ACBS World Conference 14 - Seattle, June 16-19, 2016

ACBS World Conference 14 - Seattle, June 16-19, 2016

This event has concluded.  Please find information regarding the upcoming ACBS World Conference here.



Handouts and Powerpoints from World Conference 14 can be found here.


What is the World Conference?


The World Conference brings together clinicians and researchers to present cutting-edge research in ACT, RFT, and Contextual Behavioral Science, as well as experienced trainers to lead experiential workshops so that you can learn how to better serve your clients.

The World Conference is for psychologists, social workers, professional counselors, marriage and family therapists, psychiatrists, physicians, drug counselors, health researchers, language researchers, behavior analysts, students and more.... Anyone in a similarly related helping or research field is invited to attend.

Registration in the full conference is all-inclusive and includes lunch, coffee/tea breaks, open access to workshops, research symposia, posters, panel discussions, plenary sessions with CBS researchers and practitioners, and our IGNITE sessions.

Venue

We'll see you at the Westin Seattle, 1900 5th Avenue, Seattle, WA, 98101!

Program

The brief schedule of all sessions and full program now available.  Check it out! 

Pre-Conference Intensive Workshops

First class intensive workshops held the 2 days prior to the World Conference get things started off right, June 14-15, 2016.

   

 

Conference Highlights

  • Confirmed Speakers: Kristin Neff, Marsha Linehan, Lisa Diamond, James Coan, Michael Twohig, and Sue McCurry. See more information here
  • A great venue, Westin Seattle, in the heart of Downtown Seattle, for networking & fostering local and international collaboration
  • Lunches and coffee/tea are included so that you have more time to network
  • Workshops, Workshops, Workshops. Half-day workshops are included (no extra charge), with your conference registration. These 30+ workshops are one-of-a-kind learning opportunities.

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Complete List of Pre-Conference Workshops - WC14 Seattle

Complete List of Pre-Conference Workshops - WC14 Seattle

ACBS World Conference 14, Pre-Conference Workshops

June 14-15, 2-day workshops:

  • Using RFT and ACT to Optimize Therapy for Persons with Autism

Mark R. Dixon, Ph.D.
(Clinical; Research; Beginner, Intermediate, Advanced)

  • Acceptance and Commitment Therapy for Anxiety Disorders: Transforming Anxious Suffering Into a More Vital Life

John P. Forsyth, Ph.D., Jamie R. Forsyth, M.A.
(Beginner, Intermediate)

  • Learning ACT from the Inside Out: A skills building workshop for people near the start of their ACT journey

David Gillanders, DClinPsy. & Helen Bolderston, Ph.D.
(Beginner)

  • How Contemporary Behavior Therapists Can Use the Best of DBT

Kelly Koerner, Ph.D.
(Clinical; Intermediate, Advanced)

  • From Isolation to Belonging: Using ACT and Affective Science to Deepen Your Work with Clients Stuck in Self-Criticism and Shame

Jason Luoma, Ph.D., Jenna LeJeune, Ph.D., & Melissa Platt, Ph.D.
(Clinical; Beginner, Intermediate, Advanced)

  • Mindfulness and Acceptance for Gender and Sexual Minorities: Contextual Strategies to Foster Self-Compassion, Connection, and Equality

Matthew Skinta, PhD, ABPP, Aisling Curtin, M.Sc., Reg. Psychol., Ps.S.I., & Lisa M. Diamond, Ph.D.
(Clinical; Beginner, Intermediate, Advanced)

  • Inside This Moment: Using Present Moment Interventions to Promote Radical Change in ACT - Strosahl, & Robinson

Kirk Strosahl, Ph.D., Patricia Robinson, Ph.D.
(Clinical; Intermediate, Advanced)

  • Foundations of Compassion Focused Therapy and Compassion Focused ACT for Anxiety and Mood Disorders

Dennis Tirch, Ph.D. & Laura Silberstein, Psy.D.
(Clinical; Beginner, Intermediate, Advanced)

  • Mastering the Clinical Conversation: Language as Intervention

Matthieu Villatte, Ph.D., Jennifer L. Villatte, Ph.D., & Steven C. Hayes, Ph.D.
(Clinical; Beginner, Intermediate, Advanced)

  • Acceptance & Commitment Therapy: Focusing on Values Work, Self-Care, and Self-Compassion

Kelly G. Wilson, Ph.D.
(Clinical; Research; Beginner, Intermediate, Advanced)

ACBS staff

Continuing Education (CE) Credits

Continuing Education (CE) Credits

Possible credit hours (may vary depending on desired credit type):

  • 2-day pre-conference workshops: 13 hours
  • ACBS World Conference 2016 (attending all CE events): 25 hours

Types of Credit Available:

  • CE credit is available for psychologists. (APA type)

The Association for Contextual Behavioral Science is approved by the American Psychological Association to sponsor continuing education for psychologists. The Association for Contextual Behavioral Science maintains responsibility for this program and its content. APA CE rules require that we only issue credits to those who attend the entire workshop. Those arriving more than 15 minutes late or leaving before the entire workshop is completed will not receive CE credits.

Information about the CE Process at the Event:

Please remember to scan in and out at the beginning and end of each session using our scanner system. If there is a problem and the scanners are not working, please make sure to sign in and out on the paper check-in sheet provided. We cannot give CE credit if you do not scan/sign in and out.

Please DO NOT SCAN in and out for coffee/tea breaks. CE credits are NOT available for IGNITE sessions, sessions #47, and #77, or Chapter/SIG/Committee meetings or other lunch time sessions.

You will need to complete an evaluation for each session you attend, in order to earn CEs (of any type offered). The evaluations will all be done online. You can complete your evaluations at http://contextualscience.org/evals. These online evaluations must be completed by Wednesday, July 6, 2016. We will email you a printable copy of your certificate by August 15, 2016. This email will come to you from “ACBS”. If you do not receive it, please email support@contextualscience.org.
 

BCBA credits are sponsored by Foxylearning.  Thank you Foxylearning!

*The ACBS Pre-Conference Intensive Workshops have been approved by the National Board for Certified Counselors for NBCC Credit. ACBS is solely responsible for all aspects of the program. NBCC Approval No. SP-2706.

*The ACBS Annual World Conference 14 has been approved by the National Board for Certified Counselors for NBCC Credit. Sessions approved for NBCC credit are clearly identified. ACBS is solely responsible for all aspects of the program. NBCC Approval No. SP-2707*.

*This program is Approved by the National Association of Social Workers (Approval # 886495791-0) for 13 Social Work continuing education contact hours. (This is for the pre-conference workshops.)

*This program is Approved by the National Association of Social Workers (Approval # 886495791-0) for 25 Social Work continuing education contact hours. (This is for the conference.)


Certificate with Number of Hours Attended
As an alternative to a CE certificate, some credentialing agencies (please check with yours) may accept a certificate with the number of hours attended. This requires that an individual verifies their attendance by signing in and out of each session that they attend during the event. The cost for this type of certificate is $10.00.


Fees:

A $45 fee will be required to earn CEs.  If you attend either a pre-conference workshop(s), World Conference, or both, only $45 is due.  If you register for multiple events seperately, please only pay the fee one time. This fee is non-refundable (unless you cancel your registration in its entirety before the cancellation deadline). Attendance verification (sign in/out) and evaluations also may be required.

BCBA credits are charged at $8 per credit hour, after the event.

Refunds & Grievance Policies: Participants may direct any questions or complaints to ACBS Executive Director Emily Rodrigues, acbs@contextualscience.org, or through the Contact Us link on this website.

  • CEs are only available for events that qualify as workshops, symposia, invited lecture, panel discussion, or plenary sessions. Poster sessions, IGNITE sessions, and some other specialty sessions do not qualify for Continuing Education.
  • (Note: CE credits are only available for professionals. You may not earn CE credits with a student registration.)

Commercial Support Disclosures:

The following sessions have indicated that there is commercial support for their presentation:
Pre-Conference Workshop (June 14-15, 2016): Inside This Moment: Using Present Moment Interventions to Promote Radical Change in ACT - Strosahl & Robinson
World Conference (June 16-19, 2016): Sessions 19, 95, 111, & 84

Please click here to view the commercial support disclosures.

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General Schedule of Events - June 14-19, 2016

General Schedule of Events - June 14-19, 2016

Pre-Conference Workshops (2-days)

June 14, 2016 - 9:00am-5:15pm

June 15, 2016 - 9:00am-5:15pm

ACBS World Conference 14

June 15, 2016 - (approx.) 7:30pm - June 19, 2016 - 12:00 noon


By day...

Note: The break and lunch times listed below are approximate.

Monday, June 13, 2016

5:00pm-6:00pm

Registration (registration desk on Mezzanine Level)

Tuesday, June 14, 2016

7:30am-4:30pm

Registration (registration desk on the Mezzanine Level)

9:00am-5:15pm (Breaks, 10:30-10:45am; Lunch, 12:00pm-1:15pm; Break, 3:30-3:45pm)

Workshops

Wednesday, June 15, 2016

7:30am-4:30pm

Registration (registration desk on the Mezzanine Level)

9:00am-5:15pm (Breaks, 10:30-10:45am; Lunch, 12:00pm-1:15pm; Break, 3:30-3:45pm)

Workshops

7:00pm-7:45pm

Rookies Retreat: ACBS Conference Orientation (Student and First Time Attendee event) (room: Fifth Avenue)

7:30pm-9:00pm

Registration (registration desk on the Grand Level)

7:30pm-10:30pm

Opening Social, Chapter & SIG Event (Grand Ballroom) (A cash bar will be available. All family & friends are welcome at this event.)

Thursday, June 16, 2016

7:30am-4:30pm

Registration (registration desk on the Grand Level)

8:00am-9:00am

Chapter/SIG/Committee Meetings

9:00am-5:45pm (Breaks, 10:15am-10:30am; Lunch, 12:00pm-1:15pm; Break, 4:15pm-4:30pm)

Conference Sessions

7:00pm-10:00pm

Poster Sessions, Session #1 (7-8pm), Session #2 (8-9pm) (Grand Ballroom & Grand Ballroom I)

Friday, June 17, 2016

8:00am-4:30pm

Registration (registration desk on the Grand Level)

8:00am-9:00am

Chapter/SIG/Committee Meetings

9:00am-5:45pm (Breaks, 10:15am-10:30am; Lunch, 12:00pm-1:15pm; Break, 4:15pm-4:30pm & 4:30pm-4:45pm)

Conference Sessions

19:00

Free night & Chapter/SIG socials

Saturday, June 18, 2016

8:00am-4:30pm

Registration (registration desk on the Grand Level)

8:00am-9:00am

Aikido & Embodying ACT (room: Elliott Bay)

Chapter/SIG/Committee Meetings

9:00am-5:45pm (Breaks, 10:15am-10:30am; Lunch, 12:00pm-1:15pm; Break, 4:15pm-4:30pm)

Conference Sessions

8:00pm-10:30pm (Follies begin at approx. 8:30pm)

Follies! in the Grand Ballroom (A cash bar will be available. All family & friends are welcome at this event.)

10:30pm-1:00am

Dance Party! (DJ & dance floor... what more do you need?)

Sunday, June 19, 2016

8:30am-12:00pm

Registration (registration desk on the Grand Level)

9:00am-12:00pm (Break, 10:15am-10:30am)

Conference Sessions

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Invited Speakers for the World Conference 14

Invited Speakers for the World Conference 14

Anthony Biglan, Ph.D.

Anthony Biglan, PhD, is a Senior Scientist at Oregon Research Institute. His research over the past 30 years has helped to identify effective family, school, and community interventions to prevent the most common and costly problems of childhood and adolescence.

Dr. Biglan is a former president of the Society for Prevention Research. He was a member of the Institute of Medicine Committee on Prevention, which released its report in 2009 documenting numerous evidence-based preventive interventions that can prevent multiple problems. His recent review of preventive interventions concluded that diverse psychological, behavioral, and health problems can be prevented through the promotion of nurturing families, schools, and communities.

Dr. Biglan’s book, The Nurture Effect: How the science of human behavior can improve our lives and our world (New Harbinger Publications) describes the progress that behavioral science has made in the past fifty years in improving human wellbeing 


James Coan, Ph.D.

Dr. James Coan is Associate Professor of Clinical Psychology and Director of the Virginia Affective Neuroscience Laboratory at the University of Virginia. Dr. Coan has consulted for clinicians, businesses and researchers, working with groups as diverse as the Stanford University Psychiatry Department, the Oregon Social Learning Center, Linkage Inc., the University of Arizona Communication Department, InsightLabs, Cambridge International Consulting, the Anna Freud Center, the Kurt Lewin Institute, Community of Democracies, Creating Connections, and the Mindsight Institute. He is co-editor of the Handbook of Emotion Elicitation and Assessment and has authored more than fifty scientific articles. He has been featured in Science, Nature, the New York Times, The Washington Post, Time Magazine, the New Yorker, The Atlantic, BBC News, Discovery Channel, New Scientist, Scientific American, CBS Sunday Morning, and other major media outlets. Dr. Coan received the inaugural Janet Taylor Spence Award for Transformative Early Career Contributions from the Association for Psychological Science, and the Award for Distinguished Early Career Contributions from the Society for Psychophysiological Research. He is also Chief Scientific Advisor at Movius Consulting.


Pamela J Crooke, Ph.D., CCC-SLP

Dr. Pamela Crooke is the Chief Strategy Officer and a Senior Therapist at the Social Thinking Center in Santa Clara, CA. She is the co-author (with Michelle Garcia Winner) of four award-winning books related to Social Thinking. She has served on the clinical faculty of three universities and worked in the Arizona public schools for 15 years. Her current areas of research include Practice-based research and Implementation Science related to the Social Thinking methodology. 


Lisa M. Diamond, Ph.D.

Lisa M. Diamond is Professor of Psychology and Gender Studies at the University of Utah. She studies the development and expression of sexual identity and orientation over the life course and the psychobiological mechanisms through which close relationships influence physical and mental health. Dr. Diamond is best known for her research on sexual fluidity, which describes the capacity for individuals to experience shifts in their pattern of same-sex and other-sex attraction over time. Her 2008 book, Sexual Fluidity, published by Harvard University Press, describes the changes and transformations that she has observed in the sexual attractions, behaviors, and identities of a sample of lesbian, bisexual, and “unlabeled” women that she has been following since 1995. Sexual Fluidity has been awarded the Distinguished Book award from the American Psychological Association’s Society for the Study of Lesbian/Gay/Bisexual/Transgendered Issues. Dr. Diamond has received numerous other awards for her work from the American Association of University Women, the Society for the Scientific Study of Sexuality, the Society for the Psychological Study of Social Issues, and the American Psychological Association. Dr. Diamond has published over 80 articles and book chapters, and has been invited to present her researach at over 60 Universities and international conferences. Dr. Diamond has been awarded grants in support of her research from the National Institute for Mental Health, The W.T. Grant Foundation, the American Psychological Foundation, the American Institute for Bisexuality, and the Gay and Lesbian Medical Association.


Mark R. Dixon, Ph.D.

Dr. Mark R. Dixon, BCBA-D, is a Professor and Coordinator of the Behavior Analysis and Therapy Program at Southern Illinois University. For the past ten years he has also served as the Director of an SIU initiative (Behavioral Consultant Group) to infuse behavior analysis within schools, alternative education, and residential facilities serving individuals with autism and other developmental disabilities. Mark also runs the Language and Cognition Development Clinic at SIU that delivers RFT and ACT interventions to children with autism on a daily basis. Dr. Dixon has published 10 books, over 150 peer reviewed journal articles, and delivered over 500 presentations nationally and internationally. Dr. Dixon is recognized as one of the most skilled programmers of behavior analysis research and data collection systems worldwide. His software has been distributed across many countries and has been translated into foreign languages. Mark has been the Editor of the peer-reviewed journals, Behavior Analysis in Practice and Analysis of Gambling Behavior. He is also a former Associate Editor for Journal of Applied Behavior Analysis and Associate Editor for the Journal of Organizational Behavior Management. Mark’s research and/or expert opinions have been featured in Time Magazine, Newsweek, The New York Times, National Public Radio, This American Life, and local affiliates of ABC, CBS, PBS, and the Southern Illinoisan. Most recently Dr. Dixon has developed an animal laboratory which uses cockroaches and octopuses as models of the applied challenges associated with autism.


Shannon Dorsey, Ph.D.

Shannon Dorsey, Ph.D., is Associate Professor in the Department of Psychology, Adjunct Associate Professor in the Department of Global Health, and a Licensed Clinical Psychologist at the University of Washington. Her research is on evidence-based treatments (EBT) for children and adolescents, with a particular focus on dissemination and implementation of EBT domestically and internationally. Her work has often focused on Trauma-focused Cognitive Behavioral Therapy (TF-CBT), with hybrid research designs that include both effectiveness and implementation questions. Research has focused on adaptation for unique populations (e.g., foster care) and on training and supervision strategies to deliver TF-CBT and other EBT. Dr. Dorsey is a Principal Investigator on two NIH-funded randomized controlled trials (RCT) involving TF-CBT, both of which include implementation and clinical outcome research questions. The first, in Washington State, studies the role of supervisors in public mental health settings in supporting EBT with clinicians under their supervision. It includes both a descriptive study of common supervision practices and a RCT of supervision strategies. The second, in Tanzania and Kenya, is a RCT of TF-CBT using a task-shifting/task-sharing model in which lay counselors, with little to no prior mental health training, deliver group-based TF-CBT to children and adolescents who have experienced the death of one or both parents, under close supervision by local supervisors, themselves supervised by TF-CBT experts. Dr. Dorsey is also involved in common elements EBT training initiatives and research both in Washington State and internationally, in low and middle income countries. With colleagues at Johns Hopkins Bloomberg School of Public Health, she is involved in RCT and feasibility studies in Southern Iraq, the Thailand-Burma border, Colombia, Zambia, and Ethiopia. dorsey2.png (69 KB


Debra Kaysen, Ph.D.

Dr. Kaysen is a clinical psychologist, and a Professor in the Department of Psychiatry & Behavioral Sciences at the University of Washington, with adjunct positions in the Global Health and Psychology Departments. She is the Director of the Trauma Recovery Innovations Program at the University of Washington, a division dedicated to developing and testing more robust interventions for trauma-exposed populations. Her area of specialty both in research and clinical work is in the care of those who have experienced traumatic events including treatment of PTSD and comorbid disorders. Dr. Kaysen is board certified in in cognitive and behavioral psychology by the American Board of Professional Psychology. Dr. Kaysen is a trainer in Cognitive Processing Therapy, an evidence-based treatment for PTSD providing a wide range of CPT workshops in the US, Canada, Australia, and in low- and middle-income countries. Dr. Kaysen is a prolific researcher, publishing 90 refereed articles. Her research predominantly concerns improving treatments for those who have been trauma exposed and increasing access to effective treatments. Other research involves better understanding how people cope following trauma exposure. She has been principle investigator for numerous federal grants. She has been involved in international studies to adapt evidence-based treatments for trauma-exposed populations for use in low- and middle-income settings. She is currently the Vice President for the International Society for Traumatic Stress Studies and is the Depression Therapy Research Endowed Professor for the Department of Psychiatry at University of Washington.


Marsha Linehan, Ph.D., ABPP

Marsha Linehan PhD, ABPP, is Professor of Psychology and of Psychiatry and Behavioral Sciences and is Director of the Behavioral Research and Therapy Clinics at the University of Washington where her primary research is in the development and evaluation of evidence-based treatments for high suicide risk, multi-diagnostic and difficult to treat populations with severe mental disorders. Together with the non-profit Linehan Institute and Behavioral Tech Research, Inc both of which she founded, she is also highly involved in developing effective means of disseminating evidence based behavioral treatments to all those who need them.
Dr. Linehan is the recipient of the Louis I. Dublin Award for Lifetime Achievement in the Field of Suicide, the Distinguished Research in Suicide Award from the American Foundation of Suicide Prevention and the International Academy of Suicide Research Morselli Medal for lifetime achievement in the field of suicide research.

In her honor, the American Association of Suicidology created the Marsha Linehan Award for Outstanding Research in the Treatment of Suicidal Behavior. She has also been recognized for her clinical research including the Distinguished Scientist Award from the Society for a Science of Clinical Psychology, the award for Distinguished Scientific Contributions to Clinical Psychology from the Society of Clinical Psychology and awards for Distinguished Contributions to the Practice of Psychology from the American Association of Applied and Preventive Psychology and for Distinguished Contributions for Clinical Activities from the Association for the Advancement of Behavior Therapy. The American Psychological Foundation awarded her the Gold Medal Award for Life Achievement in the Application of Psychology, is the recipient of the Association for Psychological Science APS James McKeen Cattell Award, 2014 and is the only Ph.D. to be honored with the National Alliance for Mental Health (NAMI) Research Science Award 2015.

She is the past-president of both the Association for the Advancement of Behavior Therapy and of the Society of Clinical Psychology, Division 12, American Psychological Association. Dr. Linehan is a graduate of Loyola University of Chicago and was trained in spiritual direction under Gerald May and Rev. Tilden Edwards at the Shalem Institute in Washington, D.C. and is a Zen master (Roshi) in both the Empty Cloud Sangha under Willigis Jaeger Roshi (Germany) as well as in the Diamond Sangha (USA). She teaches mindfulness via workshops and retreats for health care providers.


Robert Kohlenberg, Ph.D.

Dr. Kohlenberg received his doctorate at UCLA and is a Professor of Psychology at the University of Washington where he served as the Director of Clinical training. He is certified by the American Board of Professional Psychology and received the Washington State Psychological Association’s Distinguished Psychologist Award. He is the co-originator of Functional Analytic Psychotherapy (FAP), has attained research grants for FAP treatment development, has co-published many papers and several books, including Functional Analytic Psychotherapy: A guide for creating intense and curative therapeutic relationships.


Sue McCurry, Ph.D.

Sue McCurry is Research Professor and Vice-Chair of Research at the University of Washington School of Nursing Department of Psychosocial and Community Health, and Adjunct Research Professor in Psychiatry and Behavioral Sciences. She received her PhD at University of Nevada Reno in 1991, and was in Steve Hayes’ lab when ACT was still called “Comprehensive Distancing.” As part of the UW Northwest Research Group on Aging team, she has worked to help develop, systematically evaluate, and translate non-pharmacological interventions to improve quality of life for older adults, including persons with cognitive impairment. Dr. McCurry is a fellow in the Gerontological Society of America. She is author on over 150 scientific articles and peer-reviewed chapters, two books plus one APA video designed to help family caregivers and health care professionals provide more effective and compassionate care to cognitively impaired individuals and caregivers, and investigator on 31 Federal, State, and foundation grants related to aging and dementia. Her ongoing research includes (1) development and evaluation of training programs for family and professional staff working with persons with cognitive impairment, including homeless individuals; (2) examination of the environmental, behavioral, and psychosocial factors associated with successful physical and cognitive aging; and (3) assessment and treatment of sleep disturbances in older adults with co-morbid medical conditions including Alzheimer’s disease, chronic pain, and menopausal vasomotor symptoms.


Kristin Neff, Ph.D.

Kristin Neff is currently an Associate Professor of Educational Psychology at the University of Texas at Austin. She is a pioneer in the field of self-compassion research, conducting the first empirical studies on self-compassion over a decade ago. In addition to writing numerous academic articles and book chapters on the topic, she is author of the book "Self-Compassion: The Proven Power of Being Kind to Yourself," released by William Morrow, and the 6 CD audio set called “Self-Compassion Step by Step,” released by Sounds True. In conjunction with her colleague Dr. Chris Germer, she has developed an empirically supported eight-week training program called Mindful Self-Compassion, and offers workshops on self-compassion worldwide. Kristin is also featured in the bestselling book and award-winning documentary The Horse Boy, which chronicles her family’s journey to Mongolia where they trekked on horseback to find healing for her autistic son.


Mavis Tsai, Ph.D.

Dr. Tsai, co-originator of FAP, is a clinical psychologist in independent practice, and also works at the University of Washington as a research scientist and as the director of the FAP Specialty Clinic within the Psychological Services and Training Center. She has co-authored four books and over 50 articles, and received the 2014 Washington State Distinguished Psychologist Award in recognition of significant contributions to the field of Psychology. She is on the Fulbright Senior Specialists Roster, has presented “Master Clinician” sessions at the Association for Behavior and Cognitive Therapy, has led numerous workshops nationally and internationally, and trains clinicians all over the world in FAP via Skype.


Michael P. Twohig, Ph.D.

Michael P. Twohig, Ph.D. is a licensed psychologist in the state of Utah and an Associate Professor of Psychology at Utah State University. He received his B.A. and M.S. from the University of Wisconsin-Milwaukee, his Ph.D. from the University of Nevada, Reno, and completed his clinical internship at the University of British Columbia Hospital. He is currently the president of the Association of Contextual Behavioral Science His research primarily focuses on the use of ACT across a variety of clinical presentations. He has published over 100 scholarly works including two books: An ACT-Enhanced Behavior Therapy approach to the Treatment of Trichotillomania (with Woods) and ACT Verbatim for Depression and Anxiety (with Hayes). His research has been funded through multiple sources including the National Institute of Mental Health. His work is generally in the area of clinical behavior analysis.


David Sloan Wilson, Ph.D.

David Sloan Wilson is SUNY Distinguished Professor of Biology and Anthropology at Binghamton University. He applies evolutionary theory to all aspects of humanity in addition to the rest of life, both in his own research and as director of EvoS, a unique evolutionary studies program that has received NSF funding to expand into a nationwide consortium. His books include Darwin’s Cathedral: Evolution, Religion, and the Nature of Society, Evolution for Everyone: How Darwin’s Theory Can Change the Way We Think About Our Lives, and The Neighborhood Project: Using Evolution to Improve My City, One Block at a Time and Does Altruism Exist? Culture, Genes, and the Welfare of Others.

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Photos of the 2015 Berlin World Conference

Photos of the 2015 Berlin World Conference

                                                        

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Program

Program

Conference (June 16-19)

The final draft of the program is here:

WC14 Program Final (6MB, pdf)

The complete list of posters (including abstracts) that will be presented June 16 is here:

WC14 Posters

Detailed information about symposia (including individual paper abstracts)

WC14 Symposia

Pre-conference Workshops (June 14-15)

Complete information about our Pre-Conference workshops (June 14-15) can be found here.

We've got fantastic workshops:

  • Kelly Wilson on Self-Compassion
  • Mark Dixon on using ABA/RFT/ACT for persons with Autism
  • Kelly Koerner showing us the best uses of DBT
  • Matt Villatte, Jenn Villatte & Steve Hayes on building clinical competency
  • Kirk Strosahl & Patti Robinson on present moment interventions
  • Dennis Tirch & Laura Silberstein on CFT
  • Jason Luoma & Jenna LeJeune on Self-Criticism and Shame
  • Matt Skinta, Aisling Curtin, and Lisa Diamond on working with Gender and Sexual Minorities
  • John Forsyth on ACT for Anxiety Disorders
  • David Gillanders & Helen Bolderston on a clinician's Intro to ACT
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WC14 Posters

WC14 Posters

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

WC14 Posters

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WC14 Posters

WC14 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 Fred at acbsstaff@contextualscience.org.

Location: Grand Ballroom

Thursday, June 16, 2016, 7:00-8:00pm - Poster Session #1 

Thursday, June 16, 2016, 8:00-9:00pm - Poster Session #2

Image denotes ACBS Junior Investigator Poster Award Recipients

Thursday, June 16, 7:00-8:00pm - Poster Session #1

1. Weight-related psychological inflexibility among Hispanic college students: Initial validation of the Acceptance and Action Questionnaire for Weight-related Difficulties
Primary Topic: Behavioral medicine
Subtopic: Weight
Karley K. James, Metropolitan State University of Denver
Maureen K. Flynn, Ph.D., Metropolitan State University of Denver
Olga Berkout, Ph.D., Western Psychiatric Institute & Clinic
Solomon Kurz, M.A., University of Mississippi

There is a growing amount of evidence suggesting that psychological inflexibility influences a variety of psychological difficulties, including obesity, disordered eating, and life satisfaction. The Acceptance and Action Questionnaire for Weight-Related Difficulties (AAQ-W) is a measure psychological flexibility for weight-related issues specifically. Previous studies have shown that the AAQ-W is psychometrically sound and has mediated treatment outcomes. Weight-related flexibility has yet to be studied using in Hispanic populations. The purpose of the current study was to examine weight-related flexibility and the psychometrics of the AAQ-W in a Hispanic sample. Hispanic undergraduate students (n = 313) from a university on the Texas/Mexico border completed a battery of web-based assessments. Weight-related inflexibility was significantly associated with greater levels of disordered eating and general psychological inflexibility, and lower levels of mindfulness and obesity-related life satisfaction. Weight-related psychological inflexibility also added to the prediction of disordered eating and obesity-related wellbeing above and beyond BMI, general psychological inflexibility, and mindfulness. This study provides initial support for the validity of the AAQ-W in a Hispanic college student sample.

2. Is pain acceptance a good indicator for differential response to various rehabilitation packages?
Primary Topic: Behavioral medicine
Subtopic: Chronic pain, Interprofessional rehabilitation, Assessment & Prediction, comparison between ACT and CBT
Linn Wifstrand, MD, University of Gothenburg
Graciela Rovner, Ph.D., 3Division of Rehabilitation Medicine, Section for Highly Specialized Pain Rehabilitation, Department of Clinical Sciences, Dande
David Gillanders, Ph.D., University of Edinburgh, School of Health in Social Science, Edinburgh, United Kingdom

Introduction: Behavioral medicine and inter-professional rehabilitation is considered as the state of the art in the area of chronic pain. Rehabilitation programs based on Acceptance and Commitment Therapy (ACT) and Cognitive Behavioral Therapy (CBT) are known to have strong evidence. What is not known is which patient benefits of what kind of rehabilitation program. One way to explore differences in patients’ response to rehabilitation is to stratify and group them according to their behaviors in order to identify common rehabilitation needs. How patients relate to, and accept their pain can potentially be a useful and pragmatic indicator, according to prior studies. Aim: To investigate patients’ differential response to ACT respectively CBT-based pain rehabilitation programs and to explore the usefulness of clustering patients according to their pain acceptance. Method: This study includes 391 patients who underwent ACT or CBT based rehabilitation at Danderyd’s Rehabilitation Clinic in Sweden. Measures of physical, mental and social function were gathered. Patients were grouped into four clusters based on their pain acceptance scores measured through the Chronic Pain Acceptance Questionnaire- 8 items. Baseline differences between ACT and CBT groups were analyzed with independent t-tests and chi-square tests while the differences between the four clusters were explored with a one-way ANOVA. To compare patients’ response to rehabilitation t-tests and mixed between-within-subjects ANOVAs were performed. Results: Patients in the ACT group mainly suffered from widespread pain while the patients in the CBT group mainly had local pain (neck- and/or back). Both groups improved during rehabilitation, but only the ACT group improved regarding physical function. When clustering patients according to their pain acceptance, each cluster became homogenous regarding the patients’ status and distinct differences were found between clusters. Differential response to treatment could be identified: cluster including patients that had lower functional level and quality of life before rehabilitation, got best results from the ACT program. Overall, the group that underwent CBT decreased their kinesiophobia, but only the group that underwent ACT showed an increase of physical function. Conclusion: This study provides further support for the usefulness of clustering patients according to their pain acceptance. Results from this study suggest that patients with the lowest quality of life, highest pain and lowest function benefit more from rehabilitation with ACT than CBT. Results also suggest that ACT better targets and improves patients’ physical function compared to CBT, which in this study only induced cognitive changes regarding patients fear of movement and failed to improve their actual physical function. These preliminary results would need to be replicated with randomized controlled trials in order to be conclusive. Key word: Pain acceptance, Acceptance and Commitment Therapy, Cognitive Behavioral Therapy, rehabilitation, chronic pain The study was granted ethical clearance by the Regional Ethics Board in Gothenburg (approval number 815-12).

3. Using Acceptance and Commitment Therapy to Treat Chronic Pain
Primary Topic: Behavioral medicine
Subtopic: Cognitive defusion, self as context versus self as concept, acceptance
Ryan Tolman, MSW, LICASW, Northwest Nazarene University

Chronic pain persists for more than three months with no known way to resolve, often without physical explanation. This author sought a practical behavioral medicine tool to treat chronic pain which patients and practitioners can easily understand. Acceptance and Commitment Therapy (ACT) provides a theoretical framework of elegant simplicity which can be used with great depth by the medical or mental health practitioner yet is easy for non-professionals to understand. This author reviewed over 40 peer-reviewed journal articles related to ACT and psychological treatment of chronic pain. The literature indicates that ACT is a very hopeful treatment to alleviate suffering for chronic pain patients. Treatment as usual, including opioid painkillers and surgery, can include psychological treatment if doctors, psychologists, therapists, and other care providers have a framework (such as ACT) to guide treatment. The following themes emerged from the literature review: Using "acceptance" in therapy is indicated more effective than mindfulness to treat chronic pain; valued living (doing what matters) is an important facet to managing chronic pain; there was a wide variety of ACT consistent therapy used in research, from group therapy to workbooks to online training, and still be delivered in a manner consistent with ACT adherent theory. This author will present different ways ACT can be used for practitioners and patients towards the alleviation of suffering. Research seemed to indicate that cognitive defusion (seeing one's self in context, not as a rigid concept, such as "I'm always in pain, I can't move") combined with acceptance training is likely to be effective in treatment. The poster will have three themes. The first theme defines chronic pain and the biology/psychology of pain and how the initial signal of pain passes through neuro pathways to the brain. The second theme relates the ACT Triflex to the treatment of chronic pain. The third theme presents what this author discovered through a literature review of ACT treatment of chronic pain (i.e. results of research, ways to use ACT to treat chronic pain.) This author recognizes that the psychological treatment of chronic pain can evoke shame from the chronic pain sufferer, i.e. "You think this is all in my head!!!" This author and current researchers promote the patient following all treatment as usual and using psychological treatment as an adjunct therapy to reduce suffering and increase the patient's ability to "do what matters" to them. During this author's research, everyone who was part of the process either experienced or knew someone who experienced chronic pain. The subject matter written by this author was well received by those with chronic pain in their life, and the poster presentation will reflect empathy for chronic pain sufferers and the practitioners who may be frustrated by challenges in chronic pain treatment.

4. Coping Styles of Patients Hospitalized in an Intermediate Trauma Unit
Primary Topic: Behavioral medicine
Subtopic: Traumatic Injury
Ana C. Sala, PsyD, University of Puerto Rico, School of Health Professions and School of Medicine
Karen Martínez, MD, University of Puerto Rico, School of Medicine
Lydia Temoshok, PhD, University of Maryland
Milagros Figueroa, RN, PhD, University of Puerto Rico, School of Nursing
Omar Rodríguez, PhD, University of Puerto Rico, School of Medicine
Giselle Alicea, MA, University of Puerto Rico, School of Medicine
Lourdes Guerrios, MD, University of Puerto Rico, School of Medicine
Pablo Rodríguez, MD, FACS, FCCM, FACP, FCCP, University of Puerto Rico, School of Medicine

Background: Injury occurs in a social context. Therefore, both physical and environmental elements should be taken into account when predicting and improving patient outcomes post-injury. Patients who suffer from traumatic injuries may also experience psychological distress and there is abundant literature documenting the psychological sequelae of an unexpected injury. The physical and mental changes that a person experiences as a result of an external stressor such as a traumatic injury, may affect a patient’s coping repertoire. Effective coping, such as active and adaptive coping, involves selecting thoughts or behaviors that address the problem and decrease stress and have shown to promote healing. Ineffective coping, such as anxiety, depression, hostility and avoidant behavior, on the other hand, can negatively influence the course of injury. Although research suggests that when coping patterns and contexts are taken into account predictions of health outcomes are more accurate, there is very little research on coping styles of patients hospitalized in trauma units after unexpected injuries. This study aims to describe the coping styles of a group of patients hospitalized in our local trauma unit and their relation to patient personal and clinical characteristics in attempts to develop culturally adapted interventions that promote adaptive coping. Methods: Forty-three trauma patients (41.9% female, 58.1% male; mean age of 39.49) were recruited during their hospital stay to assess their coping styles by using vignettes that exemplify adaptive, active, avoidant, Type A & Type C coping. Median scores of each vignette were calculated to determine the most frequently used coping styles. A semi-structured socio-demographic interview and medical record review was completed to obtain patient personal and clinical characteristics (i.e., age, gender, SES, length of hospital stay, mechanism of injury, physical and psychiatric comorbidities). The association between coping style and personal and clinical characteristics and their impact on coping style were established by calculating Spearman’s correlations. Results: Patients reported higher use of adaptive coping style (median=9.0) in which they selected particular thoughts and behaviors to decrease stress, followed by active coping (median=7.0) in which they reported seeking information to take control of their situation. There were no significant correlations between patient personal characteristics and coping style. However, increased length of stay was associated with increased use of Type A coping (r=0.310; p=0.043) which is characterized by a tendency to react with a hostile edge, impatient or critical of others. Discussion: Although most of our subjects used adaptive coping skills to deal with the trauma, our findings highlight the need to develop novel, culturally appropriate interventions to sustain adaptive skills in patients with prolonged hospital stay. Acceptance and commitment therapy (ACT), which focuses on diminishing experiential avoidance, through acceptance and valued based living, has proven to be effective with multiple health-related problems including emergency care. Effective implementation of coping strategies in these more medically complicated cases may promote compliance with treatment, result in reduced recidivism and translate into lower costs for our healthcare system. “This presentation is supported by National Institute on Minority Health and Health Disparities of the National Institutes of Health Award No. R25MD007607. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.”

5. Attention bias in irritable bowel syndrome: Implications for acceptance and commitment therapy.
Primary Topic: Behavioral medicine
Subtopic: Irritable bowel syndrome, attention bias, modified stroop task, ACT
Masataka Ito, M.A., Graduate school of psychology, Doshisha University
Takashi Muto, Ph.D., Faculty of Psychology, Doshisha University

Study objective: The biopsychosocial model suggests that attention plays a role in the mechanism of irritable bowel syndrome (IBS). The present study examined selective attention to visceral stimuli in IBS and explores the relationship between Quality of Life, experiential avoidance, cognitive fusion, mindfulness, and indices of selective attention. Design: A between-subjects design was used to enable comparison between an IBS group and healthy controls in selective attention. Methods: Thirty-five undergraduates who scored above the clinical cutoff in the Irritable bowel syndrome severity index (IBS group) and 35 healthy undergraduates who scored below the clinical cutoff were recruited into the study. All participants attended a single testing session. They completed the Mixed-Modified Stroop task (using 4 word categories: neutral, IBS-related, negative, and positive). Both groups also filled out a set of psychological questionnaires (the SF-36, AAQ, CFQ, and FFMQ scales). Results: The results did not show selective attention in the IBS group (all p’s >.10). Selective attention in the IBS group showed no correlations with any measures (all p’s > .10). The IBS group showed higher scores in the AAQ and lower scores in the FFMQ factor than healthy controls. Conclusion: Contrary to the cognitive behavioral model of irritable bowel syndrome model, the IBS group showed no selective attention to IBS-related words and no correlations with any questionnaires. Although it is possible that IBS sufferers do not show selective attention to IBS-related words, we suggest using ACT for IBS.

