We live in a complex, globalized, and diverse world. Innovative research is expanding in two directions: first, becoming increasingly inclusive of diverse and historically marginalized communities and centering research around perspectives that have been underrepresented in behavioral science to date; and second, becoming increasingly inclusive through an interdisciplinary focus, bringing together diverse and rich ideas, innovative methods, and dynamic teams to tackle research questions with synergistic sophistication, creativity, and methodological rigor (see Hayes et al., 2021, “Report of the ACBS Task Force on the strategies and tactics of contextual behavioral science research”).

This Inclusive Science grant is intended to promote and support ACBS researchers in developing high quality pilot data that will form the foundation for future competitive grant proposals underpinned by inclusivity, broadly defined. More specifically, this grant focuses on facilitating the early pilot stage of potentially grant-fundable research emphasizing diversity, equity, and inclusion (DEI) and/or interdisciplinary focus. The award is to help the Principal Investigator (PI) collect high-quality DEI and/or interdisciplinary-focused pilot data to support a larger-scale competitive grant application. This grant also can support related direct research activities (e.g., surveying community leaders and stakeholders of marginalized communities ).

This grant can focus on DEI or interdisciplinary capacity building, and preferably both. Here are some examples of the type of research activities that would be a good fit for this grant:

● Collecting pilot data on a DEI or interdisciplinary-focused topic that forms the foundation of a larger study or grant proposal
● Piloting a project to work with allied health professionals (nurses, social workers, physicians, occupational therapist, spiritual care) in a hospital to test an ACT intervention for a specific behavioral health target.
● Engaging bilingual/bicultural researchers as co-investigators and working together on a pilot project toward a cultural adaptation testing RFT principles.
● Surveying stakeholders from a group/community affected by a health issue to identify CBS processes for inclusive partnership/collaboration (e.g., focus groups, needs assessments)
● Extending Prosocial research to locations or populations that are historically under-studied because of poverty, minority status, language, or cultural differences, in preparation for community action participatory research proposal

Full Grant Information attached below.

Click here to read the requirements and to apply.
 

One grant each year is reserved for qualifying projects for those researchers living/working in a low- or middle-income country according to the World Bank Country and Lending Groups list. The principal investigator (PI) must be from a low- or middle-income country; however, applications can include team members or another PI (multiple PI – mPI) from higher income countries. This grant money may be split among multiple, high quality grant submissions from LAMIC, up to $5,000 USD annually. This grant will not be awarded if a qualifying, quality grant application from a LAMIC researcher is not received.

Awards for 2021-2022:

Lydiah Maingi, PhD, Department of Psychology in Kenyatta University, Kenya; Joanna Arch, PhD, University of Colorado Boulder and University of Colorado Cancer Center

Gaps in Supportive Care for Cancer Patients in Kenya: Recommendations for Acceptance and Committment Therapy Intervention

Lay Summary

Throughout the world, a cancer diagnosis is often associated with distress for patients and their families. Greater social and emotional support for cancer patients and families is essential for improving patient quality of life. There is growing evidence supporting the efficacy of Acceptance and Commitment Therapy (ACT) interventions in coping with cancer-related distress. These studies, however, have generally been conducted in high income,majority white countries. Yet lower middle income countries in sub-Saharan Africa, including Kenya, have recently been experiencing high and growing prevalence rates of cancer, high cancer-related mortality, late stage at diagnosis, low cancer literacy, and high stigma, with concomitant widespread unmet oncology supportive care needs. Kenya’s National Cancer Control Strategy 2017-2022 (MOH Kenya, 2017) identifies psychosocial support care as a priority area in enhancing the quality of life for cancer patients yet there remains a severe dearth of supportive care interventions. Moreover, common cancer coping strategies among cancer patients in Kenya include viewing cancer as the result of a curse, witchcraft, or spiritual deficit. These challenges lead to high rates of depression, anxiety, and low quality of life among many cancer patients.

This study aims to establish the existing gaps in supportive care for cancer patients among the existing cancer care agencies in Kenya. The identified gaps will be used to inform how ACT could be adapted to meet the most important psychosocial and behavioral needs of cancer patients within a Kenyan context. This effort will include getting patient and provider input on potential ACT strategies and how to make them most effective for a Kenyan context. The ultimate goal is to develop a culturally-sensitive ACT-based intervention to support distressed Kenyan cancer patients. As Kenya is a regional leader, the impacts of this project have implications for the broader sub-Saharan region of Africa. 

