The results suggest that ACT and mindfulness training improve employees’ mental health via similar processes of change.

• School teachers’ experiences of a workplace ACT intervention: A mixed methods study
Dr. Paul Flaxman, City, University of London
Ross McIntosh, City, University of London
Shannon Horan, City, University of London
Jeff Salter, Mind the Gap Transformations
Dr. Julia Yates, City, University of London

Previous investigations of ACT’s mechanisms of change in workplace settings have focused on general mediation effects. The present paper reports the findings a mixed methods study, in which 34 school teachers attended a 4-session ACT-based training program. Participants completed measures of mental health, valuing, and mindfulness skills at pre, post, and 2 month follow-up. The same teachers participated in semi-structured research interviews during which they discussed the effects of the ACT intervention on their work and home lives. Using template analysis, and focusing initially on exemplars of the 6 hexaflex processes, we extracted specific examples of how teachers had changed in response to the intervention. Thematic analysis revealed additional themes that captured teachers’ experiences of the process of the intervention (e.g., resistance, group process) and impact on cognitive-affective experiences (e.g., decreased tension and negative affect). This strategy of linking qualitative and quantitative data shows promise for understanding more specific processes of (and barriers to) change when ACT is delivered in the workplace.

• ACT in the workplace: Exploration of multiple processes of change
Dr. Paul Flaxman, City, University of London
Dr. Niguel Guenole, Goldsmiths, University of London
Dr. Joda Llloyd, Goldsmiths, University of London
Porfessor Frank Bond, Goldsmiths, University of London

This waitlist controlled study evaluated potential processes of change in an ACT-based training intervention delivered at two organisations in the United Kingdom. The intervention was delivered to groups of employees over three half-day sessions. A total of 243 participants completed baseline assessments and were allocated to the ACT condition (n = 112) or to a waiting list control group (n = 131). Study measures were administered at baseline, two months after two initial group sessions, and again another three months after the third session (a five month evaluation period in total). The primary outcome measures were general mental health (GHQ-12) and life satisfaction. The aim of the study was to examine whether increases in positive affect, a reduction in behavioural avoidance, or increased cognitive defusion operated as unique processes of change. Results of growth modelling indicated that improvements in employees’ well-being were associated particularly with a reduction in fusion (as measured with the cognitive fusion questionnaire). Study findings support the use of various defusion exercises in brief worksite ACT programs.

• A randomized controlled comparison of worksite applications of ACT and mindfulness training: Investigating attentional and attitudinal mediators of change
Paul Flaxman, City, University of London
Dr. Vasiliki Christodoulou, Cyprus, Mental Health Services
Dr. Joe Oliver, Contextual Consulting, UK
Dr. Eric Morris, La Trobe University, Australia
Dr. Nigel Guenole, Goldsmiths, University of London

Few studies have directly compared workplace applications of ACT with mindfulness training. In addition, some authors have questioned whether ACT is truly a “mindfulness-based” intervention (MBI) because of the reduced expectation around meditation practice. In this randomised controlled trial, 199 employees of a healthcare organisation in London, UK were allocated to a 4-session ACT-based training programme (n = 67), a 4-session mindfulness training program (based on MBSR; n = 63), or to waiting list control group (n = 69). Self-report measures of general mental health and three specific mindfulness skills (acting with awareness, non-judgement, and non-reactivity) were administered on 5 separate occasions spread over a six month evaluation period. Both ACT and MT resulted in significant (and broadly equivalent) improvements in employees’ mental health. Growth modelling and mediation analysis indicated that both interventions were working primarily via the cultivation of a non-judgemental attitude toward difficult inner experience (i.e., through the FFMQ’s non-judging subscale). Results suggest that ACT and MT are targeting similar processes, and that ACT warrants classification as an MBI.

Educational Objectives:
1. Describe how ACT processes manifest in employees’ daily lives. 2. Assess ACT’s processes of change when delivered in workplace settings. 3. Explain how ACT compares to a similar-length mindfulness training program in a workplace context.

 

117. Empirical investigations of experiential avoidance and psychological well-being
Symposium (1:20-2:50pm)
Components: Original Data
Categories: Theoretical and philosophical foundations, Theoretical and philosophical foundations, Experiential avoidance, Psychological flexibility, PTSD, Addiction, childhood trauma, AAQ-II, MEAQ
Target Audience: Interm.
Location: Rue Crescent

Chair: Robert Whelan, Trinity College Dublin, Ireland
Discussant: Louise McHugh, University College Dublin, Ireland

Experiential avoidance (EA), the tendency to avoid private experiences such as thoughts, feelings, and bodily sensations, has been identified as a potential risk factor in a range of disorders. The current symposium proposal includes data from studies that examined EA with respect to post-traumatic stress disorder, symptoms of anxiety, and addiction. The first presentation (Lewis & Naugle) will report the discriminant validity of two measures of EA in predicting symptoms for those with a likely post-traumatic stress disorder diagnosis. The second presentation (Tyndall et al.) will describe how EA relates to measures of psychological distress and wellbeing, highlighting the utility of this distinct profile for working with clients within the psychological flexibility framework. The third presentation (Pennie & Whelan) will focus on the function of alcohol dependency in adults who misuse alcohol, with preliminary data suggesting that alcohol is often used as a coping mechanism to avoid present-moment experiences in individuals who misuse alcohol. Data from these three studies can further refine our understanding of EA in a range of psychopathologies.

• Measuring experiential avoidance: Evidence toward multidimensional predictors of trauma sequelae
Meaghan Lewis, Western Michigan University
Amy Naugle, Western Michigan University

The current study sought to investigate measurement discrepancies in self-reported experiential avoidance (EA). Recent research indicates EA may be more appropriately conceptualized as a multidimensional construct, operationally defined in terms of specific avoidance strategies (Gámez et al., 2014). To test this notion, EA was measured using two self-report instruments, the Acceptance and Action Questionnaire-II (AAQ-II; Bond et al., 2011) and the Multidimensional Experiential Avoidance Questionnaire (MEAQ; Gámez et al., 2011) in a convenience sample of university students. Measurement differences and unique contributions to prediction of posttraumatic stress symptoms (PTSS) and engagement in problematic behaviors were evaluated. Both the AAQ-II and MEAQ were found to significantly mediate the effect of childhood trauma exposure on PTSS. However, when levels of PTSS were dummy coded into dichotomies of those with a likely PTSD diagnosis and those without, the MEAQ was a stronger predictor of symptoms for those with a likely PTSD diagnosis than the AAQ-II. These results provide initial support for the discriminant validity of the MEAQ, which appears to be a more specific predictor of trauma-related symptoms.

• Profiles of Psychological Flexibility: A Latent Class Analysis of the psychological flexibility model in terms of depression, anxiety, stress, and positive and negative emotions
Ian Tyndall, University of Chichester, UK
Dan Waldeck, Coventry University, UK
Luca Pancani, University of Milano-Biccoca, Italy
Rob Whelan, Trinity College Dublin, Ireland
Bryan Roche, Maynooth University, Ireland

Psychological flexibility is a core tenet of the Acceptance and Commitment Therapy (ACT) model of behaviour change and emotional well-being. There are six components to psychological flexibility, with varying theoretical positions as to whether each component functions alone, or whether they work in pairs, for example. There is an ongoing current debate as to whether key self-report measures of psychological flexibility and experiential avoidance (e.g., Acceptance and Action Questionnaire-II) actually measure these important constructs. The present paper will outline a study that aims to help elucidate how important components of the psychological flexibility model relate to measures of psychological distress and wellbeing. A Latent Class Analysis (LCA; n = 557) was conducted on measures of psychological flexibility, cognitive fusion, experiential avoidance, committed action, and present-moment mindfulness, with to regard to measures of depression, anxiety, stress, and positive and negative emotions. The LCA identified three clear statistically different profiles of psychological flexibility. This presentation will highlight the utility of these profiles for working with clients within psychological flexibility and ACT frameworks.

• A functional understanding of alcohol misuse: Quantifying the role of experiential avoidance, maladaptive coping and impulse control processes
Brian Pennie, Trinity College Dublin
Rob Whelan, Trinity College Dublin, Ireland

Contact with the present moment is a key component of emotional well-being. In contrast, individuals with addiction problems tend to demonstrate a range of behavioural deficiencies including experiential avoidance, psychological rigidity, and maladaptive impulse control. We adopted a novel online method that allowed us to collect both task and psychometric data from a large sample with the aim of determining the unique and shared contributions of experiential avoidance, present-moment mindfulness, impulse control, and drinking motives on adults who misuse alcohol. Preliminary data (n=159) revealed that problematic drinking was strongly associated with maladaptive coping (r = .566, p = <.001) and impulsivity (r = .232, p = .003). Although experiential avoidance was not directly related to alcohol misuse, coping and conformity as motives for drinking were associated with both experiential avoidance (r = -.215, p = .014) and present-moment mindfulness (r= -.195, p <.001). These preliminary data suggest that alcohol may be a coping mechanism to avoid present-moments experiences in individuals who misuse alcohol.

Educational Objectives:
1. Explain how the predictive validity of the AAQ-II and MEAQ relates to trauma symptoms and childhood trauma exposure. 2. Elucidate how experiential avoidance relates to measures of psychological distress and well-being. Highlight the utility of this distinct profile for working with clients within the psychological flexibility framework. 3. Describe the unique a shared contributions of experiential avoidance, maladaptive coping and impulsivity on alcohol misuse in an adult population. Outline the importance of experiential avoidance as a maladaptive process involved in alcohol misuse.

 

118. Discrimination and microaggressions: CBS research findings and a call to action
Symposium (1:20-2:50pm)
Components: Original Data
Categories: Functional contextual approaches in related disciplines, Microaggressions, Racism, Discrimination
Target Audience: Beg.
Location: Rue Mansfield / Rue Sherbrooke

Chair: Adam M. Kuczynski, M.S., University of Washington
Discussant: Jonathan W. Kanter, Ph.D., University of Washington

Consistent with our organization’s core values, CBS must increase its efforts to predict-and-influence acts of discrimination and oppression, including—in today’s cultural climate--microaggressions. This symposium presents important data documenting that experiences of discrimination and microaggressions have harmful and clinically significant effects, predicting increases in depression and anxiety for people of color. Then, we present new findings on a contextual-behavioral measure of White individuals’ likelihood of engaging in microaggressive behavior, and we present a reliable and valid system for objectively observing and measuring the severity of observed microaggressions. Overall, results converge on conclusions that microaggressions are not simply idiosyncratic or politically motivated hyper-sensitive overreactions. Microaggressions can be objectively studied with contextual-behavioral science methods, are harmful, and are related to other indices of racism in White individuals who commit them. Discussion will encourage other CBS professionals to enter the arena of microaggression research and intervention development using CBS principles.

• Identity, discrimination, and microaggressions: New evidence and therapeutic implications
Mariah D. Corey, B.S., University of Washington
Jutta Joormann, Ph.D., Yale University
Katherine E. Manbeck, M.S., University of Washington
Jonathan W. Kanter, Ph.D., University of Washington

This paper will review data on the relationship between experiences of discrimination and microaggressions among people of color and negative health and mental health outcomes, including new data from our lab. This new data suggests that, in the current cultural and political climate in which there has been a resurgence in White nationalism and clear increases in violence against Blacks, a strong Black ethnic identity is not necessarily protective against the depressogenic effects of experiences of discrimination and may in fact be a risk factor. We offer some suggestions for how contextual-behavioral practitioners and scientists may understand these findings and work therapeutically with people of color in this climate.

• Measuring microaggressions in White individuals I: Self-reported microaggressions predict prejudice and racism
Ryan Parigoris, University of Washington
Adam M. Kuczynski, M.S., University of Washington
Cathea M. Carey, University of Washington
Mariah D. Corey, B.S., University of Washington
Monnica T. Williams, Ph.D., University of Connecticut

Previous efforts to understand microaggressions have surveyed stigmatized group members’ experiences of receiving microaggressions but not attempted to measure White individual’s likelihood of engaging in such acts. Furthermore, previous research has not attempted to understand the construct of microaggressions from a contextual-behavioral perspective. This paper presents new data, from a cross-sectional survey of almost 1,000 White undergraduate students, on a contextual-behavioral measure of one’s self-reported likelihood of delivering microaggressions and explores the association between the likelihood of delivering microaggressions and racial prejudice. We found that White students’ self-reported likelihood of engaging in microaggressive acts was significantly related to all measures of racial prejudice, suggesting that the delivery of microaggressions by white students is not simply innocuous behavior and may be indicative of broad, complex, and negative racial attitudes and explicit underlying hostility and negative feelings toward blacks.

• Measuring microaggressions in White individuals II: Objectively identifying microaggressive behavior
Cathea M. Carey, University of Washington
Mariah D. Corey, B.S., University of Washington
Ryan Parigoris, University of Washington
Adam M. Kuczynski, M.S., University of Washington
Monnica T. Williams, Ph.D., University of Connecticut

Are microaggressions objectively, reliably observable by independent observers or are they simply idiosyncratic or hyper-sensitive overreactions by those who report experiencing them? For a contextual-behavioral understanding of microaggressions, the construct must be situated in observable human actions-in-context. In a lab-based study, we video-taped 45 White individuals having conversations about current events (such as police violence against Black people or the removal of a confederate monument from a Southern city), during which they might say something experienced as microaggressive (such as “all lives matter, not just black lives”), with a Black lab assistant listening. We trained 7 independent assistants (two White, two Black, and three Asian students) to observe the videotapes and identify how microaggressive the participants were in the interactions. Students were highly reliable across several categories of microaggressions, including tendencies to deny racism or bias in oneself and others, demonstratations of discomfort and avoidance when discussing race, and being unconcerned about social justice. We also report relationships between these objective findings and participants self-reported levels of prejudice and racism.