6. Engage in ACTivity: Group therapy for chronic pain sufferers significantly improves engagement in life activities
Primary Topic: Clinical Interventions and Interests
Subtopic: Chronic Pain
Lauren Baras, M.D., Medical University of South Carolina
Sharlene Wedin, PsyD, ABPP, Medical University of South Carolina

BACKGROUND: Individuals with chronic pain often find their lives narrowly defined by their illness and the pursuit of pain elimination. Frequently individuals neglect meaningful life activities, placing life “on hold” until total pain relief is achieved. Acceptance and commitment therapy focuses on accepting unpleasant experiences while increasing engagement in value-oriented life activities. METHODS: Seventeen female patients (mean age = 46 ± 13.52) experiencing nonmalignant chronic pain of more than 6 months duration participated in a six-week acceptance and commitment therapy (ACT) group. Participants were referred from surgical and medical subspecialties at the Medical University of South Carolina. Patients were assessed initially and upon completion of therapy using the Center for Epidemiologic Studies Short Depression Scale (CES-D 10), Chronic Pain Acceptance Questionnaire (CPAQ) and the Freiburg Mindfulness Inventory (FMI). RESULTS: Mean scores were calculated for each measure at session 1 and session 6. Subscales of Willingness and Engagement on the CPAQ were calculated separately. All scores showed changes in the expected direction as follows: CES-D (16.71±8.28; 15.76±7.40), FMI (34.88 ± 6.32; 36.76 ± 7.51), CPAQ-W (16.00 ±9.41; 19.24 ±8.77), and CPAQ-E (26.23 ±14.57; 31.06 ±12.90). Paired t-test analyses revealed a significant difference in the Engagement score from session 1 to session 6 (P = .037). CONCLUSION: These findings suggest that brief ACT group treatment is an effective means of increasing engagement in life activities as measured by the Chronic Pain Acceptance Questionnaire (CPAQ). Considering that attempts to eradicate chronic pain are often unsuccessful and that chronic pain sufferers frequently neglect day-to-day activities, ACT group therapy provides a means to transition from waiting for a life after chronic pain to engaging in a meaningful life with pain.

7. Does a Reduction of Distress Following Values Clarification Relate to EA?
Primary Topic: Clinical Interventions and Interests
Subtopic: Values and Experiential Avoidance
April R. Wentworth, B.S., San Jose State University
Jannet E. Lara, San Jose State University
Stephanie Lin, San Jose State University
Elain Yin, San Jose State University
Soultana Mboulkoura, San Jose State University
Polline Villalobo, San Jose State University
Kendra Fisher, San Jose State University
Jennifer Gregg, Ph.D, San Jose State University
Jessica Meyer, San Jose State University

ABSTRACT Background. It is unclear whether a reduction in distress in experimental preparations demonstrates an effective intervention or an increase in experiential avoidance during the experiment. While studies have demonstrated a reduction in distress and cortisol following a values intervention (Gregg, Namekata, Louie, & Chancellor-Freeland, 2014) the mechanism of distress reduction is unclear. Certainly behavioral outcome measures are a stronger demonstration of effective values interventions than a reduction in distress. The current study sought to elucidate this difference by examining both distress and a behavioral values measure in a laboratory preparation of social rejection. Method. Participants (N = 29) were given false negative, neutral, or positive social feedback following a social interaction with a fellow student, and then randomized to receive a brief values clarification intervention or not. Participants then gave subjective ratings of distress and also recorded a video message for the participant with whom they interacted as a behavioral measure. Results. Results demonstrate that participants who received the values clarification exercise actually reported increased distress, compared to control participants. Discussion. Values clarification in the middle of a complex social interaction may not proffer the same distress reduction seen in other laboratory stress paradigms.

8. How Does Experiential Avoidance Cloud Values Clarification Outcomes?
Primary Topic: Clinical Interventions and Interests
Subtopic: Experiential Avoidance, Values
Kendra Fisher, San Jose State University
Soultana Mboulkoura, San Jose State University
Amanda Stacy, San Jose State University
Polline Villalobo, San Jose State University
Jannet Lara, San Jose State University
Jessica Meyer, San Jose State University
Stephanie Lin, San Jose State University
April R. Wentworth, B.S., San Jose State University
Jennifer Gregg, Ph.D, San Jose State University

Background. The relationship between experiential avoidance (EA) and values is complex, with awareness of values eliciting more, rather than less, EA in some context. For example, when examining a values clarification task in a laboratory preparation, individuals high in EA may demonstrate lower emotional reactivity and distress due to avoidance, rather than lower experienced emotion. Methods. Participants (N = 29) were assessed on baseline levels of EA, and then put in an experimental preparation where they were given false negative, neutral, or positive social feedback following a social interaction with a fellow participant. Participants were then randomized to receive a brief values clarification exercise, and Profile of Mood States were administered throughout the experiment. Results. Results indicated an interesting interaction with EA and values clarification, with individuals reporting high EA demonstrating a significantly less distressed trajectory than individuals with low EA following the values clarification. Results are discussed in terms of intervention development. Discussion. While this study demonstrated a short-term relationship between distress and EA following values clarification, studies focusing on the long-term are needed to truly understand the role of clarifying values in experiential avoidant individuals.

9. Effect of values clarification on student’s academic procrastination
Primary Topic: Clinical Interventions and Interests
Subtopic: Procrastination
Oscar Alejandro Cordoba-Salgado, Fundacion Universitaria Konrad Lorenz
Marcela Porras-Melo, Fundacion Universitaria Konrad Lorenz
Diana Riaño-Hernández, Fundacion Universitaria Konrad Lorenz

The aim of this study was to identify the effectiveness of two brief Acceptance and Commitment Therapy (ACT) based protocols. Participants were 20 university students from Bogota, ranging between 18- and 34-years-old, who reported on academic procrastination. They were assessed weekly using the Academic Procrastination Scale (APS), Cognitive Fusion Questionnaire (CFQ), Action Acceptance Questionnaire-II (AAQ-II), Values Questionnaire (VQ), and reported daily using self-record cards to assess valued actions. Ten participants were randomly assigned to each condition. The first condition was focused on values clarification exclusively and the second condition on creative hopelessness, cognitive defusion and values clarification. A multiple baseline design across participants was used. Baselines were obtained during at least two weeks and then interventions were applied. Overlap and trend analysis were performed with each case along with size effect caculations for each intervention. Results showed no difference between the interventions' effect size although a reduction on applied measures was found. Implications regarding the effect of the condition isolating the values component are discussed

10. Gamified Web-based Acceptance and Commitment Therapy program for Benzodiazepine discontinuation: A Pilot Study for Randomised Controlled trial
Primary Topic: Clinical Interventions and Interests
Subtopic: Substance Use Disorders, ACT-Technology
Toshitaka Ii, Departmant of Psychiatry, Nagoya City Univrsity Graduate School of Medical Sciences
Sei Ogawa, Departmant of Psychiatry, Nagoya City Univrsity Graduate School of Medical Sciences
Masaki Kondo, Departmant of Psychiatry, Nagoya City Univrsity Graduate School of Medical Sciences
Keiko Ino, Departmant of Psychiatry, Nagoya City Univrsity Graduate School of Medical Sciences

【Back ground】 Benzodiazepine(BZ) has been used for many anxiety disorders. However, Long term BZ using causes dependence. Tapering and Cognitive Behavioral Therapy (CBT) have been widely used for BZ dependence but, providing tapering and CBT take a high cost. One of the solution to this problem is self-help interventions, but the effectiveness of self-help interventions is not enough compared with the wait list (odds rate 2.3 95% Cl 1.3 to 4.2) and more than 50% of participants dropped out of the study. For these reasons, highly effective and motivated self-help intervention is necessary for BZ dependence. Acceptance and Commitment Therapy (ACT) is one of the promising intervention for substance use disorder. Gamified web-based ACT program may be highly effective and motivated self-help intervention for BZ discontinuation. The aim of this study is to provide a preliminary examination for randomised controlled trial. 【Methods】 In this pilot study, we targeted a sample size of five patients ages 20 to 60 years who had been taking BZ for more than two months. Participants received six weeks gamified web-based program. This program was provided free on the internet. When participants type given URL, they can access the program with their personal computer or smart phone. The primary outcome is BZ discontinuation at two months. Depression and anxiety symptoms was measured with K6 and State-Treat Anxiety Inventory. Severity of dependence was measured with Severity of Dependence Scale. Process measurement for ACT such as Cognitive Fusion Questionnaire or Acceptance and Action Questionnaire-Ⅱ was measured. 【Result】 We have already finished developing gamified web-based ACT program for BZ discontinuation. We have also recruited participants for this study. However, the follow-up assessment has not been completed yet. Results and discussions will be presented by the ACBS World Conference.

11. Self as Context Intervention Versus Focused Breathing Intervention to Cope with Negative Thoughts
Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness
Varsha Eswara Murthy, University College Dublin
Louise McHugh, Ph.D, University College Dublin

Intrusive negative thoughts are experienced by a large majority of the non-clinical population. These thoughts if intensified can lead to the precipitation of various psychopathologies. Avoidance or control strategies have been empirically proven to be an ineffective method of dealing with such thoughts, leading to the development and popularity of acceptance and mindfulness based interventions. Acceptance and Commitment Therapy’s main objective is to increase psychological flexibility, which can be facilitated through enhancing a sense of self that is decentred from one’s psychological content, known as self as context. A gap in the literature exists in highlighting how self-based mindfulness techniques can specifically enhance therapeutic outcomes, as they are normally combined with other processes such as cultivating present moment awareness. The present study aims to compare whether a self as context intervention, a verbal, self-based intervention is more effective than a somatic based mindfulness intervention for coping with a personally relevant negative thought. Participants were asked to identify a personally relevant negative thought and given either a self as context, focused breathing or control strategy to manage the negative thought over a five-day period. The self as context intervention involved the completion of the ‘observer you’ exercise daily, as well as utilising hierarchal metaphors in order to cope with the negative thought. The somatic based intervention group completed a focused breathing exercise daily, as well as being instructed to focus on their breath and bodily sensations when the negative thought occurs as a coping strategy. Daily questionnaires assessed the total frequency and level of willingness to have the thought. Also, 10 positive and negative self-statements were rated on the same scales, and self-report measures of mood, mindfulness and psychological flexibility were completed. Findings indicated that the self as context intervention lowered believability, increased comfort, increased willingness and decreased negative affect significantly more than than the focused breathing or control strategy. The focused breathing strategy also made significant gains in the same direction as the self as context strategy in comfort, willingness, believability and affect of the target negative thought, however, the control group did not. Similar trends were observed in the reduction of the frequency of negative thought occurrence and also in the effects the strategies had on the positive and negative self-statements. Levels of mindfulness increased in both intervention strategies with no group differences observed pre and post intervention, however, levels of mindfulness were maintained for the no instruction control group. Findings provide evidence for the efficacy of self-based mindfulness intervention as a superior strategy for managing negative intrusive thoughts over strategies that employ present moment awareness alone.

12. A Comparison between Cognitive Therapy and Acceptance and Commitment Therapy for dysmorphic concern in Iranian women seeking cosmetic rhinoplasty
Primary Topic: Clinical Interventions and Interests
Subtopic: Acceptance and Commitment Therapy
Milad khajepoor, Young Researcher and Elite Club, Roudehen Branch, Islamic Azad University, Roudehen, Iran
Zahra-sadat khoshcheshm, Young Researcher and Elite Club, Roudehen Branch, Islamic Azad University, Roudehen, Iran
Sajad bahrami, Young Researcher and Elite Club, Roudehen Branch, Islamic Azad University, Roudehen, Iran
Peyman Rezaiemaram, Department of Psychology, Faculty of Humanities, Tarbiat Modares University, Tehran, Iran
Sirous Momenzadeh, Queensland Health, Psychosis Academic Clinical Unit (Metro South Addiction &Mental Health Service), AUSTRALIA ، QLD
Parichehr Sharifi, Institute of Psychology, Department of Clinical Psychology and Psychotherapy, University of Leipzig, Germany

Background: Iran has high rates of cosmetic rhinoplasty in the world. According to research findings, one of the most common complaints reported by rhioplasty applicants is dysmorphic concern—an intensive and/or irrational preoccupation with slight (or imagined) flaws in physical appearance. Dysmorphic concern can lead to the tendency to take various maladaptive control strategies, such as excessive and inflexible checking/camouflaging of perceived body defects, social avoidance, reassurance-seeking about appearance, and demanding cosmetic surgeries. Cognitive Therapy (CT) focuses on individuals adopting learned strategies to alter unhelpful thought patterns about their own body appearance. However, from an Acceptance and Commitment Therapy (ACT) perspective, the focus is on learning new skills to change the relations individuals have with their negative conceptualized self and to accept uncomfortable feelings involved. ACT views ‘psychological inflexibility’ as the root cause of people’s persisting behavior in seeking rhinoplasty. Functionally speaking, the primary goal of such behavior is to avoid unpleasant private experiences related to body appearance. These reactions may be reinforced by relatives and friends. In view of the different emphasis of CT and ACT, the aim of this study was to examine the effectiveness of CT and ACT in reducing dysmorphic concerns of Iranian women who were requesting rhinoplasty. Method: The research design included a randomized pretest-posttest control group. Forty-five women, aged 18-25 years who decided to undergo rhinoplasty, at three medical centers in Tehran participated in this study. They were assigned randomly into three groups (15 participants per group). The first group received eight-sessions of CT; the second group received eight-sessions of ACT; and the third group served as a waiting control. The participants of these three groups completed the Persian version of the Body Image Concern Inventory (BICI) before and after the completion of treatments. Finally, an analysis of covariance (ANCOVA) was undertaken to investigate the effectiveness of CBT and ACT on participants' dysmorphic concern. In the analysis, the pretreatment score entered as a covariate. Results: A post-hoc analysis indicated that although the BICI score was significantly reduced in both treatment groups compared with the control group, the ACT group showed more a significant reduction than the CT group. It should also be noted that one participant of the CT group and three participants of the ACT group withdrew from the study as they refrained from cosmetic surgery. discussion: In this study, The Iranian women undergoing rhinoplasty who attended an ACT based treatment reported less dimensions of dysmorphic concerns (i.e., excessive preoccupation of one's appearance, and avoidant and safety behaviors against one's perceived flaws ) than their counterparts who attended CT based treatments. It remains unknown the underlying reasons for the ACT group in this study showing more improvement in expressing their dysmorphic concerns than the CT group. It is also not clear if their expressed concerns will be translated into a long term and more accepting behavior, where people are able to live their life without seeking further medical advice on their physical appearance. In other terms, to compare long-term therapeutic effects of these two treatments, a follow-up assessment would be beneficial. It is worth inquiring about the mediating factors contributing to such outcome and comparing the processes mediating the effect of ACT and CT on Iranian women seeking cosmetic rhinoplasty.

13. Predictors of Depression and PTSD Treatment Response Among Veterans Participating in Mindfulness-Based Stress Reduction
Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness, PTSD, Depression
Benjamin Felleman, Ph.D., UC San Diego & VA San Diego Health Care System
David Kearney, M.D., University of Washington & VA Puget Sound Health Care System

Background: Posttraumatic stress disorder (PTSD) and depression are prevalent and often co-occur among veterans. There has been a growing interest in the effects of mindfulness-based interventions among veterans. This study examined PTSD and depression outcomes, and baseline predictors of response, among veterans who participated in Mindfulness-Based Stress Reduction (MBSR). Method: A retrospective analysis of 116 veterans with PTSD before and after MBSR. Multilevel modelling assessed baseline predictors of change in PTSD and depressive symptoms. Results: There were clinically significant reductions in PTSD and depression symptoms post-treatment and at 4-months follow-up. For PTSD, effect sizes were in the medium range post-treatment (d = -.63) and at follow-up (d = -.69), and for depression post-treatment (d = -.58) and at follow-up (d = -.70). Baseline PTSD was a significant predictor of slope (β = .03, p = .04) on PCL outcomes; higher baseline PTSD predicted greater rate of reduction in symptoms. For depression (β = .04, p < .01,), those with severe or moderately severe depression exhibited the greatest rate of improvement. However, veterans with high symptom severity did remain symptomatic post MBSR. Discussion: These findings show preliminary support for MBSR in facilitating symptom reduction for veterans with severe PTSD and co-occurring depression.

14. A comparison of brief cognitive intervention methods - cognitive defusion, cognitive restructuring and perspective taking - in coping with angry thoughts
Primary Topic: Clinical Interventions and Interests
Subtopic: Anger
Tracey McDonagh, M,Sc, University College Dublin
Louise McHugh, Ph.D.

Background: Anger has many adaptive functions but can also become dysfunctional; it can be disruptive to people’s lives and the pursuit of valued living. Despite this, anger has been under researched in comparison with other emotional disorders and there is no clear consensus on how it should be defined or treated. The current study aims to assess the relative effectiveness of cognitive restructuring, cognitive defusion and perspective taking techniques for coping with angry thoughts. Method: 80 participants from student and community populations will undergo mood induction in order to bring to mind autobiographical memories of a recent anger inducing inter-personal encounter. They will report on the state anger they experienced by completing the relevant questions from a STAXI inventory. Pre- and post-intervention participants will report (a) anger associated with the thought (measured by the state items of the STAXI inventory) (b) believability of the thoughts, (c) discomfort associated with the thoughts, and (d) willingness to experience the thoughts. The experiment will involve a mixed design with group (defusion, restructuring, perspective taking, control) as the between-subject factors and Time 1 (T1) and Time 2 (T2) measures as the within-subject factor. Results: This study is exploratory, aiming to assess the potential effectiveness of the aforementioned techniques for managing angry thoughts. However, it is expected, given findings suggesting that cognitive defusion was more effective in managing negative thoughts than cognitive restructuring (Larsson , Hooper, Osborne, Bennett and McHugh, 2015) that cognitive defusion may also be more effective for managing angry thoughts. It is postulated that all three of the techniques will be more effective than a no intervention control. Discussion: While cognitive restructuring is an established technique in the treatment of anger, recent research on negative thoughts has suggested that cognitive defusion lowers believability, increases comfort and willingness to have the target thought, and increases positive affect significantly more than a control and cognitive restructuring (Larsson et al, 2015). The current study hypothesises that these findings may generalise to negative thoughts generated by affective processes. Perspective taking is also hypothesised to also be an effective brief anger reduction technique. This study may have implications for anger management treatments, which could be useful in the reduction of aggression and criminal activity, with potentially important social implications.

15. Proposing a factor structure for the Diabetes Acceptance and Action Scale and examining relations with diabetes-related outcomes
Primary Topic: Clinical Interventions and Interests
Subtopic: Adolescents with Diabetes
Tiffany M. Rybak, M.S., The University of Memphis
Kristoffer S. Berlin, Ph.D., The University of Memphis; The University of Tennessee Health Science Center
Gabrielle G. Banks, M.S., The University of Memphis
Kimberly L. Klages, B.S., The University of Memphis
Jeanelle S. Ali, M.S., The University of Memphis
Riply Wood, B.A., The University of Memphis
Ramin Alemzadeh, M.D., Le Bonheur Children's Hospital; The University of Tennessee Health Science Center
Robert J. Ferry, M.D., The University of Tennessee Health Science Center
Alicia Diaz-Thomas, M.D., Le Bonheur Children's Hospital; The University of Tennessee Health Science Center

BACKGROUND: Type-1 diabetes (T1D) is a burdensome and complex illness to manage during adolescence. Researchers have posited that psychological processes such as cognitive fusion and experiential avoidance lead to some of the difficulties with managing T1D. The Diabetes Acceptance and Action Scale is an unpublished measure developed by Greco and Hart (2005) that was developed to assess youth’s psychological flexibility with regard to having T1D. However the factor structure and validation of the DAAS has yet to been tested. The purpose of this study is to test a proposed factor structure and examine how it relates to diabetes-related outcomes, such as glycemic control, diabetes-related quality of life (QoL), adherence to medical regimen, and diabetes-specific conflict with caregivers. METHODS: Youth (N = 174) aged 12-18 (Mage = 14.63, SD = 1.68) with T1D and their caregivers completed the PedsQL 3.2 Diabetes Module, Self-care Inventory, and Diabetes Family Conflict Scale. Youth also completed the Diabetes Acceptance and Action Scale. Youth’s HbA1c was obtained from their medical record. RESULTS: Confirmatory factor analyses of a hypothesized five-factor model of the DAAS (acceptance, action, values impairment, experiential avoidance, and cognitive fusion factors) in relation to diabetes-related outcomes yielded an acceptable model fit (X2/df=1.65, CFI=0.936, RMSEA=0.061, 90% C.I. [0.054, 0.068]). Values impairment was inversely related to pediatric QoL reported by youth and caregiver (β = -0.757, p = 0.006; β = -0.979, p = 0.02, respectively). Values impairment is also positively associated with HbA1c (β = 0.844, p = 0.027). Lastly, experiential avoidance is associated with greater diabetes-specific conflict with caregiver per youth report (β = 0.704, p = 0.012). No factors were associated with reports of adherence. DISCUSSION: A five-factor model is supported for the DAAS and can help delineate elements of psychological flexibility or inflexibility that can be targeted for future ACT-based interventions for youth with T1D. One such area of focus may be on values impairment, given that it was related to poorer quality of life and higher HbA1c. Thus, it may be important to examine how strategies to manage difficult thoughts and feelings about living with T1D interfere with adolescents’ ability to live consistently with their values. Targeting experiential avoidance may lead to less diabetes-specific conflict among youth and caregivers. Overall, this study suggests that these core processes representing psychological flexibility measured by the DAAS may be influential in improving the physical and psychological wellbeing of youth with T1D.

16. Psychological flexibility and dyadic adjustment: the mediating role of communication.
Primary Topic: Clinical Interventions and Interests
Subtopic: couple, relationship satisfaction, communication, dyadic adjustment, ACT,
Alexandre Marseille, Psy.D.(c), Université du Québec à Trois-Rivières
Yvan lussier, Ph.D., Université du Québec à Trois-Rivières
Frédérick Dionne, Ph.D., Université du Québec à Trois-Rivières

Acceptance and commitment therapy (ACT) is becoming increasingly popular among behavioral therapists, having been supported empirically in the treatment of various disorders including anxiety, depression, chronic pain, substance abuse, and psychotic disorders (A-Tjak, 2015). Despite the recent emergence of ACT in all areas of psychopathology, few studies have explored the relationship between psychological flexibility and couple satisfaction (Harris, 2009; Peterson, Eifert, Feingold, & Davidson, 2009). In an attempt to better document this reality, our study attempts to assess the contribution of psychological flexibility’s major constructs (acceptance, mindfulness, and engaged action) to explain dyadic adjustment, taking into account the mediating role of communication. The sample is composed of 411 participants (87% women, M age = 28.3 years) who responded to a series of questionnaires measuring each of these variables. Results of a path analysis demonstrate that experiential avoidance associated with non-acceptance of unwanted thoughts or feelings is directly linked to weak dyadic adjustment, and indirectly linked through the demand-withdrawal communication pattern. Mindfulness and engaged action are associated to dyadic adjustment through the mediating role of positive communication. Our model explains 37% of the dyadic adjustment variance. Clinical implications as well as future research will be discussed.

17. Getting Our ACT Together: A Pilot Study with Adolescents in Outpatient Mental Health
Primary Topic: Clinical Interventions and Interests
Subtopic: Adolescence, Group Therapy
Susie McAfee, Ph.D., IWK Health Centre
Amber Johnston, Ph.D., IWK Health Centre
Melanie Khu, M.Sc., University of Calgary

The current pilot study was proposed to address a perceived gap in service within a large pediatric, hospital-based, outpatient mental health program. Current treatment options consist of traditional CBT groups for primary anxiety disorders and individual therapy (of various modalities) for depression or other presenting problems. Given that these CBT for Anxiety groups have shown low retention rates and individual therapy may not be the most cost-effective, we developed a transdiagnostic ACT group for youth 15-18 years old. Three groups are planned with results of the first two presented here (N=13). It was hypothesized that this group would have lower rates of attrition, would show increases in psychological flexibility and valued living, as well as decreases in mood symptoms, anxiety, and believability of negative automatic thoughts. Pre-post results from the first two groups demonstrated a high rate of retention, statistically significant increases in psychological flexibility (AFQ-Y) and valued living (VQ), as well as statistically significant decreases in depression (CDI2), anxiety (MASC), frequency and believability of negative automatic thoughts (ATQ). Participants will be followed for at least 3-months post-treatment to assess whether treatment results were maintained over time and explore possible reductions in costly mental health service utilization.

18. Italian validation on the AAQ-S scale: a preliminary investigation of its psychometric properties
Primary Topic: Clinical Interventions and Interests
Subtopic: Stigma assessment
Cristina Rizzo, Kore University, Enna (Italy)
Palmira Faraci, Kore University, Enna (Italy)
Michael Levin, Utah State University
Giovambattista Presti, Kore University, Enna (Italy)

Stigma can be conceptualized as a general tendency to evaluate and discriminate others based on identification with a social group. Following this conceptualization it is possible to investigate and identify the processes that contribute to the development of stigma and its generalization as well as work on it from the point of view of psychological flexibility. The Acceptance and Action Questionnaire – Stigma (AAQ-S) was specifically developed to assess psychological flexibility with stigmatizing thoughts, to have a more sensitive scale focused on a specific and unique area (Levin, Luoma, Lillis, Hayes & Villagarda, 2014). In the context of providing Italian researchers and clinicians with tools related to the psychological flexibility construct we translated and validated the AAQ-S (Levin, Luoma, Lillis, Hayes & Villagarda, 2014). The scale was translated, the translation was evaluated by experts and then back-translated by two English mother-tongue individuals, before being administered. AAQ-S was administered along with the Social Dominance Scale (SDO), the Right-wing Authoritarianism Scale. In addition the empathic attitude of the subject (Interpersonal Reactivity Index -IRI), mindfulness skills (Mindful Attention and Awareness Scale - MAAS) and Experience Questionnaire (EQ) to measure decentering were administered to correlate to the stigma construct. A heterogeneous sample of 220 individuals, 78 of whom responded online, while the others responded to a paper pencil version responded to all the questionnaires. Overall 80% of the sample is female and mean age is 22. AAQ-S in the Italian version has a bi-factorial structure with two subscales: Psychological Inflexibility Subscale and Psychological Flexibility Subscale. Preliminary analysis show a Cronbach’s alpha of .754, that the scale correlates with its two subscales AAQ-S inflexibility r=0.646 p<0.01, AAQ-S flexibility r= 0.731 p<0.01, and a positive correlation with the personal distress subscale of IRI, r=0.190 p<0.05.

19. Mindfulness as Relationship: Opportunities for Mothers and their Infants
Primary Topic: Clinical Interventions and Interests
Subtopic: Attachment
Lindsey R. Wallace, M.A., Hofstra University

Mindfulness is a way of relating to the self and others through acceptance, openness, and compassion. It is uniquely positioned to assist women in the transition to motherhood and strengthen the bond between mother and infant, as it helps to improve intrapersonal and interpersonal attunement. The purpose of this poster is threefold: (1) to address the psychological needs of women through pregnancy and childbirth (2) to emphasize the importance of prenatal and postnatal attachment, and (3) to highlight the ways in which mindfulness strategies can benefit mothers and their infants during the perinatal period. Current empirical research on mindfulness theory and mindfulness-based interventions for the prenatal and postnatal are described. Additional mindfulness strategies and directions for future research are suggested throughout.

20. Willing to Stutter? Stuttering Treatments Combined with Brief ACT Intervention Improves Speech, Quality of Life, and Employment Outcomes of Prospective Health Care Professional. A Case Report.
Primary Topic: Clinical Interventions and Interests
Subtopic: Stuttering
Anthony Garrett Hazelton, Ph.D., East Carolina University
Patricky M. Briley, M.S., East Carolina University

Background The current case study focuses on a 25 year old Caucasian female with a moderate to severe stuttering disorder. She was in her final year as a graduate student and preparing for a career in the medical field. Marked distress related to speaking led her to “white knuckle” her way in through school, particularly in situations in which speaking was involved. With years of speech therapy and ongoing disability in speech, she avoided class presentations, obtaining permission to engage in alternative projects or written activities. However, with internship and employment the next step of her professional journey, she decided to take control of her speech. She sought treatment and was offered a speech correcting device accompanied by speech therapy. Despite initial improvements in fluency, her speech therapist referred her to ACT due to ongoing and severe dysfunction on measures of speech related quality of life. Methods Patient was fitted with a SpeechEasy Device, initiated a course of Speech Therapy, and then was referred to and participated in 3 monthly sessions of ACT. Psychological treatment focused on concepts of experiential avoidance, dirty distress, mindfulness, willingness, and value based action in the context of stuttering disorder. Fluency was measured by clinical rating scales. The Overall Assessment of the Speaker’s Experience of Stuttering (OASES) was used to assess baseline and post-treatment quality of life. Results Qualitatively, at baseline she described how challenged she was socially with her speech impairment and how she continued to struggle with self-doubt and anxiety. Clinical rating scales indicated severe dysfluency in speech at the start of treatment that improved to mild dysfluency by the end of the 3 months treatment process. Her Overall Impact Rating on the OASES began in the severe range at 4.22 and by the end of treatment her score was in the mild to moderate rage at 1.97. She also obtained an internship and part-time employment in her field much easier than she had expected. Discussion The speech of a person who stutters (PWS) in a social context can result in reduced quality of life as experiential avoidance emerges from attempts to reduce social anxiety and the constant internal struggle with speech. The dirty distress that occurs when a PWS struggles with fluency can actually worsen fluency during speech. Experiential avoidance in PWS commonly occurs through disengaging socially and avoiding job opportunities that require talking. In the current case, a brief course of ACT combined with an evidence based speech protocol resulted not only in improved fluency but also in QOL and the patient finding employment. Education on experiential avoidance, defusing from the idea that dysfluency needs to be cured, enhancing mindfulness of when dirty distress arises, and value based goal setting were key ingredients to a brief and effective course of ACT in a PWS.

21. The impact of body image flexibility on dietary habits and weight gain in breast cancer adjuvant therapy
Primary Topic: Clinical Interventions and Interests
Subtopic: Eating behavior
Sara Poli, Psy, Clinical Psychology Service, Hospital “SacroCuore - Don Calabria” Negrar, Verona, Italy
Matteo Giansante, Clinical Psychology Service, Hospital “SacroCuore - Don Calabria” Negrar, Verona, Italy
Monica Turazza, Med, U.O. Oncology, Hospital Sacro Cuore-Don Calabria, Negrar, Verona, Italy
Stefania Gori, Med, U.O. Oncology, Hospital Sacro Cuore-Don Calabria, Negrar, Verona, Italy
Giuseppe Deledda, Psy, Clinical Psychology Service, Hospital “SacroCuore - Don Calabria” Negrar, Verona, Italy

Background: Weight gain is a demonstrate side effect in the adjuvant treatment (chemotherapy, endocrine therapy, radiotherapy after surgery) of breast cancer. Little is known concerning the impact of psychological variables. The aim of the study is to explore the impact of the psychological flexibility on eating behavior and weight gain in breast cancer patients during treatment. Method: Subjects enrolled in the study completed questionnaire concerning: psychological flexibility (AAQ-II; BIAAQ) and eating behavior (TFE.Q-51). The whole sample was divided on the basis of the weight changes (g1: increased; g2: loss / no change); T-tests and correlation analysis (Spearman's Rho) were finally performed. Results: 54 breast cancer patients were enrolled (age: M=53; SD=9.39]). T-test analysis showed significant difference between groups, g1 reported lower scores in BIAAQ [g1: M = 54.17 [DS = 16.69) , g2: M = 65.15 [DS = 13.85], p <.05) and higher scores in TFEQ total score (g1: M = 60.28 [SD = 5.08], g2: M = 43.08 [SD = 24.70, p <. 05]) and in TFEQ-disinhibition scale (TFEQ-Disinhibition g1: M = 8.62, SD = 2.53, g2: M = 6.02 [SD = 2.14], p <.05). Significant inverse correlation was found between BIAAQ score and TFEQ-Total score (rho = -.482 variables, <.01) and BIAAQ mean score and TFEQ- disinhibition score (rho = -. 480, p <.01). Discussion: Body image inflexibility seem to affect eating behavior and specifically disinhibition (the tendency to respond impulsively to the stimulus of hunger).

22. Measuring psychological flexibility and inflexibility in developmental age: A report on instruments available for Italian adolescents
Primary Topic: Clinical Interventions and Interests
Subtopic: Adolescents, psychological flexibility, diagnosis
Emanuele Rossi, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC); Associazione Psicologia Cognitiva (APC) - SPC
Erika Melchiorri, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC); Associazione Psicologia Cognitiva (APC) - SPC

Children and adolescents mental disorders occur very frequently, with adverse consequences from both clinical and societal point of view. An accurate and early diagnosis, made with measures characterized by strict psychometric properties and validated on particular samples of population, is necessary to take prompt action. This poster presents a review of the clinical instruments currently available in order to measure psychological flexibility and inflexibility in Italian youths. Three self-report instruments were found: (1) Child and Adolescents Mindfulness Measure (CAMM), measuring mindfulness and acceptance; (2) Avoidance and Fusion Questionnaire for Youth (AFQ-Y), assessing fusion and experiential avoidance; (3) Mindful Attention Awareness Scale for Adolescents (MAAS-A), measuring mindfulness as a "receptive state of attention and awareness of the present experience". Since in our clinical practice we use these three measures with very promising implications, we encourage other clinicians in their use. However, it is advisable to wide even more the range of the assessing instruments for psychological flexibility on Italian youth, and this represents a future achievement for our research.

23. Taking a picture of Italian adolescents: How psychological inflexibility can affect psychological well-being?
Primary Topic: Clinical Interventions and Interests
Subtopic: Adolescents, psychological flexibility, psychological distress
Emanuele Rossi, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC); Associazione Psicologia Cognitiva (APC) - SPC
Erika Melchiorri, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC); Associazione Psicologia Cognitiva (APC) - SPC
Alessia Panzera, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)

This paper outcomes moved from two validation studies of seventeen measures on two different non clinical Italian adolescents samples (n. tot = 1315). The considered instruments assess psychological inflexibility and flexibility (with a particular focus on mindfulness facets, such as acceptance, presence, awareness), psychological distress (anxiety, depression, somatization, dissociation, perceived stress), well-being and quality of life. The scores obtained were submitted to a correlation analysis in order to explore the relationship between the ACT core processes and psychological well-being. As a result, it was supported the existence of a direct correlation between psychological flexibility and psychological well-being, so that at the increase of the first parameter corresponds the increase of the second one. Furthermore, it was highlighted an inverse correlation between psychological distress and mindfulness abilities. This study has important implications for both research and clinical practice.

24. "What about being an accepting and committed mum?" An ACT contribution on psychological well-being in pregnancy
Primary Topic: Clinical Interventions and Interests
Subtopic: Psychological flexibility, distress, mindfulness, pregnancy
Erika Melchiorri, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC); Associazione Psicologia Cognitiva (APC) - SPC
Emanuele Rossi, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC); Associazione Psicologia Cognitiva (APC) - SPC
Alessia Panzera, Psy.D., Associazione Italiana Scienze Comportamentali e Cognitive (AISCC)

This study explores the effects of incorporating childbirth preparation classes with a six-week Acceptance and Commitment Therapy intervention on a group of ten pregnant women enrolled between 15 and 35 weeks gestation. The samples was non-clinical (absence of psychological or medical diagnosis) but, as reported in literature, pregnancy is characterized by deep changes, in both body and mind, for the most of the women, The study starts from the assumption that, if these changes are accepted in a mindful way, a woman’s life, as mum and partner, will be more rich and meaningful. The main focuses of the intervention were on values and on the acceptance of their private events, in order to gain a greater flexibility towards life. To check the effect of this intervention women compiled twice (T0 and T1) a set of questionnaires on psychological wellbeing, anxiety, depression, mindfulness abilities and psychological flexibility. The study reveals an increase in mindfulness, self compassion and psychological flexibility scores over time and a decrease in stress and anxiety scores. These results seem to endorse the effect of an ACT contribution on women’s psychological wellbeing during pregnancy.

25. A Preliminary Psychometric Evaluation of the I-AAQ: A measure of Interpersonal Psychological Flexibility
Primary Topic: Clinical Interventions and Interests
Subtopic: FAP
Lindsey Knott, M.A., Western Michigan University
Chad Wetterneck, Ph.D., Roger's Memorial Hospital
Sonia Singh, M.A., Bowling Green State University

Psychological flexibility appears to be an important process related to overall functioning and quality of life. This flexibility is the balance of making contact with the present moment, accepting one’s thoughts and feelings as they arise, while pursuing values toward a more meaningful existence. The Acceptance and Action Questionnaire (AAQ-II) is a measure developed in an attempt to capture this process. Thirteen years ago, one of the founders of ACT presented at the first ACBS conference and called for more specific variations of experiential avoidance to be examined (Hayes, 2003). Since that time, several variations on the AAQ have been developed to address particular disorders or relevant transdiagnostic processes. To date, no variations have been looked at for psychological flexibility in the context of interpersonal relationships. This study examines a new measure, called the Interpersonal AAQ (I-AAQ), which may fill that void. Utilizing a clinical cPTSD sample (n > 64) and a non-referred clinical OCRD sample (n > 500) we collected data on the AAQ-II, I-AAQ, and other relevant measures of interpersonal relevance (i.e., Functional Idiographic Assessment Template Short form -- FIAT-SF; Awareness, Courage, Love – ACL; Experiences of Shame Scale – ESS; Self-Compassion Scale Short Form – SCS; Quality of life measures – WHOQOL, Fear of Intimacy Scale – FIS). We evaluated basic psychometrics the I-AAQ demonstrated excellent internal consistency and demonstrated a pattern of convergent validity to related measures and divergent validity with unrelated constructs. Although the I-AAQ and AAQ-II were highly correlated, there was a differential pattern of correlations with other measures, with the I-AAQ being more highly related to interpersonal avoidance and shame than the AAQ-II. Further results and implications will be discussed.