---

Amanda Muñoz-Martínez, Ph.D., Department of Psychology in the Universidad de Los Andes (Colombia); Clara Sophie Otto-Scheiber, M.S., Hospital Universitario de la Fundación Santa Fe de Bogotá (Colombia)

Exploring the Relationship of Perceived Social Connection and Value-Based Behaviors in Adherence to Cardiac Rehabilitation Recommendations: A Momentary Ecological Evaluation

Lay Summary

Cardiovascular diseases are the leading cause of death in the world. Adherence to cardiac rehabilitation recommendations (ACRR) is crucial for reducing mortality. Nonetheless, after patients are discharged from these programs, their engagement in healthy behaviors tend to decrease. Contextual behavioral factors such as social connection and psychological flexibility have shown positive results in improving healthy behaviors such as physical activity and diet in the general population. However, evidence on how those factors can aid cardiac rehab in a within- and between-person level is unclear. Based on it, we formulate four research questions: a) Are daily perceived social connection and engagement in valuebased behaviors related to participants adherence in cardiac rehabilitation recommendations? b) Are daily interactions in high-quality social contexts and engagement
in value-based behaviors related to higher involvement in cardiac rehabilitation recommendations? c) Does the average quality of relationships moderate the relationship between social connection and adherence to cardiac rehabilitation recommendations? and d) Does psychological flexibility moderate the relationship between value-based behavior and adherence to cardiac rehabilitation recommendation? A device-contingent diary study
will be conducted (including the pilot study-phase). Fifty-four patients discharged after a cardiovascular event and referred to the cardiac rehab program at a private hospital will be eligible to participate in this study. Ongoing data of perceived social connection (PSC), value-based behaviors (VB), and ACRR will be collected for 12-weeks.

At a between-person level, it is expected to observe higher engagement in cardiac rehab recommendations in participants reporting higher levels of social connection and engagement value-based behaviors. At an individual level, it is expected to find that on the days in which participants have higher rates of interaction in high-quality social contexts and higher engagement in value-based behaviors, there is higher engagement in cardiac rehab recommendations. Likewise, it is expected that the average quality of relationships moderates the relationship between social connection and adherence to cardiac rehabilitation recommendations and that psychological flexibility moderate the relationship between value-based behavior and adherence to cardiac rehabilitation recommendation. Results will provide information for optimizing cardiac rehabilitation programs by including
strategies to modify contextual behavioral variables within their programs.

---

Amanda Rhodes, PsyD, Health Psychology and Neurobehavioral Research Group (HPNRG) in the Center for Cancer Research of the National Cancer Institute (NCI)/National Institutes of Health (NIH); Staci Martin, PhD, HPNRG; Mary Anne Tamula, MA, HPNRG; Melissa Baker, BS, HPNRG

A Pilot Randomized Controlled Trial of Acceptance and Commitment Therapy for Sleep Disturbances in Sickle Cell Disease

Lay Summary

Many individuals with sickle cell disease (SCD) exhibit sleep disturbance. Sleep disturbance has shown to relate to anxiety, depression, and executive dysfunction in this population. Unfortunately, nonpharmacological interventions for sleep disturbance have not been studied in individuals with SCD. Acceptance and Commitment Therapy (ACT) is an emerging evidence-based approach for sleep problems. Preliminary research shows ACT to be effective as measured by subjective (i.e., self-report) data. Despite current recommendations to utilize both subjective and objective methods of obtaining sleep data, ACT studies have yet to measure sleep through objective measures (i.e., actigraphy, which measures sleep through a device worn on the wrist). Thus, there is a need to study ACT for Sleep in a SCD population using objective and subjective measurements. Moreover, due to some limitations of CBT sleep interventions (e.g., minimal improvements in quality of life), ACT may offer a feasible alternative approach. Thus, our study will evaluate the feasibility and acceptability of a remote ACT intervention for sleep disturbance in individuals with SCD.

Participants will be recruited from the National Heart Lung and Blood Institute (NHLBI) and randomized to the intervention immediately or after 8 weeks. Participants will complete baseline measures, a 1-week period to obtain preliminary actigraphy/sleep diary data, 8 weekly ACT sessions with a psychologist/psychology associate, and follow-up evaluations at mid-treatment, post-treatment and four weeks later. Based on preliminary data in cancer populations, we propose that this ACT for Sleep intervention will be feasible and acceptable in individuals with SCD. Further, we will explore whether the treatment significantly improves sleep and quality of life in these patients. The current study has the potential to support ACT as a non-pharmacological treatment for sleep disturbances in SCD while promoting accessibility and decreasing health disparities in underserved medical populations through a fully-remote intervention – an area of research sorely needed.
 

Awards for 2022-2023:

General Grant - Jordan Belisle, PhD, Missouri State University; Rocco Catrone, PhD, The Chicago School of Professional Psychology

Defusing Relational Frames Underlying Autism Stigma in a Representative Sample: A Translational Investigation

Lay Summary

We are seeking to evaluate how relational framing maintains negative stigmatic biases against autistic people and to test a defusion program to weaken biases and promote flexibility. Community perception of disabilities, including of autistic communities, can have direct and negative effects on the quality of life for individuals. Conversely, positive perceptions tend to lead to greater access to resources and acceptance of individuals. There have been few studies that directly assess how these perceptions of stigma form, limiting the creation of interventions to reduce stigma and to promote flexible responding towards autistic individuals. Intervention research in contextual behavioral science has also been slow to integrate basic and translational models directly within intervention. Creating more efficient community-based programs and curating environments of acceptance and flexibility can help foster success and wellbeing for members of the autistic community.