Educational Objectives:
1. Describe recent empirical findings on the relationship between microaggressions, ethnic identity, and overt racism. 2. Discuss the development of a contextual-behavioral self-report measure of microaggressions. 3. Discuss intervention techniques from a contextual-behavioral perspective.

 

119. Using the matrix to address psychological suffering across multiple disorders
Symposium (1:20-2:50pm)
Components: Original Data
Categories: Clinical Interventions and Interests, ACT Matrix
Target Audience: Beg., Interm.
Location: Rue Saint-Paul

Chair: Emily B Kroska, Ph.D., University of Iowa
Discussant: Benjamin Schoendorff, M.A., M.Sc., , CONTEXTUAL PSYCHOLOGY INSTITUTE, MONTRÉAL

This symposium will present studies from a number of different areas of the world and that used differing research designs but that all involved using the ACT matrix to address psychological suffering in the context of severe disorders and psychiatric problems (i.e., depression and tinnitus, suicidal ideation and high functioning autism).

• The use of the Matrix in a randomized controlled trial in suicidal patients
Veronique Brand-Arpon, Ph.D., Centre Hospitalier Régional Universitaire de Montpellier

The results of the first monocentric randomized controlled trial comparing the effectiveness of ACT vs. relaxation, for patients suffering from current suicidal behaviour disorder show that, as hypothesised, ACT was more effective than relaxation to reduce severity and intensity of suicidal ideation between pre- and post-therapy, with a maintain of the effect at 3 months follow-up. In addition, ACT was more effective than relaxation to reduce level of depressive symptomatology, anxiety, psychological pain, hopelessness and anger, known to be associated to suicidal risk. Finally, ACT improved global functioning and quality of life. Therefore, this trial confirms feasibility and utility of ACT group program among high risk suicidal patients.

• Using the ACT Matrix to Enhance Perspective Taking and Psychological Flexibility in Autism: A Pilot Study
Diana Bast, Ph.D., Federal University of São Carlos
Clodagh Murray, Ph.D., National University of Ireland, Galway
Ian Stewart, Ph.D., National University of Ireland, Galway
Giovanni Miselli, Ph.D., ISTITUTO FONDAZIONE OSPEDALIERO DI SOSPIRO ONLUS (CR)
Benjamin Schoendorff, M.A., M.Sc., , CONTEXTUAL PSYCHOLOGY INSTITUTE, MONTRÉAL
Shinji Tani, Ph.D., Ritsumeikan University, Japan

This pilot study examined the utility of the ACT Matrix as an intervention to increase psychological flexibility and well-being in adolescents and young adults diagnosed with high functioning autism. A key aim was to teach participants to cope with their emotions and increase their resilience and endurance in general as well as specifically in the task of seeking employment. Four clients of the Care Trade Institute in London took part; three had been diagnosed with high functioning autism while the fourth had been diagnosed with Aspergers Disorder. They were pre and post assessed with standardized scales (DASS, AAQ-II, CFQ, Valued Living Questionnaire and The Matrix Bridging Questionnaire Part B) and pts attended for 4 hour sessions on each of four days and received a specially adopted version of the protocol. They were also given several weeks’ access to a mobile application (the ‘ACT Matrix’ app) which asked them eight times a day whether their behavior was ‘towards’ or ‘away’ from their stated values. Participants showed differing levels of improvement. Results are discussed in detail.

• Using the matrix in a Japanese context to treat a client with depression and tinnitus: A single case design
Shinji Tani, Ph.D., Ritsumeikan University, Japan

This study investigated the use of the matrix with a Japanese client suffering from Tinnitus and Depression. The client showed strong levels of fusion concerning particular relationships - with a boss in a previous workplace, and also with her father. She thought that both of them had responsibility for her Tinnitus, and she felt strong anger towards them. Functional analysis was conducted using the Matrix. The therapist helped the client explore the workability of her behaviors. He also used defusion exercises, metaphors and verbal AIKIDO so as to help her to distance herself from her thoughts, to increase her sensitivity towards contingencies, and to identify important values. Results showed that particular relational responses were weakened, while her score on the BDI-II (16 points) and the Tinnitus Cognition Questionnaire (-8 points) decreased. A decrease in AAQ (-4 points) score was also found. The talk will discuss application of the Matrix and of verbal AIKIDO in a Japanese cultural context.

Educational Objectives:
1. Describe the ACT Matrix. 2. Discuss the Matrix as a potential methodology to treat severe disorders. 3. Discuss the utility of the ACT Matrix as a cross-cultural tool.

 

121. From individual to systemic behavior change: What Behavior Analysis and Pro-sociality can bring to ACT
Symposium (1:20-2:50pm)
Components: Conceptual analysis, Literature review, Original Data, Case presentation
Categories: Theoretical and philosophical foundations, Organizational behavior management, Clinical Interventions and Interests,, Prevention and Community-Based Interventions, Performance-enhancing interventions, Educational settings, Organizational behavior management, Theoretical and philosophical foundations, Applied Behavior Analysis, Neurodevelopmental disorders, Pro-Sociality, Multi-Level Selection, Intellectual Disability, Adolescents, Adults, Autism, Establishment of event functions
Target Audience: Beg., Interm., Adv.
Location: Exclamation

Chair: Jessica Hinman, B.A., Southern Illinois University, Carbondale

This symposium explores the use of Behavior Analysis and Community-based research to the study of clinically relevant processes. The first paper uses a radical behavioral conceptual analysis to study the process behind maladaptive delay discounting strategies. The second paper presents a new theory regarding care pathways for professionals working with children and adolescents with neurodevelopmental disorders. The third paper presents a a behavioral and ACT-based environmental intervention aimed at increasing social skills and value-consistent behaviors in individuals with intellectual disabilities.

• From the Skinner Box to Socially Meaningful Behavior Change: Synthesizing ACT and Delay Discounting in the Context of Applied Behavior Analysis
Jonathan Tarbox, Ph.D., BCBA-D, University of Southern California and FirstSteps for Kids
Elizabeth Meshes, Chicago School for Professional Psychology
Amy Odum, Ph.D., Utah State University

Acceptance and commitment therapy (ACT) was originally developed as a behavioral approach to psychotherapy for treating disorders traditionally treated by clinical psychology. However, the functional analyses that form the foundation of ACT are equally applicable to anyone who has rule-governed behavior that interacts with socially meaningful overt behavior. Most daily problems of behavior involve making difficult choices between smaller short term negative reinforcers (e.g., avoiding work) versus larger longer-term positive reinforcers (e.g., successful career). Delay discounting research demonstrates that unfavorable delays and proportions of reinforcement result in less favorable choices. ACT attempts to transform the function of verbal behavior such that choosing the harder choice in the short term in order to access the larger reinforcer later is more probable. This presentation will present the radical behavioral conceptual analysis behind this process and discuss applicability across work with individuals with autism, parents of children with autism, and behavioral supervision of staff. Potential for using this analysis for extending applied behavior analysis into other important areas of applied work will also be discussed.

• Developing Care Pathways for Neurodevelopmental Disorders: Seeing Common Problems as Problems of Commons
Gustaf Waxegard, M.Sc., Ph.D. candidate, Linnaeus University, Sweden; R&D-unit, Region of Kronoberg
Hans Thulesius, Lund University, Sweden; R&D-unit, Region of Kronoberg, Sweden

Welfare-type societies tend to encourage construction of care pathways to counter fragmentation of health care services caused by the well-documented trends of increased professionalization, decentralization, and specialization. Still, care pathways for mental health problems remain poorly conceptualized, academically as well as in practice. Implementation is fraught with difficulties, and the implied collaborative behavior between professional stakeholders often fails to develop to the detriment of patients. This paper aims to increase professional ability to integrate and develop care pathways for neurodevelopmental disorders (ND) in children and adolescents. Based on multilevel empirical data, it presents a new theory about ND care pathways as commons, holding a complex common pool resource (CPR) attractive to professionals. The paper a) sets ND care pathways on a more solid theoretical footing, b) points to the PROSOCIAL framework as promising alternative for ND care pathway development work, and c) provides a rationale for further CBS-relevant research on professional behavior in care pathways för mental health based on Ostromian commons theory, relational frame theory, and the Institutional Analysis and Development (IAD-) framework.

• Club '57: Applied Behavior Analysis and Acceptance and Commitment Therapy for Individuals With Autism Spectrum Disorder
Jessica Hinman, B.A., Southern Illinois University, Carbondale
India Pauly Hertel, B.S., Southern Illinois University, Carbondale
Sebastián García-Zambrano, B.A., Southern Illinois University, Carbondale
William Root, M.S., BCBA, Southern Illinois University, Carbondale
Natalia Baires, M.S., BCBA, Southern Illinois University, Carbondale
Daniel Grishman, B.A., Southern Illinois University, Carbondale
Victoria Hutchinson, B.S., Southern Illinois University, Carbondale
Molly Lamb, B.A., Southern Illinois University, Carbondale
Miranda Morton, B.A., Southern Illinois University, Carbondale
Ruth Anne Rehfeldt, Ph.D., BCBA-D, Southern Illinois University, Carbondale

Many adolescents and young adults with autism spectrum disorder (ASD) often engage in rigid behavioral routines, including rigid self-rules. These routines may make it difficult for them to effectively adapt and respond to unforeseen changes in life, which may result in ill-adaptive avoidance behaviors in the future, all characteristics of psychological inflexibility (Pahnke, Lundgren, Hursti & Hirvikoski, 2013). The purpose of Club 57 is to provide an environment where adolescents and young adults with ASD are able to socialize, develop friendships with peers, and acquire new social skills, all while receiving Acceptance and Commitment Training (ACT) services that promote engagement in behavioral repertoires consistent with valued living. Between February and May , Club 57 has served more than 30 individuals ranging in age from 13 to 28 years old. Pre- and post-test assessments were administered to 14 participants Assessments indirectly measured levels of psychological inflexibility, experiential avoidance, social anxiety, and cognitive fusion. Overall, analyses of the assessment results found a statistically significant difference responses for three of the four assessments, suggesting an overall improvement in psychological flexibility. Given the number of adolescents and young adults with ASD that experience anxiety, depression, and social isolation, programming that directly addresses these experiences will be discussed along with the clinical significance of the results.

Educational Objectives:
1. Describe how experiential avoidance involves a choice between a smaller sooner negative reinforcer versus a larger later positive reinforcer. 2. Utilize Acceptance and Commitment Therapy (ACT) metaphors and experiential activities with adolescents and young adults diagnosed with Autism Spectrum Disorder (ASD).  3. Evaluate the effects of ACT components on cognitive fusion, acceptance, and mindfulness in adolescents and young adults with ASD.

 

122. Why philosophy matters: Reconnecting with our roots and branching out: Contextual Philosophy of Science SIG Sponsored
Symposium (1:20-2:50pm)
Components: Conceptual analysis, Didactic presentation
Categories: Theoretical and philosophical foundations, Professional Development, Theoretical and philosophical foundations, Functional contextual approaches in related disciplines, Contextualism
Target Audience: Beg., Interm., Adv.
Location: Multiplication

Chair: Douglas M. Long, Ph.D., Warren Alpert Medical School of Brown University

Why does philosophy matter? What difference does it make in our lives? This symposium will shed light on the importance of philosophy from both personal and professional viewpoints. Paper 1 will discuss functional contextualism, the philosophy underlying the development of ACT, and explore how focusing on workability can have a profound impact. Paper 2 will discuss descriptive contextualism, a sister of functional contextualism, and examine how this viewpoint can also be fruitful. Paper 3 will confront the reality that most knowledge is not born of contextualist viewpoints, and offer practical suggestions for collaborating with professionals of different backgrounds. The symposium aims to stimulate conversation and will conclude with time for open discussion and questions from the audience.

• How I fell in love with a-ontology
Kelly G. Wilson, Ph.D., University of Mississippi

The philosophical roots of ACT can be found in a philosophy of science called functional contextualism. Among the noteworthy and sometimes controversial features of this position has been steadfast abstention from ontology. Instead of focusing on the “nature of reality”—what is—functional contextualism focuses on what works. In this talk, I will provide an argument in support of a focus on workability. In my own case, I came to embrace a-ontology as a very pragmatic matter well before I began a serious study of philosophy of science. My a-ontology came through personal practice. My a-ontology had roots within multiple areas of academic study, but also through entirely nonacademic investigations. At a very particular juncture in my own life, standing at the cusp of living and dying, the simplicity and freedom of letting go of ontology was lifesaving. In this paper, I will describe a deeply personal approach to this weighty philosophical topic that led from a near death experience to a way to do science.

• The Other Contextualism: Exploring the Value of Descriptive Contextualist Approaches in Research and Practice
Donald R. Marks, Ph.D., Kean University

In the contextual behavioral science community, descriptive contextualist approaches have received less attention and theoretical explication than functional contextualism. Investigational methods associated with descriptive contextualism include narrative, historical, ethnographic, and metaphorical accounts of the act in context. Workability and practical application may have less importance to the descriptive contextualist than the exploration of possible meanings and the development of “compelling,” though tentative, accounts of behavior in context. With its emphasis on the aesthetic and rhetorical functions of scientific discourse, descriptive contextualism offers a fruitful approach for examining the behavior of scientific investigators – providing richly detailed accounts of the contexts, including socioeconomic and political contingencies, that give rise to specific scientific endeavors and claims. Drawing on the behavioral hermeneutics of Willard Day (1992), the critical epistemology of Sandra Harding (2015), and the sociology of science of Law (2004) and Latour (1993), this paper considers the value of descriptive perspectives for researchers and practitioners working in the functional contextualist tradition, while also acknowledging the scientific limitations of descriptive methods.