26. How does the Awareness Courage Love scale relate to treatment change? Results from a PTSD treatment program.
Primary Topic: Clinical Interventions and Interests
Subtopic: FAP
Chad Wetterneck, Ph.D., Roger's Memorial Hospital
Lindsey Knott, M.A., Western Michigan University
Jennifer Parra-Brownrigg, M.A., Rogers Memorial Hospital
Beth Ann Wuerl, M.A., Rogers Memorial Hospital

Post-traumatic stress often reduces one’s functioning in emotional intimacy and in engagement with interpersonally oriented values. An adjunct to prolonged exposure therapy, Functional Analytic Psychotherapy (FAP) may be a useful treatment to target disengagement in relationships in those with complex PTSD (cPTSD). Researchers recently developed a tool to that may capture important constructs in FAP (i.e., Awareness, Courage, and Love; ACL scale) and may also be beneficial for evaluating the efficacy of such enhanced treatment protocols. The ACL model and measurement tools (i.e., ACL scale) require further investigation in order to demonstrate that these constructs are relevant to functioning and engagement in interpersonal relationships. At a PTSD partial-hospitalization program, a sample of approximately 50 patients with cPTSD received prolonged exposure therapy enhanced with contextual behavior therapies, such as FAP and ACT, and completed the ACL scale at pre- and post-treatment. In order to assess engagement in interpersonal values domains, patients were given the Valued-Living Questionnaire (VLQ) each week during treatment. Preliminary results show that the interpersonally relevant domains on the VLQ (i.e., family and social) predict change in the ACL from pre- to post-treatment, indicating that the ACL may be a sensitive clinical tool to capture change over time. Likewise, this predictive relationship may indicate that intentional engagement in interpersonal relationships may be one of the mechanisms leading to change in these FAP relevant constructs. Further implications of these data will be discussed.

27. Comparison between MCBT-I and CBT-I among college student with Insomnia
Primary Topic: Clinical Interventions and Interests
Subtopic: insomnia
Yoon Jin Kim, Chung-Ang University
Haekyung Koo, M.A., Chung-Ang University
Xinyu Gu, M.A.,
Myoung Ho Hyun, Ph.D, Professor, Chung-Ang University

Background: People with insomnia have predisposing factor (i.e., rumination tendency, depression, emotional arousal, and neuroticism) precipitating factor (i.e., stressor), and perpetuation factor (i.e., frequently making up for short sleep time, doing activities in bed that are irrelevant to sleeping, having dysfunctional belief and attitude about sleeping, and worrying about daytime sleepiness and fatigue due to insomnia). Cognitive Behavior Therapy for Insomnia (CBT-I) is known as the effective therapy for insomnia. CBT-I usually includes sleep restriction, sleep hygiene, stimulus control, and correction of dysfunctional beliefs and attitudes about sleep. However, while CBT-I focuses on perpetuation factors, the therapy does not deal enough with predisposing factor and precipitating factor. In recent years, researchers have begun to apply mindfulness in diverse subjects. Mindfulness therapy is revealed to be effective on reduced depression, rumination, emotional arousal, and stress etc. Therefore we expected Mindfulness based Cognitive Behavior Therapy for insomnia (MCBT-I) to be more effective than traditional CBT-I. The aim of the present study was to compare CBT-I and MCBT-I on college students with insomnia. Method: There were total of 20 participants. 10 in CBT-I and 10 in MCBT-I. All participants individually met with a therapist six times: 1 orientation, once a week for 4-week treatment, and 1 wrap-up session. All participants recorded sleep diary, KIMS, PSAS, DBAS-16, ISI, WBSI, DHS-Revised 3 times (before treatment, end of treatment, and 2 month later after the therapy). Results: All participants showed decreased scores on PSAS, DBAS, ISI, and components of sleep diary after the treatment. However, KIMS score did not decrease after the treatment. When we compared CBT-I and MCBT-I with repeated measures ANOVA, only Wake After Sleep Onset (WASO) was significantly different: CBT-I showed greater decreased on WASO than MCBT-I. Treatment effects also maintained 2 months after the therapy. Discussion:. The Duration of treatment was too short to show significant effect of mindfulness on the participants. Also, the participants in MCBT-I showed low rate of adherence on meditation homework. All participants have primary insomnia, which means their insomnia was due to poor sleeping habits and dysfunctional belief about sleep. Therefore, mindfulness treatment was not effective to these participants. Further research should compare MCBT-I and CBT-I among people with secondary insomnia. Despite of the unexpected results, this study was first study using MCBT-I and CBT-I in individual short-term therapy.

28. Experiential Avoidance and Change in Self-Control in Response to ACTV
Primary Topic: Clinical Interventions and Interests
Subtopic: Intimate Partner Violence
Meg Berta, Iowa State University
Amie Zarling, Ph.D., Iowa State Univeristy

Experiential Avoidance and Change in Self-Control in Response to ACTV Background The current study investigates Achieving Change Through Values-Based Behavior (ACTV; Lawrence, Langer Zarling, & Orengo-Aguayo, 2014), a new treatment for male intimate partner violence (IPV) offenders in the Department of Corrections, which is modelled after Acceptance and Commitment Therapy, emphasizes experiential learning, developing adaptive responses to one’s thoughts and emotions, and recognizing and acting on one’s values. In the current study, ACTV is implemented in jail. In-jail ACTV lasts eight weeks and consists of three two-hour sessions per week. Methods ACTV targets experiential avoidance, the tendency to avoid aversive thoughts and feelings, by teaching offenders to move toward their values instead of away from aversive thoughts and feelings. One aim of this study is to examine the relationship between experiential avoidance and self-control, an important predictor of IPV, (Finkel, DeWall, Slotter, Oaten, & Foshee, 2009). In addition, changes in experiential avoidance and self-control in response to ACTV will be examined. Results Experiential avoidance was measured with the Avoidance and Fusion Questionnaire for Youth (AFQ-Y; Greco, Lambert, & Baer, 2008) due to the reading level of participants. The 10-Item Self-Scoring Self-Control Scale (Tangney, Baumeister, & Boone, 2004) showed a significant negative correlation with experiential avoidance at the start of treatment (r= -.362, p=.098). The AFQ-Y did not show a significant change over the course of treatment (t= 1.31, df= 12, p = .213). Additionally, self-control improved over the course of treatment (t= -2.931, df= 11, p=.014). Discussion While these results are preliminary, they indicate a promising connection between a target of ACT, experiential avoidance, and a core deficit among IPV offenders. ACTV’s ability to change not only experiential avoidance but self-control makes it a good choice for incarcerated IPV offenders. References Finkel, E. J., DeWall, C. N., Slotter, E. B., Oaten, M., & Foshee, V. A. (2009). Self-regulatory failure and intimate partner violence perpetration. Journal of Personality and Social Psychology, 97(3), 483-499. Tangney, J. P., Baumeister, R. F., & Boone, A. L. (2004). High self‐control predicts good adjustment, less pathology, better grades, and interpersonal success. Journal of personality, 72(2), 271-324.

29. PTSD Symptom Severity and Functional Impairment: The Moderating Role of Valued Living
Primary Topic: Clinical Interventions and Interests
Subtopic: PTSD
John Donahue, Psy.D., University of Baltimore
Jefferson Huggins, University of Baltimore
Humama Khan, MS, University of Baltimore

Background and introduction. Posttraumatic Stress Disorder (PTSD) is a psychological disorder with a lifetime prevalence of 6.8% (Kessler, et al., 2008). The debilitating nature of PTSD is evident in its consistent associations with functional impairment in social (Sayers, et al., 2009), occupational (Stein, et al., 2000), and physical (Vasterling, et al., 2008) domains. However, while the positive association between PTSD symptomology and functional impairment is generally assumed to be strong, a recent meta-analysis by McKnight and colleagues (2016) only found a moderate mean correlation between PTSD symptom severity and global functioning (M = .33). These findings are concerning when considering that treatment trials for PTSD largely use measures of symptom severity as primary outcome measures (see Becker, et al., 2011; Watts, et al., 2013). Acceptance and Commitment Therapy (ACT; Hayes, et al., 1999) is a contextual behavioral treatment with the goal of fostering psychological flexibility, with symptom reduction viewed as secondary to valued living (Hayes, et al., 2013). As such, while ACT generally results in a reduction of symptoms across problem areas (Hayes, et al., 2006), its underlying theory suggests that valued living may increase (and functional impairment thereby decrease) even in circumstances in which symptoms remain present. Aim and hypothesis. The primary aim of this study is to investigate the moderating influence of valued living in the relationship between PTSD symptom severity and functional impairment in a sample of trauma-exposed adults. It is specifically predicted that the link between symptomology and impairment will be attenuated under conditions in which valued living is high. Method. Two hundred fifty online participants (Mean Age = 35.01) from across the country completed a battery of questionnaires including the Brief Trauma Questionnaire (BTQ; Schnurr, 1999), The PTSD Checklist-5 (PCL-5; Weathers, et al., 2013), the Valued Living Questionnaire (VLQ; Wilson, et al., 2010), the Overall Anxiety Severity and Impairment Scale (OASIS; Norman, et al., 2006), and the Patient Health Questionnaire - 3 (PHQ-3; Kroenke, et al., 2001). One hundred thirty-three participants identified a history of at least one DSM Criterion A trauma, and were selected for analysis. Results. A hierarchical regression analysis was computed to examine the hypothesis that valued living moderates the relationship between PTSD symptom severity and functional impairment after controlling for PHQ-3 measured depression. Supporting our hypothesis, preliminary results revealed that the PHQ-3 (β = .48), PCL-5 (β = .39), and VLQ (β = -.14) each emerged as significant predictors; the overall model explained substantial variance in impairment, R2 = .69, F(4, 128) = 72.99, p < .001; and, the addition of the VLQ-PCL interaction explained incremental variance in OASIS ratings, ΔR2 = .02, F(1, 128) = 7.23, p < .01. Therefore, valued living was a significant moderator of the relationship between PTSD symptom severity and functional impairment. Discussion. These results empirically demonstrate valued living as an important construct in understanding functional impairment among trauma-exposed individuals, even when PTSD symptomology is high. Our discussion will emphasize the clinical implications of these findings as they relate to contextual behavioral treatments for PTSD.

30. Measuring Activation in Depressed Adolescents
Primary Topic: Clinical Interventions and Interests
Subtopic: Depression
Carmelita S. Foster, Western Michigan University
Alison DeLizza, Western Michigan University
Julissa Duenas, Western Michigan University
De'Lon Dixon, Western Michigan University
Andrew Register, Western Michigan University
Scott T. Gaynor, Ph.D., Western Michigan University

Behavioral Activation is a contemporary behavioral therapy designed to activate clients by scheduling activities that are functional and informed by the client’s life values (Kanter, Busch, & Rusch, 2009). Research evidence suggests that Behavioral Activation is a promising treatment for depression in adolescents; however, there is a paucity of research on whether or not Behavioral Activation actually increases activation levels. This study utilized a single-subject, A/B (stepped care) design, and measured the effectiveness of Behavioral Activation with 13 depressed adolescents between the ages of 14 and 18. All participants were offered up to 12 sessions, but they each received varying amounts of MIA (Phase A) or VBBA (Phase B) based on their scores on the Behavioral Activation for Depression – Short Form (BADS-SF) rating scale. Of the 13 participants who consented to treatment, three received varying amounts of Phase A and eight received varying amounts of both Phase A and Phase B. At the single case level, results suggest half of the participants, who only received MIA, showed baseline trend improvement on the Beck-Depression Inventory- Primary Care version (BDI-PC). Single case results also suggest that one participant, who received both MIA and BA, showed a significant improvement on the BDI-PC during VBBA. At the group level, all participants who received both MIA and VBBA showed significant symptom improvement on the BDI-PC and the CDRS-R. At the single case level, results suggest baseline improvement on the BADS-SF for only one of the participants who received only MIA. At the individual level, results show that four of the participants who received both MIA and VBBA showed significant trend in baseline improvement during MIA and no significant differences in scores during VBBA. There is evidence to include that activation scores increased and depression scores decreased after the exposure to the intervention, however, more rigorous methodology is needed to conclude that VBBA is responsible for the results found.

31. A comparison of four protocols for managing intrusive thoughts: A failure to replicate Marcks and Woods (2005)
Primary Topic: Clinical Interventions and Interests
Subtopic: Thought Suppression
Lucas Cylke, B.A., Wichita State University
Robert Zettle, Ph.D., Wichita State University

Wegner's seminal thought suppression research has shown that attempts to suppress thoughts can lead to a paradoxical increase in the frequency of that thought as well as distress towards that thought. This phenomenon has been a central component of cognitive- behavioral models of disorders such as obsessive-compulsive. The present study tried to replicate a Marcks and Wood (2005) study in which they compared three groups (thought suppression, acceptance, and monitor-only groups) on the frequency and distress associated with experiencing personally relevant intrusive thoughts over three five minute time periods (baseline, experimental condition, baseline). Their results revealed that those instructed to suppress their intrusive thoughts were unable to do so and experienced an increased level of distress after suppression, while the acceptance-based strategy experienced a decrease in discomfort level (but not thought frequency) after having used such a strategy. The current study used the same protocol but added 2 new conditions (total of four conditions), acceptance, acceptance using directions with a metaphor, suppression, and not suppress. It was expected, like the Marcks and Woods (2005) study, that the suppression group would have higher thought frequency and more distress towards their target thoughts. Despite our predictions, the results of the current study did not replicate, finding no difference between groups on distress and found opposite results on thought frequency, with the suppression group having significantly less frequency of intrusive thoughts than the other three groups. These results either suggest that the ironic effects of thought suppression may not be as robust as once thought or that their needs to be better methodology in studies dealing with intrusive thoughts and acceptance and suppression strategies.

32. Under One Roof: Evaluating and ACT based intensive outpatient program for military and first responders
Primary Topic: Clinical Interventions and Interests
Subtopic: Military and First Responders
Susan Faye Balaban Ph.D., Brattleboro Retreat Uniformed Service Program
Hannah Saltzman, Smith College
Nicholas Morrison M.S., Department of Psychology University of Massachusetts-Amherst
Nnamdi Pole Ph.D., Smith College Department of Psychology

This study examines the relation between individual differences in mental health difficulties and demographic variables and treatment outcomes (symptom reduction and changes in acceptance, awareness, and avoidance) in patients (primarily white, male, N = 650, M = 46) participating in an ACT-based intensive outpatient program for first responders and military personnel (current, separated, and retired). Most group based programs for uniformed service personnel partition treatment programs, focusing on "mental health" or "substance abuse," or triaging patients into separate treatment tracks based on these categories. This program, acknowledging hearty evidence that behavioral health problems in this population often involve complex combinations of chronic pain, sleep difficulties, trauma, mood disorders, neurocognitive challenges, and stress related medical problems. This study showed overall positive outcomes for patients. Our results also indicated that clinical presentation (e.g., severity of PTSD greater than severity of addiction) predicted greater benefits from ACT based treatment, as did specific demographic factors (service type & age). These results reflect the uniquely good fit of ACT based programs for culture specific therapy programs with highly diverse clinical presentations while highlighting the areas for growth and refinement in addressing the individual needs of patients struggling with diverse problems.

33. Under One Roof: Evaluating and ACT based intensive outpatient program for military and first responders
Primary Topic: Clinical Interventions and Interests
Subtopic: Military and First Responders
Susan Faye Balaban Ph.D., Brattleboro Retreat Uniformed Service Program
Hannah Saltzman, Smith College
Nicholas Morrison M.S., Department of Psychology University of Massachusetts-Amherst
Nnamdi Pole Ph.D., Smith College Department of Psychology

This study examines the relation between individual differences in mental health difficulties and demographic variables and treatment outcomes (symptom reduction and changes in acceptance, awareness, and avoidance) in patients (primarily white, male, N = 650, M = 46) participating in an ACT-based intensive outpatient program for first responders and military personnel (current, separated, and retired). Most group based programs for uniformed service personnel partition treatment programs, focusing on "mental health" or "substance abuse," or triaging patients into separate treatment tracks based on these categories. This program, acknowledging hearty evidence that behavioral health problems in this population often involve complex combinations of chronic pain, sleep difficulties, trauma, mood disorders, neurocognitive challenges, and stress related medical problems. This study showed overall positive outcomes for patients. Our results also indicated that clinical presentation (e.g., severity of PTSD greater than severity of addiction) predicted greater benefits from ACT based treatment, as did specific demographic factors (service type & age). These results reflect the uniquely good fit of ACT based programs for culture specific therapy programs with highly diverse clinical presentations while highlighting the areas for growth and refinement in addressing the individual needs of patients struggling with diverse problems.

34. The Effects of Creative Hopelessness on Wishing to Avoid Speech Situations
Primary Topic: Clinical Interventions and Interests
Subtopic: Social anxiety, Creative Hopelessness, willingness, Exposure
Kazuya Inoue, Waseda University

The present study examined effectiveness of Creative Hopelessness on avoidance feelings from speech situations. Undergraduate students with social anxiety tendency (n=29) were assigned to Creative Hopelessness groups (n=10), Control groups (n=10), Placebo groups (n=9). All participants completed measure before and after the intervention to assess Believability and Motivation of Change Agenda, SUD rating on Speech task. Results suggested reduction of Believability and Motivation of Change Agenda following the intervention were found only in the Creative Hopelessness groups as well as previous research. Moreover positive correlation was observed between the rate of change of believablitiy of Change Agenda and wishing to avoid speech Situations. But other indicators was't observed correlation for wishing to avoid speech Situations. It was considered decreasing the believablitiy of Change Agenda read to increase willingness in phobia situations.

35. The impact of a Mindfulness-Based Art Therapy Program on Body-image Dissatisfaction
Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness, Body-Image, Creative/Art Interventions
Kyle Horst, California State University, Chico
Jasmine Buck, California State University, Chico

In the context of negative body image, the use of mindfulness addresses appearance-related cognitions by encouraging self-acceptance (Stewart, 2004). Rather than attempting to control or combat one's negative thoughts and feelings, mindfulness teaches a more adaptive way of relating to one's thoughts and feelings, allowing for an increase in body image flexibility, acceptance, and non-judgmental awareness (Wendel, Masuda & Le, 2012). The following poster outlines results from a non-randomized control study of the efficacy of a Mindfulness-Based Art Therapy group program on negative body-image dissatisfaction. The poster will discuss the development of program, giving the audience samples from the program manual. The poster will also discuss the strengths and challenges of practicing mindfulness within a creative art therapy framework. Finally, pre-post, follow-up, and focus-group data from participants in three groups (Intervention Group, “Treatment as usual” group, and no treatment control) on multiple domains of body-image will be reviewed.

36. Students’ Understandings and Applications of Mindfulness Meditation
Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness, Misconceptions, Learning, Meditation
Ethan G. Lester, University of North Texas
Danielle Moyer, University of North Texas
Nina Laurenzo, Naropa University
Amy Murrell, University of North Texas

Mindfulness meditation is an increasing area of interest for both mental health professionals and the general public alike. Benefits of these practices are well documented in the literature, although the variety of measurement techniques makes interpreting research difficult. Construct definitions vary, and anecdotal accounts from practitioners suggest many people hold misconceptions about mindfulness meditation, even when taught otherwise. Still, no formal research has been introduced on misconceptions of mindfulness – or, if they exist, how such misinformation affects acquisition of related skills. The current analogue study was used to explore how the presentation of mindfulness meditations (i.e., inaccurate rationale/meditation and accurate rationale/meditation) affected university students’ acquisition of said skills. Specifically, self-reported mindfulness and meditation skills, mood questionnaires, a match-to-sample task, and qualitative measurements were used in an experimental design to assess acquisition. Results, limitations, and applications of this research for clinical scientists will be discussed.

37. Time allocation as a translational process in contextual behavioral science
Primary Topic: Clinical Interventions and Interests
Subtopic: Translational research
Cory E. Stanton, M.S., University of Nevada-Reno
Thomas J. Waltz, Ph.D., Eastern Michigan University

Background One of the goals of contextual behavioral science is to foster meaningful conversations between basic and applied scientists, and developing coordinated research programs. This poster presents empirical data from a measure development project examining the convergent and discriminant validity of self-reported time allocation, an attempted extension of the quantitative matching law from the experimental analysis of behavior. Previous basic research has shown that time allocation may be an acceptable proxy for response allocation, including work with human participants. The matching law has been linked to contextual analyses of depression. Method Undergraduate college students completed a battery of self-report measures, including measures of depression and physical / mental health. Participants also completed the Time Allocation Task (TAT), which asked participants to report time spent on meaningful activities, managing life’s negatives, and sleep. In addition, participants reported 1-10 subjective quality ratings of these three areas. Results Preliminary analyses (n = 204) suggest that the TAT predicted 22% of the variance in depression scores on the PHQ-9, and 26% of the variance on the BADS in regression analyses. Subjective quality ratings of time allocated were found to be as or more predictive of outcomes, a finding that was not expected. Final analyses for the conference will include an expanded sample, and correlation matrices of study variables. Discussion The relationship between time allocated toward life’s negatives, the perceived effectiveness of that time and the study's findings related to the AAQ-II will be reviewed.

38. Adjustment to problems of appearance in women with lipedema.
Primary Topic: Clinical Interventions and Interests
Subtopic: lipedema, body dissatisfaction
Joanna E. Dudek, University of Social Sciences and Humanities, Warsaw
Pawel Ostaszewski, Ph.D., University of Social Sciences and Humanities, Warsaw
Wojciech Bialaszek, Ph.D., University of Social Sciences and Humanities, Warsaw
Tilly Smidt

Background: Lipedema is a chronic, progressive condition that affects mainly women, is under-recognized and frequently misdiagnosed as obesity. Lipedema is characterized by accumulation of fat tissue on the extremities with accompanying swelling and pain that is not responsive to dieting or exercising. It may lead to severe disfigurement. Method: We conducted an online survey of 330 women with lipedema, mostly from North America and Europe. Results: Results showed how lipedema severity, psychological flexibility, social connection are related to adjustment to problems of appearance in women with lipedema. Further implications of these results will be discussed.

39. Softened Blows: Psychological Flexibility, Self-Compassion, and Coping Style and the Relationship between Daily Experiences of Discrimination and Distress among Gender and Sexual Minorities
Primary Topic: Clinical Interventions and Interests
Subtopic: Gender and Sexual Minorites
Lauren E Griffin, BS, University of Louisiana at Lafayette
Alyson Gieseman, BS, University of Louisiana at Lafayette
Emily K Sandoz, PhD, University of Louisiana at Lafayette

Gender and sexual minorities (GSM) are at increased risk of psychological distress, mental health difficulties, physical health problems, and high-risk behavior in several domains (Kirsch, Conley & Riley, 2015). This seems to be in part attributable to limited social resources, discrimination, and victimization experienced by many GSMs (Kirsch et al., 2015). It is unclear, however, what differentiates well-functioning GSMs from those struggling to thrive in similarly hostile social climates (Herek & Garnets, 2007). This may be related to a distinct ability of some GSMs to experience psychological distress without threat to psychological well-being. GSMs that respond to discrimination with self-compassion and psychological flexibility may be at decreased risk for the psychological suffering that contributes to mental and physical health problems and high-risk behaviors. The current study explores the distress associated with daily experiences of stigma and discrimination, along with the role of psychological flexibility, self-compassion, and coping.

40. The role of psychological flexibility in cancer patient with pain: an observational study
Primary Topic: Clinical Interventions and Interests
Subtopic: ncological patients, Pain, psychological flexibility
Dr. Giuseppe Deledda, Sacro Cuore Don Calabria Hospital Verona Italy
Dr. matteo giansante, Sacro Cuore Don Calabria Hospital Verona Italy
Dr. Sara Poli, Sacro Cuore Don Calabria Hospital Verona Italy

Background It has been extensively studied chronic pain in patients suffering from different non-cancer diseases. Aim of this study is to investigate the role of psychological flexibility in cancer patients with pain. Methods Patients with pain were asked to complete questionnaires designed to detect pain (NAS , BPI), the psychological flexibility (AAQ II), the anxiety-depressive symptoms (HADS) and distress (TS). Results 27 patients, completed questionnaires, (M= 62 years (SD 11.28)), 52% of which are female. Greater levels of psychological flexibility showed a higher correlation with lower levels of anxiety (r = - 0.73, P <0.000), depression (r = - 0.59, P <0.001), distress (r = - 0.45 P <0.019) and emotional interference (rs = 0.38, P <0:40). Discussion The results seem consistent with studies in patients with non-cancer pain. In the future study it could further investigate the role of psychological flexibility to adapting to pain in cancer disease.

41. Measuring Awareness, Courage, and Love as a Contextual Behavioral Interpersonal Process Model for the Development of Intimacy
Primary Topic: Clinical Interventions and Interests
Subtopic: Functional Analytic Psychotherapy, Social Functioning, Psychometrics
Adam M. Kuczynski, University of Washington
Jordan Epistola, University of Washington
Joanna E. Dudek, University of Social Sciences and Humanities
Jonathan W. Kanter, University of Washington

The present research describes the development and psychometric evaluation of a self-report measure of awareness, courage, and love. The items were designed to reflect a well-researched model of social connection that involves attention to interpersonal contextual cues (i.e., awareness), engagement in interpersonally vulnerable behavior in the service of one’s values (i.e., courage), and naturally reinforcing responses to those behaviors (i.e., love). With exploratory and confirmatory factor analyses we identified a subset of items that demonstrate strong reliability and validity. In total, over 1,800 participants were surveyed from five large universities. Results demonstrated a positive association with quality-of-life, self-compassion, and empathy, and a negative association with loneliness and fear of intimacy. The final measure has utility for researchers and clinicians alike.

42. KORSA: An ACT-based intervention developed to help university students live better with their stress.
Primary Topic: Educational settings
Subtopic: University students
Simon Grégoire, Université du Québec à Montréal
Lise Lachance, Université du Québec à Montréal
Thérèse Bouffard, Université du Québec à Montréal
Lysa-Marie Hontoy, Université du Québec à Montréal
Laurence DeMondehare, Université du Québec à Montréal

Stress-management workshops (www.korsa.uqam.ca) were offered to students enrolled in four universities in Canada. The workshops were based on the six core processes of ACT and included both didactic activities and experiential exercises. A pretest-posttest switching-replication design was used to assess changes in mental health (stress, anxiety, depression, psychological wellbeing) and school commitment among students (N = 179). The data were collected using self-report questionnaires at baseline (t1), week 5 (t2) and week 9 (t3) and examined using multivariate analysis of variance. The results showed that the workshops helped reduce stress, anxiety, and depression among students while they increase their level of wellbeing and school commitment. The results also showed that parts of the effects of the workshops on mental health were mediated by psychological flexibility. This study makes two important contributions: it introduces a novel ACT intervention specifically designed for university students and assesses its impact by using a research design rarely used in ACT studies.

43. Cross-Cultural Comparison of Values in Acceptance and Commitment Therapy with Expressive Writing Paradigm in the United States and South Korea
Primary Topic: Educational settings
Subtopic: cross-cultural comparison
Woolee, An, M.S., Missouri State University
Ann Rost, Ph.D., Missouri State University

The aim of the current study is threefold: (a) to explore similarities and differences in values between students in the United States and students in South Korea based on the ACT perspective; (b) to study the impact of expressive writing, which might be a tool for improving value concordant life, on value concordant living; and (c) to examine potential differences in writing across cultures. A total of 571 participants from the US and 547 participants from South Korea were recruited for part 1 of the study. Different rank orders in the Valued Living Questionnaire between these two countries were observed using mean differences. The top three important values in VLQ for the students in the United States were ‘Family Relations,’ ‘Education/Training,’ and ‘Friends/Social Life.’ However, the top three important values in VLQ for the students in South Korea were ‘Family Relation,’ Friends/Social Life,’ and ‘Marriage/Couples/Intimate Relations.’ While the top three consistent values in VLQ for the student in the United States were ‘Education/Training,’ ‘Family Relations,’ and ‘Friendships/Social life,’ the top three consistent values in South Korea were ‘Friendships/Social life,’ ‘Family Relations,’ and ‘Citizenship/Community Life.’ A total of 51 students from the US and 14 students from South Korea were recruited for part 2 of this study. A Friedman test was used, and several statistical differences were observed between these countries due to the impact of expressive writing. Participants were divided into three experimental groups: Values, Traumatic, and Control. The values in South Korea showed significant differences in anger from the POMS, and the control group showed significant difference in confusion and total scores from the POMS. However, the value groups from the United States showed several significant differences, such as the VLQ total difference score, the total AAQ score, BAI score, Anger score from POMS, and the total POMS score. The traumatic group in the United States showed significant differences in total score on the AAQ and BAI. The control group of the United States also showed several significant differences in the VLQ total difference score, the total score of AAQ, BAI score, the mental disengagement of COPE, tension score from POMS, anger score from POMS, and the total score of POMS. In the part 3 of this study, a brief content analysis was conducted on the actual writings from participants between the United States and South Korea. Different and similar values themes were confirmed from the writings between the two, consistent with the results of part 1.Most participants in the United States wrote about their family, friend, and personal values like education and recreation while participants in South Korea were mainly focused on their relationships with other people. These findings from the qualitative and quantitative analyses provide some degree of support for the concepts associated with ACT from a cross-cultural perspective. Due to the relative lack of research in this area, however, much more investigation in to these issues in warranted.

44. Improving cognitive performance in college students: The impact of a single mindfulness training session
Primary Topic: Educational settings
Subtopic: Mindfulness
Scott Williamson, Metropolitan State University of Denver
Maureen Flynn, Metropolitan State University of Denver

Past research has shown that extensive and repeated training in mindfulness techniques can help improve a variety of cognitive functions, including working memory, attentional focus, and decrease feelings of anxiety in order to improve performance on cognitive tasks (Fjorback, Arendt, Ørnbøl, Fink, & Walach, 2011: Brunye, Mahoney, Giles, et. al., 2012). This present study examines whether a single session of mindfulness training improves performance on a cognitive task, specifically questions derived from the Standardized Aptitude Test (SAT). The sample included 97 undergraduates. Study sessions were randomly assigned to the experimental condition (a brief mindfulness training session) or the control condition (an audio book recording). Results showed that participants in the single session mindfulness training reported higher levels of state mindfulness post-intervention than those in the control condition but there were no significant differences between groups on performance on the standardized test. Implications of this study will be presented.

45. The Impact of Mindfulness on Residential Treatment Direct Care Providers’ Job Satisfaction and System Participation
Primary Topic: Performance-enhancing interventions
Subtopic: Mindfulness
Drew Heckman, Ph.D., Boys Town Outpatient Mental Health Clinic
Wesley J. Sheeley, Ph.D., Complete Children’s Health Pediatric Clinic

The Boys Town Treatment Family Home Program (TFH) is part of a residential treatment approach for middle and high school aged males and females that are typically developing, but present with a wide variety of clinically significant emotional and behavioral concerns. The Boys Town model incorporates a continuum of care for these children, with TFH incorporating traditional family style living arrangements, with clinical supports and behavior modifications from a team of in-home service providers and clinical staff. Mindfulness has been shown to have positive performance impact for individuals, as well as for quality of care by mental health service providers. The study aimed to incorporate psychoeducation and regular mindfulness exercises over an eight week program to direct care providers. As the group itself is a pilot project, analysis only included pre-post testing on all data points. We assessed treatment related direct effects (i.e., self-reported job satisfaction, burn out) and indirect effects (i.e., ratios of positive to negative teaching interactions for residential youth, frequency of serious behaviors exhibited by youth in their care). A mixed methods design incorporating single case, within subject, and qualitative components was used, with data collection for burn out/job satisfaction, positive and negative point interactions with youths, and other behavioral incidences of the providers’ homes (school incident reports, consultation, etc.). Using the structured mindfulness-based cognitive behavioral therapy approach the intervention design incorporated small group discussion, mindfulness activities, and structured homework done on an individual basis. Five direct-care providers (Family Teachers) volunteered for the pilot program and participation was unrelated and in addition to their existing job duties. Data collection for Treatment B phase is currently ongoing, with baseline data visual inspection indicating high risk of burn out, issues with depersonalization from job expectations and programming, and low ratings of personal achievement. Discussion section for this study will focus on impact of mindfulness for both individual provider job satisfaction and burnout, and systemic change indicators for a residential treatment facility. The study hopes to show how mindfulness can be used as a support to improve results of a residential placement for high risk teens, relationships between providers and teen age clients, as well as reduce burn out and improve job satisfaction for a high risk mental health service position.

46. A Mindfulness-Acceptance-Commitment Based Leadership Training to Improve the Performance of Olympic Athletes
Primary Topic: Performance-enhancing interventions
Subtopic: sport psychology
Karoly Schlosser, Goldsmiths University of London
Frank Bond, Goldsmiths University of London

Applied sport psychology has become key interest field within professional sport to increase the performance and psychological well-being of athletes. Arousal regulation is one of the major approaches within the field and the interpretations of the ACT concept can be implemented well into this context. ACT works contrary to existing interventions, instead of attempting to control internal events it encourages the individual to pay attention to external stimuli resulting in better engagement in task and sense of psychological well-being and therefore in better performance (Bond, Hayes, & Barnes-Holmes, 2006). Gardner and Moore (2007) explored the ACT concept (Mindfulness-Acceptance-Commitment Approach) within the sport field and results show that it might benefit elite athletes better than typically used interventions. Combining the MAC approach with leadership development, this study aims to increase the competitiveness of the table tennis section of the British Olympic Team (N=29) for the upcoming games in Rio de Janeiro 2016. After the training, atheletes will be followed up throughout a year.

47. Examining the Effectiveness of Group Based Acceptance and Commitment Therapy for Adolescents in a Community Outpatient Mental Health Setting
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Adolescents, Group Treatment, Transdiagnostic intervention, Anxiety, Depression,
Tajinder Uppal Dhariwal, M.A., OISE/University of Toronto
Sheri Turrell, Ph.D., Trillium Health Partners
Mary Bell, M.S.W., R.S.W., Trillium Health Partners
Marci Gordeyko, M.A., OISE/University of Toronto

Background: Acceptance and commitment group therapy has been found to be effective for a transdiagnostic adult population within the hospital setting (Pinto et al., 2015). There is limited research of ACT group treatment with adolescents (Halliburton & Cooper, 2015). The effectiveness of ACT group treatment for adolescents diagnosed with heterogeneous psychiatric disorders in a community hospital has not yet been examined. Objective: The present study examined the effectiveness of 10 week group-based ACT treatment for adolescents presenting with primarily anxiety and depression-related psychiatric difficulties in a community outpatient mental health setting. Methods: Adolescents (n = 72) diagnosed with anxiety and depression-related psychiatric disorders took part in the present open trial. Data were collected prior to treatment, post-treatment and three months following the treatment. Participants completed outcome measures examining anxiety and depression symptoms and ACT process measures examining cognitive fusion/experiential avoidance, mindfulness and values-based direction. The present study consisted of data collected from fifteen groups run over four years. Results: Analyses revealed significant reductions in anxiety and depression symptoms from pre- to post-treatment. Significant reductions in anxiety and depression symptoms were also found from post-treatment to three months following the treatment. Changes in ACT processes were determined to predict changes in anxiety and depression symptoms. Discussion: The present research provides support for ACT group treatment as a transdiagnostic approach for adolescents presenting with primarily anxiety and depression-related heterogeneous psychiatric disorders in the community. Future research comparing ACT group treatment and existing treatments in the community setting with a similar population is warranted. References Halliburton, A. E., & Cooper, L. D. (2015). Applications and adaptations of Acceptance and Commitment Therapy (ACT) for adolescents. Journal of Contextual Behavioral Science, 4(1), 1–11. doi:10.1016/j.jcbs.2015.01.002 Pinto, R. A., Kienhuis, M., Slevison, M., Chester, A., Sloss, A., & Yap, K. (2015). The effectiveness of an outpatient Acceptance and Commitment Therapy Group programme for a transdiagnostic population. Clinical Psychologist. doi:10.1111/cp.12057

48. Feasibility, Acceptability, and Preliminary Outcomes of Randomized Controlled Trial Comparing Loving Kindness Meditation to Referral to Treatment as Usual for College Students with PTSD Symptoms and Problem Drinking.
Primary Topic: Prevention and Community-Based Interventions
Subtopic: PTSD, problem drinking, loving-kindness meditation
Helen Valenstein-Mah, University of Washington
Matthew Enkema, University of Washington
Hye In Cho, University of Washington
Tracy Simpson, VA Puget Sound
Sarah Bowen, Pacific University
Mary Larimer, University of Washington

Background: College can be a period of personal growth and development for many students; however, many also struggle with mental health issues, including trauma exposure and PTSD symptoms. Two thirds of students have experienced a traumatic event in their lifetime, and students with PTSD symptoms are more likely to drop out of college (Duncan, 2000). In addition to reporting high rates of trauma exposure, college students also engage in high rates of problem drinking (Perkins, 2002). They do so for a number of different reasons; however, there is increasing evidence that those experiencing PTSD symptoms often drink heavily to cope and that students with PTSD have worse drinking outcomes than those that do not (Read et al., 2012). For young adults with PTSD symptoms and problem drinking, college may be a critical time for intervention, since effective early intervention could decrease chronicity and lessen future need for PTSD and alcohol treatments. No studies to date have evaluated mindfulness for students with both posttraumatic stress symptoms and problem drinking. This study aims to evaluate a group loving-kindness meditation for college students with PTSD symptoms and problem drinking compared to existing services to determine if this intervention a) is feasible and acceptable, b) reduces PTSD symptoms and problem drinking, and c) contributes to a deeper understanding of the relationship between PTSD symptoms, problem drinking, self-compassion, experiential avoidance, and negative cognitions. Method: Undergraduate students at a large public university in the Northwest United States were recruited from the psychology subject pool. Students were eligible for the study if they: a) had experienced at least one traumatic event in their lifetime, b) had PTSD symptoms in at least two symptoms clusters lasting more than one month; c) had engaged in heavy episodic drinking at least twice in the past month; and d) were not actively suicidal or having psychotic symptoms. Students were randomized to attend either a four-week loving-kindness meditation group (based on the protocol developed by Kearney et al., 2013) or receive referrals to low-cost or free existing mental health services for college students both on and off campus. Students will be assessed pre-treatment, on a weekly basis for 4-weeks during the study, post-treatment, and at a one-month follow-up. Results: Currently 20 undergraduates are enrolled in the study and an estimated 40 will have completed the study by the ACBS conference date. Pre-to-post changes in PTSD symptoms and drinking quantity and frequency will be examined for both groups. Self-compassion, as measured by the Self-Compassion Scale (Neff, 2003), and experiential avoidance, as measured by the Acceptance and Action Questionnaire (Bond et al., 2011), will be examined as potential mediators of changes in PTSD symptoms and problem drinking pre-to-post treatment and pre-treatment to the one-month follow-up. Group acceptability, as measured by a participant satisfaction, will also be discussed. Discussion: These preliminary findings will be discussed as well as potential implications for disseminating LKM interventions for student populations will also be discussed.