Relational frame theory describes behavioral processes that may underlie social biases. This study will apply concepts from relational frame theory and extensions to explore ableism quantitatively in a large representative sample recruited through crowdsourcing marketplaces. Visual and statistical analyses will allow for detection of negative biases held towards autistic individuals. In a pilot randomized control trial design, participants will be assigned to a fusion (control) or defusion (experimental) group, where the defusion exercise will provide counter-narratives designed to weaken commonly held and erroneous beliefs held about autistic individuals. This evaluation is a direct application of relational frame theory applied to an issue of immense social importance to inform neurodiversity inclusion and justice initiatives. Supporting neurodiversity in all of its forms is critical to fostering inclusive communities and developing a context where all people can thrive. This research also has the potential to strengthen the relationship between basic / translational and applied research in contextual behavioral science while supporting core values of this community. 

---

Inclusive Science Grant - Manuel Gutierrez Chavez, B.S., Department of Psychology, University of Utah; Anu Asnaani, PhD, Assistant Professor, Department of Psychology, University of Utah

Atención Plena: Cena Conscientemente con la Familia

Lay Summary

Hispanics/Latinos (H/L) in Utah experience higher rates of obesity, a risk factor for heart disease, when compared to the rest of the state’s population. A variety of aspects of one’s life can influence obesity, including factors such as culture, family status, mental health, and lifestyle choices. Perceived stress has been associated with emotional eating (eating after experiencing a negative feeling) in H/L communities but culturally relevant interventions for perceived stress and emotional eating are missing. Our previous work has indicated that the local H/L community has great interest in this kind of cross-cutting (physical/mental health) intervention and they have further indicated that stress related to daily living should be targeted with a focus on healthy coping strategies that includes their loved ones. Using a community-informed approach, this study will conduct three distinct focus groups consisting of mothers, fathers, and young adults (16–22-year-olds) to gather information related to eating patterns, coping strategies, and how these two relate to each other at both the individual and family level. The questions of these focus groups will determine current use of mindful eating principles and current coping strategies to be able to understand this community’s relevant strengths. This information will inform the adaptation of a mindfulness-based intervention that will be piloted with a group of ten community members to determine its feasibility and acceptability in their cultural and familial contexts. Specifically, this study has three stages: (1) focus groups will highlight relevant strengths and intervention targets within family units, (2) utilization of that information to co-create a mindfulness-based intervention with our community partner (the Hispanic Health Care Task Force), and (3) piloting the intervention to determine its acceptability and feasibility in this H/L community. The planned outcomes include a culturally relevant intervention that can be piloted with a larger sample to determine effectiveness.  

 

---

LAMIC Grant - Huiyuan LI, PhD, RN, The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, China; Cho Lee WONG, PhD, RN, The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, China

Acceptance and Commitment Therapy for fatigue interference in patients with advanced lung cancer and caregiver burden

Lay Summary

Fatigue is the most common and distressing symptom among patients with advanced lung cancer patients and interferes with physical and psychological health. As fatigue interferes with patient functioning, family caregivers often report feeling burdened by increasing responsibilities and being distressed about patients’ forthcoming death. Acceptance and Commitment Therapy (ACT) has shown promising effects on improving functioning and quality of life in cancer patients. However, evidence-based psychooncological interventions (i.e. ACT) jointly addressing advanced cancer patient distress and caregiver burden are lacking. In addition, both patients and caregivers experience extensive unmet supportive care needs during the Coronavirus disease 2019 (COVID-19) pandemic and even in the post-pandemic era. Especially for patients living in remote and rural areas in China, geographical constraints severely affect the quality of life of patients and caregivers due to lacking timely psychological support. Furthermore, virtual reality technology is gradually gaining recognition in alleviating anxiety and depression in diverse populations, but few studies have applied the technology to advanced cancer patients. Thus, a pilot randomised controlled trial will evaluate the feasibility and acceptability of an online-based dyadic ACT intervention involving 360-degree virtual mindfulness for patients with advanced lung cancer and caregivers in rural areas.

A sample of 40 patient-caregiver dyads will be recruited and randomly assigned to either the online 6-week ACT intervention or the education control group. Fatigue interference for patients with advanced lung cancer and caregiver burden will be evaluated at baseline and post-intervention. A convenience sample of 10 dyads will be recruited for focus group interviews to explore dyads’ experience in ACT intervention. We will also explore the mediation role of psychological flexibility and mindfulness in the ACT process. Results will lay the groundwork for further applications of online ACT for dyads in remote areas in China, realising equal and diverse supportive palliative care.