• Collaborating Across Philosophical Worldviews
Sean P. Wright, Lutheran Community Services Northwest

The philosophical worldview of contextualism has usefully guided the development of a behavioral science that intentionally aims to change the world for the better given the challenges of the human condition. However, much of the extant knowledge of human behavior (and the ongoing research and applied interventions developed from this knowledge) is rooted in the assumptions of other philosophical worldviews, such as mechanism or organicism. It may be pragmatic for contextual behavioral scientists and practitioners to collaborate with others whose work is grounded in different philosophical assumptions for the purpose of increasing the depth of contextual analyses and to predict-and-influence the behavior of individuals who produce and consume scientific knowledge. This contribution describes guidelines for effective collaborations across worldviews that is informed by practical experience from recent collaborations among psychotherapists and an ongoing collaboration with legal scholars.

Educational Objectives:
1. Define functional contextualism as a philosophy of science and provide examples of how functional contextualism can inform personal and professional practices. 2. Define descriptive contextualism as a philosophy of science and provide examples of scientific projects informed by descriptive contextualist perspectives. 3. Name 3 guidelines for effective discussions of alternate philosophical worldviews.

 

123. Projets cliniques et de recherche novateurs en francophonie
Symposium (1:20-2:50pm)
Components: Analyse conceptuelle, Revue de la littérature, Données originales, Exercices pratiques, Présentation didactique, Étude de cas
Categories: Interventions cliniques, Approches contextuelles fonctionnelless dans des disciplines connexes, Interventions cliniques, Prévention et interventions communautaires, Interventions pour améliorer les performances, Développement professionnel, Fondements théoriques et philosophiques, Théorie des cadres relationnels, Trouble de la Personnalité Borderline, ACT TSA, Auto-compassion, Adultes - TAG, Coaching
Target Audience: Débutant, Intermédiaire, Avancé
Location: Arobase

Chair: Sylvie Rousseau M.Ps., Université de Sherbrooke

Ce symposium met en valeur des initiatives cliniques et de recherche en francophonie. D’abord, Dre Keltoum Belmihoub illustre une prise en charge du trouble de la personnalité limite sous l’angle de trois TCC de la troisième vague (schémas, ACT et DBT). Ensuite, les psychologues Lise Grond et Andrea Velez offriront une application clinique novatrice des principes de l’ACT auprès de personnes avec un trouble du spectre de l’autisme (TSA). Le Dr Ilios Kotsou, auteur et chercheur, présentera par la suite un essai aléatoire sur les effets d’un entraînement à l’auto-compassion en ligne. Enfin, Sylvie Rousseau, psychologue, décrira un protocole d’intervention basé sur l’ACT pour le trouble d’anxiété généralisée ainsi que des données sur son efficacité. Une période d’échanges permettra aux participants de poser leurs questions et de partager leurs expériences.

• Prise en charge Psychologique de la troisième vague des TCC du Trouble de la Personnalité Borderline
Keltoum Belmihoub, URNOP-Université d'Alger2.ALGERIE

Nous allons à travers une étude de cas clinique illustrer quelques concepts théoriques des trois modèles de la troisième vague de la théorie cognitivo-comportementale à savoir : 1-Le modèle de la théorie des schémas précoces inadaptés de J.Young. Qui mis l’accent sur le la relation thérapeutique pour compenser la négligence des parents, et incite le thérapeute à être un bon modèle pour le patient dans la façon d'exprimer ses émotions et ses besoins. 2-le modèle de la thérapie dialectale comportementale de M. Linhan.La dialectique met l'accent sur la valeur de la recherche de combinaisons naturelles afin de réaliser le changement chez le client, et cherche également à équilibrer, à se concentrer sur les stratégies de changement et d’acceptation. 3-le modèle de la théorie de l'engagement et de l'acceptation de S. Hayes. Qui vise à développer une flexibilité psychologique qui est la capacité d'être en contact avec les émotions et les pensées du moment présent tout en travaillant à réaliser ses objectifs selon ses valeurs et ce qui est important pour lui.

• Reflexions sur la thérapie d'acception et d'engagement chez les adultes présentant un trouble du spectre de l'autisme de haut niveau
Lise Grond, psychologue, CIUSSS de l'est-de-l'île-de-montréal (IUSMM)
Andrea Velez, psychologue, CIUSSS de l'est-de-l'île-de-montréal (CLSC de Rosemont)

La prévalence des personnes présentant un trouble du spectre de l’autisme (TSA) est en constante hausse dans le monde. Cette clientèle, qui est plus vulnérable à développer un trouble de santé mentale, représente donc inévitablement une partie des prises en charge des psychothérapeutes. Très souvent, ces professionnels se trouvent démunis face à ces patients ; des thérapies qui n’avancent plus ou sont abandonnées car le diagnostic est peu connu ou parfois même pas posé. Peu de littérature et de recherches cliniques concernant la thérapie ACT (acceptation et engagement) et le TSA existent, pourtant, ces personnes devraient obtenir la même qualité de service que la clientèle neurotypique. Dans cette présentation, les auteures partageront quelques réflexions sur l’utilisation de la thérapie ACT pour une clientèle présentant un TSA de haut niveau. Elles parleront des étapes ACT avec des pistes d’adaptation possibles. Ultimement, cette présentation vise à outiller les professionnels et à ouvrir leurs horizons pour rendre leurs services accessibles à une clientèle complexe. Finalement, elles font un appel a plus des recherches dans le domaine.

• Traiter le trouble d'anxiété généralisée par la thérapie d'acceptation et d'engagement
Sylvie Rousseau M.Ps., Université de Sherbrooke

Les recherches sur l’efficacité de l’ACT dans le traitement des troubles anxieux demeurent rares et très peu d’études cliniques utilisent un protocole standardisé basé sur l’ACT pour les traiter. Dans le cadre de mon doctorat en psychologie, que je compléterai sous peu, j'ai évalué l'efficacité de la thérapie d'acceptation et d'engagement pour le trouble d'anxiété généralisée. Les résultats de cette recherche confirment le lien existant entre le traitement ACT et l’amélioration de la qualité de vie chez les personnes qui sont atteintes du TAG. Lors de l'atelier de formation que j'aimerais présenter lors du congrès, je décrirai ce qui ressort de cette recherche. J'expliquerai le but et les principales composantes du traitement, selon le protocole élaboré par Eifert et Forsyth, soit: comprendre la nature et la fonction de l’anxiété; apprendre à mieux composer avec l’anxiété; déterminer des actions en direction de ce qui est important pour la personne comme une alternative à la gestion de l’anxiété afin d’améliorer la qualité de vie. Des métaphores et des exercices seront proposés pour intégrer les principes de l'ACT.

Educational Objectives:
1. Expliquer les concepts clés des trois modèles de la troisième vague des TCC. 2. Démontrer à travers un cas clinique l'efficacité pratique de ces concepts. 3. Comparer l'apport de chaque modèle par rapport aux autres.

 

128. Clinically relevant applications of the Implicit Relational Assessment Procedure (IRAP)
Symposium (3:10-4:25pm)
Components: Conceptual analysis, Original Data
Categories: Relational Frame Theory, Clinical Interventions and Interests, IRAP
Target Audience: Beg., Interm., Adv.
Location: Rue Sainte-Catherine

Chair: Miguel Rodriguez-Valverde, Ph.D., University of Jaen, Spain
Discussant: Louise McHugh, Ph.D., University College Dublin

Researchers in the domains of psychopathology and clinical psychology are increasingly using the Implicit Relational Assessment Procedure (IRAP) as a way of tapping into clinical phenomena that are difficult to analyze with more traditional measures. This symposium presents three papers that explore the use of the IRAP for the assessment of clinically relevant verbal relations in different areas of interest. The first paper explores the use of the IRAP as a measure of the discrepancy between perceived and desired body size that could complement existing explicit measures like silhouette scales. The second paper used the IRAP to assess automatic beliefs about the effects of cannabis use in both cannabis users and non-users, showing that implicit beliefs about the positive effects of cannabis seem to contribute differentially to the prediction of actual cannabis use. The third paper aimed to explore the common-humanity factor of self-compassion, and whether people tend to identify with this factor more in relation to their own experiences or to the experiences of others.

• Using the IRAP as a measure of discrepancy between actual and ideal body size
Monica Hernandez-Lopez, Ph.D., University of Jaen, Spain
Alberto Luis Blanco-Romero, B.A., University of Jaen, Spain
Lourdes Quiñones-Jimenez, B.A., University of Jaen, Spain
Miguel Rodriguez-Valverde, University of Jaen, Spain

The discrepancy between one's perceived and desired body size appears to be of key relevance for body dissatisfaction. Silhouette scales such as the Contour Drawing Rating Scale (CDRS: Thompson & Gray, 1995) are typically used as an explicit measure of this discrepancy. The present study explored whether it is possible to provide an implicit index of body size discrepancy based on the Implicit Relational Assessment Procedure (IRAP). Forty female and 40 male college students were presented with two different IRAP tasks each (and actual-body-size task, with the labels I am and I am not, and an ideal-body-size task, with the labels I want to be and I don't want to be). Both tasks used the same set of six drawings as targets: the three extremes of thinness and the three extremes of fatness from the nine-item CDRS (female pictures were used for female participants and male pictures were used for male participants). Participants also completed the CDRS. The differential contribution of implicit and explicit discrepancy to eating disorder symptoms and body dissatisfaction was analyzed.

• Implicit beliefs about the effects of cannabis consumption in cannabis users and non-users
Miguel Rodriguez-Valverde, Ph.D., University of Jaen, Spain
Vanesa Martinez-Reche, B.A., University of Jaen, Spain
Gloria Torres-Fernandez, M.Sc., University of Jaen, Spain
Monica Hernandez-Lopez, University of Jaen, Spain

Expectations about cannabis effects play an important role in predicting cannabis use. This study assessed both implicit and explicit beliefs about the effects of cannabis use in a sample of users and non-users. One hundred participants underwent an IRAP task with the labels With cannabis and Without cannabis, and six positive (e.g. I have fun) and six negative (e.g. I am paranoid) phrases as targets. Eighty-one of them (41 users and 40 non-users) completed the task and produced valid data. Participants also completed a visual analogue scale (VAS) with the same stimuli employed for the IRAP and questionnaires about cannabis use and severity of addiction. While both groups showed a clear implicit pro-cannabis bias it was significantly stronger for users than for non-users. There was a clear discrepancy between implicit and explicit measures for both groups, with IRAP scores showing better prediction of actual cannabis use. These results are discussed in terms of their clinical implications.

• “I Am Not Alone in My Suffering”: Implicitly Measuring the Common Humanity Factor of Self-Compassion
Eman Alasiri, Eastern Washington University
Diana Bast, Ph.D., Federal University of São Carlos, Brazil
Russel Kolts, Eastern Washington University

This study aimed to explore common humanity and whether people tend to identify with this factor more in relation to their own experiences or those experiences of others. Most of the previous research on self-compassion used explicit measures which can be scientifically limiting. The current study developed an implicit measure of common humanity using the Implicit Relational Assessment Procedure (IRAP). Stimuli in the IRAP were drawn from Neff’s (2003) sub-scales of common humanity and isolation. Participants completed the IRAP as well as two explicit measures; Neff’s Self-Compassion Scale and an IRAP analogue. Results suggest that, at an implicit level, participants expressed more common humanity toward the self. On the explicit measure, nevertheless, participants expressed less common humanity toward the self. Moreover, explicitly, participants denied feeling of isolation when they struggle in life, but did not show the same bias on the implicit measure. Finally, implicitly, participants denied that when others struggle they feel isolated, whereas, explicitly, they confirmed that. Limitations and implications of the study are elaborated in the discussion.

Educational Objectives:
1. Describe how the IRAP can be used for measuring clinically relevant verbal relations. 2. Explain the relationship between implicit verbal relations and clinically relevant measures (symptomatology, etc.). 3. List the clinical implications of IRAP research.

 

132. Increasing psychological flexibility, resilience, and coping strategies for parents of children with medical conditions: ACT and Autism SIG Sponsored
Symposium (3:10-4:25pm)
Components: Conceptual analysis, Original Data, Didactic presentation
Categories: Clinical Interventions and Interests, Behavioral medicine, Clinical Interventions and Interests, Prevention and Community-Based Interventions, Behavioral medicine, Functional contextual approaches in related disciplines, Children, parents, asthma, randomized controlled trial, mediation analysis, depression, Autism Spectrum Disorder, caregiver
Target Audience: Beg., Interm., Adv.
Location: Rue Saint-Paul

Chair: Yolanda R. Villarreal, Ph.D., McGovern Medical School at University of Texas Health Science Center Houston

This symposium explores the effects of Acceptance and Commitment Therapy interventions among parents of children with medical conditions and the mediating role of ACT processes in clinical settings. The first paper presents the results from a randomized controlled trial investigating the effects of a group-based ACT intervention combined with asthma education for parents of children with asthma. The second paper investigates the mediating effect of psychological flexibility in the management of childhood asthma among parents. The third paper uses a longitudinal design to study the mediating role of psychological inflexibility on the relationship between early (1-2 weeks postpartum) and later (3 and 6-month postpartum) depressive postpartum symptoms among new mothers with medically fragile infants. The fourth paper investigates the effects of psychological acceptance to increase resilience and coping strategies among parents of children with Autism Spectrum Disorder.