49. ACT with Mindfulness: Piloting a Curriculum for Reducing Intern/Resident Burnout
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Burnout
Amy House, Ph.D., Augusta University
Christopher F. Drescher, Ph.D., Augusta University

Background: Clinician burnout, defined as the emotional exhaustion, depersonalization, and a low sense of personal accomplishment experienced in practice (Epstein, 1999), is a prevalent phenomenon. Studies estimate up to 60% of practicing physicians report burnout (Shanafelt et al., 2002), which is correlated with poorer quality of care (Shanafelt et al., 2003), patient dissatisfaction (Haas et al., 2000), increased medical errors (Crane, 1998), decreased ability to express empathy (Shanafelt et al., 2005), increased rates of substance abuse (O’Connor & Spickard, 1997), stress-related health problems, and familial discord (Spickard et al., 2002). Burnout can be found among trainees, including up to 75% of clinicians in residency training (Shanafelt et al., 2002). As noted by Krasner et. al (2009) there remain very few programs that exist to prevent the symptoms of burnout and effectiveness data is scarce. To date, there are no studies that examine the efficacy of any such programs on the well-being of psychiatry residents and psychology interns specifically. One possible intervention to address clinician burnout, Acceptance and Commitment Training (ACT), has been used in a variety of workplace settings and been shown to improve employee well-being and reduce psychological distress (Flaxman et al., 2013). In an effort to expand the research on interventions promoting clinician resilience and preventing burnout, our project tested the impact and acceptability of an ACT intervention for reducing and preventing burnout in psychology and psychiatry trainees. Method: Psychiatry and psychology trainees at an academic medical center (n = 22) participated in a 6 session ACT intervention over 4 months, and completed pre- and post-intervention surveys. Measures included the Work-Related Acceptance and Action Questionnaire (WAAQ), the Maslach Burnout Inventory (MBI), the Professional Quality of Life Scale (ProQOL), and questions regarding how many of the ACT sessions they attended, and how satisfied they were with the intervention. Results: Analyses from the pre-intervention survey indicate that the psychology and psychiatry trainees (N = 22) were reporting high levels of professional efficacy, but also high levels of exhaustion and cynicism on the MBI. Those who completed measures at post-intervention (N = 12) reported moderate levels of satisfaction with the ACT intervention, and that it had been moderately helpful to them. Attending more sessions was correlated with perceiving the intervention to be more helpful and influential. Step-wise regression analyses examined the impact of the number of ACT sessions attended while controlling for scale scores at Time 1. The number of ACT sessions attended significantly predicted post-intervention scores on the WAAQ (β = .49, p < .01), the Burnout scale of the ProQOL (β = -.70, p < .01), the Compassion Satisfaction scale of the ProQOL (β = .65, p < .05). In contrast, the Secondary Traumatic Stress scale of the ProQOL, and the subscales of the MBI were not predicted by number of sessions attended. Discussion: The ACT intervention was successfully implemented with psychiatry and psychology trainees at an academic medical center. There was some evidence of a dose-response effect, indicating that participants attending more intervention sessions experienced greater psychological benefits. Results of this study are limited by the small sample size and attrition in data collection. ACT may be an acceptable and useful intervention to decrease clinician burnout among psychiatry and psychology trainees.

50. Extending ACT’s Reach: Building Leadership for Community Improvement
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Leadership Development
Larry Dumka, Ph.D., Arizona State University

To date, applications of ACT have focused on individual well-being and more recently, on couple and parent-child relationships.This poster presents how the ACT model is used to train university students to lead action research projects that improve community well-being. In the year long Community Action Research Experiences (CARE) program, students pitch and collaborate with a community human services organization, whose mission they are passionate about, to complete a project that increases that organization’s effectiveness. Students increase their psychological flexibility as they address the challenges of developing a proposal collaboratively, implementing their action research project, and impacting their community organization. Correspondingly, the community organizations increase their capacity to integrate evidence to improve their practices.This poster outlines how the CARE program works, how ACT is employed to transform students from consumers to citizens, and how results are evaluated.

51. Promoting emotional and cognitive health (PEACH) among African-Americans residing in Peoria, Arizona
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Emotional and cognitive health
Janina Krell-Roesch, Mayo Clinic, Scottsdale, Arizona
Yonas E. Geda, Mayo Clinic, Scottsdale, Arizona

Background: A growing body of literature indicates that in the absence of adaptive emotional self-regulation, the wear and tear of day-to-day stressors can make a person vulnerable to mental and neurocognitive disorders. We hypothesize that high levels of perceived daily stress coupled with a person’s implicit or explicit evaluation of an adverse event, can be modified by our PEACH (Promoting Emotional And Cognitive Health) intervention which is anchored upon ACT. Method: To test our hypothesis, we conducted a feasibility study involving 12 African-Americans from a church community in Peoria, Arizona that underwent 4 PEACH sessions and completed perceived stress scale (PSS), quality of life questionnaire (WHO-QOL), valued living questionnaire (VLQ-2) and cognitive measures before and after the intervention. Results and Discussion: Preliminary analyses show a significant difference between pre- and post-intervention for VLQ-2 and PSS indicating more favorable outcomes. The participants’ self-assessment revealed that post-intervention, the consistency of their actions directed towards personal values was higher and perceived stress levels were lower than at baseline.

52. Factor Analysis of the M-Tracker 5: Theoretical Significance for Mindfulness Research
Primary Topic: Theoretical and philosophical foundations
Subtopic: Mindfulness
Nicholas Borgogna M.A., RBT, Roosevelt University
Jonathan Smith Ph.D., Roosevelt University

Title: The Factor Structure of Relaxation and Mindfulness: Two States or One? Background: Mindfulness, (open monitoring meditation), is an increasingly popular form of self-regulation (Davidson, 2015). Many scholars and practitioners consider mindfulness as one of many relaxation tools (such as progressive muscle relaxation, autogenic training, tai-chi, yoga, and hypnosis). A debate has emerged as to whether such exercises evoke a single self-reported psychological state or several. Benson’s (1975) relaxation response model suggests that most approaches to relaxation and mindfulness evoke a single nonspecific state of low arousal, the “relaxation response.” If this is the case, different techniques should be interchangeable since they all reduce stress arousal. Smith (2001, 2005, 2011, 2016) has suggested that mindfulness is different from traditional relaxation exercises and that different approaches have different psychological effects. Little research has directly addressed this important question. Do mindfulness and relaxation exercises evoke a single self-reported psychological state or several? Corbeil (2015) conducted a factor analysis on the Smith Relaxation States Inventory 3 (SRSI-3), a comprehensive measure containing both items related to mindfulness and general relaxation. She found three factors: Basic Relaxation, Positive Energy, and Spirituality. Consistent with Benson’s model, she found a single relaxation factor, Basic Relaxation, defined by both relaxation items (physical relaxation) and mindfulness items (at ease/peace). However, Corbeil tested college students in class (not after practicing relaxation or mindfulness), severely limiting the generalizability of her findings. The purpose of the present study was to explore the factor structure of self-reported mindfulness and relaxation among actual practitioners of yoga relaxation and mindfulness. Method: Participants were recruited from various yoga, meditation, and mindfulness organizations in the Chicago area. Graduate research assistants attended group sessions where they administered the M-Tracker 5, an updated version of the SRSI-3 (Smith, 2016), to participants after a session (n=119). Participants also included college students from a large Midwestern university (n=115) who filled out the M-Tracker 5 at the beginning of various courses. These students did not engage in any mindfulness or relaxation related exercises. Results: We conducted an exploratory factor analysis using orthogonal varimax rotation. Five factors were initially observed; however, two items loaded on single factors. We deleted these items, and repeated the analyses. This yielded three factors with eigenvalues ≥ 1. For surviving items, communalities were all ≥ .484. Internal consistencies were r ≥ .844. Only items loading ≥ .530 on one factor were considered as defining factor items. Discussion: Consistent with Corbeil’s study, we found three factors, which we name: Mindful Relaxation, Spirituality, and Positive Emotion. Our Mindful Relaxation factor is consistent with Benson’s model of a generalized nonspecific relaxation state. We found such a state includes self-reported mental relaxation (“at ease,” “at peace”) and mindfulness (“focused,” “centered,”). However, in examining this factor it is clear that it is most heavily defined by mindfulness items, rather than items related to mental or physical relaxation. For this reason, we suggest the term “relaxation response” is misleading, as is Corbeil’s factor name, “Basic Relaxation.” If there is a generalized state evoked by both relaxation and mindfulness exercises, this state is defined primarily by our most highly loading items (loadings higher than .70). Perhaps as Smith has suggested (2016), mindfulness is the core of all self-reported relaxation. To elaborate, Smith has suggested, that one does not necessarily have to practice open monitoring mindfulness in order to experience “Mindful Relaxation.” Yoga, or any effective self-relaxation approach such as deep breathing, progressive muscle relaxation, or autogenics may cultivate easy mindful focus, which in turn may lead to psychological and physical relaxation.

53. A longitudinal study exploring the role of mindfulness and reflective functioning in the social nteractions between mothers and babies.
Primary Topic: Theoretical and philosophical foundations
Subtopic: Mindfulness
Judy Pickard, PhD candidate, University of Wollongong,
Brin Grenyer, PhD, University of Wollongong
Michelle Townsend, PhD, University of Wollongong
Peter Caputi, PhD, University of Wollongong

The importance of attachment history to developmental outcomes and its propensity to cross generations is well documented (Bowlby, 1982; Sroufe, Egeland, Carlson, & Collins, 2005a). This has generated much research interest in the factors that may influence attachment security continuity and, potential discontinuity. To this end, mindfulness and reflective functioning; the ability to make sense of one’s underlying mental state, has been identified as influential in the process (Fonagy & Target, 2005; Shaver, Lavy, Saron, & Mikulincer, 2007). The current study followed 36 mothers from the Illawarra Born Cross-generation health study during the prenatal and postnatal period. Measures relating to attachment style, mindfulness , emotional regulation and reflective functioning were completed at 30 weeks gestation and again at 7-10 weeks and six months postpartum. Video recorded feeding and teaching sessions were recorded respectively during the two post partum data collection points. The videos were coded using the NCAST Teaching and Feeding Scales (Summer & Spietz, 1994), exploring the social interaction between mother and baby. It is proposed that mothers who score higher on the measures of mindfulness and reflective functioning and lower in regards to difficulty in emotional dysregulation will exhibit higher levels of positive maternal/ infant social interaction and contingent responding, independent of their attachment history. A sequential mediation relationship between the variables is explored, suggesting an avenue for therapeutic intervention in the development of positive parenting and discontinuity from the influence of an insecure attachment history. Bowlby, J. (1982). Attachment: Attachment and Loss (2nd ed. Vol. 1). New York: Basic Books. Fonagy, P., & Target, M. (2005). Bridging the transmission gap: An end to an important mystery of attachment research? Attachment and Human Development, 7(3), 333-343. Retrieved from http://www.scopus.com/inward/record.url?eid=2-s2.0-27744441028&partnerID=40&md5=917097e48f5729922a91055ae9371f8e Shaver, P. R., Lavy, S., Saron, C. D., & Mikulincer, M. (2007). Social foundations of the capacity for mindfulness: An attachment perspective. Psychological Inquiry, 18(4), 264-271. Retrieved from http://www.scopus.com/inward/record.url?eid=2-s2.0-36349000584&partnerID=40&md5=4b68cd73509be8ba41c6155d5af2b120 Sroufe, L. A., Egeland, B., Carlson, E., & Collins, W. A. (2005a). The development of the person: The Minnesota study of risk and adaptation from birth to adulthood. New York: Guildford. Summer, G., & Spietz, A. (1994). NCAST Caregiver/Parent-Child Feeding Manual. Seattle: NCAST Publications.

54. Self-Compassion Versus Self-Esteem as Predictors of Resilience and Well-Being
Primary Topic: Theoretical and philosophical foundations
Subtopic: Self-Compassion
Kimberley Schulz, MA, Alliant International University
Jill Stoddard, PhD, Alliant International University

Background: A concept only recently considered within the literature, self-compassion involves three core components that are demonstrated during times of suffering or failure: a) self kindness and understanding, b) seeing and accepting one’s own suffering as being a part of the larger human condition, and c) adopting a stance of nonjudgmental awareness toward one’s own pain without over-identification (Neff, 2003b; Neff & Tirch, 2013). Research suggests that self-compassion is an emotionally positive attitude toward the self that enhances mental health factors, life satisfaction, optimism, and overall health and well-being (Barnard & Curry, 2011; Neff, 2003b; Raes, 2010). Despite praise for the protective nature of self-compassion, emotional resilience (a well-researched construct) has yet to be directly examined within self-compassion research. There is therefore a need to inquire more thoroughly into the protective potential of self-compassion and to understand how such protection may differ from what is offered through other psychological constructs such as self-esteem, which differs in its protective functions and stability, as well as how it may enhance these factors. This project aimed to identify differences in the relationships between self-compassion, self-esteem, and various factors associated with mental health. It predicted self-compassion to be a more powerful predictor of resilience, positive affect, psychological flexibility, and life satisfaction than self-esteem. Method: Anonymous participants were administered electronic assessments that contained the Self-Compassion Scale (SCS; Neff, 2003a), Rosenberg Self-Esteem Scale (RSE; Rosenberg, 1979), and Connor Davidson Resilience Scale (CD-RISC 10; Campbell-Sills, Forde, & Stein, 2009), in addition to scales measuring other constructs associated with mental health, including positive affect, psychological flexibility, and satisfaction with life. Statistical results were analyzed to determine if positive and negative correlations existed between the SCS, RSE, and other measures, and if differences in the relationships between self-compassion, self-esteem, and various factors associated psychological well-being were indicated. Results: Based on the general adult sample (n=139), findings indicated those more likely to be resilient express more self-compassionate attitudes; participants who respond in a more self-compassionate way to stressors also scored significantly higher on self-reported resilience. As well, there was a significant inverse relationship between self-compassion and self-esteem, indicating that those possessing more self-esteem are less self-compassionate, and vice-versa (supporting previous research). An inverse relationship between self-esteem and resilience was indicated; participants possessing higher levels of self-esteem scored lower on self-reported resilience. Lastly, correlations with psychological flexibility indicated decreases in relation to higher levels of self-compassion and resilience, but increases in relation to higher self-esteem. Preliminary analysis suggest self-compassion to be a stronger predictor than self-esteem of resilience. Discussion: In directly studying the link between resilience and self-compassion, specifically in how this relationship differs from that with self-esteem, this study further clarifies self-compassion’s benefits and protective functions. A more precise understanding of the construct can aid in more effective utilization within mental health treatment.

55. Meaning in Life, Psychological Flexibility, and Valued Living: Birds of a Feather?
Primary Topic: Theoretical and philosophical foundations
Subtopic: Psychological Flexibility
Mathew A. Tkachuck, M.A., University of Mississippi
Lauren N. Weathers, M.A., University of Mississippi
I. Andrea Florez, M.A., University of Mississippi
Stefan. E. Schulenberg , Ph.D., University of Mississippi

Background: While theoretically, meaning and life and values appear closely related, scientifically, they are conceptualized differently and have been studied as separate constructs. One important area of research related to valued living includes psychological flexibility, or the ability to achieve one’s goals and values in the face of aversive psychological events. However, there is a paucity of research investigating psychological flexibility and meaning in life more directly. The current study investigated the relationship between psychological flexibility and both the presence of meaning and the search for meaning in relation to a new validated measure of valued living, the valuing questionnaire (VQ). Methods: Questionnaires were administered to undergraduate college students, including the acceptance and action questionnaire (AAQ), the VQ and the meaning in life questionnaire (MLQ). Results: Two hierarchical regression analyses were conducted for each of the meaning in life subscales (i.e., presence [n = 408] and search [n = 412] were the dependent variables) entering the AAQ in step one and both VQ subscales simultaneously in step two. Results suggest that psychological flexibility was a statistically significant predictor of both the presence of meaning in life even after (β = -0.13, p < .001) adding valued living to the model. When controlling for psychological flexibility, progress in valued living was found to be a statistically significant predictor of the presence of meaning (β = 0.58, p < .001), while obstruction of valued living had no significant effect (β = -0.02, p = .742). Over psychological flexibility, valued living accounted for an additional 23.5% of the variance of perceived meaning in life, a statistically significant difference (F = 80.117, p < .001). In relation to the search for meaning, psychological flexibility was also found to be a statistically significant predictor of the search for meaning even after (β = 0.11, p = .008) adding valued living to the model. When controlling for psychological flexibility, only obstruction of valued living was found to be a statistically significant predictor of search for meaning (β = 0.27, p < .001). Over psychological flexibility, valued living accounted for only 2.9% of additional variance in the search for meaning, a statistically significant difference (F = 6.489, p = .002). Discussion: Findings related to perceived meaning in life were as expected; more psychological flexibility and valued living lead to an increase in how meaningful one perceives their lives to be. However, search for meaning appears to be strongly related to both psychological inflexibility and obstruction of valued living, but not related to the enactment of values. In other words, searching for meaning is viewed as a barrier to valued living. Furthermore, the significant added effect of the VQ obstruction to the AAQ suggests that there are differences in these constructs in relation to search for meaning.

56. Reuniting RFT and therapy: Implications of theory within practice
Primary Topic: Theoretical and philosophical foundations
Subtopic: RFT, ACT, Middle level Terms
Andrew Ahrendt, M.A., University of Nevada, Reno
Fredrick Chin, M.S., University of Nevada, Reno
Amanda Munoz, M.S., University of Nevada, Reno

Background Within the contextual behavioral model, there is an emphasis on using middle-level terms that are supported and explained by basic functional processes. These terms enable mental health providers across psychotherapeutic approaches to effectively treat clients without having extensive knowledge of theoretical assumptions. As such middle level terms may provide a key role in the dissemination of empirically supported treatments. Methods/Results Authors evaluated the extant research connecting ACT processes to the underlying theoretical model. More specifically, researchers examined hexaflex processes and their level of fit between research, theory and practice. Based on the gaps that exist between middle level terms and basic functional processes, authors discuss the implications of this discrepancy, and provide specific empirically supported recommendations for future research aimed at clarifying the connection between basic and applied principles. Discussion Scientists need to be grounded to basic theory in order to ensure that their account remains consistent and coherent at all levels of analysis. Such coherence allows fluid movement between basic and applied science. While middle-level terms offer utility to practitioners, the inappropriate use may affect the efficiency and effectiveness of the treatment. Though efforts have been made to better connect ACT mid-level processes with basic science, we believe that future research can be done to strengthen the connection between the transformation of functional relationships and the verbal processes that are present within applied settings. Avenues to pursue this research line include specific preparations utilizing IRAP, delayed discounting paradigms, and other conditional discrimination tasks.

57. The relationship between childhood emotional neglect and emotional non-acceptance in adulthood: Evidence for experiential avoidance
Primary Topic: Theoretical and philosophical foundations
Subtopic: Experiential avoidance
Meaghan Lewis, M.S., Western Michigan University
Amy Naugle, Ph.D., Western Michigan University
Summer Chahin, Western Michigan University
Elise Trim, B.S., Battle Creek Veterans Affairs Medical Center

Contextual behavioral scientists are increasingly interested in emotional non-acceptance and the factors that contribute to its development. Emotional neglect is linked with a series of harmful consequences in adulthood such as depression and posttraumatic stress disorder (Valdez, Bailey, Santuzzi, & Lilly, 2014). While emotional neglect is associated with alexithymia (Aust, Härtwig, Heuser, & Bajbouj, 2013), few studies report information on the relationship between emotional neglect and general emotional non-acceptance. Experiential avoidance is one proposed paradigm for understanding functional classes of behavior that operate to escape or avoid emotion. Conceptually, individuals who experience emotional neglect in childhood may lack effective skills repertoires in effectively managing emotions such that they overemploy experiential avoidance. Overuse of experiential avoidance may take the form of harmful behaviors. The present study aimed to further elucidate the relationship between emotional neglect and non-acceptance of emotions through an experiential avoidance framework. It was hypothesized that experiential avoidance would mediate the effect of emotional neglect on non-acceptance of emotions. A sample of undergraduate students at a Midwestern university (N = 226) completed self-report measures using an anonymous survey regarding experiential avoidance, emotion dysregulation, childhood trauma history, and engagement in problem behaviors. Multiple regression analyses indicated that experiential avoidance predicted non-acceptance of emotions above and beyond emotional neglect in childhood. Experiential avoidance was also predictive of deliberate self-harm and restrictive eating beyond emotional neglect. A single mediation model was evaluated using non-parametric bootstrapping in Process software by Hayes (2013), revealing a partial mediating effect of experiential avoidance on the relationship between emotional neglect and non-acceptance of emotions. Early childhood repertoires in the development of workable emotion regulation strategies may play an important role in preventing emotional non-acceptance. Preventing harmful consequences of pervasive experiential avoidance will be discussed using an acceptance-based therapy framework.

58. The Role of Executive Attention in the Relationship between Mindfulness and Emotion Regulation.
Primary Topic: Theoretical and philosophical foundations
Subtopic: Mindfulness
Lindsey R. Wallace, M.A., Hofstra University

The mechanism through which mindfulness works to engender effects on cognitive and emotional outcomes is an unresolved question in the literature. The present study seeks to understand if attention mediates the relationship between mindfulness skills and improvements in emotional regulation. The Attention Network Test (ANT) was modified to examine attention network responses to both non-word cues and negative, positive, and neutral word cues. The “ANT-E” was modeled off of the Ainsworth, Eddershaw, Meron, Baldwin, and Garner (2013) paper. The task differs in that it includes positive word cues and the words were chosen based on arousal and valence from norming data. Participants completed the Five-Facet Mindfulness Questionnaire (FFMQ), the Difficulties in Emotion Regulation Scale (DERS), and the emotional variant of the ANT. Proposed results are that mindfulness scores will be inversely correlated with emotion dysregulation, and mindfulness will be positively correlated with executive control in the ANT-E. Expectations are that participants with stronger emotion dysregulation will have lower scores on executive attention for positive and negative cue words, but not for neutral cue words. Predictions are that executive function scores will mediate the relationship between mindfulness and emotion regulation. Results might suggest that mindfulness targets deficits in executive attention that are implicated in problems with emotion regulation. This study is novel in that it includes positive word cues. If results are as expected, it would lend support for the idea that individuals with emotion dysregulation have deficits in disengaging their attention from emotionally salient stimuli, regardless of their valence.

59. The Utility of Self-Compassion for Experiences of Ostracism: A Proposed Model
Primary Topic: Theoretical and philosophical foundations
Subtopic: Self-Compassion; Ostracism
Russell Anderson, M.S., University of Denver

Ostracism is a ubiquitous social phenomenon that has debilitating consequences, such as heightened aggression, decreased self-regulation, and suppressed immune and cardiovascular functioning (Wölfer & Scheithauer, 2013). Research suggests that self-esteem (SE) moderates the detrimental effects of ostracism, including poor health and risk behaviors. Interestingly, however, individuals with high SE have been shown to experience more stress on high rejection days compared to individuals with low SE (Ford & Collins, 2013). These results may suggest that individuals with high SE expect good outcomes and feel deserving of these outcomes; and ostracism, an unexpected contingency, results in increased stress. Perhaps, self-compassion, a related but different construct, offers a more functional alleviation to the effects of ostracism without the potential negative side effects of high SE. While self-esteem typically entails a comparison of one's self to another, self-compassion can be fostered independently of others through mindfulness in times of suffering, awareness of common humanity, and self-kindness (Neff, 2003). While self-compassion and ostracism have been researched extensively and independently, the extant literature on the relationship between self-compassion and ostracism is lacking. The purpose of this project is to examine the independent literature regarding these two constructs and propose a model for the relationship between self-compassion and ostracism. One prominent model of rejection reactions suggests that responses occur in five successive stages: immediate response (e.g., negative affect, lowered self-worth), construal (e.g., perceived unfairness), motivated response (e.g., prosocial response; withdrawal), achievement of restoration of sense of acceptance, and mental and physical health outcomes (Smart Richman & Leary, 2009). This author proposes that self-compassion moderates the relationship between the event that connotes rejection and the initial reaction stage of immediate response, thus transforming the succession of reactions following rejection. The functions of this mechanism are detailed in this paper from a synthesis of existing literature in self-compassion and ostracism research, elaborating on all three facets of self-compassion as they relate to coping with experiences of ostracism. While this conceptual project may propose a sound theoretical model, experimental studies need to be constructed to empirically test the relationship between self-compassion and ostracism. This task can be accomplished through experimental designs that include simple self-compassion interventions preceding and/or following ostracism manipulations, using established paradigms such as Cyberball (Williams & Jarvis, 2006). If this proposed model is supported by empirical research, then self-compassion interventions specific to ostracism can be justifiably formulated for dissemination to clinicians.

60. Experiential avoidance predicts impulse control difficulties in adulthood beyond childhood physical abuse
Primary Topic: Theoretical and philosophical foundations
Subtopic: Experiential avoidance
Meaghan Lewis, M.S., Western Michigan University
Dana Goetz, B.S., Western Michigan University
Amy Naugle, Ph.D., Western Michigan University
Elise Trim, B.S., Battle Creek Veterans Affairs Medical Center
Summer Chahin, Western Michigan University

Traumatic events experienced during childhood appear to be important distal risk factors in predicting deleterious outcomes in adulthood (Hovens et al., 2015). In particular, childhood trauma exposure is associated with harmful consequences such as risky sexual behavior, alcohol use, and psychological distress in adulthood (Min, Farkes, Minnes, & Singer, 2007; Walsh, Latzman, & Latzman, 2014). Yet the mechanisms by which childhood trauma exposure relates to adverse adulthood experiences are not well understood. From a behavior analytic perspective, difficulties regulating emotions with a negative valence in particular may be linked with a reinforcement history of avoiding said emotions. Indeed, there is emerging evidence to suggest experiential avoidance plays a critical role in maintaining a number of problem behaviors regardless of form (Kingston, Clarke & Remington, 2010). The present study collected data from a sample of primarily young adult undergraduate students at a Midwestern University. Data were collected in the form of an anonymous online survey regarding childhood trauma experiences, experiential avoidance strategies, and difficulties in emotion regulation. It was hypothesized that individuals with a history of childhood trauma may experience difficulties regulating emotions later in life. Difficulties regulating emotions was hypothesized to be maintained through an overreliance on experiential avoidance. At the bivariate level, experiential avoidance was strongly associated with both childhood trauma history and impulse control difficulties. Hierarchical linear regression analyses indicated that experiential avoidance predicated impulse control difficulties over and above a history of childhood physical abuse. Survivors of childhood physical abuse may be at particular risk for impulse control difficulties which may serve an experiential avoidance function. Implications for understanding this trajectory are discussed within a contextual behavioral framework.

61. A Comparison between Islamic Spiritual Therapy (IPS) and Acceptance Commitment Therapy (ACT)
Primary Topic: Theoretical and philosophical foundations
Subtopic: Comparision Islam and ACT
Associate Professor Dr Tahereh Seghatoleslam, University of Malaya/ Shahid Beheshti university of Medical Sciences tehran Iran
Professor Hussain Habil, Universitof Mahsa Malaysia

This study has clarified the differences and similarities between ISP and ACT from an Islamic point of view. It showed that there are a lot of similarities and a few differences in ISP and ACT principles. However, in Islam, everything is related to Allah, and it is said that everything is done in the name Allah; therefore, the Holy Quran emphasises on some actions that are mentioned as “Wajib”, which means they are compulsory, and stresses on the importance of avoiding any unacceptable Islamic behaviour which is a cardinal sin in the Holy Quran. Whereas in ACT, cognitive avoidance is not encouraged. In Islam, there are five prayer times that are “Wajib” (Compulsory) for all Muslims. It is similar to mindfulness in ACT that is the cause of consciousness. The Holy Quran orders that you have to be conscious and be responsible for all of your actions and behaviour to yourself and to other people. Otherwise, you are committing Haram. “Haram” is a religious word that is opposite of Wajeb, which means “compulsory to be avoided”. In the Islamic point of view, it is also recommended that the values play an important role in both personal and social life. These values developed the framework of a cognitive life. Regarding the time as mentioned by ACT, the moment is one of the principles that was proposed by Steven Hays. Moreover, Islam mentions that you should always be aware of the future and think of life in the next world. It is also mentioned that if you care about life in the other world, your future will be blessed by Allah. These dimensions are considered completely in the original paper.

62. Problems with psychological testing for the behavior analyst: Issues of philosophical dissensions beyond semantics
Primary Topic: Theoretical and philosophical foundations
Subtopic: traditional psychological assessment
Lindsey Gagnon, Psy.D., private practice
Ragnar Storaasli, Ph.D., University of Denver

Traditional psychological testing is arguably the gold standard for clinical assessment and diagnosis in most areas of contemporary psychology. Consequently, the ability to competently administer and/or interpret tests impacts marketability for independent clinicians and agencies, particularly as pressure increases to offer outcome informed evidence based practice hinged on a diagnostic system. For the behavior analyst, however, traditional psychological assessment is at odds with the philosophical and theoretical foundations of contextual behavioral science and according therapeutic applications. Such odds are not just semantics that can be accommodated with choice of terminology, but rather begin at the level of worldview. Differences in worldview between behavior analysis and mainstream contemporary psychology are discussed with emphasis on major distinctions in relation to language, causality, and science plans, and how these distinctions directly apply to psychological assessment. The paper concludes with a discussion about how the behavioral analyst can approach testing given some fundamental philosophical dissensions that cannot be modified or translated via semantic changes.

Thursday, June 16, 8:00-9:00pm - Poster Session #2

1. Trauma and Somatic Symptoms: Psychological Flexibility as a Mediator
Primary Topic: Behavioral medicine
Subtopic: Adolescents
Anne I. Roche, B.S., University of Iowa
Emily B. Kroska, M.A., University of Iowa
Michael W. O'Hara, Ph.D., University of Iowa
Rosaura Orengo-Aguayo, M.A., University of Iowa

Background: Students who attend alternative high schools are at increased risk for a variety of adverse experiences, including having been victims of physical or sexual abuse (Lehr et al, 2009). Studies have consistently shown a relationship between a history of childhood traumatic events such as physical, sexual, and verbal abuse and various types of chronic pain (Goldberg & Goldstein, 2000). These relationships have been examined in patients with pelvic pain, lower back pain, fibromyalgia, facial pain, migraines, and gastrointestinal disorders (Goldberg and Goldstein, 2000). While previous research has examined these associations within the context of pain conditions, little research has focused on somatic symptoms that do not rise to the level of a diagnosable condition. Importantly, studies have indicated that engaging in pain acceptance rather than avoidance strategies results in better outcomes for chronic pain patients (McCracken et al, 2003). Pain acceptance is emphasized in Acceptance and Commitment Therapy (ACT), which has strong empirical support for the treatment of chronic pain. Research on the association between trauma and pain has not been examined in the context of psychological flexibility, which is the ability to engage in values-based behavior in the presence of difficult internal experiences. The current study seeks to understand the mechanism by which trauma leads to increased somatic symptoms (including pain) in the context of the ACT model. Method: The present study examined the mediating roles of avoidance and mindfulness in the relationship between traumatic experiences and somatic symptoms in a group of at-risk adolescents enrolled in an alternative high school in the Midwest (N=51). The sample was 60% female and 40% male, and students were 16.29 years old (SD=1.01) on average. Measures included the Early Trauma Inventory, Acceptance and Fusion Questionnaire-Youth, the Child Acceptance and Mindfulness Measure-10, and the Patient Health Questionnaire—Somatic Symptom Severity scale (PHQ-SSS). The mean number of traumatic experiences reported in this sample was nearly three times the average reported by healthy adults in the study validating this measure (M = 9.61; Bremner et al., 2007). Results: Mediation analyses were conducted in SPSS, version 23, using the PROCESS macro (Hayes, 2013). All direct pathways were significant (ps < .05). We tested the significance of the indirect effects using bootstrapping. The mediation analyses showed significant indirect effects through both avoidance (CI: 0.0019-0.2650) and mindfulness (CI: 0.0289-0.2953) in the association between traumatic events and somatic symptoms. The models accounted for a substantial amount of the variance in somatic symptoms: mindfulness and trauma (r2 = .4896), avoidance and trauma (r2 = 0.486). Discussion: The results indicate that avoidance and mindfulness significantly mediate the association between traumatic events and somatic symptoms. The findings underscore the importance of psychological flexibility as a point for intervention in the established association between trauma and physical symptoms. Furthermore, the current analyses provide support for the use of ACT as a prevention tool in traumatized or at-risk populations. Interventions aimed at decreasing avoidance and increasing mindfulness are of critical importance in improving outcomes.

2. From values identification to committed action in persons with chronic illness: Where does the rubber meet the road?
Primary Topic: Behavioral medicine
Subtopic: Chronic Illness
Abbie Beacham, Ph.D., Xavier University
Jennifer K. Altman, M.A., University of Louisville
Meghan Jones, B.A., Xavier University
Matthew Maley, M.A., Xavier University

Background: Values clarification can illuminate a path toward valued living. This process becomes motivational as the discrepancy between values and behaviors becomes apparent. Various modalities of values assessment have been applied in different populations and settings. Although identification of importance of valued domains and corresponding behaviors is necessary, it may not be sufficient to prompt action. We hypothesized that the Importance-Satisfaction discrepancy would be predictive of actions in valued domains. Method: We surveyed online Chronic Illness (CI) support group members between ages 20-84 (N=399; Mage=53.05, SD=12.49). Participants were primarily married/partnered (62.5%), Caucasian (90.7%), female (80.9%), well educated (Myrs=15.48, SD=2.57) and had an average of 2.34 CIs. The Valued Directions worksheet (Eifert & Forsyth, 2005) was adapted to assess ten domains: Family, Intimate Relationships, Parenting, Friends/Social, Work/Career, Education/Training, Recreation, Spirituality, Citizenship and Health/Physical. Participants rated (1=Not at all to 10=Very) “How important is this area to you?” and in areas regarded as important, “Overall, how satisfied are you with the quality and depth of your experience in this aspect of your life?” Followed by, “How often have you done something to move you forward in this area during the last week?” For each of the domains, an Importance-Satisfaction deviation score (I-SDiff) was calculated and predictors of actions specific to each domain were assessed. Those who rated Importance >=7 were selected for analyses. IVs entered into regression models were: I-SDiff, #CIs, Perceived Illness Disability, Mindfulness, Positive and Negative Affect, Experiential Avoidance and CI Acceptance (Activity Engagement and Willingness). Results: The primary focus of this study was to assess predictors of action in the Health/Self-care domain. However, domain specific I-SDiff scores were significant in each of the ten domains (Betas = -.320 to -.728, all p’s <.001). CI Acceptance - Activities Engagement predicted Action in 8 of 10 domains (Betas = .144 to .234, all p’s<.05). Models accounted for .239 to .629 of the total variance. Discussion: Notably, none of the other IVs in the models were significant. Counter to our a priori predictions, Mindfulness, Experiential Avoidance and Affect all failed to predict actions. Contradictory to previous findings, perceived illness disability failed to predict Action. Results underscore the need to assess not only the importance of patients’ valued domains, but the extent of the disparity with satisfaction in them.

3. Navy's First Functional Restoration Pain Program: Improving Readiness, Restoring Function, and Relieving Pain.
Primary Topic: Behavioral medicine
Subtopic: Biospsychosocial Chronic Pain Treatments
Kathleen A. McChesney, Psy.D., Naval Medical Center San Diego
M. Schumacher, Naval Medical Center San Diego
Steven Hanling, M.D., Naval Medical Center San Diego
Tara Sheridan, M.D., Naval Medical Center San Diego
Parisa Navahandi, Naval Medical Center San Diego
Sheila Medina-Torne, Naval Medical Center San Diego

A multimodal, interdisciplinary functional restoration pain program (FRPP) is a cost-effective way to reduce chronic musculoskeletal pain and to promote a speedier return to full active duty in some military personnel. Chronic pain is a significant issue in the military because of the associated escalating health care and disability costs as well as loss of productivity and income. Authors conducted this study to test the efficacy of the FRPP for increasing patients' physical and mental coping strategies and to encourage patient independence from medical treatment resources through the promotion of self-efficacy, independent & patient-driven active modes of self-care, acceptance, and enhanced resiliency with flexible functionality. The FRPP consists of five half days per week for 8 weeks and combines optimization of psychoeducation on the biopsychosocial model of health, medication management, utilization of psychological interventions including ACT, CBT, Motivational Interviewing, Mindfulness, Mind Body Medicine, provision of complementary alternative medicine modalities, nutrition, sleep care, and quantitatively directed progressive exercise rehabilitation. All the patients were diagnosed with musculoskeletal disorders with pain duration > 3 months and have not responded well to treatments such as high dose medication and other standard interventions. Outcome measures used include Pain Catastrophizing Scale, Chronic Pain Acceptance Questionnaire, and the NIH Patient-Reported Outcomes Measurement Information System measures of pain interference, physical function, fatigue, sleep-related impairment, depression, anxiety, anger, and social satisfaction. All patient data—pre and post FRPP—were collected using the Pain Assessment Screening Tool and Outcomes Registry (PASTOR), a tool that produces a comprehensive 3-page clinician report of a patient's chronic pain. PASTOR portrays the data in a longitudinal manner that improves clinic efficiency and allows patient and providers to easily see areas of improvement. Their pilot study found that 73% of the 22 active duty members included in the study were cleared for full duty upon completing the 8-week long program, enabling formerly limited service members to return to active duty status, retain their careers, and reduce healthcare and disability costs. This interdisciplinary education program teaches military service members and families to take a proactive self-regulation approach in managing their pain, in order to regain a sense of internal empowerment and commitment toward meaningful & value-based actions. Authoritative organizations and expert panels worldwide promote an active, as opposed to passive, approach to rehabilitation. This, in turn, creates a focus on restoration through education, exercise, pain-coping and pacing skills, and the use of stress-management techniques. While there may not be a cure for chronic pain, it is believed many people are able to regain a better quality of life, improve mood, anxiety, and experiential avoidance, and gain flexibility, strength, and endurance through this program. This study was funded by an award from the Congressionally Directed Medical Research Program.

4. Clinical utility and characteristics of the Chronic Illness Acceptance Questionnaire-Short Form
Primary Topic: Behavioral medicine
Subtopic: Primary Care
Abbie O. Beacham, PhD, Xavier University
John Forrette, M.A., Xavier University
Chava Urecki, M.A., Xavier University
Desiree Green, M.A., Xavier University
Mike Bruner, M.A., Xavier University

Background: Chronic illnesses (CI) and health conditions are among the most frequently diagnosed illnesses and costly in health care. In real world settings, patients seek “simultaneous” medical care for multiple co-morbid CIs and related symptoms (Grumbach, 2003; Starfield et al, 2003). We previously adapted a measure of Acceptance effectively utilized in chronic pain populations (Chronic Pain Acceptance Questionnaire; CPAQ; McCracken, Vowles, & Eccleston, 2004) for use with patients with heterogeneous CI diagnoses to create the Chronic Illness Acceptance Questionnaire (CIAQ; Beacham et al., 2015). The 20-item CIAQ replicated the CPAQ two factor structure - Activity Engagement (AE) and Willingness (W) - with adequate-to-good fit to the data. The AE factor reflects a commitment to engaging in valued activities even in the face of illness related symptoms and the W factor constitutes a willingness to experience sometimes painful or aversive symptoms if it means being able to participate in valued life activities (McCracken, 2010). Although there is high utility for this measure in a variety of medical populations and settings, there remains a need to have similar, but more brief, valid and reliable assessment instruments. Given that the majority of CIs are managed in primary care settings where behavioral healthcare consults and appointments are allotted 15-30 mins, brief measures of this nature are even more vital. The purpose of this study is to evaluate preliminary data and utility of a CIAQ-Short Form (CIAQ-SF). Method: In accordance with the development of the CPAQ-8 (Fish et al, 2010), we selected a total of 8 items from the CIAQ with the strongest factor loadings (4 per factor) as follows: AE .77 to .82 and W .58 to .75. Data collected from online (CI) support group sample participants (Ppts; N = 397) were analyzed. Ppts ranged in age from 20-84 years [Mean age = 53.18 (12.39)] and were diagnosed with 1-7 (M = 2.36; SD = 1.39) CIs. Items for the AE and W subscales were summed and had moderate-to-high Internal Consistencies (Alphas = .887, .679, respectively). Results: CIAQ- SF scores were strongly correlated with CIAQ long form scores (r’s = .888 - .922, p’s < .001). Consistent with previous results with the CIAQ long form, the CIAQ-SF subscale scores were associated with other measures of psychological flexibility and affect. Both the AE and W subscales were positively associated with Mindfulness and Positive Affect (r’s = .193 to .589) and inversely associated with Experiential Avoidance and Negative Affect (r’s = -.163 to -.507). Regression analyses (Method=Enter) again replicated previous findings. With all measures of psychological flexibility, affect and # CIs entered, 43.2% of variance was accounted for by the model [F (7, 277) = 31.885, p<.001]. Perceived Illness-Related Disability (DV), a “proxy” for functional outcomes in medical populations, was predicted by # of CIs (Beta= .188, p<.001), CIAQ-SF- AE (Beta = -.518, p<.001) and CIAQ-SF-W (Beta = -.166, p=.001). Discussion: These preliminary analyses of existing data suggest that the CIAQ-SF would perform adequately and similarly to the longer version. Although additional data collection and analyses are necessary, this brief CI Acceptance measure offers considerable utility in a variety of health care settings especially fast-paced primary care settings.