---

General Grant - Conor McCloskey, PhD student from University College Dublin; Louise McHugh, PhD, University College Dublin

Mixed Signals: Rule-Based Insensitivity Through Competing Sources of Reinforcement

Lay Summary

Awards for 2023-2024:

General Grant - Yors Garcia, Mariana Tellez, Guillermo Aldana and Sandra Liliana Valderrama

Effectiveness of ACT on quality of life, depression, and adherence in people living with HIV

Lay Summary:

The purpose of this project is to investigate the effectiveness of Acceptance and Commitment Therapy (ACT) on depression, quality of life, and medication adherence in people living with HIV/AIDS (PLWHA). PLWHA faces numerous behavioral, mental health, and social challenges  associated with their illness. For example, 22% to 61% of PLWHA report symptoms of depression (Du et al., 2023). Depression has been associated with a significant decrease in health-related quality of life (HRQoL; Cooper et al., 2017). Improvements in quality of life for PLWHA reduce the risk for probable infections associated with HIV and improves medication adherence to antiretroviral therapy (ART; Miners et al., 2014). ACT is a process-based intervention that has demonstrated significant improvements in multiple mental health disorders (Gloster et al., 2020), yet the empirical evidence is very limited in increasing health indicators in PLWHA (Moitra et al., 2015; Skinta et al., 2015). Therefore, the main goal of this project is to advance the CBS research in ACT with PLWHA and investigate the impact of ACT in underexplored areas such as depression, quality of life and treatment adherence and evaluate the maintenance of health gains after the end of the intervention. A pretest-posttest design with a waiting list control group will be implemented in this study. A total of 50 HIV/AIDS positive participants will be randomly assigned to two groups, treatment and waiting list control groups. Depression, psychological flexibility, HRQoL and medication adherence measurements will be administered at pretest, posttest, and at 1- and 3-months follow-up. Participants in the treatment group will receive seven ACT sessions covering topics such as acceptance, values, mindfulness and defusion. We expect the treatment group to show significant improvements in the four outcome measures and demonstrate maintenance over time compared to the waiting list group. 

 

---

General Grant - Jennifer Krafft and Natalie Tadros

Reframing health behavior change: A randomized controlled trial of an RFT-informed values intervention for health

Lay Summary:

Clarification of personal values is a core motivational process in acceptance and commitment therapy (ACT). Values theoretically provide a stable and inexhaustible source of positive reinforcement. Both basic and applied research have demonstrated that values clarification is generally effective at increasing motivation and improving well-being. However, from a process-based framework, it is important not just to know that values clarification is beneficial, but how values clarification can be targeted most efficiently and when values clarification is most likely to be useful. Given the high prevalence and severe impact of lifestyle-related health problems, health behavior change is one area in which enhancing motivation is particularly important. Linking specific health behaviors to personal values through relational framing should theoretically both
increase motivation and make motivation more stable.

Thus, this randomized controlled trial will evaluate the impact of values clarification, implemented over 4 weeks through daily writing exercises in a prototype mobile app, relative to a control intervention that engages in daily writing exercises focused on self-reflection. In order to clarify how to most effectively engage values clarification, we will test the impact of values clarification prompts that employ distinct relational frames (hierarchical, conditional, distinction, and deictic). Participants will be 64 individuals who are interested in improving their health through behavior change and have regular internet access. We hypothesize that using a prototype mobile app focused on values clarification will improve motivation and facilitate health behavior change, and that values clarification will be particularly useful (relative to self-reflection) in the context of stressors or negative affect. This study is consistent with the aims of process-based intervention science, as it both examines a treatment process from a multilevel perspective (i.e., an applied intervention informed by RFT) and explicitly evaluates the contexts in which values clarification is linked to positive outcomes.  

 

---

Inclusive Science Grant - Miriam N. Mukasa, Joseph Mugarura, Rosco Kasujja and Michael Levin

Cultural adaptation of the ACT Guide for anxiety treatment among college students in Uganda

Lay Summary:

Throughout the world, college/university is a right of passage transition time that comes with great responsibilities, higher academic achievement expectations and change. This can be an especially stressful time for individuals and as a result there are increased levels of stress and anxiety reported. Acceptance and Commitment Therapy (ACT) is an evidence based transdiagnostic intervention that has been proven helpful in the treatment of several disorders including depression and anxiety. There are several gaps in mental health access in sub–Saharan Africa due to shortage of mental health practitioners among other barriers. There is a call for digital mental health programs to address the challenges in providing mental health to the population. To minimize training burden and maximize effectiveness, the ACT guide has been designed as an intervention that offers a single session for anyone with mental distress to access online with an option to get long-term support.

The proposed study aims to contextually adapt the ACT Guide and explore its acceptability amongst Ugandan college students. Using a mixed method design we intend to recruit a total of 100 participants using purposive sampling. Data will be collected using focus group discussions
and surveys. 

Awards for 2020-2021:

Samuel Spencer, M.A., University of Hawai‘i at Mānoa; Akihiko Masuda, Ph.D., University of Hawai‘i at Mānoa

Acceptance and commitment therapy as a transdiagnostic treatment for mental health concerns among adults in Hawai’i

Lay Summary

Alleviating the impact of mental health concerns is an important goal within behavioral healthcare. While much research exists concerning outcomes of cognitive behavioral psychosocial treatments, relatively less is known about the processes of change underlying treatment efficacy. Understanding empirically supported processes of change linked to treatment procedures may also be useful for adapting interventions to better serve individuals from diverse sociocultural contexts, such as those found in Hawai’i. One intervention that is commensurate with a process-based, transdiagnostic approach to treatment is acceptance and commitment therapy (ACT), an empirically supported psychosocial treatment that seeks to increase values-embodied adaptive functioning (i.e., engaged living) and improve overall quality of life in individuals suffering from a wide variety of behavioral health concerns.