• A randomized controlled trial of group-based Acceptance and Commitment Therapy in parents of children with asthma: Effects on the asthma outcomes of children
Yuen-yu Chong, School of Nursing, The Hong Kong Polytechnic University, Hong Kong
Yim-wah MAK, School of Nursing, The Hong Kong Polytechnic University, Hong Kong
Alice Yuen LOKE, School of Nursing, The Hong Kong Polytechnic University, Hong Kong

Childhood asthma imposes a heavy psychological burden on parents which could affect their child’s health. Fostering parental psychological flexibility through Acceptance and Commitment Therapy (ACT) may help parents to accept their psychological difficulties and to improve their childhood asthma management for their personally held values. A randomized controlled trial was conducted to examine the efficacy of a parental training program using group-based ACT plus asthma education (ACT), in comparison with an asthma educational talk (Control), on the utilization of acute healthcare services due to asthma exacerbations in children. One hundred and sixty-eight parents of children aged 3-12 years with asthma were consecutively recruited in a public hospital in Hong Kong. Generalized estimating equations analyses showed that children whose their parents in the ACT group had significantly fewer ED visits (adjusted IRR) = 0.20, 95%CI [0.08,0.53], p=.001) due to asthma exacerbations over a 6-month period, measured at 6 months post-intervention. Results of this study suggest that ACT as an adjunct to parental asthma education could improve the health outcomes of children with asthma.

• Exploring mediators of change in a parental training program using ACT for improving asthma outcomes in children: An analysis using structural equation model based on a clinical trial data
Yuen-yu Chong, School of Nursing, The Hong Kong Polytechnic University, Hong Kong
Yim-wah MAK, School of Nursing, The Hong Kong Polytechnic University, Hong Kong
Alice Yuen LOKE, School of Nursing, The Hong Kong Polytechnic University, Hong Kong

Most of the psychological interventions for parents of children with asthma are based on cognitive behavioral models, suggesting that improvements of child’s health outcomes can occur through different processes, such as increasing parental self-efficacy or reducing psychological distress in asthma care. In this study, the mediators of change in a randomized controlled trial evaluating the effects of ACT in parents for improving their children’s asthma outcomes were explored. Data from 168 parent-child dyads who were randomly assigned to either a parental training program using group-based ACT plus asthma education; or an asthma educational talk were analyzed. Potential mediators in the structural equation models were tested: parental PF, parental psychological symptoms (anxiety, depression and stress) and parental self-efficacy in childhood asthma management. The results showed that only parental PF at post-intervention mediated the group effect on improving child’s asthma symptoms at six months post-intervention (indirect effect = 0.133, 95% CI [0.048, 0.287], p<.001). This study contributes to the body of evidence regarding the mediating role of parental PF in the management of childhood asthma.

• Psychological Flexibility and Depression in New Mothers of Medically Vulnerable Infants: A Mediational Analysis
Yolanda R. Villarreal, Ph.D., McGovern Medical School at University of Texas Health Science Center Houston
Michelle R. Klawans, MPH, McGovern Medical School at University of Texas Health Science Center Houston
Thomas F. Northrup, Ph.D., McGovern Medical School at University of Texas Health Science Center Houston
Mackenzie L. Spellman, McGovern Medical School at University of Texas Health Science Center Houston
Angela L. Stotts, McGovern Medical School at University of Texas Health Science Center Houston

Maternal postpartum depression is prevalent and associated with negative child outcomes, including behavior problems and cognitive delays. Mothers of children admitted directly after birth to the neonatal intensive care unit (NICU) are at even higher risk for depressive symptoms and infants born premature and/or at low birth weight may be more vulnerable to the adverse effects of maternal depression. Understanding mechanisms, particularly modifiable mechanisms, involved in development/persistence of depressive symptoms is critically important for developing effective treatments. This longitudinal, secondary analysis investigated the role of psychological inflexibility as a mediator of the relationship between early (1-2 weeks postpartum) and later (3 and 6-months postpartum) depressive postpartum symptoms among mothers (N = 360) with an infant in the NICU. Psychological inflexibility measured two weeks after infant discharge fully mediated the relationship between early and later depressive symptoms at 3-months postpartum, with partial mediation at 6-months, while controlling for factors previously found predictive of postpartum depression. Acceptance therapies specifically targeting psychological inflexibility may be promising in reducing depressive symptoms postpartum among new mothers with a NICU infant.

• Parents helping parents of children with Autism Spectrum Disorder through ACT
Kenneth Fung, University of Toronto
Johanna Lake, Centre for Addiction and Mental Health
Lee Steel, Extend-A-Family Toronto
Kelly Bryce, Surrey Place Centre
Yona Lunsky, Centre for Addiction and Mental Health

While there are many interventions targeted to help parents of children with Autism Spectrum Disorder (ASD) apply behavioral principles with their children, there are relatively fewer interventions developed to support parents’ resilience. Psychological acceptance is one of the many challenges parents face, making ACT an ideal intervention. This paper will share some of the experiences, observations, and quantitative data from ACT groups for parents of children with ASD to increase their resilience and coping. In particular, these groups were run by parents of children with ASD themselves, and this aspect will be highlighted in the discussion.

Educational Objectives:
1. Describe the intervention components of a parental training program using group-based ACT combined with asthma education conducted in a Hong Kong setting. 2. Lists ome of the challenges facing parents of children with ASD, and describe how ACT processes can be employed to help increase their resilience. 3. Describe the benefits and pitfalls to having parents of children with ASD lead ACT groups and the potential implications of this for sustainability and dissemination.

 

134. Using technology in creative ways to assess and improve ACT interventions
Symposium (3:10-4:25pm)
Components: Original data
Categories: Educational settings, Prevention and Community-Based Interventions, Clinical Interventions and Interests, Clinical Interventions and Interests, Prevention and Community-Based Interventions, Performance-enhancing interventions, Educational settings, Organizational behavior management, Higher Education, ACT, adults, online, e-mental health, workplace, college/university student mental health
Target Audience: Beg., Interm., Adv.
Location: Exclamation

Chair: Shelley Viskovich, University of Queensland, Australia

This symposium presents results of different studies using technology and Acceptance and Commitment Therapy (ACT)-based interventions. The first paper explores whether or not an ACT values-based approach using Ecological Momentary Intervention (EMI) impacts procrastination in an online educational environment. The second paper presents a co-designed, web-based ACT intervention developed to increase engagement in difficult to reach populations (i.e. farmers). Finally, the third paper discusses results obtained from 4-week web-based ACT intervention to promote mental health in university students. Results showed that the four ACT processes (cognitive fusion, valued living, acceptance and mindfulness) mediated changes on the primary outcomes depression, well-being, self-compassion, and life satisfaction.

• Acceptance and Commitment Therapy: A Values-based Approach to Reduce Procrastination Among Online University Students
Nelly A, Dixon, Ed.D., BCBA, LBA, Kaplan Universtiy
Edward Cumella, Ph.D., Kaplan University
Emily Sandoz, Ph.D., Univeristy of Louisiana, Lafayette

In online higher education environments, students present with diverse personal circumstances. Contextual factors present barriers that decrease students’ abilities to engage in timely coursework. There is limited research on Acceptance and Commitment Therapy (ACT) and procrastination within online educational settings. The present investigation explores whether or not an ACT values-based approach using Ecological Momentary Intervention (EMI) impacts procrastination in an online educational environment. Fifty students enrolled in a 10 semester online masters of psychology program will be randomly assigned to either an experimental or control group. Treatment consists of a short ACT-based presentation and values exploration. After viewing the presentation, participants will write for five minutes to define values and create a list of 10 keywords, which will be integrated into EMI prompts as augmentals. Participants will complete pre, post, and 5-week follow-up questionnaires, the Academic AAQ and Academic Procrastination Scale-Short Form. Outcome data from questionnaires, Discussion Board timeliness, and late assignments will be analyzed using repeated measures MANOVA covering the three time periods, contrasting experimental and control groups to determine if procrastination was reduced.

• Evaluation of an Acceptance and Commitment Therapy (ACT) web-based mental health promotion program for university students
Shelley Viskovich, University of Queensland, Australia
Kenneth I. Pakenham Ph.D., University of Queensland, Australia

This study evaluated a web-based Acceptance and Commitment Therapy (ACT) mental health promotion program called YOLO (You Only Live Once) for university students. YOLO is a 4-week 4-module program encompassing all six ACT processes with no face-to-face contact. A total of 134 participants were randomised to one of three intervention groups investigating varied program delivery methods. Primary outcomes assessed were depression, anxiety, stress, well-being, self-compassion, alcohol and drug use and life satisfaction. ACT processes assessed were acceptance, cognitive fusion, education values, valued living and mindfulness. Improvement on the primary outcomes and ACT processes did not differ among the three intervention groups. Program engagement was similar across groups with 25% completing all four modules. Analyses showed significant improvements on primary outcomes depression, anxiety, stress, well-being, self-compassion and life satisfaction, and ACT processes cognitive fusion, engaged living, and mindfulness. Four ACT processes (cognitive fusion, valued living, acceptance and mindfulness) mediated changes on the primary outcomes depression, well-being, self-compassion, and life satisfaction. These preliminary findings provide support for a web-based ACT mental health promotion program for university students.

Educational Objectives:
1. Describe how a values-based exploration using self-generated augmentals affects procrastination behaviors in online college students. 2.Explain the temporal effect the Ecological Momentary Intervention (EMI) has on the submission of student assignments in online courses. 3. Describe how consumers can be involved in the co-design of ACT-based interventions to increase engagement in difficult to reach populations.

 

135. Mindfulness and self-compassion as key processes in mediating life outcomes
Symposium (3:10-4:25pm)
Components: Conceptual analysis, Literature review, Original data
Categories: Research on the mechanisms of mindfulness, Theoretical and philosophical foundations, Evolution, Clinical Interventions and Interests, Performance-enhancing interventions, Theoretical and philosophical foundations, Child malttreatment, Adults survivors of trauma, Self capacity, Role of mindfulness, Mindfulness, Experiential avoidance
Target Audience: Beg., Interm.
Location: Multiplication

Chair: Éliane Dussault, B.A., University of Quebec in Montreal

This symposium presents results on the mediating role of mindfulness and self-compassion on different important life outcomes. The first paper studies the mediating role of mindfulness on the link between child neglect and relatedness (i.e., interpersonal relationships, idealization/disillusionment and fear of abandonment) in a sample of adults. Results revealed that mindfulness acts as a significant mediator between child neglect and relatedness. The second paper investigates the role of self-compassion in the relationship between meditation practice and overall life satisfaction. Results showed that self-compassion is a significant mediator of meditation practice and life satisfaction. Finally, the third paper studies self-compassion as a mediator of the relationship between psychological inflexibility and psychological resilience. Results revealed that self-compassion acts as a partial mediator in the model.

• Childhood neglect and adult relatedness: The indirect effect of being mindful
Éliane Dussault, B.A., University of Quebec in Montreal
Noémie Bigras, M.A., University of Quebec in Montreal
Natacha Godbout, Ph.D., University of Quebec in Montreal

While child maltreatment is related to negative long-term effects such as poorer health and intimate violence (Dugal et al., 2017), limited research has studied the link between childhood neglect (CN) and adult relatedness (i.e., interpersonal relationships, idealization/disillusionment and fear of abandonment). Trauma-based theory postulates that experiencing CN could affect the survivors' disposition towards mindfulness, which in turn may lead to impairments in adult relatedness (Godbout et al., 2016). More research is however necessary to support this postulate. The current study examined the role of mindfulness as mediator in the relationship between CN and adult relatedness. An online survey evaluating CN, mindfulness and relatedness, was conducted among a community sample of 480 adults. Path analyses revealed that mindfulness acts as a mediator of the link uniting CN and relatedness. More precisely, CN was indirectly associated with relatedness through three specific components of mindfulness: acting with awareness, nonreactivity and nonjudgment, explaining 42% of the variance. These results suggest that mindfulness-based interventions could help adult survivors of CN to form and maintain significant relationships.

• The Mediator Role of Self Compassion in the Relationship Between Psychological Inflexibility and Psychological Resilience
ENGİN BÜYÜKÖKSÜZ, OKAN UNIVERSITY
IŞIL TEKİN, İSTANBUL MEDENİYET UNIVERSITY

From the perspective of ACT, the reason of the pains and psychological problems people have originates from the narrowing of the behaviours occurring as a result of cognitive fusion and experiential avoidance. The aim of this study is to search the mediator role of self compassion in the relationship between experiential avoidance and psychological resilience. Participants of this study are undergraduate students (N=285: 61 males; 224 females).Measuring instruments of this study are acceptance and action questionnaire-II, self-compassion scale, and brief resilience scale. In order to mention the mediator effect of the mediator effect model, some conditions should be provided.The meaningfulness of the results were found via PROCESS, and then with the aim of calculating direct effects and indirect effects, regression based PROCESS was used in accordance with the suggestions. As a result of this study, it is seen that self compassion plays a partial mediatory role between experiential avoidance and psychological resilience.

Educational Objectives:
1. Explain the indirect role of mindfulness in the relationship between childhood neglect and adult relatedness. 2. Discuss theoretical considerations of adapting Buddhist philosophy to Western psychological theory. 3. Describe how the psychological resilience increase the mediator of self compassion.

 

136. Seeing through the eyes of others: How can ACT reduce prejudice and harmful behaviors?
Symposium (3:10-4:25pm)
Components: Conceptual analysis, Literature review, Original Data, Experiential exercises
Categories: Educational settings, Clinical Interventions and Interests, Prevention and Community-Based Interventions, Clinical Interventions and Interests, Organizational behavior management, Spirituality and Religion, Empathy health care workers, Spirituality and Religion, Sexual harassment training
Target Audience: Beg., Interm., Adv.
Location: Arobase

This symposium explores different contexts in which ACT can be helpful to reduce prejudice and harmful behaviors. The first paper presents a current research project investigating the effects of an intervention focused on perspective-taking skills aimed at reducing health care providers’ stereotypes and stigma. The second paper describes the psychospiritual constructs of demonization and desecration in the context of the 2016 U.S. presidential election and summarizes results of a cross-sectional study on the significance of negative spiritual appraisals regarding the 2016 U.S. presidential election on psychological adjustment. The third paper discusses sexual harrassment, critiques the existing sexual harassment trainings and describes how ACT and perspective-taking could be a helpful scientifically grounded alternative to reduce harassment behaviors.