5. Valued Action in Breast Cancer survivors: What predicts Action in highly valued life domains?
Primary Topic: Behavioral medicine
Subtopic: ACT Assessment
Abbie O. Beacham, PhD, Xavier University
Stefanie Schmidbauer, M.A., Xavier University
David Downing, B.A., Xavier University
Stacy Lorenz, M.A., Xavier University

Background: Cancer diagnosis and survivorship can enhance potential for positive psychosocial and health behavior change (Andrykowski et al., 2006). Values consistent behavior change in cancer patients and survivors has been conceptualized as a response to an extraordinary opportunity for ‘growth’ and ‘benefit-finding’ (Antoni et al., 2001; Kissane et al., 2003; Stanton et al., 2002). Accordingly, in clinical application, the identification of one’s values can lay a sound foundation for movement toward increased satisfaction and function in valued life domains. Although identification of importance of valued domains and corresponding behaviors is necessary, it may not be sufficient to understand what facilitates action. We hypothesized that the Importance-Satisfaction discrepancy would be predictive of actions in highly valued domains in a sample of breast cancer survivors. Method: We surveyed online breast cancer (BrCA) support group members between ages 20-79 (N=286; Mage=55.01, SD=10.26). Participants were primarily Caucasian (87.8%), well educated (Myrs=15.45, SD=2.62) and 88.1% diagnosed with stage 0-II breast cancer. The Valued Directions worksheet (Eifert & Forsyth, 2005) was adapted to assess ten domains: Family, Intimate Relationships, Parenting, Friends/Social, Work/Career, Education/Training, Recreation, Spirituality, Citizenship and Health/Physical. Participants rated (1=Not at all to 10=Very) “How important is this area to you?” and in areas regarded as important, “Overall, how satisfied are you with the quality and depth of your experience in this aspect of your life?” Followed by, “How often have you done something to move you forward in this area during the last week?” Those in the sample who rated Importance >=7 in respective life domains were selected for each of the regression analyses. For each of the domains, an Importance-Satisfaction deviation score (I-SDiff) was calculated and predictors of actions specific to each domain were assessed. IVs entered into regression models were: age, education, Mindfulness, Positive and Negative Affect, Experiential Avoidance and Chronic Illness Acceptance (Activity Engagement and Willingness) and I-SDiff score for the corresponding life domain. Results: Notably, the primary focus of this study was to assess predictors of action in the Health/Self-care domain in a “medical” population. However, domain specific I-SDiff scores were significant predictors of Action in 9 of 10 domains (Betas = -.360 to -.666, all p’s <.001). Surprisingly, and counter to our a priori predictions and findings in other samples, none of the other IVs were significant with the exception of positive affect which predicted Action in 4 of 10 domains (Betas = .220 to .423, all p’s<.05). Models accounted for .259 to .441 of the total variance. We examined predictors of in the Health/Self-care domain more closely. Given that The I-SDiff score predicted Action (Beta = -.570) all other IVs were assessed as predictors of I-SDiff scores. Of these, Acceptance: Activity Engagement (Beta = -.300, p = .029) and Experiential Avoidance (Beta= .332, p = .034) predicted I-SDiff scores. Discussion: Taken together, results underscore the need to assess not only the importance of patients’ valued living domains, but the extent of the disparity between importance and satisfaction within them. Preliminary results also suggest that it may be useful to assess core ACT processes as they relate to the importance-satisfaction disparities. Certainly, in medical populations, there is merit to doing so especially in the area of health and self-care as those are germane to survivorship quality of life (Andrykowski et al, 2006).

6. Building Prosocial communities in Sierra Leone
Primary Topic: Clinical Interventions and Interests
Subtopic: Developing nations, prosocial, ACT, PTSD
Edmond Brandon, commit and act
Tien Mandell, commit and act, University of Glasgow

Sierra Leone is a land of powerful mixtures. scarred by a history of deprivation and conflict, the people value peace and resilience, living in a land of majestic mountains, lush greenery and many beautiful beaches. it is now faced with many challenges, such as teenage pregnancy, exploitation, violence against girls, female genital mutilation, ebola and many socio-economic problems. our charity, commit and act, has supported people through many of these problems. in our girl shelter, we provide individual and group counseling session for victims, parents, and caregivers. helping to heal the bodies inside and out with prosocial behavior change, food for daily sustenance, dignity kits, educational opportunities, medical support, legal support, support the caregiver, recreational facilities and follow-up visitations. commit and act centre practice prosocial and act in our meetings, trainings and workshops to change behavior. we have helped people to create rich, full and meaningful lives, whilst accepting that life inevitably brings pain. we use act mindfulness exercises to help handle painful thoughts and feelings, and the matrix to support them in taking valued directions to achieve the goals that really matter. in the recent fight against Ebola, we trained teachers that have gone into the communities to help to break the chain of transmission of Ebola in the Bo district with cultural-specific behavioral changes.

7. A Research Proposal: Self-Compassion as the Antidote for Shame in Transgender Adolescents
Primary Topic: Clinical Interventions and Interests
Subtopic: Transgender
Emily Ball, Gonzaga University

“Owning our story and loving ourselves through that process is the bravest thing that we will ever do.” (Brown, 2010) Background: Why is owning our story such a hard thing to do? Many would argue that it is difficult because “owning our story” means acknowledging and accepting our imperfections. Our imperfections are integral to our identity as human beings, yet as a human race we condemn the imperfections both that others display and that we display within ourselves. One population that is frequently condemned is the transgender population. Transgender individuals are often seen as sick, freakish, and threatening. These stigmas thrusted upon the transgender population often then become internalized by the transgender individual him/herself which leads to staggering rates of depression, anxiety, and suicide. This research examines one component of this internalized stigma—shame—and proposes a quantitative way of measuring shame and the reduction of shame via self-compassion therapeutic intervention. While the research has not yet been conducted, as I am only a first year graduate student, this proposal lays the groundwork for how professionals in the field of mental health may better reach their transgender clients. Hypothesis: Shame levels will decrease in transgender adolescents as self-compassion levels increase within transgender adolescents through self-compassionate therapeutic intervention. Method: Subjects - The subjects participating in this study will be from a nonrandom, purposive sample. Subjects will be 30 self-identifying transgender adolescents. For this study, adolescent is defined as a person aging from 13-17. Subjects will be individuals who are seeking out therapy due to some aspect of their status as a transgender person. Subjects will be fully informed of the process and assured that their identities will be kept anonymous. Subjects will also be assured that the resulting research will be a by-product of their therapy and that they may withdraw their information for research purposes at any time. Instruments - The instruments used in this study will be the Shame Inventory (Rizvi, 2010) and the Self-Compassion Scale (Neff, 2015).The Shame Inventory (Rizvi, 2010) is a self-report measure designed to assess an individual’s experience of shame both globally and in response to specific life events. The inventory has two parts. Part I examines general experiences of shame on a 5-point Likert scale, such as the frequency, intensity, and negative effects of shame. Part II looks at 50 potential shame cues. Subjects are asked to rate each cue on a 0–4 scale to indicate the intensity of their current levels of shame about that event or characteristic, or to indicate if they have never experienced the event/ behavior/characteristic. The total score is the average rating on selected items and ranges from 0 to 4, with 4 indicating higher degrees of shame. The Self-Compassion Scale is also a self-report inventory comprised of 26 questions about the participant’s typical behavior. The subjects rank how often they do or do not experience the specific behavior referenced rating from 1 (almost never) to 5 (almost always). Lower scores indicate lower levels of self-compassion, while higher scores indicate higher levels of self-compassion. Overall score is then averaged and coded accordingly. Design - The research design will be an experimental pre-test/post-test design using self-report inventories to measure the variables. The dependent variable studied will be shame and the independent variable studied will be self-compassion. Subjects will be given the Shame Inventory (Rizvi, 2010) and the Self-Compassion Scale (Neff, 2015) both at the start of therapy and at the end of therapy to measure baseline levels of shame and self-compassion and post-intervention levels of shame and self-compassion. The hope is that after self-compassion therapeutic intervention, shame levels will be reduced, as quantitatively measured by the Shame Inventory (Rizvi, 2010), and self-compassion levels will have increased, as quantitatively measured by the Self-Compassion Scale (Neff, 2015), thus resulting in a correlation between the two variables. Procedure - Transgender subjects will seek out self-compassion therapy on their own accord. I, as both the researcher and a licensed mental health counselor, will describe the self-compassion therapeutic process and its success in reducing negative states of being. If the client chooses to pursue therapy, he/she will sign off on the informed consent document. The counselor will then give the client the shame and self-compassion assessment tools to establish a research baseline. Germer and Neff (2013) suggest an outline for what each session should look like. I have chosen to allot 10 sessions per subject to ensure that rapport is established and that the client does not feel rushed at any point during the process. At the end of 10 sessions, the same instruments will be used to assess post-intervention levels of shame and self-compassion. The same process will be repeated until the researcher has collected data on 30 subjects. The gathering of data will sought to be completed over a span of 5 years or less. Subjects will receive counseling services at no charge. Results: I expect that after running the one-way repeated measure ANOVA test, my post-test data will differ significantly from the pre-test data. As the hypothesis suggests, I am anticipating there to be a negative correlation between shame and self-compassion. As self-compassion levels increase among subjects, shame levels decrease. Ideally, after running the test my ANOVA value would compute close to -1, demonstrating that not only does a relationship exist between the variables, but that there is a negative correlation between them—endorsing my intervention as a successful one. Discussion: The National Alliance on Mental Illness, NAMI, (2015) reports that “between 38-65% of transgender individuals experience suicidal ideation” and suicide remains to be a leading cause of death for transgender individuals. The time is now to develop effective strategies for helping transgender individuals—this includes within the counseling setting. Assuming my study yields significant results, this study would provide the counseling profession with a framework for working with transgender individuals, which is currently somewhat of uncharted territory. Shame is a common reported feeling across suicidal individuals, yet the shame a transgender person feels is a very unique kind of shame that most people will never experience. However, this does not mean that we cannot empathize or develop ways to preserve these lives and restore worth and self-compassion within the transgender population. My findings would indicate a way to do just that—preserve lives through an effective therapeutic relationship and restore self-worth by way of increasing self-compassion. The process of acceptance and tolerance must begin within the self. The results of my study would specify how to facilitate the rejection of shame and embark on the journey of self-compassion leading to feelings of worth and kindness to self, thus reducing suicidal ideation and self-hatred amongst the transgender population.

8. Acceptance and Commitment Therapy (ACT) for a female Chinese adolescent with Depression and Trichotillomania (Hair Pulling Disorder): A single case study.
Primary Topic: Clinical Interventions and Interests
Subtopic: Children and Youth, Trichotillomania, Depression
Celeste Cai Jieni, MA (Applied Psychology), KK Women's and Children's Hospital, Singapore

Background: Trichotillomania (TTM) is characterised by repeated hair pulling that results in noticeable hair loss (American Psychiatric Association, 2000). The highest incidence of the onset of TTM is experienced during childhood and adolescence (Huynh, Gavino, Magid, 2013) and prevalence of depression and anxiety is also common (Lewin et al., 2009). ACT Enhanced Behavioral Therapy (AEBT) for TTM has shown promising results for the treatment of adults (Twohig & Woods, 2004; Woods, Wetterneck, et al., 2006). However, there is limited empirical evidence regarding the efficacy of ACT in adolescent TTM and none of them has featured treatment of depression with TTM in adolescents. This single case study aims to illustrate the use of ACT in the treatment of a 14-year old female Chinese adolescent suffering from major depression and TTM. Zoe is a high achiever secondary school student whose depression was triggered by her poor performance in her exams during one of her school terms. To cope with her stressful experiences and negative feelings, she engaged in a hair-pulling habit which gradually developed into TTM. Method: 10 sessions were conducted using the AEBT protocol. Steps were taken to modify her treatment according to her needs and progress. To investigate the effectiveness of ACT, direct measures of trichotillomania, Massachusetts General Hospital (MGH) Hair Pulling Scale (Keuthen et al., 2007) was used at the start of every session. Acceptance and Action Questionnaire (AAQ-II) (Bond et al., 2011), and Beck Youth Inventories (BYI-II) (Beck, Beck, Jolly, Steer, 2005), were used at pre and post treatment intervals. Results indicated a reduction of experiential avoidance, decreased depression symptoms and decreased hair-pulling severity. Discussion: The third-generation cognitive behavioural therapies such as ACT can significantly improve negative feelings as it deals with the person's tendency to avoid, control or escape from thoughts, urges, emotions or any other unwanted internal experiences (Hayes, Strosahl, Wilson, 1999). In TTM, evidence has shown that the act of pulling controls these negative internal experiences and as such, the pulling is used to avoid or escape from them (Begotka, Woods, & Wetterneck, 2004; Norberg, Wetterneck, Woods, Conelea, 2007). The data from the present case report is one of the first to suggest that ACT may be a suitable treatment for adolescent with depression and TTM. Further research involving the application of ACT on TTM in adolescents is also therefore worth exploring.

9. Effects of brief-ACT on college student drinking and correlates of drinking: A pilot study
Primary Topic: Clinical Interventions and Interests
Subtopic: College student drinking
Justine A. Grosso, M.S., Baylor University, Waco, TX
Lauren L. Greenberg, Psy.D., George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT
Jules C. Martowski, B.A., Baylor University
Alexis Humenik, B.A., The George Washington University, Washington, DC
Thomas A. Fergus, Ph.D., Baylor University, Waco, TX
Sara L. Dolan, Baylor University, Waco, TX

Existing empirically supported individual-level interventions for college student drinking reduction focus on changing perceptions of social norms and expectancies (e.g., social motives, conformity motives) in order to affect drinking outcomes. Researchers are beginning to target college student motives for drinking related to changing unpleasant internal experiences (e.g., coping motives) via brief mindfulness- and acceptance-based interventions. The current study examined the preliminary effectiveness of a single session of Acceptance and Commitment Therapy (ACT). Participants were 139 undergraduate students (77.7% women, M = 19.28 years old, 79.1% Caucasian) who completed questionnaires at baseline (BL), the intervention, and then questionnaires at follow-up (FU; two- to four-weeks post-intervention). The study investigated whether various drinking outcome variables (e.g., negative alcohol-related consequences, alcohol quantity and frequency) would significantly decline after the intervention as well as how drinking coping motives may be associated with these drinking outcomes. Statistically significant reductions were found in all drinking outcomes (Cohen’s d’s = .35 – 1.78) from BL to FU. Exploratory autoregressive analyses using hierarchical linear regression revealed significant positive associations between all drinking outcomes and coping motives for drinking (semi-partial r2s = .10 - .18, small effects). These findings suggest that this intervention may be associated with reducing some of the most impairing symptoms along the alcohol use disorder continuum. These data also suggest that drinking coping motives are an important target deserving of continued focus. It may be that certain processes targeted by ACT, such as experiential avoidance/acceptance and cognitive fusion/defusion, attenuate automatic alcohol coping behavior in response to unpleasant internal experiences.

10. Cognitive fusion: pre-post changes associated with a brief-ACT intervention and its moderating role on the relationship between baseline and follow-up negative alcohol-related consequences
Primary Topic: Clinical Interventions and Interests
Subtopic: Cognitive fusion
Justine A. Grosso, M.S., Baylor University, Waco, TX
Lauren Greenberg, Psy.D., George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT
Jules Martowski, B.A., Baylor University, Waco, TX
Alexis Humenik, B.A., The George Washington University, Washington, DC
Thomas A. Fergus, Ph.D., Baylor University, Waco, TX
Sara L. Dolan, Ph.D., Baylor University, Waco, TX

Cognitive fusion, a theoretically-hypothesized mechanism of change in Acceptance and Commitment Therapy (ACT) has yet to be evaluated empirically in treatment studies. Participants were undergraduate students (N = 139; 77.7% women, M = 19.28 years old, 79.1% Caucasian) who completed questionnaires at baseline (BL), a single-session ACT intervention, and questionnaires at follow-up (FU; two- to four-weeks post-intervention). The present study examined pre-post changes in cognitive fusion as well as cognitive fusion’s moderating role on the relationship between BL and FU negative alcohol-related consequences. Cognitive fusion was measured using the Cognitive Fusion Questionnaire (Gillianders et al., 2014). There was a statistically significant reduction in cognitive fusion from BL (M = 26.07, SD = 9.33) to FU (M = 23.76, SD = 9.78), t(138) = 3.32, p <.001 (Cohen’s d = 0.24, small effect). Additionally, the interaction between BL cognitive fusion and BL negative alcohol-related consequences was statistically significant. Simple slope analyses indicated that BL and FU negative alcohol-related consequences were significantly positively associated at 1 SD below the mean of cognitive fusion (β = 0.26, p < .001) and significantly positively associated at 1 SD above the mean of cognitive fusion (β = 0.62, p < .05). The pattern of the interaction indicates that participants who had high BL levels of cognitive fusion had greater stability of negative alcohol-related consequences and those with lower levels of BL cognitive fusion had greater reductions of alcohol-related consequences from BL to FU. It may be that individuals who were high in BL cognitive fusion were so reactive to internal experiences that attachment to unpleasant thoughts and feelings were not weakened enough by the intervention. Results suggest that increasing session number or session duration to accommodate additional experiential exercises that facilitate defusion may further weaken urges to drink to cope with unpleasant internal experiences and subsequent negative alcohol-related consequences for individuals who were high in cognitive fusion at BL.

11. Effectiveness of Acceptance and Commitment Therapy (ACT) on resiliency of female with psoriasis
Primary Topic: Clinical Interventions and Interests
Subtopic: Acceptance and Commitment Therapy, Psoriasis, Resiliency
Asghar Aghaei, Professor, Department of educational science and psychology, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
Pariya Heidari, M.A. Department of educational science and psychology, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran

Background: The purpose of this study was to investigate the effectiveness of Acceptance and Commitment Therapy (ACT) on resiliency of female with psoriasis in Isfahan(Iran) . Methods: This was an experimental study with pre-test, post-test and follow up.The statistical population were psoriasis patients referred to Sedighe Tahereh’s Skin and Leishmanias Research Center who have been referred by specialist Doctors and have records. Thirty patients were randomly selected and were contacted to come and involve in study. The selected patients were divided into two groups of 15 people as intervention group and non intervention.Acceptance and Commitment therapy in the experimental group during the post two month, in weekly meeting for 120 minutes was performed. The subjects completed the following questionnaire: Resiliency (Conner and Davidson, 2003). Results:The result of covariance analysis showed that there were significant differences between experimental and control groups(P<0.05). Discussion:The results of this research had shown that Acceptance and Commitment Therapy was effective in the increase resiliency .The result also showed a treatment effect was persistent during the follow up. So ACT may be considered to be an effective intervention approach for increase of resiliency in patient with psoriasis.

12. Effectiveness of acceptance and commitment therapy on family cohesion in spouses of drug dependent men
Primary Topic: Clinical Interventions and Interests
Subtopic: Acceptance and Commitment Therapy, family cohesion, family process, spouses of drug dependent men
Leyli Nourian, M.A., Islamic Azad University, Najafabad branch, Isfahan, Iran
Fereshteh Sedighi, M.A., Islamic Azad University, Najafabad branch, Isfahan, Iran
Asghar Aghaei, Ph.D., Department of educational science and psychology, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran

Background: The purpose of this study was to determine the effectiveness of acceptance and commitment therapy on family cohesion in spouses of drug dependent men. Method: This research was a quasi-experimental research with pre-test, post-test and tow month fallow up with control group. The statistical population consisted of all spouses of drug dependent men who refereed to addiction treatment centers of Isfahan (Iran). 32 spouses of drug dependent men were selected with available sampling method among the statistical population (from two treatment centers). They were randomly incorporated to an experimental and a control group (16 per group). All participants were assessed by cohesion subscale of family processes scale (Samani, 2008) at pre-test, post-test and tow month after the treatment in the follow up stage. The intervention involved 10 sessions of acceptance and commitment therapy, each lasting for 90 minute, which were administered only to the experimental group. Results: The result of covariance analysis indicated a significant improvement in the experimental group in variables of family cohesion in post-test (p<0.05) and the results were sustainable in fallow up (p<0.05). Discussion: According to the findings of this research, use of this therapeutic approach is recommended to improve family cohesion in family of drug dependent men.

13. Psychological Flexibility as a Predictor of Quality of Life and Eating Disorder Risk in a Residential Treatment Setting
Primary Topic: Clinical Interventions and Interests
Subtopic: Eating Disorders
Eric B. Lee, MA, Utah State University
Ellen Bluett, MS, Utah State University
Clarissa Ong, BA, Utah State University
Ginger Lockhart, Ph.D., Utah State University
Michael Twohig, Ph.D., Utah State University
Tera Lensegrav-Benson, Ph.D, Avalon Hills Residential Eating Facility
Benita Quakenbush-Roberts, Ph.D., Avalon Hills Residential Eating Facility

Psychological flexibility has been hypothesized to be a mechanism of change within eating disorders. However, little data has examined this proposed relationship. Promoting psychological flexibility could potentially play an important role in improving ridged, perfectionistic thinking and obsessive behaviors often seen in those with eating disorders. It was hypothesized that increasing psychological flexibility would reduce eating disorder risk and improve quality of life of individuals with an eating disorder. The data presented in this talk were collected from 112 inpatients of a residential treatment facility. Sequential multiple regression analyses were performed to test whether pre-treatment levels of psychological flexibility longitudinally predicted quality of life and eating disorder risk after controlling for age and baseline effects. Pre-treatment psychological flexibility significantly predicted post-treatment quality of life. The incremental change in R2 at the final step was significant, Finc (1, 109) = 4.209, p<.05 and the adjusted R2 indicated that approximately 19% of the variation in post-treatment quality of life was attributable to age and pre-treatment psychological flexibility. Similar results were found when testing post-treatment eating disorder risk as an outcome, as pre-treatment psychological flexibility significantly predicted post-treatment eating disorder risk. The incremental change in R2 at the final step was significant, Finc (1, 110) = 4.367, p<.05 and the adjusted R2 indicated that nearly 30% of the variation in post-treatment eating disorder risk is attributed to age and pre-treatment psychological flexibility. These data were examined used change scores, with results indicating that improvement in psychological flexibility over the course of treatment lead to improved quality of life and eating disorder risk outcomes.

14. A Pilot Study of Acceptance and Commitment Therapy for Anger Dysregulation among Trauma-Exposed Military Veterans
Primary Topic: Clinical Interventions and Interests
Subtopic: Anger and Aggression
John Donahue, Psy.D., University of Baltimore
Andrew Santanello, Psy.D., Center for Deployment Psychology
Mary Marsiglio, Ph.D., VA Portland Health Care System
Lynn Van Male, Ph.D., VHA CO, Office of Public Health, Occupational Health Strategic Healthcare Group

Background: Anger dysregulation and attendant problem behaviors are commonly reported by treatment-seeking military veterans, particularly those with a history of trauma exposure. However, there is a paucity of studies examining interventions for dysregulated anger and aggressive behavior in this population. With its emphasis on promoting psychological flexibility, both theory and empirical evidence suggest Acceptance and Commitment Therapy (ACT; Hayes, Strosahl, & Wilson, 1999) may be a viable and effective treatment for anger dysregulation among veterans. Method: The present study sought to examine the feasibility and preliminary effectiveness of an open trial of a 12-week ACT group intervention for trauma-exposed military veterans reporting difficulties with anger and aggressive behavior. Participants were recruited from mental health and primary care clinics at a large Veterans Health Administration (VHA) medical center in the northwestern United States. Participants were assessed at pre-treatment, post-treatment, and six-week follow-up on a variety of self-report measures, including anger (Dimensions of Anger Reactivity Scale), trait physical and verbal aggression (Aggression Questionnaire), psychological flexibility (Acceptance and Action Questionnaire - II), quality of life (Quality of Life Questionnaire), and a participant satisfaction survey. Results: Results indicated that treatment completers (n = 16) found the intervention favorable, participation was associated with improvements in trait physical aggression and psychological flexibility, while findings pertaining to changes in anger were mixed. Furthermore, changes in psychological flexibility accounted for substantial variance in participants' reduction in physical aggression, after accounting for relevant control variables. Discussion: Findings suggest a group-based ACT intervention for anger dysregulation is feasible among trauma exposed military veterans and warrants further investigation.

15. A Meta-Analytic Review of Functional Analytic Psychotherapy Single-Subject Research
Primary Topic: Clinical Interventions and Interests
Subtopic: Meta-Analysis
Sonia Singh, M.A., Bowling Green State University
Leah Bogusch, Bowling Green State University
William H. O'Brien, Bowling Green State University

Functional Analytic Psychotherapy (FAP) is a contextual behavior therapy that utilizes basic behavioral principles to within the therapy session to implement change in order to allow these changes to generalize outside of session. The therapist works to reduce problematic in-session behavior (CRB1s) and increase functional in-session behavior (CRB2s). A majority of the published studies in FAP are single-subject design. The current study synthesized data from FAP single-subject investigations using single-subject meta-analytic techniques. Percentage of non-overlapping data (PND) was calculated for graphed outcome data. The reliable change index (RCI) was calculated for questionnaire outcome data. Results indicated that cumulative PND for CRB1s was 57.76% and fell in the “moderately effective” range, and for CRB2s was 81.06% and fell in the “fairly effective” range. The overall RCI for was 4.03 which indicates that pre-post changes on questionnaire outcome data are large and statistically reliable.

16. A preliminary investigation of Acceptance and Commitment Therapy as a treatment for binge eating disorder in Japanese female adults.
Primary Topic: Clinical Interventions and Interests
Subtopic: binge eating disorder
Takashi Muto, Ph.D., Doshisha University
Kazuyo Kikuta, M. A., Clinical Center of Doshisha University
Takashi Mitamura, Ph.D., Ritsumeikan University
Aiko Ohya, Doshisha University

Binge eating disorder (BED) is one of the feeding-and-eating-disorders in DSM-5, characterized by recurrent binge eating (i.e., eating an unusually large amount of food, accompanied by a sense of loss of control and marked distress) in the absence of significant compensatory behaviors (e.g., self-induced vomiting, excessive exercise). Some individuals with BED have these disordered behaviors as a function of experiential avoidance, that is, a way of escaping and distracting themselves from difficult thoughts and emotions. Acceptance and Commitment Therapy (ACT) may be an effective intervention for individuals diagnosed with BED because it directly undermines experiential avoidance and promotes alternative valued behaviors. In this study, 4 Japanese female adults who met the criteria for BED (moderate severity level) were treated with 10 weekly sessions of ACT, followed by 6 biweekly booster sessions, and follow up was conducted at intervals of 3, 6, 12, 18, and 24 months. The effects of the intervention were assessed using a multiple probe across participants design. After the last ACT booster session, all participants self-reported having very few episodes of binge-eating behavior per week. At follow-up sessions, they reported that these improvements had been maintained and their weight had decreased. Moreover, questionnaire scores for disordered eating, depression, general mental health, experiential avoidance, and self-compassion were also improved and maintained over 2 years. This preliminary study suggests that ACT might be an effective treatment for Japanese female adults with BED.

17. Acceptance and Commitment Therapy: Focused Brief Intervention for Health-Related Behavioral Change.
Primary Topic: Clinical Interventions and Interests
Subtopic: Brief Interventions, ACT
Monica Barreto, MS., Western Michigan University
Scott Gaynor, Ph.D., Western Michigan University

Substance misuse, physical inactivity, and unhealthy eating and sleeping habits are important health-related behaviors for current life satisfaction and forestalling chronic health conditions. The current study examined the plausibility of offering a 1-session (60 minute) acceptance and commitment therapy (ACT) intervention for college students seeking health-related behavior change. In this ongoing study, the 22 participants who have received the ACT session reported a statistically significant increase in their confidence in making the desired health-related behavior change immediately following the session, t = 3.80, p = .001. Moreover, the 9 participants who have currently completed the 30-day follow-up period reported statistically significant changes in the health-related behavior targeted for change in the ACT session, t = 2.99, p = .02. Other non-targeted health-related behaviors showed no statistically significant change. These data suggested that a single session of focused ACT may be useful in promoting health-related behavior change.

18. The interaction between mindful awareness and acceptance in predicting couples satisfaction
Primary Topic: Clinical Interventions and Interests
Subtopic: Couples, Mindfulness
Jennifer E. Krafft, Utah State University
Jack Haeger, Utah State University
Benjamin Pierce, Utah State University
Michael E. Levin, Ph.D., Utah State University

Background: Previous studies have connected mindfulness to a wide range of relationship outcomes. Research on specific components of mindfulness is limited, but preliminary findings highlight the role of the awareness and acceptance components of mindfulness in relationship satisfaction (Khaddouma et al., 2015). Yet, no studies have investigated the possibility that the awareness and acceptance components of mindfulness interact to predict relationship outcomes (a moderating effect that has been found with other problems such as substance abuse; Eisenlohr-Moul et al., 2012). Method: This poster presents the results of an online survey assessing components of mindfulness and couples’ satisfaction in a sample of undergraduate students (n=135). The Couples Satisfaction Index (CSI; Funk & Rogge, 2007) and Philadelphia Mindfulness Scale (PHLMS; Cardaciotto et al., 2008) were administered. Results: Higher acceptance predicted higher couples satisfaction (β=.34, p<.001), but higher awareness predicted lower satisfaction (β =-.18, p=.035). There was a significant interaction effect for acceptance and awareness (ΔR2=.05, p=.004). Higher levels of awareness predicted lower couples’ satisfaction only when acceptance was low (β =-.21, p=.003), but not when acceptance was high (β =.04, p=.52). When switching the moderator and predictor variable, higher levels of acceptance predicted greater couples’ satisfaction when awareness was high (β =.22, p<.001), but not when awareness was low (β =.01, p=.82). Discussion: These results highlight the importance of the combination of awareness and acceptance for relationship satisfaction and suggest that components of mindfulness should be considered not just individually, but in terms of interactions.

19. Modeling the Cognitive Mechanisms Linking Autism Symptoms and Anxiety in Adults
Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness and Acceptance
Max Maisel, Brigham Young University
Kevin Stephenson, Brigham Young University
Mikle South, Ph.D., Brigham Young University
Jacqui Rodgers, Ph.D., University of Newcastle
Mark H. Freeston, Ph.D., University of Newcastle
Sebastian Gaigg, Ph.D., City University London

Background: Emotional acceptance, alexithymia, and intolerance of uncertainty (IU) contribute to anxiety disorders in neurotypical populations. Their association with anxiety in people diagnosed with autism spectrum disorder (ASD) has not been studied. We aimed to model the contributions of these constructs on the relationship between dimensional measures of autism and anxiety. Method: Participants were 151 adults recruited from two sites, including those diagnosed with ASD (n=76) and a matched comparison group (n=75). All participants completed a battery of questionnaires measuring core autism symptoms, anxiety, emotional acceptance, alexithymia, and intolerance of uncertainty. Results: Structural equation modeling with mediation was used to examine directional relationships among these variables. Autism symptoms directly predicted less emotional acceptance and increased alexithymia and IU. Alexithymia and acceptance were shown to explain 64% of the effect between autism symptom severity and anxiety level. Discussion: This study suggests that people with ASD experience increased levels of anxiety because they are more likely to react aversively to their emotional experiences, while lacking the ability to identify and understand their emotions. Developing and implementing mindfulness-based interventions aimed at assuaging alexithymia and IU, while increasing emotional acceptance, may be especially helpful in treating anxiety in ASD.

20. Assessing the efficacy of a self-help ACT based program in the treatment of anxiety disorders: a single-case study
Primary Topic: Clinical Interventions and Interests
Subtopic: Self-help
Catherine Ethier, D.Psy (c), Université du Québec à Trois-Rivières
Frédérick Dionne, Ph.D., Université du Québec à Trois-Rivières
Frédéric Langlois, Ph.D., Université du Québec à Trois-Rivières

In North America, one person out of five suffers from an anxiety disorder. ACT has shown its efficacy in the treatment of a wide range of anxiety disorders. Self-help programs stand as a promising option to enhance accessibility to treatments while offering an excellent cost-efficiency ratio. This single-case study (N=4) with repeated measures (daily, weekly and pre/post treatment) aims to assess the efficacy of a six weeks self-help ACT based program relying on the book The Happiness Trap (Harris, 2008). Participants all suffered from anxiety at a clinical or subclinical level, diagnostics ranging from generalized anxiety disorder to social anxiety disorder and panic disorder. As expected, preliminary analysis show an association between the program and a enhancement in quality of life, as well as an improvement of the core change processes of ACT, connection to the present moment, acceptance and defusion. However, the intervention did not reduce anxiety symptoms for all participants. This study contributes to shed light on the potential effects of a self-help ACT based treatment and its limitations. The challenges related to the implantation of such an intervention and future directions will be discussed.

21. Telephone-supported Acceptance and Commitment Bibliotherapy for People with Multiple Sclerosis and Psychological Distress: A Randomised Controlled Feasibility Trial
Primary Topic: Clinical Interventions and Interests
Subtopic: Multiple Sclerosis
Barnaby, J, Proctor (BSc), The University of Nottingham, UK
Nima Moghaddam, The University of Lincoln, UK
Roshan Das Nair, The University of Nottingham, UK

Background: Telephone-supported self-help Acceptance and Commitment Therapy (ACT) may be a way of providing accessible and effective psychotherapy to people with Multiple Sclerosis (MS). The aim of this trial was to determine the feasibility of a randomised controlled trial (RCT) of telephone-supported ACT bibliotherapy compared to treatment-as-usual (TAU), and explore the effectiveness of the intervention. Methods: The study was a randomised control feasibility trial. The intervention was eight weekly support calls guiding participants through the ACT self-help text “Get Out Of Your Mind and Into Your Life” (Hayes, 2005). Participants were assessed at baseline and post-intervention using the Generalised Anxiety and Depression Measure (GAD) and the Patient Health Questionnaire (PHQ) as primary outcome measures. The EuroQol (EQ-5D-5L) and Multiple Sclerosis Impact Scale (MSIS-29) were secondary outcome measures, and the Acceptance and Action Questionnaire (AAQ-II) was a process measure. A sample of participants were interviewed to assess RCT feasibility. Results: 27 participants with MS with anxiety and/or depression were recruited from an outpatient MS clinic and an MS charity. The majority of participants found the different elements of the RCT acceptable. Overall attrition was 66%, and 64% in the intervention group. Linear mixed model analysis and effect size calculation found a significant effect (p=0.004) and large effect size (0.84 (95% confidence intervals 0.02-1.66)) at post-intervention in favour of the intervention on anxiety in intention-to-treat analysis. Smaller non-significant positive effects were found on other measures. Intervention completers had significantly lower scores on the MSIS and the AAQ-II at baseline. Discussion: Telephone-supported ACT bibliotherapy delivered in a RCT format may be a feasible research method for people with MS, and the intervention has the potential to be effective in reducing psychological distress. However, attrition rates must be addressed: practical changes to the method of delivery to increase participant retention are suggested.

22. Acceptance and commitment therapy for Tojikomori in Japanese older adults: A preliminary investigation
Primary Topic: Clinical Interventions and Interests
Subtopic: Tojikomori, Acceptance and commitment therapy (ACT), Japanese elderly
Kohei Hashimoto, M.A., Graduate School of Psychology, Doshisha University
Takashi Muto, Ph.D., Faculty of Psychology, Doshisha University

Tojikomori means being housebound in old age without any deficits in physical or cognitive functioning. Elderly people with Tojikomori have low levels of physical, psychological and social health, and Tojikomori is a risk factor for disability. It is thought that individuals with Tojikomori have psychological problems such as cognitive fusion with a damaged conceptualized self and feeling they have nothing to live for (i.e. unclear value and persistent inaction). In this study, 2 Japanese elderly women living in a nursing home who met criteria for Tojikomori (P1 and P2) were treated with acceptance and commitment therapy (ACT). The treatment was delivered in 7 weekly sessions and 2 biweekly booster sessions in participants’ living rooms. The effects of the intervention were assessed using a nonconcurrent multiple baseline across participants design. P1 whose acceptance and defusion processes were well at baseline showed a positive change in physical activity. Her psychological flexibility, psychological quality of life, and depression remained well across the treatment phase. P2 whose acceptance and defusion processes were unwell at baseline showed positive changes in psychological flexibility and psychological health across the treatment phase and improvements were maintained in 1 month. However, no improvements were observed in physical activity in this participant. One of the factor that inhibit the effectiveness of ACT for physical activity for P2 seemed to be a decline of physical function across the study duration. Implications and the distinctiveness of ACT as a treatment for Tojikomori are discussed.

23. Does imagination affect efficacy of ‘leaves floated down the river’ defusion exercise?
Primary Topic: Clinical Interventions and Interests
Subtopic: Defusion
Yuuka Nakatani, Doshisha University
Aika Shinomiya, Doshisha University
Yuri Shirouchi, Tsukuba University
Asako Sakano, M. A., Doshisha University
Takashi Muto, Ph. D., Doshisha University

Study objective: The present study examined whether the differences between low and high imagination have influences on the efficacy of cognitive defusion exercise needed mental operation. Design: Two Groups (low imagination (LI) or high imagination (HI)), pre-post comparison. Participants: Twenty-four undergraduates, 11 with high imagination and 13 with low imagination. Intervention: All participants completed cognitive defusion exercise, or ‘leaves floated down the river’. Measure: (1) a score of Cognitive Fusion Questionnaire (CFQ), and (2) the increasing ratio of tolerance time in cold pressor task. Results: (1) An ANOVA revealed that a score of CFQ didn’t significantly differ between two groups (LI and HI). (2) The t-test revealed that LI group reported significantly lower increasing ratio of tolerance time in cold pressor task than HI group. Conclusion: The present results suggested low imagination worked against the efficacy of ‘leaves floated down the river’ defusion exercise.

