ACBS Research Development Grant Scheme - 2019-2020 Awardees

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.