• How can ACT prevent racism and prejudice?
JoAnne Dahl, Ph.D., Uppsala University

There is significant evidence that health care providers hold stereotypes based on race, class sex and other characteristics that, in fact, influence interpretations of behaviours, symptoms as well as clinical decisions and treatment. Health care workers are often unaware of these stereotypes or stigma which they carry. There is also evidence to show that heath care providers interact less effectively with clients from minority groups than with those from similar class, culture and race. So far, most programs for dealing with this problem have been to focus on improving health care providers with cross-cultural communication skills which have had only limited effects on these mostly unaware stigma that result in stereotyped conceptualisation and resulting action. The aim of the research we are presently doing is to investigate the effects of an intervention focused on perspective taking skills based on Relational Frame Theory.

• Demonization, desecration, and the 2016 U.S. presidential election: The role of negative spiritual appraisals on post-election psychological adjustment
Serena Wong, M.A., M.E., Bowling Green State University
Tabitha Waite, M.A., Bowling Green State University
Rachel Wasson, B.A., Bowling Green State University
Augustus Artschwager, B.A., Bowling Green State University
Kenneth I. Pargament, Ph.D., Bowling Green State University
William H. O'Brien, Ph.D., Bowling Green State University

Demonization and desecration are negative spiritual appraisals associated with psychological maladjustment across political and relational contexts (Krumrei, Pargament, & Mahoney, 2011; Mahoney et al., 2002; Pargament et al., 2005). To what extent do people perceive the election of President Trump as the work of evil forces or a violation of the sacred? Using a cross-sectional online sample of 252 Americans, the authors examined the prevalence and role of negative spiritual appraisals of the 2016 U.S. presidential election on psychological adjustment. Approximately one-third of participants endorsed some level of such appraisals. Desecration and demonization also predicted maladjustment above and beyond vote and voter demographics. Moreover, the interactive effect between vote and negative spiritual appraisals accounted for unique variance in maladjustment. At higher levels of demonization and desecration, those who voted for President Trump reported greater difficulties with emotion regulation than those who voted against President Trump. Negative spiritual appraisals also moderated the relationship between vote and thought suppression, antagonism, congeniality, and perceived negative impact of the election. Implications for mental health and psychospiritual interventions are discussed.

Educational Objectives:
1. Create a pro social action based on the perceived needs of the ‘other’. 2. Describe the psychospiritual constructs of demonization and desecration. 3. Describe how ACT could be used to develop a conceptually-sound, empirically-grounded training.

 

Sunday, July 29

143. Heart Rate Variability: A Potential Physiological Marker of Thriving
Symposium (9:00-10:15am)
Components: Original Data
Categories: Psychophysiology, Psychophysiology, Heart Rate Variability
Target Audience: Beg., Interm., Adv.
Location: Rue Sainte-Catherine

Chair: R. Sonia Singh, M.A., Bowling Green State University
Discussant: Jennifer McGrath, Ph.D., MPH, Concordia University

Mindfulness is defined as non-judgmental, focused present moment awareness (Kabat-Zinn, 1990) and is an important correlate of psychological flexibility. Additionally, mindfulness-based interventions are designed to promote outcomes that are closely aligned with psychological flexibility and related constructs. The Neurovisceral Integration Model posits that heart rate variability (HRV) is one index of neural structures that are critically important for the regulation and integration of cognitive, emotional, physiological, and behavioral responses (Thayer and Lane, 2000). These neural structures are collectively referred to as the central autonomic network. Multiple lines of research have demonstrated that processes in central autonomic network are associated with the capacity to flexibly respond to stressors and emotional experiences. Further, the central autonomic network has been associated with the capacity to generate flexible responses to address environmental demands. Given that both the central autonomic network and mindfulness are associated with psychological flexibility and related constructs, it stands to reason that they should also be significantly associated with each other. The current symposium synthesizes several research studies examining this association.

• The Role of Mindfulness in Cardiovascular Reactivity and Recovery from Laboratory-Induced Pain
Mariya Zaturenskaya, M.A., University of Texas Health Science Center at San Antonio/STRONG STAR Multidisciplinary PTSD Research Consortium – Fort Hood Site
William H. O'Brien, Bowling Green State University

Despite a growing number of mindfulness-based intervention studies, the mechanism through which mindfulness relates to positive health outcomes is poorly understood. Using Heart Rate Variability (HRV) as an index of autonomic function may be helpful in elucidating the relationship between mindfulness and positive outcomes. The current study examined the relationship between mindfulness (Five Facet Mindfulness Questionnaire; Baer at al, 2006) and HRV reactivity and recovery from a physiological stressor. HRV data of healthy university students (N = 49) were collected during three phases: a baseline period, a cold pressor task, and a recovery period. Differences in pain tolerance, distress, and heart rate variability between the high and low mindfulness groups were assessed across the three phases of the experiment. Participants were found to be reactive to the stressor, which supports the validity of our pain/stress induction. Individuals higher in mindfulness had better HRV recovery from the stressor, suggesting the high mindfulness group responded to, or recovered from, the stressor more adaptively.

• Greater Mindfulness Predicts Autonomic Recovery from Stressors Inducing both Parasympathetic activation and Withdrawal
Tanya Watford, M.S., Bowling Green State University
William H. O'Brien, Bowling Green State University

Both mindfulness and stress have garnered attention given their impact on autonomic functioning (Garland, 2011). However, the role of mindfulness in targeting the physiological mechanisms of stress is not well understood. The present study examined mindfulness (Mindful Attention Awareness Scale (MAAS); Brown & Ryan, 2003) of healthy participants (n = 57; mean age = 20; 61% Female; 75% Caucasian) before recording their high-frequency heart rate variability (HF-HRVn.u.) in response to two counterbalanced 3-minute stress inductions (i.e., math task and surgical video). The high mindfulness group (HM) demonstrated greater baseline HF-HRV compared to the low mindfulness group (LM), t(54) = -3.77, p < .001. All participants demonstrated expected HF-HRV increases during the math task and decreases during the video. However, only HM demonstrated significant autonomic recovery from both stressors, F(1,53) = 7.15, p = .01. Thus, mindfulness predicts recovery from stressful experiences that provoke both parasympathetic activation and withdrawal.

• Difficulties in Emotion Regulation Mediate the Relation Between Mindfulness and Heart Rate Variability
Alex H. Buhk, B.A., University of Toledo
Julia Richmond, M.A., University of Toledo
Jason C. Levine, Ph.D., University of Toledo
Matthew T. Tull, Ph.D., University of Toledo
Kim L. Gratz, Ph.D., University of Toledo

Despite the effectiveness of mindfulness-based interventions (MBIs) for psychological disorders, the underlying psychological and neurobiological mechanisms are unclear (Guendelman et al., 2017). Although research has found a negative relationship between mindfulness training and heart rate variability (HRV; Krygier et al., 2013) - a central modulator of emotion and self regulation (Appelhans & Luecken, 2006), research on explanatory psychological processes is needed. Given mindfulness is centered on focusing one’s attention using “non-elaborative, non-judgmental awareness” of present-moment experience (Kabat-Zinn, 2005), Gratz and colleagues’ (2010) model of emotion regulation which emphasizes “awareness, understanding, and acceptance” may explain the relationship between mindfulness and HRV. Participants completed the difficulties in emotion regulation scale (DERS; Gratz & Roemer, 2004) and mindfulness scale (MAAS; Brown & Ryan, 2003). HRV was measured over three hours. The current study employed mediation analysis (Preacher & Hayes, 2008). The results revealed an indirect effect suggesting that effects of mindfulness on HRV are mediated by DERS. This presentation will discuss the findings in the context of contemporary emotion regulation theory and purported acceptance and MBI processes.

Educational Objectives:
1. Describe the role and significance of mindfulness in recovering effectively from stress that results in both arousal and withdrawal. 2. Demonstrate the usefulness of heart rate variability as a measure of both stress reactivity and the effect of mindfulness on recovery, providing a physiological index of thriving. 3. Discuss the findings in the context of contemporary emotion regulation theory and purported acceptance and MBI processes.

 

145. Brief ACT Matrix Interventions for Medical Inpatients: Addressing Suffering and Promoting Workability
Symposium (9:00-10:15am)
Components: Conceptual analysis, Literature review, Original Data, Didactic presentation, Case presentation
Categories: Behavioral medicine, Clinical Interventions and Interests, Pain, opioid use, multi-problem patients, consult-liason psychiatry
Target Audience: Interm.
Location: Rue Crescent

Chair: Aliza Weinrib, Ph.D., Toronto General Hospital, University Health Network
Discussant: Benjamin Schoendorff, Contextual Psychology Institute & Institut Universitaire en Santé Mentale de Montréal

The ACT matrix – a visual diagram that can be used to succinctly communicate the ACT model – is a natural fit for brief interventions aimed at medical patients. This symposium will highlight the application of the ACT matrix in three independent hospital-based initiatives. First, a one-day ACT matrix workshop has been developed and tested for patients before major orthopedic surgery. Secondly, a brief one-on-one psychotherapy protocol utilizing the matrix has been applied after major surgery to support patients coping with complex post-surgical neuropathic pain, which often becomes chronic. We will share data regarding the efficacy of these ACT interventions in reducing opioid use after surgery. The third initiative presented is an ACT approach to consult-liaison psychiatry, which integrates the matrix into the behavioral assessment and brief treatment of acutely ill medical patients presenting with comorbid psychiatric disorders that can hamper medical treatment. This symposium includes both theoretical and data-driven components, along with clinical insights regarding applying the matrix in the medical setting in order to reduce suffering and promote workability.

• ACT for Prevention of Persistent Post-surgical Pain and Opioid Use in At-Risk Veteran Patients
Lilian Dindo, Ph.D., Baylor College of Medicine
Barbara Rakel, University of Iowa

High levels of pain, significant anxiety, and/or depressive symptoms prior to surgery put patients at elevated risk for persistent pain and prolonged opioid use following surgery. We examined the preliminary effects of a 1-day ACT workshop in “at-risk” patients for the prevention of prolonged pain and opioid use following orthopedic surgery. In a small randomized controlled trial, 60 at-risk Veterans undergoing orthopedic surgery completed a 1-day ACT workshop (N = 31) or Treatment as Usual (TAU; N =30). Pain levels and opioid use were assessed up to 3 months following surgery. Participants in the ACT condition reported greater reductions in average pain than the TAU group. Additionally, 23% of ACT group were still taking opioids at 7 weeks post-op vs. 45% of TAU group. These promising results merit further investigation. Providing an intervention prior to surgery for at-risk veterans has the potential to change clinical practice from a focus on management of postoperative pain to prevention of chronic pain in at-risk individuals.

• ACT for Complex Post-Surgical Pain: Theory, Application, and Clinical Outcome Data
Aliza Weinrib, Ph.D., Toronto General Hospital, University Health Network
Kathryn Birnie, Hospital for Sick Children & Toronto Western Hospital, University Health Network

Patients who undergo major surgeries (e.g., organ transplantation, removal of tumors) are often overwhelmed by pain and distress in the aftermath of the life-saving procedure. They are at risk of persistent neuropathic pain, long-term dysregulation of mood and functioning, and chronic high-dose opioid use. The world-first Transitional Pain Service (TPS) cares for patients experiencing persistent, neuropathic post-surgical pain who are no longer eligible for the hospital-based acute pain service, and are not yet appropriate for an outpatient chronic pain clinic. The TPS includes a behavioral component that is grounded in the ACT model and utilizes the matrix. Based on 4 years of clinical experience with this population, hexaflex models of psychological flexibility and psychological inflexibility after surgery have been formulated. These models take the ACT processes that we are familiar with in the domain of chronic pain, and explicate their applicability in the more novel domains of acute pain treatment. Clinical outcome data will be presented, showing improved outcomes in terms of post-surgical opioid tapering, depressed mood, and functioning for patients who received ACT.

• ACTIVE Consult-Liaison Psychiatry: A novel application of the ACT Matrix for assessment and intervention in acute medical settings
M. Brandon Goodman, M.D., University of North Carolina School of Medicine, Department of Psychiatry
Jonthan S. Gerkin, MD, University of North Carolina School of Medicine, Department of Psychiatry

Patients with serious mental illness -- including bipolar affective disorder, depressive disorders, and psychosis -- make up a significant portion of the American health care system. These patients are often referred to consult-liaison (CL) psychiatry, with the goal of removing behavioral obstacles to effective medical treatment. In order to address the needs of these patients in tertiary care, we have developed Acceptance and Commitment Therapy Integration for Value Elucidation (ACTIVE) - an ACT approach to CL assessment and treatment. ACTIVE fosters patient-centered, value-based and workable committed action by both the patient and their medical team. Using the ACT matrix, the consult-liaison psychiatrist works with the patient and medical team to identify medically-ineffective behaviors, as well as core values and shared behavioral goals for the patient’s hospitalization. Values serve as an anchor for developing goals that allow for pursuit of a rich, meaningful life and optimal medical care, including behavioral/psychiatric care. The resulting intervention aims to support the values of the patient, the primary medical team, the psychiatrist, and the broader health care system.

Educational Objectives:
1. Describe key elements of the ACT matrix as applied with medical patients. 2. Describe key ACT processes to target in medical patients using the ACT matrix, so that psychological flexibility and workable behaviors are increased. 3. List effects of ACT matrix interventions on opioid use in post-surgical populations.