24. What is an effective defusion exercise for persons with low imagination?
Primary Topic: Clinical Interventions and Interests
Subtopic: Defusion
Aika Shinomiya, Doshisha University
Yuuka Nakatani, Doshisha University
Yuri Shirouchi, Tsukuba University
Asako Sakano, M.A., Doshisha University
Takashi Muto, Ph.D., Doshisha University

Study objective: The present study examined an effective defusion exercise for persons with low imagination. Design: Two-factor mixed design was used; Group (experimental group, control group) × time (pre, post). Participants: twenty-seven under-graduates with low imagination participated in this study. Intervention: A freight train exercise was used. Experimental group completed it in the real scene, whereas control group completed it with imagination only. Measures: (1) The increasing ratio of tolerance time in cold pressor task and (2) the score of Cognitive Fusion Questionnaire were used. Results: (1) There was no significant difference between experimental group and control group (t(23)=1.13, ns.). (2) Main effects of group and time were not significant (F(1,23)=0.002, ns. ; F(1,23)=.05, ns.). Interaction was significant (F(1,23)=5.98, p<.05), but all simple main effects were not significant. Conclusion: These results couldn’t clarify what defusion exercise might be effective for persons with low imagination.

25. Can ACT enhance effects of abstinence-based contingency management in patients with cocaine use disorder?
Primary Topic: Clinical Interventions and Interests
Subtopic: ACT
Angela Stotts, Ph.D., University of Texas Health Science Center at Houston, McGovern Medical School
Kathryn Tipton, MA, University of Texas Health Science Center at Houston, McGovern Medical School

Background: Contingency management (CM) is a reinforcement-based approach that provides tangible rewards for objectively verified drug abstinence. CM is the most effective available behavioral intervention for cocaine use disorders; however, response to CM is variable, with significant rates of nonresponse. A secondary profile analysis of potentially modifiable cognitive–affective characteristics of cocaine dependent patients participating in a CM treatment found that CM nonresponders (i.e., continued users), relative to responders (i.e., abstinent), reported significantly higher levels of avoidance and behavioral inflexibility (p < .01) in the context of distressing cocaine-related thoughts, feelings, and bodily sensations (Stotts et al., 2015), as measured by the Avoidance and Inflexibility Scale (AIS). These data suggest that acceptance and commitment therapy (ACT) may serve as a therapeutic strategy for enhancing response to CM for cocaine use disorders. Methods: We adapted an opioid use disorder treatment manual to target cocaine use and pilot tested the first 6 sessions with two clients diagnosed with severe cocaine use disorder. Twice-weekly individual ACT therapy sessions focused on acceptance and defusion from unpleasant cocaine thoughts and cravings and were delivered in conjunction with high-magnitude abstinence-based CM. Results: Both participants attended 100% of treatment sessions and reported high rates of satisfaction at end-of-treatment. Participant #1 (54yo, AA, Fe) failed to achieve abstinence, defined as four consecutive cocaine-negative urine screens. This participant’s AIS scores at baseline and treatment Week 4 showed no change in response style to cocaine-related thoughts, feelings, and bodily sensations. In contrast, Participant #2 (42yo, AA, Ma) successfully achieved two weeks of cocaine abstinence and showed clinically meaningful reductions in AIS scores from baseline to Week 4. This participant’s scores on measures of emotional and physical distress tolerance showed similar improvement during ACT with CM treatment, relative to Participant #1. Therapist ratings of attention and engagement correlated with observed differences in treatment outcome, with Participant #1 described as “difficult to rouse and engage in therapy-related activities.” Discussion: Based on these first two pilot cases, we are encouraged about the feasibility of using ACT to enhance CM effects. Both therapist and participant feedback are being used to finalize the manual in preparation for a large-scale adaptive clinical trial.

26. Five facets of mindfulness and its associations with disordered eating behaviors among Japanese college samples: Implications of treatment for eating related problems.
Primary Topic: Clinical Interventions and Interests
Subtopic: mindfulness, disordered eating
Naoki Mampuku B.A., Graduate School of Psychology, Doshisha University
Takashi Muto Ph.D., Faculty of Psychology, Doshisha University

Background: Many studies have examined the efficacy of mindfulness-based interventions in the treatment for disordered eating. However, few researchers have explored the associations between facets of mindfulness and eating behavior. This study aimed to investigate multiple facets of mindfulness (acting with awareness, non-reactivity, non-judging, describing, and observing) and its associations with three disordered eating behaviors (restrained, emotional, and external eating). Method: An online survey was conducted to assess the relationship between eating behavior and facets of mindfulness among a Japanese sample. In this study, Japanese undergraduate students (n=243, female: 147 male: 96) completed the Five Facets of Mindfulness Questionnaire and the Dutch Eating Behavior Questionnaire, in addition to filling out a demographic questionnaire. Results: Regression analysis revealed that “acting with awareness” and “non-reactivity” were negatively associated with emotional eating (β=-.14, p<.05, β=-.15, p<.05). “Non-judging” was inversely related to external eating (β=-.17, p<.05), independent of sex, age, and body mass index. Moreover, “observing” and “acting with awareness” were positively associated to restrained eating (β=.14, p<.05, β=.16, p<.05). Discussion: Different facets of mindfulness were associated with more restrained and less emotional and external eating in a Japanese college sample. These results are discussed considering the potential role of facets of mindfulness in disordered eating.

27. Self-help for Social Anxiety: Preliminary Results on a Mindfulness and Acceptance-based Approach
Primary Topic: Clinical Interventions and Interests
Subtopic: Social Anxiety
Nancy Kocovski, Ph.D., Wilfrid Laurier University
Jan Fleming, MD, Mindfulness Clinic
Meagan MacKenzie, Ph.D., Ryerson University
Alison Flett, Wilfrid Laurier University
Rebecca Blackie, M.A., Wilfrid Laurier University

Although there are empirically supported treatments for social anxiety, many people are not able to access them for various reasons (e.g., financial, lack of availability, stigma). Self-help may be one way to access these underserved populations. The present study reports preliminary results on the effectiveness of an ACT-based self-help book for social anxiety (Fleming & Kocovski, 2013). Community participants wanting help with social anxiety or shyness were recruited via flyers and online posts and randomly assigned to self-help or wait-list (N = 120 recruited; data collection in progress). Those assigned to self-help were given the book and asked to follow an 8-week plan, including the following strategies: mindfulness practice, values and goals, defusion, and exposure. At post-treatment (8 weeks; based on n = 90), compared to the control condition, those in the self-help condition reported being significantly less fused with thoughts, less socially anxious and depressed, and had higher levels of mindfulness and self-compassion. Data are also being collected at a one-month follow-up (data collection will be complete by time of conference). Given the difficulties with accessing treatment for some individuals with social anxiety, a mindfulness and acceptance-based self-help approach may be recommended.

28. A case study of acceptance and commitment therapy for a Japanese woman with chronic low back pain
Primary Topic: Clinical Interventions and Interests
Subtopic: Chronic pain
Asako Sakano, M.A., Graduate School of Psychology, Doshisha University
Takashi Muto, Ph.D., Faculty of Psychology, Doshisha University
Mie Sakai, Ph.D., Center for Clinical Psychology, Doshisha University
Masataka Ifuku, Ph.D., Ifuku Pain Clinic

In recent years, there has been an increase in the demand for psychological treatments for chronic pain in Japan. We examined the effects of acceptance and commitment therapy (ACT) on a Japanese woman in her 40s with chronic low back pain. The treatment program was delivered in ten sessions. Using an AB design with baseline and treatment phases, we assessed the effects of the program on outcome measures (activity based on her values, health-related quality of life, and other psychological variables) and process measures (AAQ, CFQ, and FFMQ). Results showed an increase in valued activity. Additionally, Short Form Health Survey (SF-36) scores significantly improved from pre- to post-treatment in terms of general health perception, vitality, role functioning/emotional, and mental health, while physical functioning improved from pre-treatment to the four-month follow up. The scores for physical disability, pain catastrophizing, anxiety, and depression also significantly improved and were maintained until the four-month follow up. Furthermore, process measures of ACT improved before changes to the outcome measures were observed. Overall, the results suggest that ACT helps participants with chronic low back pain by weakening the influence of pain-related thoughts or feelings on their behavior and improved functional performance and quality of life.

29. The Relationship of Experiential Avoidance and Value Importance with Related Behavioral Choices
Primary Topic: Clinical Interventions and Interests
Subtopic: Values
Jia Hui Chaw, M.A., Wichita State University
Dr. Robert Zettle, Wichita State University

Background: The ultimate goal of acceptance and commitment therapy is to enhance psychological flexibility or the ability to make behavioral adjustments necessary to live a life congruent with personal values. One barrier to psychological flexibility targeted by ACT is experiential avoidance (EA). The purpose of this project was to examine at both macro and microlevels of analyses how EA and the importance of personal values in various life domains contribute to related behavioral choices. Method: A total of 222 college students were included in this study. For the microanalysis, the Value-Congruent Behavior Scale (VCBS) was developed to assess scenario-specific, value-consistent actions within nine life domains. The Valued Living Questionnaire (VLQ) was administered for the macroanalysis. Participants also completed the Acceptance and Action Questionnaire-II (AAQ-II) and two measures on social desirability. Correlations and regression analyses were conducted to analyze the data. Results and discussion: While the interaction between levels of EA and the importance of values predicted value-consistent behavior at a macrolevel of analysis, similar findings were obscured by social desirability when examined at a microlevel with the VCBS. Discussion: The implications of the findings for further study of the contributions of EA and values to related behavior in addition to clinical practice are discussed. The use of ecological momentary assessment may be a viable alternative to measure value-congruent behaviors while minimizing the risk of social desirability and recall biases. If the interaction found is replicated in a clinical population, value-congruent behaviors can be increased in clinical work by either increasing the motivational impact of values or reducing the experiential barriers to these behaviors.

30. Long-term effectiveness of Group acceptance and commitment therapy for chronic dizziness: a pilot single-arm study
Primary Topic: Clinical Interventions and Interests
Subtopic: somatic symptom disorder
Masaki Kondo, Nagoya City University Graduate School of Medical Sciences
Wakako Igarashi, Kikuchi mental clinic
Keiko Ino, Nagoya City University Graduate School of Medical Sciences,
Toshitaka Ii, Nagoya City University Graduate School of Medical Sciences,
Sei Ogawa, Nagoya City University Graduate School of Medical Sciences,
Meiho Nakayama, Nagoya City University Graduate School of Medical Sciences,
Tatsuo Akechi, Nagoya City University Graduate School of Medical Sciences

Background: Chronic dizziness, so-called psychogenic dizziness, is characterized by dizziness or unsteadiness unexplained medically and existing most days for months or years. Chronic dizziness has a great impact on quality of life, and is assumed to be related to multi factors, such as vestibular function, somatic sensation, visual sensation, autonomic nervous system, and psychological elements. Cognitive behavioral therapy is one of the promising interventions, however, some patients seems to be reluctant to it because of their experiential avoidance. Therefore, we hypothesized that acceptance strategy may be functioning. The purpose of this preliminary study is to examine long-term effectiveness of group acceptance and commitment therapy for chronic dizziness. Methods: We enrolled adult outpatients at a special dizziness clinic who met the criteria of persistent postural-perceptual dizziness, which is the diagnosis criteria equivalent to chronic dizziness defined by the International Society for Neuro-Otology. Other vestibular diseases such as Ménière's disease, benign paroxysmal positional vertigo were accepted. Schizophrenia, bipolar disorder, depression, substance abuse and dependence, and severe medical condition were excluded. Participants received six weekly sessions of manualized group acceptance and commitment therapy combined with vestibular rehabilitation. The primary outcome was Handicap due to dizziness at six months after the intervention, measured by Dizziness Handicap Inventory. The secondary outcome was frequency of vestibular-related symptoms at six months after the intervention, measured by Vertigo Symptom Scale-short form. Paired t-test was conducted and within-subject effect size was calculated. Results: All nine participants received group acceptance and commitment therapy. Both handicap due to dizziness and frequency of vestibular-related symptoms were significantly decreased between pre-intervention and six months after the intervention with Hedges’s g = 1.56 and 1.09, respectively. . Conclusion: The results suggest that group acceptance and commitment therapy for chronic dizziness may remain effective for six months.

31. Long-term effectiveness of group acceptance and commitment therapy for chronic dizziness: a pilot single-arm study
Primary Topic: Clinical Interventions and Interests
Subtopic: somatic symptom disorder
Masaki Kondo, Nagoya City University Graduate School of Medical Sciences
Wakako Igarashi, Kikuchi mental clinic
Keiko Ino, Nagoya City University Graduate School of Medical Sciences
Toshitaka Ii, Nagoya City University Graduate School of Medical Sciences
Sei Ogawa, Nagoya City University Graduate School of Medical Sciences
Meiho Nakayama, Nagoya City University Graduate School of Medical Sciences
Tatsuo Akechi, Nagoya City University Graduate School of Medical Sciences

Background: Chronic dizziness, so-called psychogenic dizziness, is characterized by dizziness or unsteadiness which is unexplained medically and existing most days for months or years. Chronic dizziness has a great impact on quality of life, and is assumed to be related to multi-factors, such as vestibular function, somatic sensation, visual sensation, autonomic nervous system, and psychological elements. Cognitive behavioral therapy is one of the promising interventions, however, some patients seem to be reluctant to cognitive behavioral therapy because of their experiential avoidance. Therefore, we hypothesized that acceptance strategy may be functioning. The purpose of this preliminary study is to examine long-term effectiveness of group acceptance and commitment therapy for chronic dizziness. Methods: We enrolled adult outpatients at a neuro-otology clinic who met the criteria of persistent postural-perceptual dizziness, which is the diagnostic criteria equivalent to chronic dizziness defined by the International Society for Neuro-Otology. Other comorbid vestibular diseases such as Ménière's disease, benign paroxysmal positional vertigo were accepted. Schizophrenia, bipolar disorder, depression, substance abuse and dependence, and severe medical condition were excluded. Participants received six weekly sessions of manualized group acceptance and commitment therapy combined with vestibular rehabilitation. The primary outcome was handicap due to dizziness at six months after the intervention, measured by the Dizziness Handicap Inventory. The secondary outcome was frequency of vestibular-related symptoms at six months after the intervention, measured by Vertigo Symptom Scale-short form. Wilcoxon signed-rank test was conducted and within-subject effect size was calculated. Results: Nine participants received group acceptance and commitment therapy. Handicap due to dizziness was significantly decreased between pre-intervention and six months after the intervention (p<0.01, Hedges’s g = 1.56). Frequency of vestibular-related symptoms showed non-significant improvement between pre-intervention and six months after the intervention (p=0.051, Hedges’s g = 1.09). Conclusion: The results suggest that group acceptance and commitment therapy for chronic dizziness may remain effective for six months.

32. Psychometric properties of the Spanish version of the Valuing Questionnaire
Primary Topic: Clinical Interventions and Interests
Subtopic: Valuing Questionnaire, Values, ACT
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz
Juan C. Suárez-Falcón, Universidad Nacional de Educación a Distancia
Diana Riaño-Hernández, Fundación Universitaria Konrad Lorenz

The Valuing Questionnaire (VQ) is a measure of valued living according to the definition of values of the acceptance and commitment therapy (ACT). It has a robust two-factor structure, comprising Progress and Obstruction. The VQ has shown good internal consistency and convergent and incremental validity. The current study analyzed the psychometric properties and factor structure of the Spanish version of the VQ in Colombia. The VQ was administered to a total sample of 1587 participants, including undergraduates, general population, and a clinical sample. Results were very similar to those obtained in the original VQ version. Internal consistency across the different samples was good (global Cronbach’s alpha of .85 for Progress and .84 for Obstruction). The two-factor model showed a good fit to the data, and measurement invariance was found across sample and gender. The mean Progress and Obstruction scores of the clinical sample were lower and higher, respectively, than the scores of the nonclinical samples. Correlations with other constructs were in the expected direction. The VQ was sensitive to the effects of a one-session ACT intervention. In conclusion, the Spanish version of the VQ shows good psychometric properties in Colombia.

33. Cognitive Defusion versus Cognitive Restructuring: An Analogue Examination of Potential Moderating Variables
Primary Topic: Clinical Interventions and Interests
Subtopic: Cognitive Defusion
Eric Richardson, M.A., Wichita State University
Robert Zettle, Ph.D., Wichita State University

The impact of negative self-referential thoughts on psychological problems has long been targeted in cognitive behavioral therapy (CBT) through cognitive restructuring. More recently, acceptance and mindfulness-based approaches within CBT have suggested cognitive defusion as an alternative strategy. The primary purpose of this analogue study was to compare the effects of brief cognitive restructuring and cognitive defusion protocols in reducing the believability and discomfort of targeted negative self-referential thoughts among college students. Its secondary purpose was to investigate whether levels of dysfunctional attitude endorsement and cognitive fusion differentially moderate the impact of the two interventions. While both protocols significantly reduced believability and discomfort to an equivalent degree, moderating effects were noted only for reducing emotional discomfort via cognitive defusion. The impact of this intervention was greatest for participants who endorsed dysfunctional attitudes to a lesser degree and reported greater entanglement with negative thoughts.

34. Designing a measure of generalized pliance: The Generalized Pliance Questionnaire
Primary Topic: Clinical Interventions and Interests
Subtopic: Generalized pliance, measurement
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz
Juan C. Suárez-Falcón, Universidad Nacional de Educación a Distancia
Paula Odriozola-González, Universidad de Valladolid
Diana Riaño-Hernández, Fundación Universitaria Konrad Lorenz
Adrián Barbero-Rubio, Universidad de Almería
Juan C. López-López, Universidad de Almería
Nikolett Eisenbeck, Universidad de Almería

Pliance is a functional class of rule-governed behavior under the control of a history of socially mediated reinforcement for the correspondence between the rule and the person’s behavior (Zettle & Hayes, 1982). Generalized pliance occurs when social approval is established as the main, verbally constructed reinforcer across life domains (Luciano, Valdivia-Salas, & Ruiz, 2012; Törneke, Luciano, & Valdivia-Salas, 2008). The most relevant characteristic of individuals displaying generalized pliance is their hypersensitivity to social whim in a way that no consequences are important and/or contacted other that those socially mediated. This behavioral pattern is often problematic because traps the person in needing social approval, which is highly uncontrollable and unpredictable, and prevents contacting with many other naturally, positively reinforcing consequences. This study shows the development and psychometric properties of the Generalized Pliance Questionnaire (GPQ) in Spain and Colombia. Thirty-eight items were written by experts in relational frame theory and were applied to a Spanish sample of 130 undergraduates. According to the psychometric results, 20 items were eliminated and the 18-item questionnaire was applied to samples of undergraduates, general population, and clinical participants in both countries. The results showed that the GPQ has excellent psychometric properties and theoretically coherent correlations with other constructs.

35. Experiential avoidance mediates the relationship between generalized pliance and depression
Primary Topic: Clinical Interventions and Interests
Subtopic: Generalized pliance, Experiential avoidance, Depression
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz
Paula Odriozola-González, Universidad de Valladolid
Juan C. Suárez-Falcón, Universidad Nacional de Educación a Distancia
Diana Riaño-Hernández, Fundación Universitaria Konrad Lorenz

Generalized pliance represents a rigid pattern of behavior regulation that can be summarized as behaving how it is supposed to in order to obtain others’ approval. It is often problematic because traps the person in needing social approval, which is highly uncontrollable and unpredictable, and prevents contacting with many other naturally, positively reinforcing consequences (e.g., Törneke et al., 2008). Thus, generalized pliance would potentially lead to negative thoughts and depressive feelings in reaction to negative life events mainly related to social issues. Even worse, generalized pliance often leads to patterns of experiential avoidance and psychological inflexibility because feeling good is usually connected to others’ approval and it is established as a necessary state to do other things in life (Luciano et al., 2012). The current study aimed to test whether experiential avoidance mediates the effect of generalized pliance in depression symptoms in diverse nonclinical and clinical samples from Spain and Colombia. The results were widely consistent with the previous assumption.

36. Group ACT Program for Patients with Panic Disorder.
Primary Topic: Clinical Interventions and Interests
Subtopic: Panic disorder
Keiko ino, Nagoya City University Graduate School of Medical Sciences
Toshitaka Ii, Nagoya City University Graduate School of Medical Sciences

【Background】 Panic disorder is a recurrent or chronic disease in the majority of cases. The most promising psychotherapy for panic disorder is cognitive behavioral therapy(CBT), and it works in a group setting as well as in individual. However, CBT works out controlling strategy, that sometimes allows patients to control anxiety in vain and then their symptoms remain. Acceptance and commitment therapy(ACT) developed opposite strategy that helps patients to release control and live for their value. ACT is promising therapy for treatment resistant panic disorder for this reason. Since ACT was introduced in Japan, it have been conducted in an individual setting in most cases. We started group ACT program specialized for panic disorder patients, which was the first attempt in Japan as far as we know. The aim of this study is to examine effectiveness of this program. 【Methods】We enrolled outpatients with chronic panic disorder in our university hospital. Participants received 12 weekly sessions which took 2 hours for each. One group was for 2 to 4 patients. We made our program reviewing “Acceptance and Commitment Therapy for Anxiety Disorder ” written by G.H. Eifert and J.P. Forsyth. The primary outcome is Panic Disorder Severity Scale(PDSS). We examined Cognitive Fusion Questionnaire and Acceptance and Action Questionnaire-Ⅱ as secondary outcome. 【Results】Two participants completed all the sessions and after a month follow up, as far as this abstract submission. On baseline assessment their PDSS scores located in 13 (markedly ill) and 9 (slightly ill). After the therapy, their scores improved to 7 (slightly ill) and 3 (borderline). One month after treatment, their PDSS scores are 1 (normal) and 2 (normal) and patient didn’t complain any symptoms. We are enrolling several patients and group therapy is now ongoing. 【Conclusion】Group ACT for panic patients may be effective. Patients improve their symptoms much better during one month after therapy. We will examine efficacy of this program with more participants and be ready for presentation at ACBS world conference, 2016.

37. Mindfulness and Acceptance for Type 2 Diabetes: A Meta-Analysis
Primary Topic: Clinical Interventions and Interests
Subtopic: Meta-analysis
Leah Bogusch, M.A., Bowling Green State University
Sonia Singh, M.A., Bowling Green State University
William O'Brien, Ph.D., Bowling Green State University
Tanya Watford, M.S., Bowling Green State University

Among people with Type 2 Diabetes Mellitus (T2DM), mindfulness and acceptance may be associated with decreased distress and improved health outcomes. The present study provides a quantitative review of studies utilizing mindfulness or acceptance interventions among individuals with T2DM to improve diabetes-related outcomes. A literature search yielded 12 unique treatment-outcome studies. Meta-analytic results of mindfulness- and acceptance-based interventions yielded a small and reliable effect size for pre-post changes on HbA1c and fasting blood glucose for treatment groups (d = .23, 95% CI = .06, .41), and an unreliable effect size for control groups (d = .11, 95% CI = -.12, .34). Treatment-control group comparisons at post-test were statistically unreliable for HbA1c and fasting blood glucose (d = -.07, 95% CI = -.46, .32). These results indicate that participation in mindfulness- or acceptance-based interventions likely confers improvement in metabolic functioning, though these effects may be partially attributable to unrelated factors.

38. Coping With Autism - Providing Functional Contextual Support for Parents in Crisis
Primary Topic: Clinical Interventions and Interests
Subtopic: Depression, Coping, Autism, Parenting
Carmen McGuinness, EdD, BCBA-D, Chrysalis School, Chrysalis Center for Change, Nova University, Capella University
Larry J. Leech, Freelance author of memoirs

BACKGROUND: The diagnosis of autism can be devastating news for parents. Whether parents lean in and cope through engagement with their child, or avoid and deny the problem, is directly related to their sense of well-being. Parents who engage have a higher sense of well-being, while parents who deny or avoid have a lower sense of well-being. Children whose parents are actively engaged in parenting and treatment will have better outcomes than their peers whose parents deny or avoid. Parenting self-efficacy is also associated to coping strategies for parents of children with autism. When parents know what to do it is easier to cope by engaging. When parents do not know what to do parenting self-efficacy is low, which worsens sense of well-being as well as child outcome trajectory. METHOD: A single-subject quasi-experimental A-B-C research design study was conducted to investigate the effects of a 6-week parent training workshop in Applied Behavior Analysis on parent coping, parent self-efficacy, parent sense of well-being, and child compliance to parental requests. Baseline, treatment, and follow-up phase data were collected. During the treatment phase parents received training in behavior change procedures, the interaction of behavior and development, compliance training, thoughts as behaviors, parental coping, reinforcement and the physiology of thoughts, and reframing and defusion. Parents were taught to use applied behavior analysis for the management of their child’s behavior as well as their own behavior insomuch as it relates to their child’s behavior and their own sense of well-being. RESULTS: Phase data were graphed for visual analysis of repeated measures. Analysis included intensity of parental coping, parental self-efficacy, and parental sense of well-being, and frequency of child compliance. Results of this study indicate that parents’ engagement coping, parenting self-efficacy, parents’ sense of well-being, and child compliance to parental requests increased significantly following a 6-week parenting workshop. DISCUSSION: These findings point to the importance of functional contextual treatment of parents of children with autism in conjunction with instruction in behavior analytic practices for treatment of autism. With the rise in autism diagnoses, it is critical that therapists prepare for supporting parents of children with autism.

39. The Role of Psychological Flexibility in Living with Lipedema
Primary Topic: Clinical Interventions and Interests
Subtopic: ACT, lipedema
Joanna E. Dudek, M.A., University of Social Sciences and Humanities, Warsaw
Adam M. Kuczynski, University of Washington
Pawel Ostaszewski, Ph.D., University of Social Sciences and Humanities, Warsaw
Wojciech Białaszek, Ph. D., University of Social Sciences and Humanities, Warsaw
Tilly Smidt

Background Lipedema (lipoedema) is a chronic disease of unknown etiology that leads to uncontrollable, visible changes in body appearance and associated chronic pain. It affects approximately 11% of women in Western countries and is often mistaken as obesity given that the main symptom is fat accumulation on the extremities. Previous research shows that psychological flexibility (PF) positively predicts quality of life in women with lipedema when controlling for symptom severity. Methods 330 women suffering from lipedema were recruited from various international online groups. Each participant took an hour-long online survey to explore the association between psychological flexibility (PF) and quality of life while controlling for symptom severity, mobility, psychological functioning, and appearance related avoidance and distress. Results Using hierarchical multiple regression analysis, we replicated the results of existing research as well as demonstrated that PF remains a significant predictor of quality of life while controlling for other important variables. Discussion Results suggest that an intervention targeting psychological flexibility may be beneficial for women with lipedema.

40. Acceptance and Commitment Therapy in a Maximum Security Prison
Primary Topic: Clinical Interventions and Interests
Subtopic: Maximum Custody Offenders
Eric Rainey-Gibson, Ph.D., Washington State Penitentiary (WSP)
Jamie Davis, MA, Washington State Penitentiary (WSP)

Background: Both at the Federal and the State level, there is increasing attention being placed on segregated offenders in a prison population setting. Currently, there is a push coming down from the headquarters level of our state prisons to be providing programming to segregated offenders. As such, there is a need to identify and address the psychosocial needs of this at risk population using culturally relevant and accepted methods. Acceptance and Commitment Therapy (ACT) principles, though relatively new to the prison culture is proving effective in working with this particular population. Method: Students are selected to participate in the Achieve Your Potential (AYP) program at Washington State Penitentiary’s (WSP’S) maximum security unit based on submitted applications, mental health diagnosis, and willingness to participate in programming. Students attend classes twice a week. Students learn Dialectical Behavior Therapy skills and Acceptance and Commitment Therapy Skills over the course of 8 weeks. Classes include psycho-education, group discussion, skills application, and homework assignments. Outcomes measures include the following self-report measurement: the Acceptance and Action Questionnaire (AAQ-II). The AAQ-II is administered pre-treatment, mid-treatment, and post-treatment. Preliminary results for 16 patients will be available for presentation in June 2016 together with a discussion on clinical implications and future research plans. Discussion implications of these results and future prison implementation will also be discussed. Future studies should include using ACT processes across different prison custody levels and prison settings (maximum custody, close custody, medium custody, minimum custody, residential treatment, women’s prison).

41. Exposure Therapy and Mindfulness for Agoraphobia in a Nursing Home Setting
Primary Topic: Clinical Interventions and Interests
Subtopic: Mindfulness
Mary Moeller, Bowling Green State University
Leah Bogusch, M.A., Bowling Green State University
William O'Brien, Ph.D., Bowling Green State University

BACKGROUND: Agoraphobia is one of few anxiety disorders that seem able to occur for the first time during old age (Flint, 1994). The widely-accepted treatment for agoraphobia is exposure therapy. Mindfulness can be used to increase willingness to approach uncomfortable situations (Treanor, 2011). Because teaching mindfulness is associated with improvement in emotion regulation, it may supplement exposure therapy well (Arch & Craske, 2006; Treanor, 2011). Very few studies have used mindfulness on nursing home residents, and this present case study also explores the feasibility and efficacy of using such an intervention with that population. METHODS: The participant in this study was a 59-year-old ambulatory Caucasian female who had lived in a nursing home for the past year and was experiencing symptoms of severe agoraphobia. Progress was measured using a pedometer to track the number of steps she took. Self-report measures were also used, including the Acceptance and Action Questionnaire (AAQ-II), Five Facet Mindfulness Questionnaire (FFMQ), daily rankings of depression and anxiety, and a brief questionnaire asking how many times she left her room each day and how many people she interacted with. The intervention was administered over the course of five weekly hour-long sessions. Baseline data were collected during the first two sessions, and it was during those sessions that exposure therapy was explained and the patient collaborated with the researchers to create a values hierarchy. A functional analytic model of her behavior was also created after two sessions with the client and was updated as needed throughout the study. The third, fourth, and fifth sessions focused on implementing progressive exposures based on her values hierarchy and brief mindfulness exercises. RESULTS: Therapy outcomes were analyzed using Reliability of Change Indices for the AAQ and FFMQ. They showed that the client had a significant reduction in psychological inflexibility (RCI: -4.46) and a significant increase in global mindfulness (RCI: 5.07). The percentage of non-overlapping data points for the number of steps taken by the client (33.33% above baseline) showed that the client increased her activity levels with treatment. The results also indicated through non-overlapping data points that the client had less anxiety (22.22% below baseline) and depression (22.22% below baseline) after the last session. DISCUSSION: Results indicate that the patient became more willing to face uncomfortable emotions and sensations associated with leaving her room. Increases in mobility may have psychological implications for her: among the nursing home population, increased mobility is associated with better mental health and quality of life (Aydin, Sari, Bingul, & Bulgan, 2014). These findings provide preliminary support for the use of mindfulness to supplement exposure therapy among nursing home residents with agoraphobia. They also support the use of mindfulness in a nursing home setting in general. References Arch,J. J., & Craske, M. G. (2006). Mechanisms of mindfulness: Emotion regulation following a focused breathing induction. Behaviour Research and Therapy, 44,1849-1858. Aydin, M., Sari, N., Bingul, B. M., & Bulgan, C. (2014). The effects of recreation activities on life quality of old age people in a local nursing home. International Journal of Academic Research, 6(1), 117-120. Flint, A. (1994). Epidemiology and comorbidity of anxiety disorders in the elderly. The American journal of psychiatry, 151(5), 640-650 Treanor, M. (2011). The potential impact of mindfulness on exposure and extinction learning in anxiety disorder. Clinical Psychology Review, 31, 617-625.

42. Policy and Prejudice: Implicit Bias Toward People in Poverty and its Predictive Relationship to Welfare Funding and Voting Behavior
Primary Topic: Functional contextual approaches in related disciplines
Subtopic: IRAP
A. Theodore Artschwager, B.A., University at Albany, State University of New York
Timothy R. Ritzert, M.A., University at Albany, State University of New York
John P. Forsyth, Ph.D., University at Albany, State University of New York

Background: Negative bias toward people in poverty is highly prevalent. Such response tendencies can manifest as a range of behaviors such as discrimination, stigmatization, and reduced willingness to contribute to social programs assisting people in poverty, resulting in negative outcomes. However, poverty bias research has been conducted solely using explicit self-report questionnaires, which are prone to social desirability influences. Indeed, poverty researchers have suggested it might be helpful to assess poverty bias using implicit measures, which do not require deliberate introspection and elaborated responding. Yet, no research has used implicit assessments to examine responses to people in poverty. Moreover, little research has explored the relation between poverty bias and important behaviors, such as voting. Such work is important considering attention given to social issues such as economic inequality during recent US elections. Better understanding how people respond to those in poverty, and how such tendencies relate to other behaviors, might increase understanding of voting behavior and aid in the design of interventions targeting reductions of economic inequality. Objective: The aims of this study are to evaluate explicitly- and implicitly-assessed poverty bias, the relation of poverty bias to relevant constructs, and the incremental predictive validity of implicitly assessing poverty bias in the prediction of voting behavior related to welfare programs and political candidates. Method: Data collection is ongoing, with 30 undergraduates completing a version of the Implicit Relational Assessment Procedure (IRAP; Barnes et al., 2006) designed to assess properties of relational responding toward people in poverty and middle-class individuals. The IRAP is an implicit measure, based on Relational Frame Theory (RFT), that assesses the strength of relational responses (i.e., the degree to which stimulus relations have been derived in the past). Participants are also completing self-report measures assessing beliefs about poverty causes, political party affiliation, and relevant constructs. Finally, participants are completing an assessment measuring willingness to allocate funds to government-run welfare programs and voting preference for US Presidential candidates. Conclusions/Expected Results: We expect participants to demonstrate IRAP effects indicative of an anti-poor/pro-middle-class relational bias, suggestive of histories of responding negatively to poor people. Furthermore, we expect IRAP effects correlate with related self-report measures and political party affiliation, such that individuals exhibiting traditionally conservative attributes (e.g., endorsement of the Protestant Work Ethic) will display stronger IRAP effects. Finally, we anticipate that IRAP effects will predict voting behavior, over and above explicit measures. Results will be discussed in the context of using a contextual behavioral science (CBS) approach to assessing the nature and impact of poverty bias. This work is consistent with recent efforts to expand the reach of CBS outside clinical psychology, using CBS to address a broad spectrum of social justice issues.

43. On Being Present in Therapy: Validation of a French Translation of the Therapeutic Presence Inventory
Primary Topic: Other
Subtopic: Therapeutic Presence
Marie-Eve Martel, M.A., Psy.D.(c), Université du Québec à Trois-Rivières
Joel Gagnon, Ph.D.(c), Université du Québec à Trois-Rivières
Maxime Bourgault, Psy.D.(c), Université du Québec à Trois-Rivières
Frédérick Dionne, Ph.D., Université du Québec à Trois-Rivières

Background: Despite the growing amount of research on mindfulness over the past few years, therapeutic presence seems to have only lately begun to spark interest in scientific research, and more research is needed to better understand its role in psychotherapy. Recently, the Therapeutic Presence Inventory (TPI; Geller, Greenberg, & Watson, 2010) has been developed to measure therapists’ presence in psychotherapy, but this self-report measure has yet to be translated and validated in French for clinicians or researchers. Method: This study aims to bring preliminary data on the factorial structure of a French translation of the 21-item TPI. The study was conducted among a sample of 151 French-speaking therapists in the province of Quebec (Canada). The majority of participants were women (70%), with a mean age of 46.3 (SD = 11.32). Results: Results from an exploratory factor analysis yielded a two-factor solution in which positively worded items represented one factor and negatively worded items represented the other factor. Confirmatory factor analyses were used to test for possible method effects based on the wording of items. Six alternative models were tested. Results showed that all the models controlling for method effects fit the data better than the two-factor solution. Discussion: These results suggest the presence of possible method effects based on the wording of items of the French TPI. Implications and future research directions will be put forward. Keywords: Therapeutic Presence; Mindfulness; Psychotherapist Training/Supervision/Development; Process Research; Translation.

44. Predicting psychological well-being of children based on their mothers psychological flexibility, mindfulness, mother-child relationships and demographic characteristics
Primary Topic: Other
Subtopic: psychological well-being, psychological flexibility, mindfulness, mother-child relationship
Leili Nourian, M.A., Islamic Azad University, Najafabad branch, Isfahan, Iran
Asghar Aghaei, Ph.D., Department of educational science and psychology, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran

The aim of this study was to predict psychological well-being of children based on their mother’s psychological flexibility, mindfulness, mother-child relationship and demographical characteristics. The research employed a correlational method. The sample consisted of 472 children (221 boys, 251 girls) aged 9 to 13, who were selected through multi-stage random cluster sampling from elementary school students in Isfahan (Iran) in 2015. Research Instruments were String Children’s Well-being Scale (SCWBS), Parental Psychological Flexibility Questionnaire (PPF), Five Facet Mindfulness Questionnaire (FFMQ), Mother-Child Relationship Evaluation (MCRE), and demographic characteristic questionnaire. The results of stepwise regression analysis indicated that cognitive defusion and acceptance of mothers, age of fathers, mothers education and financial situation of family can predict children’s well-being (P<0.05). So, using treatment methods to help mothers to increase their acceptance and cognitive defusion skills is recommended to increase the children psychological well-being. Also some of demographic characteristics like financial situation of family, level of mother’s education and age difference between father and child, should be considered as influential variables on psychological well-being of children.

45. The Reliability and validity of the Korean version of Parental Acceptance Questionnaire(6-PAQ)
Primary Topic: Other
Subtopic: Parenting, children, psychological flexibility
Seunmin Kim, Seoul Women's university
Kyung Park, Ph.D, Seoul Women's unversity

Background: The purpose of this study focused on the validation of the korean version of the Parental Acceptance Questionnaire(6-PAQ) which was developed by Greene, Field, Fargo and Twohig(2015). The 6-PAQ assesses all six process of parental psychological flexibility. Recently, the researchs of the ACT for distressed parents has been conducted, and the therapeutic effects has been proven in korea. But for the general measure of psychological flexibility is uesed the Acceptance and Action Questionnaire-II. So, the development of measurement tools that adequately measure psychological flexibility in the parenting is needed in korea. Method: To develop the Korean version of 6-PAQ, after obtaining permission of the original authors, one clinical psychologist and professional translator translated the English version into korean. Then, two clinical psychologists and ACT professionals modified the korean version to preserve the conceptual equivalence of original version. The participants were parents of children between the ages of 3 and 12 who agree with the purpose of this study. The study materials included the K-6-PAQ, K-AAQ-II, KIMS, EQ, PWBS, PSOC, PSI/SF, PANAS and Hwa-Byung symptom scale. Results: Now, the collected data is in the process of conducting statistical analysis.