In the current study, we will investigate the effects of, and process of change within, an individually delivered ACT intervention in a university-based community sample in Honolulu, Hawai‘i. Inclusion criteria will focus on experiential avoidance (EA), an underlying generalized process of change within ACT. A multiple baseline design (MBD) across participants will be used to analyze treatment effects and processes of change within participants (N = 5-7). Daily self-monitored clinically relevant target behaviors (e.g., behavioral excesses and deficits related to each participant’s presenting concerns), as well as daily measures of EA and engaged living (EL) will be collected as the primary variables of analysis, along with weekly nomothetic self-report measures of EA and EL. Self-report measures of relevant outcome variables (e.g., psychological distress, quality of life) will also be collected at pre-/mid-/post-treatment/3-month follow-up. The current study aims to better understand the processes of change within ACT and evaluate its impact on transdiagnostic behavioral health issues within a university-based community sample in Hawai’i. This research seeks to further the CBS mission of developing and refining interventions for the betterment of individuals in diverse contexts. 

Marianna Zacharia, BSc, MSc, PhD candidate, University of Cyprus, ACTHEALTHY lab; Maria Karekla, Ph.D., University of Cyprus and Center for Cognitive Behavioral Psychology, Nicosia, Cyprus; Artemis Theofanous, B.A., M.A., University of Cyprus, ACTHEALTHY lab

An Intervention for female breast CANcer: Acceptance and Commitment Therapy (I-CAN-ACT) for depression and physical pain

Lay Summary

Women with breast cancer encounter various debilitating, frequently co-occurring psychological and physical symptoms due to the cancer diagnosis and medical treatment/surgery. Depression and physical pain frequently co-occur and are common symptoms breast cancer patients seek help for. Acceptance and Commitment Therapy (ACT) is a promising intervention model with preliminary empirical evidence to suggest its effectiveness for dealing with the psychological parameters associated with cancer. However, the ACT-based Randomized Clinical Trials conducted thus far have not focused on examining its effects on physical pain within the cancer context and have mainly focused solely on depression or anxiety. The aim is to examine the efficacy of a brief ACT-based intervention for both, depression and physical pain compared to a waitlist control group for women with breast cancer, who have undergone breast surgery, and experience at least mild depression and intensity and interference of physical pain. The ACT intervention will be delivered in a group format, 90 minutes weekly, for six weeks. Treatment outcomes will include quality of life, physical pain intensity and interference, depression, and anxiety. Also, treatment acceptability and adherence to the brief ACT intervention in terms of retention, treatment engagement and satisfaction with each session and with the overall treatment will be assessed. Reasons for dropout will be recorded. The mediating effects of the ACT-based intervention on treatment outcomes will be examined through ACT proposed processes (acceptance, cognitive defusion, contact with the present moment, self-as-context and self-compassion, values clarification, and committed action). The improvement in ACT proposed processes will be assessed daily during the intervention period (Ecological Momentary Assessment methodology). This study will enable the clarification and refinement of ACT theory for female breast cancer patients experiencing physical pain and depression. 

Psychopathology prevention programs can be developed and psychological treatment can be ameliorated by targeting cancer-related symptoms through transdiagnostic processes. 

Awards for 2019-2020:

Clarissa Ong, M.S., Utah State University; Eric B. Lee, Ph.D., Institute of Living, Anxiety Disorders Center, Hartford Hospital; Michael P. Twohig, Ph.D., Utah State University; Michael E. Levin, Ph.D., Utah State University 

A Process-Based App Intervention Study for Clinical Perfectionism

Lay Summary

In clinical psychology, there has been a growing movement toward process-based therapy (PBT), which conceptualizes assessment and intervention based on shared principles and ideas across empirically supported approaches. The goal of PBT is to improve human wellbeing with evidence-based procedures and processes of change. While PBT has the potential to increase availability and accessibility of resources, more precise tests of its application are needed to clarify its real-world feasibility. The proposed project aims to test the feasibility of the PBT model using an online app intervention (containing two training modules) targeting clinical perfectionism. Clinical perfectionism was chosen because3⁄4like PBT3⁄4it is defined by processes (e.g., rigidity around personal standards) rather than specific behaviors or symptoms. It is also transdiagnostic in that perfectionism is relevant to many diagnoses including OCD, OCPD, GAD, and anorexia nervosa. The trainings will teach cognitive variation and motivational variation respectively, two elements of PBT. Cognitive variation refers to responding flexibly to cognitive stimuli (e.g., reappraisal, decentering) whereas motivational variation refers to being able to contact reinforcement for behaviors from various sources (e.g., tangible rewards, values). We hypothesize: (1) the trainings will specifically move the change processes they target (e.g., cognitive variation training will increase cognitive variation), showing precision of procedures, and (2) the change processes will, in turn, move meaningful outcomes, showing relevance of change processes to personal well-being. Support for these hypotheses would provide evidence that the PBT approach is feasible, effective, and can be applied with precision. Future research can build on this work and focus on refining intervention approaches in line with PBT principles to improve quality and accessibility of mental health services. 