 

146. Changes in Values as a Process of Posttraumatic Growth after Violent Trauma
Symposium (9:00-10:15am)
Components: Conceptual analysis, Literature review, Original Data
Categories: Clinical Interventions and Interests, Performance-enhancing interventions, Posttraumatic Growth
Target Audience: Interm.
Location: Rue Mansfield

Chair: Thea Comeau, Ph.D. candidate, McGill University
Discussant: Marilyn Fitzpatrick, Ph.D., McGill University

Values change is considered one of three ways in which Posttraumatic Growth (PTG) manifests after violent trauma (Tedeschi & Calhoun, 2004). In spite of its central role in models of PTG, there is a dearth of research exploring these positive values changes after trauma, as well as factors which may contribute to this specific form of growth. The current panel will present three papers. The first of these will review the research and provide a conceptual and empirical framework for the role of values in understanding PTG. The two subsequent papers will report on findings of an Interpretative Phenomenological Analysis of interviews with 12 survivors of the Troubles conflict in Northern Ireland. The second paper will review the intersection of values and spirituality in those individuals who report having experienced positive changes in their values following religious violence. The third paper will report on the role self-compassion plays in the experience of positive changes in values following injury or traumatic bereavement. Clinical implications of the findings will be discussed.

• Values Provide a New Lens for Examining Posttraumatic Growth
Thea Comeau, Ph.D. candidate, McGill University
Jiwon Lee, McGill University
Emma Cox, McGill University
Marilyn Fitzpatrick, McGill University

Posttraumatic growth manifests in three ways: changes in self, relationships, and in values (Tedeschi & Calhoun, 2004). Though growth after trauma has been frequently reported, methodological and conceptual concerns limit the utility of this concept (Coyne & Tennan, 2010; Jayawickreme & Blackie, 2016). Positive changes in values are an under explored component of growth after violent trauma (Comeau et al., in preparation). Following exposure to violence, individuals are more likely to participate in philanthropic and altruistic behaviors (Vazquez, Perez-Sales, & Hervas, 2008), which may indicate shifts in values and values congruent behavior. This paper will summarize the literature on positive values change after trauma, including the experience and process of these changes. It will demonstrate the potential role values change can play in both facilitating and tracking posttraumatic growth. It will also highlight ways in which the exploration of values change after trauma can strengthen our understanding of posttraumatic growth. Finally, this paper will suggest tools to assess values, both clinically and for research, to enable the identification of this specific type of posttraumatic growth.

• Spirituality and Positive Changes in Values in Northern Ireland Conflict Survivors
Emma Cox, McGill University
Jiwon Lee, McGill University
Thea Comeau, McGill University
Marilyn Fitzpatrick, McGill University

Both spirituality and values have been identified as essential components of posttraumatic growth (Calhoun & Tedeschi, 2013). Research has not explored the intersection of these two components. This paper reports the findings of an Interpretative Phenomenological Analysis, which investigated the experience of positive changes in values following victimization through religious violence in Northern Ireland. Participants who had experienced traumatic bereavement or injury engaged in one 1-3 hour semi-structured interview. Out of the 12 participants in the original study, 7 identified spirituality as an essential component in their growth. Findings of a sub-analysis of these 7 participants yielded five themes: after trauma, faith and spirituality provided comfort and healing; spirituality guides the clarification and enactment of values; spirituality strengthened the connection between the living and their deceased loved ones; trauma deepens spirituality, resulting in positive change; and faith in divine healing provided more healing than reliance on earthly justice. This research suggests that even in the context of religious violence, people can still thrive through refining and reflecting on their own spiritual beliefs and personal values.

• Self-Compassion in Survivors of Trauma with Positive Changes in Values
Jiwon Lee, McGill University
Emma Cox, McGill University
Thea Comeau, McGill University
Marilyn Fitzpatrick, McGill University

Research has shown that lower levels of self-compassion are associated with a higher degree of suffering post-trauma, and increases in self-compassion may mitigate some post-trauma symptoms (Bistricky et al., 2017). Further, cognitive processes associated with self-compassion may contribute to posttraumatic growth (Wong & Yeung, 2017). To date, however, the relationship between self-compassion and the values change associated with posttraumatic growth have not been analyzed. This study explored how the three components of self-compassion – self-kindness, mindfulness, recognition of common humanity – play a role for people who have experienced a positive change in values following violence. Interviews were conducted with 12 survivors of the Troubles conflict in Northern Ireland and were analyzed by using Interpretative Phenomenological Analysis. Results suggested that while different participants displayed different components of self-compassion, only the participants displaying self-kindness continued to demonstrate all of the other components of self-compassion. Therefore, self-kindness may act as a central component of self-compassion for individuals who have experienced positive changes in values after surviving violent trauma. Implications for research and theory will be discussed.

Educational Objectives:
1. Apply ACT conceptualizations of values to post traumatic growth theory in new ways. 2. Critique previous conceptualizations of post traumatic growth which do not adequately consider the role of values. 3. Design new values based interventions to use with clients struggling with traumatic experiences to facilitate posttraumatic growth.

 

147. When positive emotions function in unexpected ways: A transdiagnostic treatment consideration
Symposium (9:00-10:15am)
Components: Conceptual analysis, Literature review, Original Data, Didactic presentation
Categories: Clinical Interventions and Interests, Theoretical and philosophical foundations, Positive emotions, posttraumatic stress disorder, substance use disorders, borderline personality disorder
Target Audience: Beg., Interm.
Location: Rue Saint-Paul

Chair: Lia S. Bishop, M.A., Clark University, Worcester, MA, USA
Discussant: Kathleen M. Palm Reed, Clark University, Worcester, MA, USA

When positive emotions are considered within the context of clinical psychology, they are often viewed as putatively adaptive - serving as “buffers” against negative emotions. However, from a contextual behavioral framework the inflexible avoidance of, or attachment to any emotion regardless of valence could be related to decrements in mental health and well-being. The current symposium will provide theoretical and empirical presentations, informed by contextual behavioral science, that illustrate the importance of identifying both positive and negative emotions as transdiagnostic treatment considerations, and emphasize the clinical and empirical utility of doing so. Lia Bishop will begin the symposium with a literature review that compares and contrasts the function of positive emotions within both a mainstream psychology and a contextual behavioral perspective. Next, using longitudinal data, Dr. Hollie Granato will examine the relationships between experienced joy, emotion regulation, and risk behaviors in a treatment-seeking population of clients. Finally, Dr. Jessica Armstrong will present qualitative findings on the role of positive emotions in drug and alcohol relapse among individuals seeking inpatient treatment for substance use disorders.

• State of the Research: Positive Emotions
Lia S. Bishop, M.A., Clark University, Worcester, MA, USA
Kathleen M. Palm Reed, Clark University, Worcester, MA, USA

Among western civilizations, the ideal of living free from physical or mental distress has led to the pursuit of ever-increasing happiness and comfort. In clinical psychology, this has been reified through clinical interventions that attempt to increase positive and decrease negative emotions. Yet increasing evidence suggests that positive emotions like joy, love, and happiness may not be putatively pleasurable, and may instead elicit responses of fear and/or avoidance for some individuals. A contextual behavioral science model suggests that rigid responses to any type of emotion (positive, negative, or neutral) could lead to poorer mental health. However, extant research has predominantly focused on negative emotions when validating this theory. This symposium will aggregate research on positive emotions and (1) identify how researchers have operationalized “positive emotions,” (2) contrast the function of positive emotions across mainstream psychology and contextual behavioral science, and (3) provide a clinical example of this construct by exploring fear of positive emotions among individuals with posttraumatic stress disorder (PTSD). Clinical utility, empirical import, and areas of future research will be discussed.

• Positive Emotions and Emotion Dysregulation: The Relationship between Positive Emotions and Urges to Use Substances among High-Risk Individual Diagnosed with Borderline Personality Disorder
Hollie F. Granato, Ph.D., Harbor – UCLA Medical Center, CA, USA

To date, most studies have focused on negative affect when evaluating emotion dysregulation among individuals diagnosed with Borderline Personality Disorder (BPD), and found that negative emotions increase risk for impulsive behavior (Linehan et al., 2015). However, research on substance use suggests that a link may also exist between positive affect and risk for impulsive behavior (Smith & Cyders, 2016). To explore the relationship between positive affect and emotion dysregulation among individuals diagnosed with BPD, this presentation will examine a path analysis model of emotion dysregulation's impact on the relationship between joy and substance use urges over the course of DBT treatment. This study will include approximately 50 clients who meet criteria for BPD and are enrolled in standard DBT in an outpatient community mental health clinic. Preliminary analyses suggest that joy mediates the relationship between emotion dysregulation and substance use urges longitudinally. Data will be evaluated at two time points, and a strength of this study is the use of longitudinal statistical modeling. Additional findings, clinical implications, and limitations will be discussed.

• Seeking Relief from Emotional Pleasure: Using Thematic Analysis to Explore the Role of Positive Emotions in Self-Reported Reasons for Relapsing to Drugs and Alcohol in Individuals with Substance Use Disorders
Jessica L. Armstrong, Ph.D., Veterans’ Administration – Connecticut Healthcare System, CT, USA

Substance use disorders (SUDs) are chronic, relapsing conditions (McLellan, 2002). Evidence supports the role of negative emotions in predicting substance use and relapse (Sinha, 2007). From a contextual behavioral framework, strong attachment to – or aversion of – any emotion should elicit similar behavioral responses. Yet there is limited research examining the role of positive emotions in self-reported reasons for relapsing to drugs/alcohol. The current study used qualitative methods to examine the role of positive emotions in relapse behaviors among individuals receiving inpatient SUD treatment. A total of 30 participants were interviewed for the purposes of this study, and approximately one third (n = 9) described positive emotions as contributing to their relapse experiences. Thematic analyses revealed two primary themes across these interviews, including (1) beliefs that positive emotions were not “deserved” and (2) desires to escape or avoid feeling good or “doing well” in recovery. Thus, substance use ultimately functioned to “relieve” participants of the discomfort associated with feeling good. Finding nuances, clinical implications, and study limitations will be discussed.

Educational Objectives:
1. List and operationalize “positive emotions” within a contextual behavioral framework, and clarify the clinical utility of this construct. 2. Discuss how positive emotions manifest across a range diagnoses in both intuitive and counter-intuitive ways. 3. Examine how strong avoidance of, or attachment to, positive emotions impacts treatment engagement and outcome among individuals with trauma histories, personality disorders, and substance use disorders.

 

149. Integrating ACT with other models
Symposium (9:00-10:15am)
Components: Conceptual analysis, Literature review, Original Data, Didactic presentation, Case presentation
Categories: Clinical Interventions and Interests, Theoretical and philosophical foundations, Functional contextual approaches in related disciplines, Social Anxiety Disorder, FAP, FACT, Sex Therapy, Depression, Parenting
Target Audience: Beg., Interm., Adv.
Location: Exclamation

Chair: Kate Morrissey Stahl, LCSW, Ph.D., CST, University of Georgia

This symposium explores the integration of Acceptance and Commitment Therapy (ACT) with familiar clinical frameworks. The first paper explores the integration of the Emotionally Focused Therapy with ACT for sex therapy. The second paper presents the development and preliminary results of a Mindfulness, ACT intervention for patients with depression in a group therapy setting.

• Acceptance and Commitment Therapy and Emotionally Focused Therapy: Integrating the Approaches for Sex Therapy
Kate Morrissey Stahl, LCSW, Ph.D., CST, University of Georgia

This paper explores how a systemic approach to therapy, Emotionally Focused Therapy (EFT), could be integrated with a behavior analytic functional contextual approach, Acceptance and Commitment Therapy (ACT), which has a strong evidence base for use with individuals, for sex therapy. This integrated approach could be used with couples in a way that is likely to be more efficacious than ACT alone, and possibly with individuals in a way that is more efficacious than EFT alone. The benefits of integration will be discussed as well as details about how the styles of therapy complement each other, implications for sex therapy practice with couples, and a case example.

• Mindfulness, Acceptance and Commitment combined in Cognitive Behavioral Group Therapy for patients with depression – First results of an ongoing study
Nina Schulze, Dipl. Psych., Neuropsychiatric Center Hamburg
Moritz, Steffen, Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Martinistr. 52, 20246 Hamburg, Germany
Silja C. Reuter, Neuropsychiatric Center Hamburg
Yvonne Nestoriuc, Department of Psychosomatik Medicine and Psychotherapy, University Medical Center Hamburg, Martinistr. 52, 20246 Hamburg, German
Peter Tonn, MD, Neuropsychiatric Center Hamburg

Background: CBT is constantly being developed further. Most recently, mindfulness-based and acceptance-based methods have been integrated. Practicing mindfulness improves self-awareness and self-care. The ability to accept unpleasant situations and emotions reduces suffering and emotional pain. Methods: Randomized controlled trial (RCT). The MAC group receives an intervention of eight sessions of group therapy, in which the aspects of Mindfulness, Acceptance and Commitment are taught. The control group will receive a training of progressive muscle relaxation. Measurement at several time points, pre-post analysis, mediation analysis, complementary measurement of negative therapy effects, session evaluations, follow-ups. Discussion: Due to a structural reform in the german health care system, it has become a lot easier for therapists to offer group therapy. Therefore the goal of our study was not only to create and evaluate a new group treatment, but also to develop a therapy manual in which the treatment is described in detail and which we can give to other therapists to spread the use of ACT based interventions in Germany.

Educational Objectives:
1. Discuss how to adapt FAP and ACT with molar perspective for treatment of Social Anxiety. 2. Apply ACT approach in a sex therapy context with couples.