46. Impact Of A Routine Treatment Programme Applied in Addiction Centers In Turkey On Psychological Flexibility
Primary Topic: Other
Subtopic: drug addiction
Dr. M. Emrah Karadere, MD, Hittite University, School of Medicine, Department of psychiatry , Corum
Turkan Dogan, Eskişehir State Hospital, Eskişehir, Turkey
Basak Demirel, Konya Training and Research Hospital, Konya, Turkey
Esra Porgalı Zayman, Elazıg State Hospital For mental Health and Disorders
Sevinc Ulusoy, Elazıg State Hospital For mental Health and Disorders
Ece Yazla, Hittite University, School of Medicine, Department of psychiatry , Corum

Background: Substance use disorders are characterized by recurrent, maladaptive use of drugs and/or alcohol (1) which often leads to significant distress and impairment in social, interpersonal, and occupational settings (2,3). Several psychotherapy approaches and medications are being used in the treatment of addiction. SAMBA is a kind of psychoeducation programme applied in the form of group therapy in addiction centers of state hospitals in Turkey (4). Investigation the impact of SAMBA programme on psychological flexibility is aimed in this study. Method: According to DSM-V criteria, 15 inpatients with cannabis and opioid use disorders from three different addiction centers in Turkey were enrolled. Patients participated three-week and 9 session SAMBA programme. Clinical Global Impression scale (CGI), Beck depression inventory (BDI), Beck Anxiety Inventory (BAI) and Acceptance and Action Questionnaire-II (AAQ-II) were applied before and after the treatment programme to evaluate the clinical change. Also Addiction Severity Index (ASI) was used to evaluate disorder severity. Results: The mean age of participants was 27,63±8,67 and all of them were male. The 40% (6) were married, 47,7%(7) were single and 13,3% (2) were divorced. 53,3%(8) of the participants were primary school graduate, 33,3%(5) were high school graduate and 13,3%(2) were university graduate. Ratio of the subscales of ASI was: drug 0,45; alcohol 0,33; psychological 0,45; physical 0,22; family 0,46; employment 0,58. The initial mean scores of BDI, BAI, CGI and AAQ-II were 32,27±15,17; 23,60±15,69; 28,00±10,99; 3,87±1,06 respectively. A significant difference was found between the initial and after treatment mean scores of BDI and CGI (p<0,001). No significant difference was found between the initial and after treatment mean scores of BAI(p=0,042) and AAQ-II(p=0,046). Discussion: This paper shows the preliminary results of a study about psychological flexibility and psychoeducation weighted group therapy programme.Our results about BDI and BAI can show that change process may be related with metacognitive process like rumination rather than worry. It should be replicated in a large sample for certain results. Reference: 1. American Psychiatric Association, 2013. Diagnostic and statistical manual of mental disorders, 5th ed. American Psychiatric Publishing, Arlington, VA. 2. Henkel, D., 2011. Unemployment and substance use: a review of the literature (1990–2010). Curr. Drug Abuse Rev. 4, 4–27. 3. Mueller, S.E., Degen, B., Petitjean, S., Wiesbeck, G.A., Walter, M., 2009. Gender differences in interpersonal problems of alcohol-dependent patients and healthy controls. Int. J. Environ. Res. Public Health 6, 3010–3022. 4. Ögel K., Koç C., Aksoy A., Basabak .A, Evren C. Sigara, Alkol ve Madde Bağımlılığı Tedavi Programı (SAMBA). Yeniden Yayınları, İstanbul, 2012

47. Psychological Inflexibility Predicts Attitudes Toward Syrian Refugees and National Security Policies
Primary Topic: Other
Subtopic: Political Psychology
Arthur Hatton, M.S., Georgia Southern University
Michael Nielsen, Ph.D., Georgia Southern University

Our research examines whether psychological inflexibility predicts support for national security policies that limit civil liberties, unfairly target Muslims, and exclude Syrian refugees from entering the country. New research has suggested that high psychological inflexibility may be implicated in prejudice (Vilardaga, Estevez, Levin, & Hayes, 2012). According to that theory, inflexibility may contribute to discriminatory behaviors because it describes a person's tendency to engage in behaviors aimed at down-regulating internal distress. Recently, an enormous number of refugees from Syria have relocated from Syria into the EU, other Middle Eastern Countries, and in the United States. A political backlash to both the threat of terrorism and the large number of refugees has emerged in the United States, with a number of governors declaring that their states will not accept these refugees. We hypothesize that inflexibility may predict whether people support policies aimed at making the nation safer in light of terrorist threats, even if those policies restrict civil rights or unfairly target minorities. We surveyed 107 students from a southern American university to examine whether psychological inflexibility predicted support for a number of civil rights-restricting security policies, including policies that ban Syrian refugees from entering the country. We found that inflexibility was highly correlated with support for these policies. We then ran a regression to see which personality traits were most predictive of support for banning Syrian refugees from settling in the country. The results showed that political conservatism and inflexibility were both significant predictors, with inflexibility being slightly more predictive.

48. The Efficacy and Acceptability of Third Wave Behavioural and Cognitive eHealth Treatments: A Systematic Review and Meta-analysis of Randomised Controlled Trials
Primary Topic: Other
Subtopic: eHealth
Martin O'Connor, M.Sc., University College Dublin
Anita Munnelly, Ph.D., University College Dublin
Robert Whelan, Ph.D., University College Dublin
Louise McHugh, Ph.D., University College Dublin

Background: eHealth has the potential to improve access to third wave behavioural and cognitive therapies. This systematic review and meta-analysis aimed to determine the efficacy and acceptability of third wave eHealth treatments. Methods: A comprehensive search of electronic bibliographic databases including PubMed, PsychINFO and Web of Science was conducted to identify randomised controlled trials of third wave treatments in which eHealth was the main component. Results: Twenty-six studies were included in the review, 24 of which featured in the meta-analyses. Meta-analyses revealed that third wave eHealth significantly outperformed both inactive and active control conditions at post-treatment with small to medium effect sizes. The efficacy of third wave eHealth was not significantly different to that of comparison interventions. Conclusions: The findings of this review indicate that third wave eHealth treatments are acceptable to participants and efficacious in improving a range of psychological problems, but not more so than comparison interventions.

49. Unwillingness: Finding common ground among experiential avoidance, distress intolerance and related constructs
Primary Topic: Other
Subtopic: Measurement of core constructs
Tamara Loverich, PhD, Eastern Michigan University
Kate Happel Krautbauer, Eastern Michigan University
Jessica Baker, Eastern Michigan University
Sarah Webb, Eastern Michigan University

Experiential avoidance and distress intolerance are key transdiagnostic constructs in contextual behavioral science. Many studies utilize one or both concepts as indices of the unwillingness to adaptively experience private events, whether purely physiological, or more broadly cognitive or emotional in nature. Conceptually related constructs such as intolerance of uncertainty, low frustration tolerance, nonacceptance, and shame aversion have been similarly employed. Our science may be better served by further clarifying the conceptualization and measurement of unwillingness and its factors. This presentation will offer pilot data from a university sample using EFA and CFA to initially explore the convergence and distinctiveness of the dimensions of the AAQ-II, MEAQ, IUI-A, DTS, IUS, FDS, SSAS, DERS and the SHARQ, and discuss the potential for and implications of developing consensus around a single unifying unwillingness construct.

50. The Acceptance and Action Questionnaire - Stigma: An exploratory factor analysis using a Hispanic college student sample
Primary Topic: Prevention and Community-Based Interventions
Subtopic: stigma
Jessica Villarreal, Metropolitan State University of Denver
Maureen K. Flynn, Ph.D., Metropolitan State University of Denver
A. Solomon Kurz, M.A., University of Mississippi

The Acceptance and Action Questionnaire – Stigma (AAQ-S; Levin, Luoma, Lillis, Hayes, & Vilardaga, 2014) is a measure of psychological flexibility with stigmatizing thoughts. The AAQ-S has adequate internal consistency reliability and good construct validity (Levin et al., 2014). Regarding factor structure, the AAQ-S showed a two-factor solution using a principal components analysis (PCA) with a varimax rotation (Levin et al., 2014). Problems arise, however, when examining the factor structure of a measure using a PCA and varimax rotations and it is recommended that an exploratory factor analysis (EFA) with an oblique rotation be used instead (e.g., Preacher & MacCallum). To date, there are no published studies examining the factor structure of the AAQ-S using an EFA. The purpose of the current study was to examine the factor structure of the AAQ-S using an EFA. The current study’s sample consisted of 237 Hispanic college students enrolled in a university on the Texas/Mexico border. A parallel analysis was conducted to determine the number of factors in the AAQ-S. This examination suggested that three factors could be extracted from the data. Next, an EFA with a direct oblimin rotation using Maximum likelihood estimation was conducted. Results showed a three-factor solution. No items were removed due to high cross loadings with other factors. Implications and future directions will be discussed.

51. Effects of Mindful Food Parenting on Children’s Eating Habits and Behavior
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Mindfulness
Lindsey Roberts, M.A., Bowling Green State University
Lynnel Goodman, B.S., Bowling Green State University
Jenna Marx, M.S., Bowling Green State University
Dara Musher-Eizenman, Ph.D., Bowling Green State University

Children’s eating habits and taste preferences are established early, with many children establishing lasting patterns and relations to food during the preschool years (e.g., Birch & Marlin, 1982). Although parental feeding practices have been studied in relation to children’s weight and food intake, relatively little attention has been paid to mindfulness and the ways in which it might relate to children’s eating habits and behavior. The current study (N = 481) looked at mindful food parenting for children 3 to 6 years old and hypothesized that increased parental mindfulness would be associated with healthier eating patterns and less problematic behavior by children. Two subscales--Present-Centered Awareness and Satiety Mindfulness— comprise the Mindful Food Parenting Scale (Meers, 2013). As hypothesized, linear regressions revealed that both subscales were negatively associated with children’s problematic mealtime behavior (r2 = .11, p < .001), emotional overeating (r2 = .23, p < .001), food fussiness (r2 = .15, p < .000), and food responsiveness (r2 = .16, p < .001); contrary to hypotheses, parental mindfulness did not predict children’s satiety responsiveness. Overall, these results suggest that promoting mindful feeding practices among parents could help children to establish healthy relations to food at a young age, with mindfulness serving as a low-cost, easily applicable intervention with long-lasting health implications.

52. Mindful Food Parenting Practices across Parenting Styles
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Mindfulness, Parenting, Feeding
Lynnel Goodman, B.S., Bowling Green State University
Lindsey Roberts, M.A., Bowling Green State University
Jenna Marx, M.S., Bowling Green State University
Dara Musher-Eizenman, Ph.D., Bowling Green State University

Parents play an important role in developing their child(ren)’s eating habits, with research suggesting that parenting style is related to child weight and eating behaviors (e.g., Rhee, Lumeng, Appugliese, Kaciroti, & Bradley, 2006). However, very little research has examined the role of mindfulness in feeding. The present study (n = 475) examined how two aspects of mindful feeding—Present-Centered Awareness and Satiety Mindfulness—differed across three parenting styles (authoritative, authoritarian, and permissive), hypothesizing that authoritative parents would use more mindful feeding practices than would permissive or authoritarian parents. A one-way MANOVA revealed that mindful feeding significantly differs across parenting styles, Wilks’ λ =.834, F (4,562) = 13.34, p <.001. Pairwise comparisons revealed that authoritative parents (M = 3.87, SD = .74) were significantly higher in Present-Centered Awareness than authoritarian (M = 3.35, SD = .67) or permissive parents (M = 3.56, SD = .69). Authoritative parents were also significantly higher in Satiety Mindfulness (M = 4.25 SD = .61) than authoritarian (M = 3.70 SD = .70) or permissive parents (M = 3.84 SD = .70). Overall these results suggest that authoritative parents feed their children more mindfully than authoritarian or permissive parents, suggesting that mindfulness may be one mechanism through which authoritative parenting predicts positive feeding outcomes and may be important to include in feeding interventions.

53. ACT with At-Risk Adolescents: A Community-Based Preventive Intervention
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Adolescents
Emily B. Kroska, M.A., University of Iowa
Rosaura Orengo-Aguayo, M.A., University of Iowa
Michael O'Hara, PhD, University of Iowa
James Marchman, PhD, University of Iowa

Background: Acceptance and Commitment Therapy (ACT) has demonstrated improvements in functioning across mental and physical health domains and has garnered empirical support through hundreds of clinical trials. Community-based interventions and prevention research are a necessary step in both research and dissemination. The use of ACT as a prevention tool will help individuals to develop and implement psychological flexibility before the emergence of psychopathology. Recent research suggests that ACT may be particularly effective with youth (Horowitz & Garber, 2006). The current study addressed three gaps in the ACT research literature: 1) the application of ACT to prevention science, 2) the implementation of ACT in community settings, and 3) the use of ACT with adolescents. Method: The present study tested the effectiveness of a five-hour group ACT intervention with adolescents attending an alternative high school in Iowa. Fifty-three students were aged 14-18 volunteered to participate in the study. The intervention was based on the core ACT processes with the goal of increasing psychological flexibility. Experiential activities and discussion were used to clarify valued life directions, examine the workability of avoidance, and suggest mindfulness and acceptance as alternatives. Participants completed assessments at baseline (at time of enrollment), pre-intervention, one-month follow-up, three-month follow-up, six-month follow-up, and one-year follow-up. In addition, attendance and grades data were obtained at pre- and post-intervention. Results: Longitudinal analyses using mixed-effects modeling revealed significant improvements in the targeted processes (higher levels of mindfulness, reduced avoidance) and secondary outcomes (lower levels of depressive and anxiety symptoms). Objective data obtained from the school indicated that attendance increased between pre- and post-intervention (trend-level significance). Moderation analyses indicated that change over time varied as a function of the number of traumatic experiences reported at baseline. Simple effects analyses revealed that individuals who reported higher levels of trauma benefited most from the intervention across depression, anxiety, avoidance, and mindfulness. Discussion: The current study underscores the importance of applying ACT to prevention work and in community settings. The findings indicate that significant change was observed over time across outcome variables, and this change was moderated by number of traumatic experiences. Thus, the implementation of ACT in an alternative high school was feasible and acceptable. The effectiveness of this intervention should be further examined through a RCT.

54. Examining the Effectiveness of Group Based Acceptance and Commitment Therapy for Adolescents in a Community Outpatient Mental Health Setting
Primary Topic: Prevention and Community-Based Interventions
Subtopic: Adolescents, Group Treatment, Transdiagnostic intervention, Anxiety, Depression
Tajinder Uppal Dhariwal, M.A., OISE/University of Toronto
Sheri Turrell, Ph.D., Trillium Health Partners
Mary Bell, M.S.W., R.S.W., Trillium Health Partners
Marci Gordeyko, M.A., OISE/University of Toronto

Background: Acceptance and commitment group therapy has been found to be effective for a transdiagnostic adult population within the hospital setting (Pinto et al., 2015). There is limited research of ACT group treatment with adolescents (Halliburton & Cooper, 2015). The effectiveness of ACT group treatment for adolescents diagnosed with heterogeneous psychiatric disorders in a community hospital has not yet been examined. Objective: The present study examined the effectiveness of 10 week group-based ACT treatment for adolescents presenting with primarily anxiety and depression-related psychiatric difficulties in a community outpatient mental health setting. Methods: Adolescents (n = 72) diagnosed with anxiety and depression-related psychiatric disorders took part in the present open trial. Data were collected prior to treatment, post-treatment and three months following the treatment. Participants completed outcome (anxiety and depression symptoms) and ACT process measures (cognitive fusion/experiential avoidance, mindfulness and values-based direction). The present study consists of data collected from fifteen groups run over three years. Results: Analyses revealed significant reductions in anxiety and depression symptoms from pre- to post-treatment. Significant reductions in anxiety and depression symptoms were also found from post-treatment to three months following the treatment. Changes in ACT process measures were determined to predict changes in anxiety and depression symptoms. Discussion: The present research provides support for ACT group treatment as a transdiagnostic approach for adolescents presenting with primarily anxiety and depression-related heterogeneous psychiatric disorders in the community. Future research comparing ACT group treatment and existing treatments in the community setting with a similar population is warranted. References Halliburton, A. E., & Cooper, L. D. (2015). Applications and adaptations of Acceptance and Commitment Therapy (ACT) for adolescents. Journal of Contextual Behavioral Science, 4(1), 1–11. doi:10.1016/j.jcbs.2015.01.002 Pinto, R. A., Kienhuis, M., Slevison, M., Chester, A., Sloss, A., & Yap, K. (2015). The effectiveness of an outpatient Acceptance and Commitment Therapy Group programme for a transdiagnostic population. Clinical Psychologist. doi:10.1111/cp.12057

55. Implicit attitudes to female body size in women with high and low body dissatisfaction: An IRAP study.
Primary Topic: Relational Frame Theory
Subtopic: IRAP
Alba Antequera-Rubio, M.Sc., University of Jaén, Spain
Monica Hernandez-Lopez, Ph.D., University of Jaén, Spain
Miguel Rodriguez-Valverde, Ph.D., University of Jaén, Spain

Background: Research on implicit attitudes to body size reveals the existence of a preference for images of thinness over images of fatness. Studies that have employed the Implicit Relational Assessment Procedure (IRAP) have shown that this attitudinal bias is specifically attributable to a pro-thin attitude, rather than to an anti-fat one. Method: In this study two groups of nonclinical female college students (22 women with high levels of body dissatisfaction and 21 women with low levels of body dissatisfaction, measured by the Body Shape Questionnaire) completed an IRAP with two labels (Pleasant and Unpleasant) and twelve targets (six photographs of underweight girls and six of overweight girls). Additionally they completed a visual analogue scale with the same photographs to measure explicit attitudes. Results:The IRAP results indicate that women with high levels of body dissatisfaction showed a pro-thin bias while women with low levels of body dissatisfaction did not. The explicit measure results revealed a general pro-overweight but not anti-thin attitude in both groups. The pro-overweight attitude was stronger in participants with high levels of body dissatisfaction. Discussion: Dissatisfaction with one's own body image appears to affect implicit attitudes to thinness and fatness.

56. Investigation of validity on the Kanji maze task as a defusion measure from verbal relation and relational responding.
Primary Topic: Relational Frame Theory
Subtopic: Depression Defusion
Yuki Shigemoto, Graduate School of Psychology, Doshisha University, JSPS Research Fellow
Takashi Muto Ph.D, Faculty of Psychology, Doshisha University

Background: The purpose of this study was to investigate whether the Kanji maze task is a valid measure of defusion. While the IRAP (Implicit Relational Assessment Procedure) is a useful tool for assessing defusion, it is difficult to implement in clinical interview due to its length. Thus, this study developed a new behavioral task, the Kanji maze task, to measure defusion and investigated its validity in regard to verbal relation and relational responding. Method: An alphabet-maze was the basis of the Kanji maze task. In this study two types of Kanji maze were developed. One is the depressed words Kanji maze and the other is the neutral words Kanji maze. A total of 73 undergraduate students completed the Ruminative Response Scale (RRS), Cognitive Fusion Questionnaire (CFQ), Acceptance and Action Questionnaire-II (AAQ-II) and Beck Depression Inventory-II (BDI-II) and performed the IRAP and Kanji maze task. Results: Two scores are calculated for the Kanji maze task: the reaction time as a measure of verbal relation ant the inflexibility score as a measure of relational responding. The validity of verbal relation was examined using reaction time on the Kanji maze task and the IRAP. No correlation was found between scores on these two tasks. However, those who scored higher on the BDI-II chose depressive words of Kanji maze faster than those with a lower BDI-II score. A 2 (high score / low score of questionnaire)×4 (4 trial types of IRAP) ANOVA was conducted. On the AAQ-II and CFQ, high-scoring individuals confirmed positive feelings more slowly and refused negative feelings faster than low-scoring ones. The validity of relational responding was examined through the inflexibility score of the Kanji maze and overall Dscore of the IRAP. A significant negative correlation between inflexibility score and overall Dscore was found. Discussion: The results of indicate that the reaction time on the Kanji maze task is not a valid measure of verbal relation. However, the results do suggest that the reaction time of depressive individuals is slower than that of minimal or mild depressive individuals. The finding for relational responding showed that the inflexibility score of the Kanji maze task has validity.

57. An Initial Application of Relational Frame Theory to Anorexia Nervosa
Primary Topic: Relational Frame Theory
Subtopic: Anorexia Nervosa
Kate Happel Krautbauer, B.A., Eastern Michigan University
Tamara Loverich, Ph.D., Eastern Michigan University

Background: Anorexia nervosa impacts approximately 0.4% of young women. This disorder is particularly concerning because it has a higher mortality rate than many other mental illnesses, with an estimated mortality rates between 5% and 15%. However, there is currently no clearly evidence-based treatment for the disorder in adults. Thus, improving current knowledge about anorexia is vital. Method: Data were collected as part of a larger qualitative study examining pro-anorexia (“pro-ana”) social media sites. Frequency counts for codes relating to thinness, desirability, social approval, fatness, and negative emotion were obtained to determine how often these codes occurred simultaneously. Results: Data are still being collected for this study, however preliminary results indicate high overlap between codes relating to thinness, desirability, and social approval. Preliminary results also suggest that codes related to fatness and disgust and anger demonstrate a high frequency of overlap. Discussion: The intersection between codes indicating “good” and “thinner than” and social desirability suggest that these concepts may have come to be linked in a relational frame by social media users reporting anorexia. It is also interesting to note the apparent opposite frame, “bad” related to “fatter than”. These results provide insight into the relational frames be maintaining factors in anorexia nervosa and may suggest an initial formulation of anorexia using an RFT framework.

58. Face off: implicitly and explicitly detecting “emotional threshold” by grading facial expressions.
Primary Topic: Relational Frame Theory
Subtopic: IRAP
Annalisa Oppo Psy. D., SFU, Milan (ITALY)
Enrica Basile (ITALY), Kore University, Enna Italy
Valeria Squatrito, Kore University, Enna Italy
Giovambattista Presti, MD, Kore University, Enna Italy

In addition to different contextual stimuli successful social interactions may depend also from the recognition of some of them as “emotional”: facial expressions are the most salient among them. Research commonly uses marked exemplars of facial expressions and the role of soft expressions remain unclear at the explicit level and rarely investigated at the implicit level. The aim of this study was to assess an “emotional threshold” both at explicit and implicit level, using implicit relational assessment procedure (IRAP) for the latter one. Thirty-seven participants were enrolled in this study. Assessment included explicit measures that evaluated self-compassion skills and depressive symptoms. A standardized set of graded, from full expression to neutral, emotional faces developed by Tottenham et al. (2009) and adapted by Gao & Maurer, D. (2009) were used. Following the procedure described by Calder and colleagues (1996) and using MorphX software facial expressions at varying intensity levels were generated. In this study facial emotions of anger, fear, sadness, happiness, disgust, and surprise at 100% versus 25% were used. Each stimulus has a resolution of 506 X 650 pixels with RGB color. Results showed that the “emotional threshold” seems higher at the explicit level than at the implicit level. Furthermore depressive symptoms seems to moderate the threshold both at the implicit and at the explicit level. Preliminary results will be presented. References Calder, A. J., Young, A. W., Perrett, D. I., & Etcoff, N. L. (1996). Categorical perception of morphed facial expressions. Visual Cognition, 3, 81–117. Gao, X. & Maurer
, D. (2009). Influence of intensity on children’s sensitivity to happy, sad, and fearful facial expressions. Journal of Experimental Child Psychology. Journal of Experimental Child Psychology 102(4):503-21. Tottenham, N., Tanaka, J. W., Leon, A. C., McCarry, T., Nurse, M., Hare, T. A., et al (2009). The NimStim set of facial expressions: Judgments from untrained research participants. Psychiatric Research, 168, 242–249.

59. Diffusion of Defusion: A Mixed-Methods Approach to Longitudinally Measure the Implementation of Acceptance and Commitment Therapy in a Community Mental Health Center.
Primary Topic: Supervision, Training and Dissemination
Subtopic: Evidence-based practice implementation, Qualitative data
Sean P. Wright, MA, MS, LMHC, Lutheran Community Services Northwest
Sonia Combs, MS, LMHC, Lutheran Community Services Northwest
Monica Frost, MS, Grand Canyon University; Lutheran Community Services Northwest

In community mental health, dissemination and implementation of evidence-based practices (EBPs) traditionally involves a top-down approach in which particular EBPs are specified at the system level by funders or agency administration. Little is known about individual clinician preferences for specific EBPs as well as preferences for implementation of new EBPs in agency settings. To address this gap, we surveyed clinicians at our agency to capture their attitudes toward EBPs and measure specific interest and knowledge about Acceptance and Commitment Therapy (ACT) since ACT is currently not an official EBP at the agency and all training efforts are therefore voluntary. We measured demographic variables, qualitative responses to open-ended questions about EBPs using a grounded approach, ACT experience level using questions adapted from Long (2015), and knowledge of the ACT model using the ACT Knowledge Questionnaire (Luoma & Vilardaga, 2013). Using a diffusion of innovations framework, we hypothesized that clinician commitment to learning ACT will increase over time (and there will be reliable predictors of which clinicians voluntarily commit to training in and using ACT with clients). From a population (N = 39), we obtained a high response rate (56%, n = 22). Qualitative coding of data replicated previous findings in the literature that clinicians typically are in favor of proven interventions provided they are flexible to use, apply to client population, and are supported by supervisors. We also replicated the literature finding that clinicians face significant barriers to training in new EBPs such as large caseloads, concern about burnout, and lack of system support for the specific EBP. We confirmed our hypothesis that current levels of ACT experience and enthusiasm can be partially accounted for based on the clinician’s organizational ties to the two peer clinicians who are leading monthly trainings in ACT. The diffusion of innovation prediction that clinical knowledge will precede experience was confirmed: mean ratings of Likert-scale items for competence and confidence in the model were low; however, performance on the ACT knowledge questionnaire was significantly above chance performance for the 16 clinicians who agreed to have their knowledge tested (two-tailed t=2.144, p < 0.05). Together, these data suggest that our survey is a sensible way to measure the diffusion of ACT in a community mental health setting. It further suggests the need to design training interventions that address perceived barriers. Finally, our mixed method approach will be refined in preparation for a second round of data collection in May 2016, which will allow within subjects comparisons and model fitting. These forthcoming data will be incorporated into this poster. Long, D. (2015). Development and evaluation of an acceptance and commitment therapy online competency assessment: A contextual behavioral building block approach (Unpublished doctoral dissertation). University of Nevada, Reno. Luoma, J. B. & Vilardaga, J. P. (2013). Improving therapist psychological flexibility while training acceptance and commitment therapy: A pilot study, Cognitive Behavioral Therapy 42(1), 1-8.

60. ACT Workshop for teachers and staffs working for children having disabilities
Primary Topic: Supervision, Training and Dissemination
Subtopic: Teachers, staffs
Shinji Tani, Ph. D., Ritsumeikan University
Kotomi Kitamura, Ph.D., Osaka University of Human Sciences

Background: The ACT is expected to give benefits to children having disabilities. Teachers and staff learn the skills of ACT, and teach children mindfulness skills and other relating skills to ACT. That could be useful. Furthermore, teachers and staffs often have some mental health issues. Therefore, it could be beneficial for them to learn ACT on both children and themselves. Purpose: The purpose of this research is to show the effects of ACT WS on acquisition of knowledge and skills of ACT and mental health of participants. Method: 37 participants (six men and 31 women, ranged 23 to 68 years old) attended this research. They are teachers or staffs working at social service agents for children having disabilities. They attended the ACT WS, which was conducted in a group format and lasted for five hours. AAQ-II, FFMQ, and GHQ-28 were used to assess the effect of the WS. The knowledge test of ACT was conducted after the WS. Pre-test/post-test experiment design was used. Three questionnaires were implemented before starting the WS and a month after the WS. A textbook and a Power Point slide were used in the WS. Experiential exercises and metaphors were practiced in order to learn ACT skills and knowledge. Results: The statistical analysis revealed the score of AAQ-II, some of FFMQ were changed between pre-test and post-test significantly. There is no significant change on the score of GHQ-28. However, negative significant correlation was found between the score of AAQ-II at the pre-test and the change score of GHQ-28. This result indicated participants showing low psychological flexibility at the pre-test improved in psychological QOL (GHQ-28) after the WS. There were ten participants showing above six of the score of GHQ-28. The score of AAQ-II and GHQ-28 changed significantly among them. The result of the knowledge test showed the mean was 15.7 (11-20), SD was 2.5. There was no correlation with any measures. Discussion:The results showed the WS was effective for both of acquisition of knowledge and skills of ACT and mental health issues. The participants learned mindfulness skills. The participants showed lower QOL improved after the WS.

61. Therapist Agreement with Sensitivity to Context (TASC) and deictic relational complexity: Demonstration of an assessment prototype
Primary Topic: Supervision, Training and Dissemination
Subtopic: Assessment
Douglas M. Long, Ph.D., Alpert Medical School of Brown University

Background: This poster describes a prototypical demonstration of a procedure that extends the basic contextual behavioral science of language and cognition into the area of therapist skill assessment and training. While expert-guided consultation and experiential training are increasingly recognized as essential ingredients in efforts to address global health challenges through clinical workforce development, public health needs remain unmet in part because the processes by which expertise is transferred are not understood with a degree of precision necessary for efficient regulation of scarce training resources. Relational Frame Theory (RFT) provides an empirically progressive analysis of symbolic behavior that precisely specifies the manipulable social conditions under which otherwise arbitrary stimuli acquire behavior regulatory functions (Hayes, Barnes-Holmes, & Roche, 2001). RFT comports with the evolution science of language development, has demonstrated clinical utility in predicting and influencing cognitive skills – including those involved in perspective-taking, and can be used to guide clinician behavior in the delivery of any psychosocial intervention (Villate, Villate, & Hayes, 2016; Wilson, Hayes, Biglan, & Embry, 2014). Method: Therapist Agreement with Sensitivity to Context (TASC) is an assessment strategy whereby participant relational responses to contextual cues (i.e., videos of simulated therapy sessions) are compared to the relational responses of experts to those same stimuli. The TASC prototype presented in this poster was developed as a web-based competency assessment in Acceptance and Commitment Therapy (ACT) that was distributed to clinicians before and after participation in experiential training workshops (Long & Hayes, 2015). In an analysis of TASC responses provided by 76 therapists of varying skill levels, agreement with experts required participants to demonstrate perspective-taking responses of high relational complexity (i.e., “I see YOU seeing THAT process THEN which is DIFFERENT from THIS process I see HERE NOW”). Results: Variability in perspective-taking responses was mildly associated with number of years spent practicing as a clinician and with self-rated familiarity with RFT – even while statistically accounting for other ACT-consistent TASC responses -- creating a regression model with R-squared = .155, p = .007. Discussion: While this correlation was small, its specificity was notable, in that other therapist demographic and training-history variables did not display this relationship. This provides an empirical demonstration of the relevance of RFT to the development of clinical skill assessments that can be used to efficiently evaluate psychotherapy training practices.

62. Fostering Psychological Flexibility in Cancer Patients: A Chilean Experience
Primary Topic: Clinical Interventions and Interests
Subtopic: Cancer, Oncology, Psycho-Oncology
Cristian Soza, Ph.D., Oncoloop Foundation
Tatiana Corbeaux, Ph.D., Oncoloop Foundation
Fernando Parada, Oncoloop Foundation

Cancer is one of the main causes of morbidity and mortality around the world; In 2012 there were approximately 14 million new cases and 8,2 million Cancer-related deaths. It is expected that the number of new cases grow to an approximate of 70% in the next 20 years, this means that the annual Cancer cases will grow from 14 million in 2012 to 22 million in the next 2 decades. Of the new cases mentioned, over 60% come from Africa, Asia, Central and South America. These regions represent 70% of the Cancer Deaths around the World. The World Health Organization and the Panamerican Health Organization have dedicated great efforts to revert and prevent this situation, revealing that health institutions have a key role in this subject: "Organizing systems that articulate the access and continuity in health assistance". These systems should provide prevention tools, early diagnosis, treatment and paliative care against these diseases. In Chile, Cancer is the second cause of death after Cardiovascular Disease. From 20% to 25% of the deaths nationwide are caused by this disease. It is estimated that in 2008, 22 thousand people died from Cancer, this statistics are more similar to an industrialized than to a developing country. According to the National Health Ministry, the main objective in the battle against Cancer is to cure, prolong and improve quality of life, as well as to alleviate pain and suffering, which can be achieved in 90% of the cases. This is why both the private and public health system in Chile have organized to help offering paliative care for Cancer, being included as a part of the National Health Warranties (GES for Garantías Explícitas en Salud). As part of this nationwide effort to prevent and treat Cancer, the Oncoloop foundation emerges as an organization dedicated to the evaluation and improvement of the existent treatment protocols for Cancer in Chile, as well as to the design and implementation of new and evidence-based interventions for the effective approach and treatment of this disease. In this context, the Onocloop foundation is currently working in several areas related to well being and quality of life in Cancer patients, one of which is the Psychological area. Currently in Chile there is no unified protocol for the Psychological assistance of Cancer patients. Despite there's a significant amount of psychologists working in Oncology units and the existence of a Diploma in a State University regarding Pyscho-Oncology, there are no official protocols for the best evaluated psychological treatment for Cancer in Chile, which could be a problem when it comes to measuring and evaluating outcomes. Therefore, the Oncoloop Foundation is currently working in the Design and Implementation of a group protocol for people diagnosed with Cancer. This protocol is based on the studies and trials conducted in developed countries, such as Spain, England and United States, all related to the use of Acceptance and Commitment Therapy (ACT) and Mindfulness for the improvement of quality of life and mental health of these patients. The main goal for this protocol is to foster psychological flexibility in people diagnosed with Cancer, which has been related to improvements in their quality of life, distress and mood issues (Feros, et, al, 2013). In order to accomplish such goal, a 6 session protocol has been designed to aim specific Psychological Flexibility processes with participants, which are expected to foster these abilities and, therefore, improve their quality of life, distress and mood indicators. This is an ongoing investigation, results and conclusions will be published once the process is finished.