Jessica Kingston, DClinPsy, PhD, MSc., BSc (Hons), Royal Holloway, University of London and Richard Irwin, PGDip in Clinical Neuropsychology, DClinPsy, MSc., BSc.(Hons), Royal Hospital for Neurorehabilitation 

Values and committed action for inpatients with acquired brain injury and depression: A Single Case Experimental Design.

Lay Summary

ABI has a devastating effect on the lives of many people. Survivors face long lasting changes to cognitive, emotional, and physical abilities; life changes profoundly. Not surprisingly, psychological distress is common and can be more disabling than primary cognitive and physical impairment. The evidence-base for enhancing psychological adjustment is limited. Psychological therapies can help; however, the complex and heterogeneous nature of difficulties experienced by this group are well suited to treatments that can address a range of co-occurring difficulties (i.e., transdiagnostic approaches). Preliminary research suggests that Acceptance and Commitment Therapy (ACT) - a transdiagnostic therapy – can help individuals suffering from an ABI.

A major impact of an ABI is that it severely compromises an individual’s ability to participate in activities that give their life meaning, purpose and vitality, especially in the context of mood difficulties. Traditional rehabilitation is goals-focused, with the primary aim of improving concrete everyday functions, rather than life meaning. The values and committed action components of ACT, which can be successfully delivered independent of other ACT components, offer a trandiagnostic method for connecting individuals with life areas that are deeply meaningful and that, with support, can be brought to the forefront of traditional neurorehabilitation.

Recently, we conducted a pilot study testing a 6-week values and committed action intervention (alongside standard care) for individuals admitted to an inpatient rehabilitation service post-ABI. Acceptability and retention was good and improvements in valued behaviours and mood were observed. Having refined the intervention, we now aim to empirically test, for the first time, whether individuals with ABI plus depression can derive meaningful benefits from this intervention. We will make a valuable contribution to the evidence-based for CBS and ABI – an area that is significantly under- developed. We will also provide clinicians with tangible guidance in using values and committed action with this group. 

Awards for 2018-2019:

Mary Lally, The Chicago School of Professional Psychology; Yor Garcia, The Chicago School of Professional Psychology; Amanda Mahoney, The Chicago School of Professional Psychology; and Tom Szabo, Florida Institute of Technology

The effects of defusion and values exercises on special education teacher’s measures of stress and committed actions.

Lay Summary

Special education teachers working with students with emotional and behavioral difficulties report higher rates of occupational stress, job - related stress, and attrition (Kokkinos & Davazoglou, 2009). Additionally, special education teachers working with students with emotional and behavioral difficulties are approximately six times more likely to the leave the classroom than other special education teachers (Lawerson & McKinnon, 1982, as cited in Biglan, Layton, Jones, Hankins, & Rusby 2013). Moreover, teachers report that working with children with autism and emotional difficulties present the most stress (Wisniewski & Gargiulo, 1997, as cited in Biglan et al., 2013). Therefore, there is a need for strategies that address student behaviors while decreasing teachers’ levels of stress. As such, A cceptance and Commitment Therapy ( ACT, Hayes, Strosahl, Wilson, 1999) ) training is one method that has demonstrated high acceptability when addressing private verbal behavior s in the classroom setting (Pistorello et al. , 2013). Similarly, Behavioral Skills Training (BST) research has demonstrated that it is an effective staff training procedure (Parsons, Rollyson, & Reid, 2012). Yet, there has been little research that examines the effects of BST plus ACT interventions on the overt behaviors of teachers and students. With that, the objectives of the proposed research are to determine if training in three ACT processes (committed actions, values, and defusion) increases overt values driven behaviors while reducing measures of stress among special education teachers. Additionally, the research will attempt to determine if ACT based training following BST results in increased treatment fidelity scores for guided compliance procedures implemented in the classroom setting.

 

Nima Golijani Moghaddam, DClinPsy, Ph.D., University of Lincoln, and Anna Tickle, DClinPsy, Framework Housing Association, Nottingham

ACT on homelessness and multiple complex needs: Contextually - adapted series of hermeneutic single - case efficacy designs

Lay Summary

In the UK, recent policy and service developments increasingly recognize the complex emotional and psychological needs of people experiencing homelessness. This population are typically not accessing mainstream psychological support services and can present challenges to such services – which are not configured to meet the needs of individuals who are socially - excluded, mult iply disadvantaged, and subject to unstable living conditions. It is therefore essential to embed psychological support within services that have established closer contact with people experiencing homelessness (e.g., supported housing services). However, our understanding of how best to provide psychological support within these services – i.e., what models or forms of intervention may be useful – is limited. There have been some reported instances of successful practice, but the quality of research has be en generally poor, preventing clear conclusions about whether/how interventions might work. The complexity and instability of work with this population demands that approaches to both intervention and research are suitably flexible and adaptable to dynamic individual circumstances. Acceptance and Commitment Therapy (ACT) offers an evidence - based model for psychological intervention that is conceptually well - suited to working adaptively with people experiencing homelessness. To examine whether ACT can deliv er on its promise for this population, we need research strategies that are similarly adaptive and sensitive to context. We will therefore use a series of tailored single - case designs, drawing on quantitative and qualitative evidence from multiple sources, to investigate the efficacy of ACT for supporting people experiencing homelessness and multiple complex needs. We will make a valuable contribution to the evidence - base around ways of providing psychological support to people experiencing homelessness – an under - served population, with complex emotional and psychological needs that (unaddressed) can perpetuate homelessness and instability and contribute to poor health and functional outcomes. We will also provide a template approach for conducting Contex tual Behavioral Science research in challenging real - world environments.
 