 

151. How Do We ACT in Asia? - The Contextualization of ACT in Eastern Asian Culture: Asian Culture and CBS SIG Sponsored
Symposium (9:00-10:15am)
Components: Conceptual analysis, Literature review, Original Data, Didactic presentation, Case presentation
Categories: Clinical Interventions and Interests, Prevention and Community-Based Interventions, ACT in China, Hong Kong, South Korea
Target Audience: Beg., Interm.
Location: Arobase

Chair: Yan Li, Duke University
Discussant: Zhuohong Zhu, Chinese Academy of Sciences

CBS, by definition, should put a huge emphasis on understanding different contexts. There are 1.6 billion people, about 22% of the world’s population, living in East Asia. Their cultural contexts are underrepresented in CBS literature. The purpose of this symposium is to present how CBS research is done in East Asian cultures. We bring together scholars from China, Hong Kong and South Korea. In this symposium, we will discuss: a)The effects of a group-based ACT intervention for improving parental management of childhood asthma in Hong Kong. The researchers recruited 168 participants in their Randomized Controlled Trial (RCT), and the results are positive. We will also present how ACT was used with this population. b) The validation of the Chinese Psychological Flexibility Inventory and its application with over 30,000 public sector employees. This study paves the way for future empirical ACT studies in China. (c) A systematic review of ACT treatment research in South Korea. This review will identify novel and distinct findings in applying ACT among Korean participants.

• Using group-based Acceptance and Commitment Therapy for improving parental management of childhood asthma: Effects on parent and child outcomes
Yuen-yu Chong, The Hong Kong Polytechnic University
Yim-wah MAK, The Hong Kong Polytechnic University
Alice Yuen LOKE, The Hong Kong Polytechnic University

Fostering psychological flexibility of parents of children with asthma through Acceptance and Commitment Therapy (ACT) may help them to accept psychological difficulties, leading to eventual improvements of their psychological well-being, as well as their children’s health outcomes. A randomized controlled trial was conducted to examine the efficacy of a parental training program using group-based ACT combined with asthma education (ACT), in comparison with an asthma educational talk (Control), on the utilization of acute healthcare services due to asthma exacerbations in children. One hundred and sixty-eight parents of children aged 3-12 years with asthma were consecutively recruited. Generalized estimating equations analyses showed that when compared with the children in the Control group, children whose their parents in the ACT group had significantly fewer ED visits due to asthma exacerbations over a 6-month period. The parents who received the ACT training became more psychologically flexible; had less negative emotional experiences such as guilt and worry sorrow and anger, and attained a better quality of life.

• The Structural Validity of the Chinese Version of Psychological Flexibility Inventory and Its Use in Different Professional Groups
Shujuan Wang, Chinese Academy of Sciences
Zhuohong Zhu, Chinese Academy of Sciences
Min Lu, Chinese Academy of Sciences

The development of Chinese version of Psychological Flexibility Inventory (PFI) is discussed in this article. Psychological flexibility is the core concept within the Acceptance and Commitment Therapy(ACT). Extant comprehensive ACT process measures include the Comprehensive Assessment of Acceptance and Commitment Therapy Processes (CompACT) and the Multidimensional Psychological Flexibility Inventory (MPFI). Based on the current work, we developed a Chinese version of comprehensive measure of ACT processes (PFI) and explored the measure’s factorial structure, validity and reliability in order to provide a psychometrically sound instrument in China. Psychological flexibility has been found to mediate important therapeutic outcomes. In order to provide evidence that psychological flexibility can serve as a functional diagnostic dimension, the study is then to further explore the effect of psychological flexibility on indicators of psychological status with job stress in different work environment. Now we have gathered more than 30,000 of investigation data in Chinese police officers, government employees and bank workers. Results of the investigation will be reported and some interesting results will be discussed in the article.

• A systematic review of ACT treatment research in South Korea
Woolee An, Utah State University
Eric Lee, Utah State University
Michael P. Twohig, Utah State University
Michael E. Levin, Utah State University

In the past decade, numerous studies using Acceptance and Commitment Therapy (ACT) have been published in South Korea. However, most of these studies were published in Korean and unknown to the broader ACBS community. In order to promote cross-cultural communication, this talk aims to systematically review ACT treatment research in South Korea. Electronic databases relevant to psychology in South Korea were searched for articles specifying the use of ‘수용전념치료’ and ‘acceptance and commitment therapy’ up to December 2017. Seventy-three relevant abstracts were yielded and analyzed. Fifty studies were identified as clinical trials, 30 of which were randomized control trials. Anxiety was the most frequently studies problem area. The majority of studies found positive results for effects of ACT on psychological, physiological, and life-style change outcomes. Common limitations within the research literature included small sample sizes, use of disparate multiple outcomes, and inadequate validation of questionnaires with Korean populations. This review identifies novel and distinct findings in applying ACT among Korean participant.

Educational Objectives:
1. Apply ACT in the parental management of childhood asthma with people from Hong Kong. 2. Describe the validation of Chinese Psychological Flexibility Inventory and its application. 3. Explain how to use ACT with people from South Korea.

 

157. ACT and CBS as solutions to problematic eating behaviors
Symposium (10:35am-12:05pm)
Components: Conceptual analysis, Literature review, Original data
Categories: Clinical Interventions and Interests, Behavioral Clinical Interventions and Interests, Behavioral medicine, Theoretical and philosophical foundations, Functional contextual approaches in related disciplines, Health, Obesity, Weight, Weight loss, Veterans, Measurement, Weight management, Problematic Health Behavior
Target Audience: Beg., Interm., Adv.
Location: Rue Crescent

Chair: Anne I. Roche, MA, University of Iowa

The symposium presents a diversity of approaches or studies addressing Acceptance and Commitment Therapy and Contextual Behaviorial Science as solutions to problematic eating behaviors. The first paper in the symposium describes the opportunity for developing new interventions based on integration of ACT, Molar Behaviorism and Wearable Technologies in order to create more lasting results in a rehabilitation program. The second paper presents a study that compared the psychometric properties of different questionnaires assessing experiential avoidance in obese and overweight veterans. The third paper presents a study examining the relationship between binge eating and depressive symptoms and the interactive effects of the latter and experiential avoidance. Findings suggest, among others, that depressive symptoms and experiential avoidance are independent risk factors for binge eating in individuals seeking weight loss treatment. The fourth and last paper of the symposium focuses on two studies that allow to gain a greater understanding of functional processes, such as avoidance and mindfulness, involved in the development and maintenance of problematic health behavior.

• ACTonFOOD: Address Obesity and Overweight Through an Extended Contextual Behavioral Approach
Giorgia Varallo, M.A., IRCCS Istituto Auxologico Italiano, Verbania, Italy - Catholic University of the Sacred Heart, Milan
Rob Cattivelli, Psy.D., Ph.D., IRCCS Istituto Auxologico Italiano, Verbania, Italy - Catholic University of the Sacred Heart, Milan
Anna Guerrini, Clinical Psychology Lab, San Giuseppe Hospital IRCCS Istituto Auxologico Italiano, Verbania, Italy
Nicola Maffini, MA, Private Practice
Francesco Vailati Riboni, Catholic University of the Sacred Heart, Milan
Alessandro Musetti, University of Parma, Italy
Chiara Spatola, IRCCS Istituto Auxologico Italiano, Verbania, Italy - Catholic University of the Sacred Heart, Milan
Emanuele Giusti, IRCCS Istituto Auxologico Italiano, Verbania, Italy - Catholic University of the Sacred Heart, Milan

Obesity and weight problems are growing steadily and becoming a global epidemic. Recent research reports 64% of the adult population as overweight. The social and economic impact is increasing and most of the rehabilitation programs, while effective in the short-term, do not produce long lasting results. From an extended behavioral perspective, integrating contextual behavioral science and multiscale approach, healthy habits are difficult to establish, due to a problematic balance between impulsive, ephemeral choice and global, long-term gains. To foster long-term, value-based decisions, individualized tech friendly feedbacks represents a new opportunity to set flexible and individual goals. The aim of this work is to combine Acceptance and Commitment Therapy, Molar Activities Analysis, and Wearable Technology to develop efficient and sustainable interventions, effective also at the end of structured rehabilitation programs, providing adequate contingencies of reinforcement and, integrating systematic measurements, continuous feedbacks and individualized, values-based objectives. We offer a comprehensive overview, from a conceptual to empirical viewpoint presenting novel, promising data in the obese population.

• Psychometric Properties of the Acceptance and Action Questionnaire for Weight-Related Difficulties (AAQW) in Overweight and Obese Veterans
Cara Dochat, B.A., San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology
Jessica Gundy Cuneo, Ph.D., Department of Psychiatry, University of California, San Diego
Kathryn M. Godfrey, Ph.D., Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University
Niloofar Afari, Ph.D., VA San Diego Healthcare System; VA Center of Excellence for Stress and Mental Health

Experiential avoidance (EA) contributes to psychopathology maintenance and poor health outcomes. The Acceptance and Action Questionnaire (AAQ) was developed to measure EA process change, however, condition-specific measures are needed to effectively assess EA in various populations. We compared the psychometric properties of the AAQ-II with those of the AAQ for Weight-Related Difficulties (AAQW) and its revised version (AAQW-R) in overweight and obese Veterans who recently completed a behavioral weight loss treatment (N=89). Overall, the AAQW-R showed adequate reliability and validity, and appears to measure weight-specific, rather than general EA. Only the AAQW-R, not the AAQW, was significantly correlated with BMI and showed stronger relationships with measures of related constructs. Exploratory factor analysis of AAQW-R items identified three factors which largely comport with the AAQW-R subscales. However, discrepancies highlight possible differences in the latent construct for this sample of mostly male Veterans. Administering these measures in larger samples to assess sensitivity to change and test-retest reliability is necessary to confirm the measure’s utility for assessing weight-related EA.

• Depressive symptoms and binge eating in individuals seeking behavioral weight loss treatment: the moderating role of experiential avoidance
Kathryn M. Godfrey, Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA
Meghan Butryn, Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA.
Evan Forman, Center for Weight, Eating, and Lifestyle Science (WELL Center), Drexel University, Philadelphia, PA, USA.
Nancy E. Sherwood, Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN, USA.

Depressive symptoms (DS) and binge eating (BE) are prevalent in weight management populations and limit treatment success. DS may trigger BE, and BE-related distress could increase DS. Elucidating the psychological processes, such as experiential avoidance (EA), within this relationship could inform theory and clinical practice. This study examined the relationship between DS and BE and hypothesized a moderating role of EA. Participants (N = 468, 76% female) initiating weight loss treatment completed self-report questionnaires of BE, DS, and EA. In regression models, DS (B = 0.72, p < 0.001) and EA (B = 0.22, p < 0.001) were significantly associated with BE. There was a significant DS by EA interaction (B = -0.03, p = 0.002), such that EA had a stronger association with BE in individuals with lower DS. Findings highlight that DS and EA are independent risk factors for BE and that individuals with lower DS are vulnerable to BE at higher levels of EA. EA is a mechanism to consider targeting for tailoring and enhancing efficacy of weight loss treatment.

• Problematic health behaviors: Experiential avoidance as a common function
Anne I. Roche, MA, University of Iowa
Emily B. Kroska, MA, University of Iowa

Although different problematic health behaviors are formally distinct, they may serve a common avoidant function. This presentation will focus on 2 studies: 1) an observational study examining the association between childhood trauma and problem behaviors in adulthood, and 2) two meta-analyses examining the efficacy of acceptance- and mindfulness-based interventions vs. controls for smoking cessation (N =11) and weight loss (N = 25). Study 1: Mediation analyses indicated that experiential avoidance significantly mediated the association between childhood trauma and problem behavior among college students (PM = .43). Multiple mediation analyses indicated that two mindfulness facets significantly mediated the same association. Study 2: Results indicated small but significant effect sizes favoring acceptance- and mindfulness-based interventions over controls for smoking cessation (OR = 1.562, p < .001) and weight loss (g = .301, p < .001). When converted to a common metric, effect sizes were comparable (smoking: d = .246; weight loss: d = .305). These findings provide insight into the potential effectiveness of targeting functional processes such as avoidance and mindfulness in health behavior change efforts.

Educational Objectives:
1. Describe the opportunity for developing new interventions based on integration of ACT, Molar Behaviorism and wereable technologies. 2. Discuss issues in measuring process change of acceptance-based constructs. 3. Discuss depressive symptoms and experiential avoidance as risk factors for binge eating in individuals seeking weight loss treatment.

 

159. Using Acceptance and Commitment Therapy to Help Parents Thrive in the Context of Child Struggles
Symposium (10:35am-12:05pm)
Components: Original Data, Experiential exercises, Case presentation
Categories: Clinical Interventions and Interests, Parenting, autism, anxiety, pilot study, feasibility study, group treatment
Target Audience: Interm.
Location: Rue Saint-Paul

Chair: Phoebe S. Moore, Ph.D., University of Massachusetts
Discussant: Lisa W. Coyne, Ph.D., McLean Hospital / Harvard Medical School

In this symposium, we will discuss the challenges for parents caring for children with significant struggles, such as anxiety disorders, OCD, and autism, and we focus on the promise of Acceptance and Commitment Therapy for helping parents and families thrive in this context. We will review three separate pilot studies of an ACT parenting protocol and discuss data on acceptability and feasibility of the parent treatment protocol as well as treatment outcomes. Guided by the findings of these feasibility trials, we recommend future directions for research and clinical adaptation of our ACT for Parents therapy model.

• Acceptance and Commitment Therapy for Parents of Anxious Children: Pilot Open Trial
Ashley Hart, Ph.D., University of Massachusetts
Jacqueline Raftery-Helmer, Ph.D., Worcester State University
Madeline Levitt, M.A., Clark University
Lisa W. Coyne, Ph.D., McLean Hospital / Harvard Medical School
Phoebe S. Moore, Ph.D., University of Massachusetts

We will present data from a pilot study of Acceptance and Commitment Therapy for Parents of Anxious Children (ACT-PAC), a six-week group intervention that aims to alleviate psychological distress in parents, reduce stigma surrounding pediatric anxiety disorders, and ultimately improve outcomes for youth with these common and impairing conditions. Twenty-three parents (3 males, mean age = 45) of children with a primary anxiety disorder diagnosis (9 males; mean age = 13) reported subjectively (during qualitative feedback interviews) and objectively (mean total score on Client Satisfaction Questionnaire = 25.4, SD = 4.8) that they found ACT-PAC helpful. Pre- and post-group assessment data suggest that ACT-PAC may increase parents’ psychological flexibility (e.g., decrease mean Cognitive Fusion Questionnaire scores, t = -2.32, p = .03) and improve children’s anxiety symptoms (e.g., decrease mean scores on the GAD subscale of the parent-report version of the SCARED, t(22) = -2.53, and on the anxiety/depression subscale of the Child Behavior Checklist, t(22) = -2.05, p = .02). We will discuss our experiences with, ways to enhance, and future directions for ACT-PAC.

• Acceptance and Commitment Therapy (ACT) for Parents of Children with ASD: A Pilot Study Turned Case Study
Kirstin B. Birtwell, Ph.D., Massachusetts General Hospital / Harvard Medical School
Lisa W. Coyne, Ph.D., McLean Hospital / Harvard Medical School

Parents of children with autism spectrum disorder (ASD) play an integral role in their children's treatment. These parents experience more depression, stress, and poorer quality of life relative to parents of typically developing children and are even more vulnerable if they rely on avoidance to cope with the challenges that arise from intense caregiver demands. To address this risk, an ACT-focused parenting group was initiated at a multidisciplinary autism clinic. As a pilot, 3 parents completed a 5-session ACT-based parenting support group. While qualitative data on satisfaction, experiential avoidance, wellness, and quality of life will be presented (including increased self-compassion, decreased depression, and improved life satisfaction from pre- to post-treatment), the current presentation will focus specifically on an in-depth discussion regarding group-format feasibility, the importance of initiating therapeutic contact, and the benefit of combining individual and group ACT treatment models for parents of children with ASD.

• Pilot Testing of ACT for Parents of Anxious Children in an Irish Clinic
Sarah Cassidy, Ph.D., Smithsfield Clinic and Maynooth University, Ireland
Steven Gannon, Ph.D., Smithsfield Clinic and Maynooth University, Ireland
Lisa W. Coyne, Ph.D., McLean Hospital / Harvard Medical Schol

Aims: ACT has a growing body of research evidence demonstrating its effectiveness with a variety of different populations with different presentations. The current study aimed to evaluate an ACT intervention for parents of anxious children, designed by Coyne and Moore, in an Irish context. Methods: The intervention was delivered once weekly, for 2 hours, 6 consecutive weeks. 7 families attended the training, comprised of 11 parents. All parents had children who had been assessed/treated at the clinic for anxiety. Demographic information was gathered prior to the intervention commencing. Numerous measures were administered pre and post intervention (e.g., DASS, PSI, Parenting Scale, PSOC, MBCRPR, SLS, CHAOS, Family Environment Scale, SDQ). Results: Data trends will be discussed but overall show improvements in parenting sense of competence and reduction in feelings of stress, anxiety and chaos in the home. Conclusion: This exploratory work has shown training parents in using ACT therapy is very effective at helping families to lessen the impact of anxiety on their lives.

Educational Objectives:
1. Describe data on the promise of ACT delivered to parents for supporting meaningful positive change in parent and family well-being. 2. Understand clinical challenges to implementing ACT in the populations of parents with anxiety or autistic children. 3. Develop strategies for addressing challenges to effective engagement of families affected by anxiety and autism in parenting treatment research on ACT.

 

161. Thriving in Community Settings: An Investigation into the Benefits of ACT and Self-Compassion for Adolescents: Children, Adolescents & Families SIG and Alberta Chapter Sponsored
Symposium (10:35am-12:05pm)
Components: Conceptual analysis, Literature review, Original Data, Didactic presentation, Case presentation
Categories: Prevention and Community-Based Interventions, Clinical Interventions and Interests, Performance-enhancing interventions, Self-compassion, DNAv, rural, adolescents, parents, groups, schools, community-based participatory research, using ACT models with parents as care-givers in Anxiety
Target Audience: Beg., Interm.
Location: Exclamation

Chair: Alisha Henson, McGill University
Discussant: Marilyn Fitzpatrick, Ph.D., McGill University

This symposium presents two projects based, developed and implemented in the context of rural Ontario. Accessibility to specialized mental health treatment for youths in rural areas is challenging and limited. Mental health practitioners must show creativity and innovation to reach these youth. ACT and self-compassion interventions can be considered innovative in themselves as they involve challenging societal norms regarding how internal experiences and challenges are perceived and treated. Both proposed models go beyond intervening with youth and include working within the context of their environment, one in a school setting and the other by involving the family environment (parent), which can widen the impact of such interventions. This presentation will demonstrate how two different approaches, one focusing on self-compassion and values and the other on ACT processes (using the DNA-v model), can help youth learn to regulate their emotions, increase well-being and decrease mental health symptoms while learning to connect with youth in their community.

• Benefits of a Group-Based Self-Compassion and Values Intervention for Youth in a Rural School Setting: A Feasibility Study
Alisha Henson, McGill University
Dr. Marilyn Fitzpatrick, McGIll University
Dr. Jessica Ruglis, McGill University
Dr. Dianna Lanteigne, Phoenix Centre for Children and Families
Abby Doner, Phoenix Centre for Children and Families

Green (2008) calls for the engagement of both practitioners and consumers in the research and development of evidence-informed practices (e.g., interventions and program evaluations) to increase validity, applicability, and expedite program development. This multi-step research project engaged youth with mental health experiences in a Community Based Participatory Research (Leung, Yen, & Minkler, 2004) process to evaluate and edit a Self-Compassion (Germer & Neff, 2013) program for rural youth. Subsequently, thirty rural adolescent girls participated in a self-compassion - values workshop as part of their physical education class. Data were analyzed using a mixed sequential design, utilizing quantitative measures, as well qualitative analysis of the student's program workbooks. Outcomes indicated that there was an increase of both hedonic and eudaimonic well-being and a decrease in mental health indicators. Overall, the youth reported positive qualitative experiences and an increase in awareness of the self, their values, and their relationship to others. The findings aid in the continued development of the program and help understand benefits of self-compassion-valued based programs for early intervention in schools.

• Thriving Together: A Joint Group-Based Intervention for Youths Struggling with Emotion Regulation and their Parent. A Case Study of Three Parent-Youth Dyads
Marie-Christine Bois, Université du Québec en Outaouais
Dr. Dave Blackburn, Université du Québec en Outaouais
Alisha Henson, McGill University

Parent-child communication and relational challenges are an ongoing concern for many families. An ACT group-based intervention was developed and implemented, targeting rural adolescents (14-16 years) experiencing psychological distress and emotion regulation problems and their parent(s). In this parent-adolescent DNA-v inspired group (Hayes, 2015), dyads developed skills to allow for more psychological flexibility, to form a common language to talk about challenging experiences, and to learn to communicate their internal struggles; with the goal of improving their relationship and increase openness to one another. Three dyads completed the full program. Data from their pre and post questionnaires and feedback from exercises completed during the intervention and qualitative surveys were analyzed and form of three case studies. Outcomes indicate a decrease in adolescent mental health symptoms and psychological flexibility, as well as an increase in positive behaviours and overall functioning. Attention was also given to the impact for the group on the parents, including changes in their parenting attitudes, parental stress regarding their youth and their confidence in their abilities as a parent.

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• A Structured Experience Group Model using ACT concepts and methods (from Thriving Teen, DNA-v and BOLD models) for Parents of Highly Anxious teens; a 10 year review and analysis
J Neil Mulholland, Ph.D., Glenrose Rehab. Hosp. & U of Alberta, Edmonton, Canada

In Murrell's and Scherber's state of the the research address on ACT with Children &/or Parents, they cover studies from 1989 - 2006. In that they note, in the summary chart, that only 2 studies, up until then focused on parents. Within this same address, Murrell, Coyne, Wilson (2006) note that "Evidence suggests that ACT can be useful to parents dealing with challenges children present" This presentation focuses on: A Group Model to assist parents of Highly Anxious Teenagers, using ACT (DNA-V) and Compassion Therapies; pre and posttests from 20 groups. This model also involves anxious teenagers who are in a parrel group or are integrated with the parent group.

Educational Objectives:
1. Describe the challenges of providing and accessing specialized mental health services in rural areas and small communities. 2. List the benefits of working with youths in the context of their environment when using ACT or self-compassion based interventions to help support an increase in well-being and decrease mental health symptoms. 3. Describe the development of two programs, the challenges of implementing them and the benefits of these programs for the youths participants.

 

163. Designing and evaluating the effectiveness of Acceptance and Commitment Therapy interventions for addictions
Symposium (10:35am-12:05pm)
Components: Original data, Case presentation
Categories: Clinical Interventions and Interests, Prevention and Community-Based Interventions, Behavioral medicine, Professional Development, Anxiety, Substance Abuse, Addiction, smoking cessation, Brief Acceptance and Commitment Therapy, primary health care setting, Chinese
Target Audience: Beg., Interm.
Location: Arobase

Chair: Danielle E. Ryals, Phoenix Programs, Inc

This symposium presents results on the clinical effectiveness of the Acceptance and Commitment Therapy (ACT) model for addiction. The first paper studies the effectiveness of the ACT model to decrease anxiety and increase well-being among adults with substance use disorders. The second paper investigates whether an ACT intervention is more effective than drug counseling on retention and cocaine abstinence. The third paper presents data regarding the effectiveness of an individual, brief ACT over treatment as usual for smoking cessation among adults.

• Acceptance and Commitment Therapy for the Treatment of Anxiety in Clients with Substance Use Disorders
Danielle E. Ryals, Phoenix Programs, Inc.
Laura Cameron, Phoenix Programs, Inc.
Heather Harlan, Phoenix Programs, Inc.

This project examined the effectiveness of the Acceptance and Commitment Therapy model and its impact on values-based living as well as the use of mindfulness practices in the acceptance of unwanted internal distress regarding anxiety in clients with substance use disorders. Data collected during the project was compared to previous treatment as usual consisting of intervention focused on symptom reduction. Participants in this program were adults who scored a 2 or higher on the Generalized Anxiety Disorder 7 (GAD7) assessment measure. Treatment consisted of individual counseling, and/or group therapy meeting weekly for 8-12 weeks. To achieve the primary aim a treatment fidelity measure was used to assure compliance with established treatment protocol by the counselors providing services as well as an assessment measure given to participants included the GAD7. Well-being and to assist in compiling data regarding movement toward values-based committed action and acceptance practices demonstrated toward the experience of anxiety was compared at intake, discharge, and 6-month follow-up using the results of the Acceptance and Action Questionnaire II, and the Quality of Life Index.

• How SMART is your trial? Preliminary data from a SMART design targeting cocaine use disorder with ACT and contingency management
Angela Stotts, Ph.D., University of Texas Health Science Center, McGovern Medical School
Charles Green, Ph.D., University of Texas Health Science Center, McGovern Medical School
Joy Schmitz, Ph.D., University of Texas Health Science Center, McGovern Medical School

A core principle of drug addiction treatment states that no single treatment is appropriate for everyone; rather, treatments need to be adjusted based on patient characteristics and response in order to be maximally effective. Ideally, clinicians would identify a sequence of interventions that works best across different stages of treatment, from abstinence initiation to relapse prevention. Development of effective adaptive interventions calls for a shift in how we conduct randomized clinical trials (RCTs). A sequential, multiple assignment, randomized trial (SMART) is being conducted to test multiple, sequential intervention strategies for cocaine use disorder. In Phase 1, Acceptance and Commitment Therapy (ACT) plus contingency management (CM) are being compared to Drug Counseling (DC) plus CM on retention and cocaine abstinence. Synergism of ACT+CM on primary treatment mechanisms of experiential avoidance and reward sensitivity is hypothesized. In Phase 2, based on Phase 1 cocaine treatment response, participants are re-randomized to additional pharmacotherapy. Initial Phase I data (N = 36) suggest that the ACT+CM is associated with superior retention and higher initial abstinence rates relative to DC+CM.

• Effectiveness of an individual, brief acceptance and commitment therapy for smoking cessation in adults recruited in primary health care settings: a randomized controlled trial
Yim Wah Mak, RN, RM, Ph.D., School of Nursing, The Hong Kong Polytechnic University
Alice Yuen LOKE, School of Nursing, The Hong Kong Polytechnic University

This is the first randomised control trial to adopt an individual, Acceptance and Commitment Therapy (ACT) for smoking cessation that was delivered in primary health care settings, with subsequent sessions delivered by telephone, using a proactive approach among the Chinese population. This study aimed to examine whether individual, brief ACT together with educational materials can help smokers to quit more effectively when compared with the usual care. Secondary outcomes such as psychological flexibility and smoking cessation self efficacy were also measured. Compared to the control group, participants who underwent 3 brief sessions of ACT and were given educational materials were more ready to quit smoking, perceived a greater importance in quitting, and had more psychological flexibility, a specific indicator of change through the ACT intervention. A proactive approach to recruiting participants for a smoking cessation trial was found to be feasible with the support of the staff of primary health care settings. Future research is needed to examine the optimal length and duration of the intervention.

Educational Objectives:
1. Implement Acceptance and Commitment Therapy Model for the treatment of anxiety in clients with substance use disorders. 2. Describe the role of the program manager, counselors, family team and financial officer in the implementation process of the ACT project. 3. Describe the role of SMART designs in developing and testing interventions based on patient characteristics and treatment response.