Awards for 2017-2018:

Elena Ballantyne, Psy.D., St. Joseph Healthcare Hamilton and McMaster University

Evaluating the Effectiveness for a Modified Intervention Group for Psychiatric Illness and Cognitive Impairment

Summary

The purpose of this research is to determine if a mindful meditation and acceptance and commitment therapy (ACT) group, called the MINDful ACTion Group, is helpful for people with a mental health condition and problems with their thinking skills (e.g. attention, memory). For this group, traditional mindfulness/ACT exercises have been made easier to do, e.g. shorter meditation, guided videos and CDs, more hands-on techniques, and participants will be taught strategies to help remember to do home practice and to address barriers to living a value-based life. Little is known about how effective these kinds of changes to mindfulness/ACT interventions are, particularly for those with a severe mental illness. We predict that participants will report higher levels of mindfulness skills/acceptance, improved ability to engage in meaningful activities despite intense emotions, greater acceptance, and lower levels of emotional distress following the mindfulness group. We also want to know why group is helpful. To do so, participants will complete paper-and-pencil questionnaires each week about acceptance and mindfulness skills. We will also ask open-ended questions during weekly phone calls about successes/barriers to using skills. Groups will be small, 6-8 people per group for a total of 32 participants who must have a formal mental health diagnosis and concerns about their thinking skills. In order to understand the concerns and needs of the participants, the group members will complete a brief assessment of their thinking skills before the study begins, and complete questionnaires about mindfulness/acceptance, thinking skills, and emotions before and after their participation. The group will meet 90 minutes each week over 10 weeks. Two booster sessions will be offered at 1 month and 2 months to refresh skills. If successful, the group will offer mindfulness/ACT interventions for individuals who may not otherwise be able to participate due to cognitive impairment.
 

 

 

Karoly Schlosser, Institute of Management Studies, Goldsmiths, University of London, and Frank W. Bond, Ph.D., Institute of Management Studies, Goldsmiths, University of London

Acceptance Commitment Training to Improve the Performance and Well-being of Astronauts and Flight Controllers of the European Space Agency for Long-duration Space Missions.

Summary

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 other planets and moons. These endeavours will require significantly longer missions and so it is crucial for astronauts 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 resilient in supporting each other and addressing unexpected issues. We believe that Acceptance and Commitment Therapy (ACT) and mindfulness meditation, underpinned by over two decades of empirical research, is wellplaced to improve the psychological and behavioural skills needed for such demanding missions. ACT is a leading-edge form of cognitive-behavioural therapies (CBTs); research clearly shows that ACT improves mental health, productivity, prosocial behavior and innovation by increasing people’s psychological flexibility: people’s ability to pursue their important goals, even when they experience challenging thoughts, feelings, fears, and emotions. The application of ACT incorporates mindfulness as a key therapeutic skill; it is an enhanced awareness of the present moment in an open and non-judgemental way.Its practice and effectiveness are increasingly being seen in clinical, educational, financial, media and public sectors to enhance human benefits. It is for these reasons, amongst others, that we believe that ACT could benefit astronauts who face unique and continual environmental and biopsychosocial challenges.

Awards for 2016-2017:

Ahmet Nalbant, M.D., Bakirkoy Research and Training Hospital for Mental Health, Bakirkoy/Istanbul, Türkiye; K. Fatih Yavuz, M.D., Bakirkoy Research and Training Hospital for Mental Health, Bakirkoy/Istanbul, Türkiye; Louise McHugh, Ph.D., University Of Dublin, Ireland:

Do Antipsychotics Have Any Effect on Perspective Taking in Schizophrenia?

Lay Summary
Schizophrenia is a highly debilitating disorder and managing negative symptoms is challenging even today. Atypical antipsychotics were expected to reduce burdens which arise from negative symptoms such as avolution and anhedonia. Although their well-known efficacy in terms of positive symptoms, benefits about negative symptoms and their related disabling outcomes are beyond expected.

Also, it seems that there are other aspects which might be important in social functioning in people with schizophrenia. Theory of Mind (ToM) impairments are one of them and is widely studied by cognitive psychologists in schizophrenia. There are very limited data about changes in ToM with antipsychotics. Moreover, whereas ToM impairments in schizophrenia are found to be related with social functioning and linked to anhedonia or disorganized thought, the impact of symptoms on different aspects of cognitive perspective taking is still not well known.

Since ToM research is cognitive developmental in nature and this brings that these skills develop or not, it tells us little about how one can improve social skills in this regard. A more recent contextual behavioural account to cognitive perspective taking was provided by relational frame theory (RFT). RFT suggests that the deictic relational frames of I–you, here–there, and now–then are critical in the development of perspective taking behavior and this is especially important while perspective taking skills can be taught.

This study aims to research whether different antipsychotics have any effect on perspective taking in people with schizophrenia and to investigate its processes along with psychotic symptoms. Understanding the processes of the change between deictic framing and the symptomatology of schizophrenia might lead us developing better interventional models to improve social functioning in schizophrenia.

 

Thomas G. Szabo, Ph.D., BCBA-D , Commit & Act, LLC, Florida Institute of Technology; Corinna Stewart; Ross White; Timothy Gordon; Brooks Witter; Jonathan Tarbox

DARE to Connect: A Pilot Study Using ACT to Foster New Intra-Familial Relationship Skills in Men

Lay summary
Commit & Act (C&A) is an NGO that has been working in Sierra Leone since 2010. Currently, the organization is coordinating a project called DARE to Connect (Defuse, Accept, Recenter, and Engage) that aims to teach partners in intimate relationships to relate to each other with both flexibility and resilience. DARE trains men and women to build relationships with mutual respect and emotional intimacy. We emphasize nurturing partnership in parenting, friendship-building, and sexually intimate relationships. Our aim is to curb domestic violence (DV) by supporting men at risk of committing or adjudicated after partner violence offences new ways to relate to themselves, their thoughts, desires, and emotions.

A. Exploratory research on a) prevalence, b) incidence, and c) recidivism of partner violence.
B. Multiple baseline design study across three dyads to evaluate the DARE to Connect intervention. In session, we will measure micro-aggressions. Between sessions, we will collect self-reports from each dyad. Also, we will collect private individual reports via an accessible online portal on incidences of partner violence. As DV in Sierra Leone is typically treated as a private family matter, we will compare data from these venues to assess whether the intervention serves to transform the functions of intra-family secrets from “acceptable” to “unacceptable”. We will use repeated measures data to assess changes in explicit attitudes voiced by men and women partners.

Data from this pilot investigation will be used to inform workshops and mentor Sierra Leonean therapists, law enforcement/corrections agents, teachers, medical professionals, and counsellors. These professionals will then be empowered to carry the work forward in their communities. We will mobilize partnerships with specific agencies in the region and strive to achieve larger levels of societal adoption. We aim to begin in Bo and replicate these efforts in other districts across Sierra Leone.

Awards for 2011-2012:

Ian Stewart, Ph.D., NIU Galway, Ireland, Nic Hooper, Ph.D., Middle East Technical University, Northern Cyprus Campus, & Louise McHugh, Ph.D., Swansea University, Wales, U.K.:

The Derived Generalisation of Thought Suppression Functions: Extension of the basic paradigm

Lay Summary
The aim of the current proposal is to empirically model unintentional generalization as a cognitive process involved in the failure of thought suppression. Previous research has suggested that thought suppression is difficult because the to-be-suppressed thought becomes associated with intentional distracters. Using a behavioural paradigm known as derived relational responding, the proposed study aims to model a process in which further elements which are not intentional distracters but which become linked to those initial distracters can further contribute to breakdown of intended suppression and consequent rebound of the to-be-suppressed thoughts over time.

Tanja Hundhammer, Ph.D., University of Cologne, Germany, and Gayannée Kedia, Ph.D., University of Cologne, Germany:

Beyond self-compassion: Does mindfulness reduce stereotyping towards despised social targets?

Lay summary
Functioning social relationships make us happy and healthy. To get along well with others we need an open mind. Conversely, stereotyping limits our socializing capacities and often precludes us from making friends. Social psychology’s attempts to reduce stereotyping have so far come up against an intrinsic limit: They are all group-specific. We think that a more general change in social thinking would be fruitful and propose mindfulness training as a viable way to reach this change.

Mindfulness meditation trains non-elaborative, non-judgmental awareness - i.e., one learns to recognize and let go of upcoming thoughts. If one is mindful in a social encounter with a member of a despised social group, one should just recognize upcoming stereotypic thoughts, and then return to the momentary experience (individualized information about the person). Although mindfulness is likely to reduce stereotyping, it has not been tested in this regard.

We want to test mindfulness’ stereotyping reduction capacities in two experimental lab and two correlational field studies. In the experiments, we will instruct participants to become mindful vs. to mind-wander (cf. Kiken & Shook, 2011). Afterwards, participants will judge a member of a despised social group (e.g., drug addict). We hypothesize that as mindfulness distances the person from automatic stereotypic associations, it reduces stereotyping, even on implicit measures like the Implicit Association Test. In our correlative studies we will compare participants with various levels of meditation experience in a Buddhist meditation center and in a mindfulness-based stress-reduction class.

If mindfulness reduces stereotyping, it won’t only be a self-help tool for patients, but also a method to promote social harmony. Mindfulness could alleviate distorted social perceptions, as in social phobia, depression, and in aggression. This could permit a deeper understanding of the mental mechanisms which contribute to human suffering and rehabilitation, on an individual and societal level.