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WC14 Powerpoints & Handouts

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Pre-Conference Workshops 

Tuesday-Wednesday June 14-15, 2016


Learning ACT from the Inside Out: A skills building workshop for people near the start of their ACT journey 
David Gillanders, DClinPsy.
Helen Bolderston, Ph.D
Handout 1

From Isolation to Belonging: Using ACT and Affective Science to Deepen Your Work with Clients Stuck in Self-Criticism and Shame
Jason Luoma, Ph.D.
Jenna LeJeune, Ph.D.
Melissa Platt, Ph.D.
Handout 1
Handout 2
Powerpoint 1
Powerpoint 2

Inside This Moment: Using Present Moment Interventions to Promote Radical Change in ACT
Kirk Strosahl, Ph.D.
Patricia Robinson, Ph.D.
Handout 1
Handout 2
Handout 3

Acceptance & Commitment Therapy: Focusing on Values Work, Self-Care, and Self-Compassion
Kelly G. Wilson, Ph.D.
Handout 1
Powerpoint

Acceptance and Commitment Therapy for Anxiety Disorders: Transforming Anxious Suffering Into a More Vital Life
John P. Forsyth, Ph.D. and Jamie R. Forsyth, M.A.
Handout 1 
Handout 2

Mastering the Clinical Conversation: Language as Intervention
Matthieu Villatte, Ph.D., Jennifer L. Villatte, Ph.D., Steven C. Hayes, Ph.D.
Powerpoint 1
Powerpoint 2 
Powerpoint 3
Powerpoint 4 

Mindfulness and Acceptance for Gender and Sexual Minorities: Contextual Strategies to Foster Self-Compassion, Connection, and Equality
Matthew Skinta, Ph.D., Aisling Curtin, Ph.D., Lisa Diamond, Ph.D.
Powerpoint 1
Powerpoint 2
Powerpoint 3

Foundations of Compassion Focused Therapy and Compassion Focused ACT for Anxiety and Mood Disorders
Dennis Tirch, Ph.D., Laura Silberstein, Psy.D.
Powerpoint


Conference Sessions


Thursday June 16, 2016


1. Aging and ACBS: A Scientist/Practitioner Journey
Susan McCurry, Ph.D.
Powerpoint 1

2. Getting Your Frames Straight: A Primer on Functional Contextualism and RFT for Practitioners
Chad Drake, Ph.D.
Handout 1

5. Defining Defusion: Structure, Intervention, and Effects of Cognitive Defusion in Research and Clinical Practice
Theresa A. Morgan, Ph.D., J. T. Blackledge, Ph.D., Kristin Naragon-Gainey, Ph.D., Kristy L. Dalrymple, Ph.D.
Powerpoint

6. Harmonious Healing Traditions: ACT and Indigenous Cultures
Kenneth Fung, M.D., FRCPC, MSc., Alison Kiawenniserathe Benedict, MSW, RSW
Powerpoint

7. Building the Values of Acceptance and Commitment in Children: The World's first ACT School, ACT Summer Camp, and Daily Treatment Guide to a Mindful Education 
Mark Dixon, Ph.D.
Powerpoint

11. Pursuing a comprehensive assessment agenda for Functional Analytic Psychotherapy
Amanda M. Muñoz-Martínez, MSc., William C. Follette, Ph.D., Cory Stanton, M.S., Timothy Feeney
Powerpoint 1
Powerpoint 2

12. RFT Bridges Behavior Therapy “Waves” with Pragmatism as Supports 
Hank Robb, Ph.D.
Handout 1

15. ACT for Parents and Children
Sacha Rombouts, Ph.D., Chris McCurry, Ph.D.
Powerpoint 1

16. ACT in Medicine: Efficient Contextual Interventions that Target Diverse Medical Populations
Joanna J. Arch, Ph.D., Kirk Strosahl, Ph.D., Lilian Dindo, Ph.D., Megan Oser, Ph.D., Aliza Weinrib, Ph.D. 
Powerpoint 

17. New Title: What is the Role of Behavioral Science in the Fight to Protect and Promote Sexual and Gender Diversity??
Lisa Diamond, Ph.D.
Powerpoint  

18. Uncovering the process of ”Creative Hopelessness”
Rikke Kjelgaard, M.Sc., Robyn Walser, Ph.D.
Powerpoint

19. It's a Matter of FACT: Training Medical Providers to Address Behavioral and Mental Health Concerns in Primary Care
David Bauman, Psy.D., Bridget Beachy, Psy.D., Kirk Strosahl, Ph.D., Patricia Robinson, Mindy Udell
Handout 1
Handout 2
Handout 3
Handout 4
Handout 5
Handout 
6

23. Beyond the couch: Functional contextual applications for community mental health and behavior change
Daniel S. Steinberg, M.A., Antony Biglan, Ph.D.,  Matthew D. Skinta, Ph.D., Monica M. Gerber, M.S., Stephanie V. Caldas, M.S.,
Powerpoint 

26. To start learning RFT 
Niklas Törneke, M.D.
Powerpoint

27. How to implement case study in the era of evidence-based practice in psychology (EBPP): Some new methods of measuring, graphing, and analyzing: Japan Chapter Sponsored
Takashi Muto, Ph.D., Steven Hayes, Ph.D., Kohei Hashimoto, B.A., Asako Sakano, M.A., Naoki Manpuku, B.A.
Handout 1
Handout 2

32. West meets East or East meets West?: Opportunities and Challenges of Disseminating ACBS to Eastern Culture: Washington Chapter Sponsored 
Jonathan Bricker, Ph.D., Steven Hayes, Ph.D., Louise Hayes, Ph.D., Zhu Zhuohong, Ph.D., Harriet Phinney, Ph.D.
Powerpoint 1 (Panel)
Powerpoint 2 (Zhu)

34. Mission impossible: From trouble teens to thriving families
Patricia E. Zurita Ona, Psy.D., Sandra Georgescu, Psy.D.
Handout

39. Challenges in the application of ACT in clinical psychiatric settings: Empirical data and clinical experiences: Psychosis SIG Sponsored
Andreas Larsson, Ph.D., Roger Vilardaga, Ph.D., Mårten Tyrberg, M.Sc., Johanna Linde, M.Sc., Johan Pahnke, M.Sc.
Powerpoint


Friday June 17, 2016


41. Health, Happiness, and the Social Regulation of Perception
Jim Coan, Ph.D.
Prezi

45. Helping the helpers: ACT interventions for healthcare providers
Dayna Lee-Baggley, Ph.D., Patricia Robinson, Ph.D., Melissa Baker, Ph.D., Sarah T Trane, Ph.D.
Handout 1
Handout 2
Handout 3
Handout 4

46. Using Psychological Flexibility to Reach Across the Barriers of Prejudice: Examinations of Obesity, Race, and Sexual Orientation Stigma
Regan M. Slater, Ph.D., Matthew Skinta, Ph.D., Emily R. Squyres, M.S., Yash Bhambhani, M.A., Maureen K. Flynn, Ph.D.
Powerpoint 1
Powerpoint 2
Powerpoint 3

50. Ignites #1
Jason Luoma, Ph.D., Kristen Abbondante, Wesley J. Sheeley, Ph.D., Kara Massie, Ph.D., Rawya Al-Jabari, Ph.D., Vinod Srivastava, Sarbjit S. Johal, Ph.D., Jeffrey Swails, M.A., John Parkhurst, Ph.D., Susan Boafo-Arthur, Ph.D.
Handout 1

51. Incorporating ACT-based Interventions into University Classrooms: University Student Mental Health SIG Sponsored
Wanda L. Smith, Ph.D., Jaqueline Pistorello, Ph.D., Cody Christopherson, Ph.D., Anna Whitehall, M.A., Sarah Kupferschmidt, M.A.
Handout

55. Navigate the Growing Pains of Dialectical Behavior Therapy (DBT) Skills Groups with Functional Analytic Psychotherapy (FAP): Creative Adaptations to Help Your Groups Thrive 
Renee Hoekstra, Psy.D.
Powerpoint

58. Functional Analytic Psychotherapy (FAP): Creating Intense and Curative Therapeutic Relationships
Mavis Tsai, Ph.D., Robert J. Kohlenberg, Ph.D., ABPP, Mary Plummer Loudon, Ph.D., Daniel Maitland, Ph.D.
Handout

61. RFT & Rule Governed Behavior: Conceptual and Empirical Developments
Gina Boullion, M.S.
Powerpoint

63. Improving Outcomes and Better Understanding Processes: Using Smartphone Technologies in Clinical Research
Jonathan Bricker, Ph.D.
Powerpoint

65. Processes of Change
Rebecca Schneider, M.A., Chad E. Drake, Ph.D., Andreas Larsson, Miguel Rodriguez-Valverde, Ph.D.
Powerpoint 1
Powerpoint 2

72. Fix My Teen, Fix My Parents: Ontario Chapter Sponsored
Sheri Turrell Ph.D., Chris McCurry, Ph.D., Mary Bell, MSW, RSW
Powerpoint
Handout
References

78. Investigating the effects and processes of brief ACT interventions with different populations
Fredrik Livheim, MSc.
Handout

80. This Modern (Evaluative) World: Exploring Contemporary Approaches to Assessing and Addressing Stigmatizing Attitudes toward Psychological Struggles
Chad E. Drake, Ph.D., Teresa Hulsey, B.A., Trent Codd, EdS, Ethan G. Lester, B.S.
Handout 1
Handout 2
Handout 3

81. 1-day intervention for problematic eating behaviors and body image concerns 
Lilian Yamamoto, M.A., Patricia E. Zurita Ona
Powerpoint


Saturday June 18, 2016


BB. Research-based Practice SIG; Adapting Research to the Clinical Environment: Computer-aided verbal behavior analysis (CAVBA) of treatment process and outcomes 
Angela Cathey, M.A., Gareth Holman, Ph.D., Matthieu Villatte, Ph.D.
Handout

84. Development & Application of DBT: Practical Strategies for Practical Therapists
Marsha Linehan, Ph.D.
Powerpoint

86. End the Insomnia Struggle: Individualizing Cognitive Behavioral Therapy for Insomnia (CBT-I) Using Acceptance and Commitment Therapy (ACT) 
Alisha Brosse, Ph.D., Colleen Ehrnstrom, Ph.D. 
Powerpoint 

90. RFT & Education 

Thomas Szabo, Ph.D., Jacob H. Daar, M.A., Jonathan Tarbox, Gloria Torres-Fernandez, M.Sc.
Powerpoint 1
Powerpoint 2

91. Nurturing Communities in Higher Education: Helping At-Risk Undergraduate Students "Show Up and Do What Matters"
Jennifer Block Lerner, Ph.D., Donald R. Marks, Psy.D., Jacqueline Pistorello, Ph.D., Michael Femenella, Ph.D., Ashlynne Mullen, M.A.
Powerpoint

93. Ignites #2
Rodrigo Nunes Xavier, Dayna Lee-Baggley, Ph.D.
Powerpoint 1
Powerpoint 2

96. Delivering ACT in Technology-Based Formats: Outcomes, Processes, and Provider Attitudes 
Kristy Dalrymple, Ph.D., Roger Vilardaga, Ph.D., Stephanie P. Goldstein, B.S., Michael E. Levin, Ph.D.
Powerpoint 1
Powerpoint 2

97. Building an Empirical Bridge: Linking Technique to Evaluation in Applications of the Matrix: Mexico Chapter Sponsored
Benjamin Pierce, M.S., Michel Reyes, Ph.D., Fabián Olaz, Psy.D.
Powerpoint 1
Powerpoint 2

 

100. A collaborative approach to translational research: The mutual interest model
Michael P. Twohig, Ph.D. 
Powerpoint 

101. Self-Compassion in Acceptance Based Treatment 
Kristin Neff, Ph.D., Christopher Germer, Ph.D.
Handout 1

105. To blend or not to blend: Advantages of mixing ACT with new technologies 
Ellen Excelmans, Psy.D., Michael E. Levin, Ph.D., Roger Vilardarga, Ph.D., Jack A. Haeger, B.A., Arpita Bhattacharya, M.S.
Powerpoint 1
Powerpoint 2 (Haeger, Pierce, & Levin)
Handout (List of CBS related apps)

108. Substance Use and CBS 
Aaron L. Bergman, M.A., M.S., Don Sheeley, M.D., Jeff Foote, Ph.D., Matthew Enkema, Sean P. Wright, M.A., M.S.
Handout 1

110. Thriving adolescents: Introducing the DNA-V model for youth
Louise Hayes, Ph.D., Joseph Ciarrochi
Handout

112. Trauma, BPD, Suicide
Sean M. Barnes, Ph.D., John Donahue, Psy.D., Lia Stern, M.A., Michel A. Reyes Ortega, Ph.D.,Ren Stinson, Ph.D.
Powerpoint

113. Delivering ACT in Group Format: Learn how to promote mental health, resilience, and productivity using Acceptance and Commitment Therapy
Fredrik Livheim, MSc.
Handout

114. An Open Invitation: Become a PROSOCIAL facilitator
Alan Honick, David Sloan Wilson, Ph.D., Steven Hayes*, Ph.D., Paul Atkins, Ph.D., Beate Ebert*, Edmond Brandon
Handout 1

115. Cognitive Change: A Contextual Behavioral Approach
Jennifer Villatte, Ph.D., Matthieu Villatte
Handout

116. ACT for Psychosis and Other Chronic Mental Health Conditions: Rocky Mountain ACBS Chapter Sponsored 
Richard Tingey, Ph.D., Adria Pearson-Mauro, Ph.D., Gretchen Sholty, Ph.D.
Handout

118. Helping Students Make School Meaningful 
Lauren Porosoff, Jonathan Weinstein, Ph.D.
Handout

119. RFT: Novel Approaches & Analyses
Yvonne Barnes-Holmes, Miguel A. Lopez-Medina, BSc, Martin Finn, Maarten De Schryver, Benjamin Ramos
Powerpoint 1

121. Enriching your clinical work with mobile technology
Michael Levin, Ph.D., Megan Oser, Ph.D., Jack Haeger
Powerpoint
Handout

123. Awesome Papers 1 
Candice Fieg
Handout 1

124. How Does ACT Enhance Our Understanding of Exposure?
Eric Lee, M.A., John Forsyth, Ph.D., Carlos Rivera, M.S., Brian Thompson, Ph.D., Timothy Ritzert, M.A.
Powerpoint


Sunday June 19, 2016


127. Ecological momentary assessments (EMA) to measure ACT processes and behavioral health across populations 
Javier Rizo, B.A., Michael Levin, Ph.D., Ethan Moitra, Ph.D., Angela Cathey, M.A., Jennifer Villatte, Ph.D.
Handout
Powerpoint 1
Powerpoint 2
Powerpoint 3
Powerpoint 4

131. Training perspective taking in children with Autism, in the laboratory, and in the clinic
Josh Kaplan, Carmen Luciano, Thomas G. Szabo, Ph.D., BCBA-D, Paul Guinther, Ph.D., Benjamin Schoendorff, M.A., MSc.
Powerpoint

132. Using ACT Interventions to Help Clients Explore the Possibilities of Gender Identity: LGBTQA SIG Sponsored Workshop
Trish Leonard, Ph.D., Lauren Grousd, M.A.
Powerpoint
Handout 1
Handout 2
Handout 3
Handout 4

136. The Flexible Therapist: ACTing on your Values when Facing Struggle
Rikke Kjelgaard, M.Sc., Trym Nordstrand Jacobsen, M.Sc.
Powerpoint 1

137. Conceptualization of awareness, courage, and love as clinical targets in Functional Analytic Psychotherapy
Jonathan Kanter, Ph.D.
Powerpoint

138. Metaphor: From science to psychotherapy 
Niklas Törneke, M.D.
Powerpoint

140. Practicing Verbal Aikido to train Psychological Flexibility: The basics of the non resistance principle in the clinical conversation
Fabián Orlando Olaz
Powerpoint

141. ACT for Obesity and Weight-Related Stigma: Concept and Treatment
Sarah Potts, M.S., Emily Sandoz, Ph.D., Jason Lillis, Ph.D., Emily R. Squyres, M.S., Michael E . Levin, Ph.D.
Powerpoint 1
Powerpoint 2
Powerpoint 3

143. Utilizing Acceptance and Commitment Therapy to Understand and Prevent Suicide
Sean M. Barnes, Ph.D., Nazanin H. Bahraini, Ph.D., Brandon A. Gaudiano, Ph.D., Jacqueline Pistorello, Ph.D., Debbie Sorensen, Ph.D.
Powerpoint

144. Awesome Papers 2
Melissa Daniel
Handout 1

145. ACT with Clients who Struggle with Depression
Rob Zettle, Ph.D., Jeff Swails, M.A.
Powerpoint

146. Functional Analytic Psychotherapy Interventions Across Populations: Mexico Chapter Sponsored
Daniel Maitland, Ph.D., Matthew Skinta, Ph.D., ABBP
Powerpoint

ACBS staff

WC14 Symposia Detail

WC14 Symposia Detail

Thursday, June 16
Friday, June 17
Saturday, June 18
Sunday, June 19

 

Thursday, June 16

5. Defining Defusion: Structure, Intervention, and Effects of Cognitive Defusion in Research and Clinical Practice
Symposium (10:30am-Noon)
Components: Conceptual analysis, Literature review, Original data
Categories: Clinical Interventions and Interests, Clin. Interven. & Interests, Other, Defusion
Target Audience: Beg., Interm.
Location: Vashon 1

Chair: Theresa A. Morgan, Ph.D., Rhode Island Hospital, Alpert Medical School of Brown University
Discussant: J. T. Blackledge, Morehead State University

Defusion is integral to Acceptance and Commitment Therapy (ACT) and has a documented effect on treatment outcomes. It is targeted directly in ACT using a combination of experiential exercises, metaphors, and didactics that shift emphasis away from literal meanings, and highlight the independence of thought and behavior. Nevertheless, there is little research examining defusion’s primary structural components, assessment, and associations with related constructs. Moreover, targeted examinations of defusion interventions are rare, and its acceptability and effect in naturalistic treatment settings is not well established. This symposium presents three investigations of defusion including both experimental and applied studies in diverse populations. The first addresses the conceptual underpinnings, measurement, and structure of defusion across four samples. The second presents rapid effects of a technology-enhanced defusion technique on thought believability and distress in a clinical sample. The third discusses the effectiveness of initiating ACT-based treatment with defusion in an acute treatment setting.

• Examining the Structure and Construct Validity of Defusion and Decentering
Kristin Naragon-Gainey, Ph.D., University at Buffalo, the State University of New York
Kenneth G. DeMarree, Ph.D., University at Buffalo, the State University of New York

Defusion and decentering are related constructs that describe an objective, distanced, and open approach towards one’s internal experiences (Bernstein et al., 2015). Numerous measures of these constructs exist, but little is known about how they relate to one another or their ability to predict important outcomes like thought believability. Across four samples (clinical and non-clinical), we found that five measures of defusion and decentering were only weakly to modestly associated with one another. Item-level analyses revealed a two-factor structure, consisting of “Observer Perspective” and “(Lack of) Struggle with Thoughts,” which generally showed expected and distinct patterns of convergent and discriminant validity, although the latter factor had questionable discriminant validity viz-a-viz psychological distress. The factors also related differently to believability of positive vs. negative thoughts, which was partially explained by the predominance of negative items in defusion and decentering measures. Implications for the conceptualization and assessment of defusion are discussed.

• The Immediate Effect of Cognitive Defusion in a Clinical Sample: Distress, Believability, and the Role of Psychological Flexibility
Kristy L. Dalrymple, Ph.D., Rhode Island Hospital; Alpert Medical School of Brown University
Brandon A. Gaudiano, Ph.D., Butler Hospital; Alpert Medical School of Brown University
Lia Rosenstein, B.A., Rhode Island Hospital; Alpert Medical School of Brown University
Emily Walsh, B.A., Rhode Island Hospital; Alpert Medical School of Brown University

Defusion tasks (e.g., vocal repetition) result in greater reductions in distress and believability towards negative thoughts relative to thought control or distraction tasks (e.g., Masuda et al., 2009; 2010). A few studies have been conducted in clinical samples, but no known studies have examined the use of mobile technology to enhance the defusion effect. We previously conducted intermediate analyses of the effects of nontechnology and technology-enhanced defusion tasks compared to a thought distraction task on negative thoughts in a subsample diagnosed with a depressive disorder. The current study will present results from the final sample of 97 participants and explore the role of psychological flexibility. Results showed that defusion resulted in decreased believability from pre- to post-task compared to thought distraction. Greater psychological inflexibility was associated with less change in distress and believability in the thought distraction condition only. Additional findings, limitations, and implications of the findings will be discussed.

• Changes in Symptoms and Functioning After Initiating Treatment with Defusion
Theresa A. Morgan, Ph.D., Rhode Island Hospital; Alpert Medical School of Brown University
Brian Pilecki, Ph.D., Rhode Island Hospital; Alpert Medical School of Brown University
Catherine D'Avanzato, Ph.D., Rhode Island Hospital; Alpert Medical School of Brown University
Kirsten Langdon, Ph.D., Rhode Island Hospital; Alpert Medical School of Brown University
Darren Holowka, Ph.D., Rhode Island Hospital; Alpert Medical School of Brown University
Kristy Dalrymple, Ph.D., Rhode Island Hospital; Alpert Medical School of Brown University
Mark Zimmerman, MD, Rhode Island Hospital; Alpert Medical School of Brown University

Few studies examine the unique effect of defusion on clinical treatment, but those that do identify it as a significant contributor to positive outcomes (e.g., Levin et al., 2012; Bach & Hayes, 2002). Despite this, we could find no reported clinical protocols that begin treatment with defusion or that quantify the results of doing so. The current study examines the effect of applying defusion at intake in ACT-based group treatment. Participants include 750 patients in an open-enrollment, ACT-based partial hospitalization program, 144 of whom initiated treatment with defusion. Preliminary results showed that patients receiving defusion at intake reported significant improvement in symptoms and functioning 24 hours after initiating treatment. Group comparisons showed higher defusion and flexibility in the intake-defusion group 24 hours after initiating treatment, however these differences were no longer present at discharge. Clinical implications and issues that arise when applying defusion early in treatment will also be discussed.

Educational Objectives:
1. Describe the primary elements that underlie measures of defusion and decentering, evaluate the construct validity of existing defusion scales, and identify current challenges in measuring and conceptualizing defusion. 2. Describe the effects of nontechnology and technology-enhanced defusion tasks on negative thoughts compared to a thought distraction task, and the association between these effects and pre-task psychological flexibility. 3. Discuss the effectiveness and outcomes of applying defusion interventions at intake in acute psychiatric settings, and the clinical issues associated with this process.

 

9. Mindfulness and Acceptance-Based Interventions for PTSD in Acute and Complex Populations: Refining Treatment and Clarifying Mechanisms of Change
Symposium (10:30am-Noon)
Components: Literature review, Original data
Categories: Clinical Interventions and Interests, PTSD, partial hospitalization, Adults, veterans
Target Audience: Beg., Interm.
Location: Cascade 1B

Chair: Catherine D'Avanzato, Ph.D., Rhode Island Hospital
Discussant: Victoria M. Follette , Ph.D., Department of Psychology, University of Nevada Reno

ACT-based interventions have demonstrated efficacy for trauma-exposed populations. Given the complexity and functional impairment characterizing this population, ACT may be a particularly suitable intervention, as it has demonstrated improved outcomes among individuals who do not respond adequately to traditional behavioral therapies. This symposium will address two important gaps in the existing literature on ACT for PTSD: first, a lack of research investigating higher-level care settings which are increasingly serving this population and second, a need to clarify the pathways through which change in specific ACT processes influences outcomes. The first presentation (Megan Kelly) focuses on examining change in experiential avoidance as a mechanism underlying social support among returning Veterans. The second (Catherine D’Avanzato) and third (Kirsten Langdon) presentations highlight outcome data of a specialty PTSD partial hospital program, as well as underlying ACT mechanisms of change. Implications for refining existing ACT-based interventions for PTSD will be discussed.

• Experiential avoidance as a mediator of the association between posttraumatic stress disorder symptoms and social support: A longitudinal analysis
Megan Kelly, Ph.D., VISN 1 Mental Illness Research, Education, and Clinical Center, Bedford, MA, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA; Social and Community Reintegration Research Program, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA; University of Massachusetts Medical School, Worcester, MA
Bryann B. DeBeer, Ph.D., Dept. of Veterans Affairs, VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX; Texas A&M University
Eric Meyer, Ph.D., Dept. of Veterans Affairs, VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX; Texas A&M University
Nathan Kimbrel, Ph.D., Durham Veterans Affairs Medical Center; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center; Duke University School of Medicine
Suzy Gulliver, Ph.D., Warriors Research Institute, Baylor, Scott & White Healthcare System, Waco, TX, USA
Sandra Morissette, Ph.D., The University of Texas at San Antonio, Department of Psychology

Veterans with PTSD often experience difficulties with social reintegration following deployment due to avoidance of social interaction. The present study evaluated whether experiential avoidance (Acceptance and Action Questionnaire – II ) mediated the association between PTSD symptoms (Clinician Administered Scale for PTSD) and post-deployment social support (Deployment Risk and Resilience Inventory – Post Deployment Social Support Questionnaire). Veterans (n = 145) who served in support of the conflicts in Iraq and Afghanistan participated in a study evaluating returning Veterans’ experiences. Results showed experiential avoidance was a significant mediator the relationship between lifetime PTSD symptoms and 8-month social support, indirect effect = -.0048 (95% CI: -.0074, -0.0029). Results also showed that experiential avoidance was a significant mediator of the association between baseline PTSD symptoms and 8-month post-deployment social support, indirect effect = -.0061 (95% CI: -.0101, -.0027). Experiential avoidance appears to be an important mediator between PTSD symptoms and social support following deployment.

• Effectiveness of an ACT-based Partial Hospitalization Program for PTSD: Trajectories of Change in PTSD symptoms and Core ACT Processes
Catherine D'Avanzato, Ph.D., Rhode Island Hospital, Providence, RI
Darren Holowka, Ph.D., Rhode Island Hospital; Alpert Medical School of Brown University
Kirsten J. Langdon, Ph.D., Rhode Island Hospital
Theresa A. Morgan, Ph.D., Rhode Island Hospital; Alpert Medical School of Brown University
Brian Pilecki, Ph.D., Rhode Island Hospital; Alpert Medical School of Brown University
Sarah McCutcheon, M.A., Rhode Island Hospital

ACT appears to be an efficacious and well-received intervention for trauma-exposed individuals (e.g. Walser et al., 2015; Mulick et al., 2011), however further research demonstrating its efficacy is needed. Further, as partial hospital programs are becoming an increasingly prevalent treatment modality for this population, more research is needed on the effectiveness of ACT for PTSD in acute care settings. The present study investigated the effectiveness of our ACT-based PTSD track in reducing PTSD severity, as indicated by the PTSD Check List (PCL), building upon past results indicating significant change in anxiety and depression symptoms. We first validated the PCL in our non-veteran sample, comprised of individuals exposed to diverse trauma types. A significant reduction in PTSD severity from pre to post-treatment was hypothesized and tested using structural equation modeling (N>300). Results on pre-post change in symptoms, quality of life, functioning, and ACT processes will be reviewed, as well as trajectories of symptom change over time. Implications for the refinement of ACT-based PTSD interventions in higher level care settings will be discussed.

• Experiential avoidance and mindfulness: Putative mechanisms underlying symptom change during intensive ACT-based treatment among a trauma-exposed population
Kirsten J. Langdon, Ph.D., Rhode Island Hospital
Darren Holowka, Ph.D., Rhode Island Hospital; Alpert Medical School of Brown University
Catherine D'Avanzato, Ph.D., Rhode Island Hospital
Theresa A. Morgan, Ph.D., Rhode Island Hospital; Alpert Medical School of Brown University
Brian Pilecki, Ph.D., Rhode Island Hospital; Alpert Medical School of Brown University
Sarah McCutcheon, M.A., Rhode Island Hospital
Kristy Dalrymple, Ph.D., Rhode Island Hospital; Alpert Medical School of Brown University
Mark Zimmerman, MD, Rhode Island Hospital; Alpert Medical School of Brown University

Recent research suggests that ACT may be an especially effective treatment for trauma-exposed populations, given its emphasis on encouraging participants to observe and accept unwanted thoughts, feelings, and memories (McLean & Follette, 2015; Woidneck, Morrison, & Twohig, 2014). The present study evaluated whether change in certain ACT-based processes, namely experiential avoidance and mindfulness, during participation in a specialized PTSD track within a partial hospital program, predicted improvement in symptom severity across treatment. Results indicated that decreases in experiential avoidance and increases in mindfulness were associated with reductions in PTSD, anxiety, depression, and anger severity across time. An examination of the differential effects of specific mindfulness facets in relation to symptom change will also be presented. These data highlight experiential avoidance and mindfulness as putative mechanisms underlying change in PTSD and related symptoms during intensive ACT-based treatment. Clinical implications for addressing experiential avoidance and encouraging mindful awareness in trauma-exposed populations will be discussed.

Educational Objectives:
1. Present data on the effectiveness of three ACT-based interventions for PTSD in novel populations and/or setting. 2. Examine the relation between specific ACT core processes and treatment outcome indices. 3. Discuss implications for developing and refining ACT interventions for PTSD in novel clinical settings and populations.

 

11. Pursuing a comprehensive assessment agenda for Functional Analytic Psychotherapy
Symposium (10:30am-Noon)
Components: Conceptual analysis, Didactic presentation
Categories: Performance-enhancing interventions, Superv., Train. & Dissem., Assessment
Target Audience: Interm., Adv.
Location: Cascade 2

Chair: Amanda M. Muñoz-Martínez, MSc., University of Nevada, Reno
Discussant: William C. Follette, Ph.D., University of Nevada, Reno

Research in Functional Analytic Psychotherapy (FAP) has advanced in different directions. Several methods have been implemented to identify how therapeutic relationship produce changes in-session and its effect on client’s natural contexts. However, FAP lacks of a coordinated methodological agenda that extends its empirical support in a functional perspective instead a topographical approach. This symposium addresses some issues to unstuck research progress in this therapeutic approach. First, we explored psychometric measurements that assess improvements in the interactions in-session and out-of-session, that could provide standardized parameters of clients improvements. Second, we discuss areas of influence on client's behavior and the complexities of functional assessment. Third, we propose implementing systematic functional descriptive analysis as an option, to guarantee the integrity of the independent variable and the reliability of the dependent variable, in FAP.

• Psychometric measurement of interactions in- and out-of-session
Timothy Feeney, University of Nevada, Reno
Cory Stanton, M.S., University of Nevada, Reno

Functional Analytic Psychotherapy (FAP) is an approach that assumes interpersonal interactions between the therapist and client account for a large proportion of the variance explaining therapeutic change. Measures have been developed that directly target features important to the intervention. These include measures that inform a functional case conceptualization, provide procedures for coding and analyzing the dyad, and measures of dependent variables. The field of interpersonal interventions is not limited to FAP; methods and measures have been developed that maintain features important to the analytic goals of FAP (prediction and influence). This paper will discuss measurement procedures that exist in FAP, what is missing, and what methods have been developed for other domains that may be adapted for research that takes a functional approach to the therapist-client dyad as a mechanism of change. The paper will explore the varying clinical and empirical implications for using these devices in a functional paradigm.

• Areas of influence on client behavior and the complexities of analysis
William C. Follette, Ph.D., University of Nevada-Reno

Functional Analytic Psychotherapy (FAP) is an approach to therapy that assumes there are functional and definable features of the therapeutic dyad. Further, these features account for a significant proportion of the variance that contribute to the probability of achieving an outcome favorable to both the therapist and the client. Some proportion of this variance will be called “client characteristics;” these are functional repertoires of behavior that may be under generalized stimulus control and interact with “therapist characteristics” in a way that increases or decreases the probability of achieving therapeutic goals. Other features that contribute to the variance will be discussed and include treatment fidelity, the supporting influences of the client’s direct acting environment, and how these interact with “client and therapist characteristics.” All of these units are functional and contextual and provide a dynamic view of the change process and create a context where attending to treatment adherence is insufficient.

• Assessing treatment integrity and reliability in FAP
Amanda M. Muñoz-Martínez, MSc., University of Nevada, Reno
Natalie Bennett, University of Nevada, Reno

Treatment adherence or treatment integrity, as the extent by which an intervention is implemented as intended, is an important aspect of research in psychotherapy. Strong conclusions cannot be drawn between the independent variable (treatment) and dependent variable (client’s behavior) unless it is known whether or not the therapist adhered to the treatment (Gresham, 2009). Otherwise, reliability of the dependent variable is fundamental to provide accurate conclusions about treatment effectiveness. Currently, Functional Analytic Psychotherapy (FAP) lacks standardized assessments of treatment integrity and reliability, given its emphasis on client–therapist functional interaction. We propose utilizing assessments that integrate descriptions of functional units of analysis by clients (CRB’s) and therapist’s (therapeutic rules) behaviors in-session to obtain inter-observer agreement as a feasible alternative to evaluate FAP therapist’s adherence and the consistency of therapeutic achievements across research in diverse domains.

Educational Objectives:
1. Describe the current state of assessment in Functional Analytic Psychotherapy and its impact on research progress. 2. Present alternative methods to evaluate FAP effectiveness, validity, and reliability, in- and out-of-session. 3. Discuss the importance of integrating measurements, that account for FAP effects with fidelity and control confounding variables in the therapeutic interaction.

 

16. ACT in Medicine: Efficient Contextual Interventions that Target Diverse Medical Populations
Symposium (10:30am-Noon)
Components: Original data
Categories: Behavioral medicine, Clin. Interven. & Interests, Behavioral Medicine
Target Audience: Beg., Interm., Adv.
Location: Mercer/Denny

Chair: Joanna J. Arch, University of Colorado Boulder
Discussant: Kirk Strosahl, Ph.D., Mountainview Consulting

The vast majority of adults with mental health problems present in medical settings; additionally, many medical conditions put adults at risk for mental health problems. These twin facts create a remarkable need for mental health professionals with knowledge of medical populations. Fast-paced medical settings demand brief, resource-efficient interventions that target transdiagnostic principles of change to quickly facilitate improvement. This symposium highlights ACT’s potential to flexibly intervene with diverse medical populations using targeted, efficient interventions. We will present original data from five studies in diverse medical populations that employ ACT interventions ranging from one-day workshops to weekly groups. We will also reflect upon the lessons learned from deploying ACT in medical settings. Our collective work demonstrates the feasibility and preliminary efficacy of applying ACT to address the psychosocial needs of diverse medical populations.

• One-Day Acceptance and Commitment Training Workshops Targeting Distress in Medical Populations
Lilian Dindo, Ph.D., Baylor College of Medicine
James Marchman, Ph.D., University of Iowa
Jess Fiedorowicz, M.D., Ph.D., University of Iowa
Ana Recober, MD, University of Pennsylvania

Management of chronic medical illnesses can be challenging. The challenge is accentuated by comorbid depression or anxiety, which interfere with motivation and drive. ACT provides a unified model of behavior change and has shown promise in treating depression, anxiety, and chronic medical conditions. Aim: To evaluate the efficacy of a 1-day ACT intervention on depression and anxiety in different medical populations. Study 1: patients with vascular disease and comorbid depression or anxiety were assigned to 1-day ACT plus Illness Management (ACT-IM) or Treatment as Usual (TAU); Study 2: patients with comorbid depression and migraine were assigned to ACT-IM or TAU. Results: In both studies, patients in the ACT-IM condition showed significantly greater improvements in depression, anxiety, and functioning at the 3- month follow-up compared to patients in TAU. The benefits and challenges of, and lessons learned from, implementing 1-day ACT workshops in medical contexts will be discussed.

• Acceptance and Commitment Therapy for medical patients with co-occurring psychiatric conditions
Megan Oser, Ph.D., Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School
Gabe Gruner, LICSW, Department of Psychiatry, Brigham and Women’s Hospital
Vanessa Alvarez, M.A., Department of Psychology, Suffolk University

We conducted a pilot feasibility test of an Acceptance and Commitment Therapy (ACT) group for medical patients with psychiatric conditions (N = 32). We characterize the sample; evaluate pre to post changes, and discuss lessons learned from embedding ACT in this medical context. Treatment completers did not differ from non-completers (n = 11) on baseline anxiety screener (PHQ-4), quality of life (SF-8), experiential avoidance (Acceptance and Action Questionnaire-II), anxiety sensitivity (Anxiety Sensitivity Index), and distress tolerance (Distress Tolerance Scale). However, non-completers endorsed significantly higher pre-treatment depressive symptoms (p = .01). Although improvements in experiential avoidance and anxiety sensitivity were observed, only distress tolerance (p = .03) and mental health related QoL (p = .01) significantly improved during treatment. Limitations of statistical analyses for a heterogeneous sample, the incubation period of capturing improvements in ACT, and adaptations for patients with medical conditions will be discussed.

• Integrating the ACT Matrix into Post-Surgical Pain Management
Aliza Weinrib, Ph.D., Toronto General Hospital; Department of Psychology, York University, Toronto
Muhammad Abid Azam, M.Sc., Toronto General Hospital; Department of Psychology, York University, Toronto
Janice Montbriand, Ph.D., Toronto General Hospital; Department of Psychology, York University, Toronto
Hance Clarke, MD, Ph.D., Dept. of Anesthesia and Pain Management, Toronto General Hospital
Timothy Gordon, MSW, Private Practice
Joel Katz, Ph.D., Toronto General Hospital; Department of Psychology, York University, Toronto

The Transitional Pain Service at Toronto General Hospital is a novel, multidisciplinary approach to managing pain after major surgery that incorporates an ACT Matrix protocol. The service provides acute pain care in-hospital for complex surgical patients and continued care for the 5-10% of patients who develop chronic post-surgical pain after hospital discharge. Early findings (N = 143) indicate that patients who participated in more than two sessions of the ACT intervention (n = 36) were able to reduce their opioid use after surgery more than patients who participated in less than two sessions (n = 32) or no sessions (n = 75). In addition, reductions in pain intensity for the 2+ session ACT group were associated with less depressive symptoms and reduced pain interference in daily activities; these correlations were not significant in patients who received less or no ACT treatment. Lessons learned from clinical implementation will be discussed.

• An Acceptance and Commitment Therapy Group Intervention for Cancer Survivors Experiencing Anxiety at Re-entry
Joanna J. Arch, Ph.D., University of Colorado Boulder, Department of Psychology and Neuroscience
Jill L. Mitchell, LCSW, Ph.D., Rocky Mountain Cancer Centers-Boulder; Tebo Family Medical Pavilion, Boulder, CO

Background: This paper will present data from a pilot study (n=42) investigating the preliminary feasibility and efficacy of an ACT group intervention for anxious adult cancer survivors. We will present “lessons learned” from this pilot study that we applied to our recently initiated randomized clinical trial (RCT) comparing ACT to usual care in community cancer care centers throughout Colorado (target n=100+). Methods: We assessed pilot study outcomes across a month-long multiple baseline period, mid-intervention, post-intervention, and 3-month follow-up. Results and Conclusions: Intent-to-treat, HLM analyses demonstrated robust improvement across all outcomes from the multiple baseline to Post, ps ≤ .05, ds = .21-.78, and FU, ps ≤ .01, ds = .37-1.00, with anxiety and depression symptoms showing the largest improvements. Change in cancer-related psychological flexibility predicted or nearly predicted subsequent change in 8 of 9 outcomes. Numerous “lessons learned” have facilitated a successful first year in the ongoing RCT.

Educational Objectives:
1. Describe adaptations of acceptance-based interventions for use with medical populations. 2. Use the broad range of psychological and health-related outcomes that acceptance-based interventions can impact. 3. Apply 'lessons learned' about implementing ACT interventions and research in diverse medical settings.

 

21. Receptivity to ACT as a Smoking Cessation Intervention for People with Mental Health Conditions
Symposium (2:45-4:15pm)
Components: Original data
Categories: Clinical Interventions and Interests, Smoking cessation
Target Audience: Beg., Interm., Adv.
Location: Vashon 1

Chair: Jaimee L. Heffner, Ph.D., Fred Hutchinson Cancer Research Center
Discussant: John Forsyth, University at Albany, State University of New York

People with mental health conditions have two to three times higher prevalence rates of cigarette smoking than people without these conditions, and quit rates are up to 50% lower. Standard treatment approaches for smoking cessation, based on US Clinical Practice Guidelines, do not address some of the unique barriers to quitting reported by smokers with mental health conditions, including fears about worsening mental health symptoms and smoking to “treat” symptoms of the disorder. ACT may be a better treatment model, helping smokers with mental health symptoms to quit through acceptance of these smoking triggers and identification of core values guiding quitting. As a step toward developing tailored ACT interventions for smokers with mental health conditions, the presenters in this symposium will provide evidence that smokers with posttraumatic stress symptoms (Dr. Kelly), social anxiety symptoms (Dr. Watson), and bipolar disorder (Dr. Heffner) respond favorably to ACT for smoking cessation.

• Receptivity of a Web-Delivered ACT Smoking Cessation Treatment for Smokers with Posttraumatic Stress Disorder Symptoms
Megan M. Kelly, Ph.D., Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA; University of Massachusetts Medical School
Jaimee L. Heffner, Ph.D., Fred Hutchinson Cancer Research Center
Kristin E. Mull, M.S., Fred Hutchinson Cancer Research Center
Jonathan B. Bricker, Ph.D., Fred Hutchinson Cancer Research Center

An ACT smoking cessation treatment may be particularly helpful in addressing triggers related to stressful and traumatic life events, which are often substantial triggers for tobacco use. The present study evaluated the receptivity and engagement of a web-delivered ACT smoking cessation therapy by individuals who endorsed clinically significant posttraumatic stress disorders symptoms (measured on a 6-item abbreviated version of the PTSD checklist; n= 694) compared to those who endorsed fewer symptoms (n=622). Participants with clinically significant PTSD symptoms were less likely to login to the program (p=.002) than participants with fewer symptoms. However, participants with clinically significant PTSD symptoms were more satisfied with the program (p=.008) and felt like it was more useful for quitting (p=.042) than participants with fewer symptoms. Overall, people who endorse more clinically significant PTSD symptoms related to stressful life events appear to be more satisfied with a web-delivered ACT smoking cessation treatment.

• Smokers with Social Anxiety: Comparing Receptivity to Web-Delivered ACT vs CBT in the Large WebQuit Randomized Trial
Noreen L. Watson, Fred Hutchinson Cancer Research Center
Jaimee L. Heffner, Ph.D., Fred Hutchinson Cancer Research Center
Kristin E. Mull, M.S., Fred Hutchinson Cancer Research Center
Jonathan B. Bricker, Ph.D., Fred Hutchinson Cancer Research Center

Background: Smokers with social anxiety disorder (SAD) are less likely to quit smoking with standard treatments. ACT-based cessation programs might be better suited for these smokers, but no prior studies have tested this hypothesis. Methods: In a large general sample RCT (N = 2,637), we compared receptivity among smokers with SAD (n =796) randomized to an ACT (n=408) or a CBT (n=388) cessation website at 3-months post-randomization (91% follow-up). Results: Compared to those assigned to CBT, smokers with SAD assigned to ACT: (1) logged-in more often (M = 11 vs. 4 times; p <.0001), and (2) rated intervention exercises and the website as more useful (ps < .05). Conclusions: Socially anxious smokers were more engaged with and receptive to the ACT intervention. Since engagement predicts outcome, results show the potential value of ACT for socially anxious smokers. Implications for tailoring web-based interventions for this group will be discussed.

• “It’s Not as Much Willpower as It Is Embracing It and Letting It Go”: Qualitative Analysis of Response to an ACT Intervention for Smokers with Bipolar Disorder
Jaimee L. Heffner, Ph.D., Fred Hutchinson Cancer Research Center
Noreen L. Watson, Ph.D., Fred Hutchinson Cancer Research Center
Jennifer B. McClure, Ph.D., Group Health Research Institute
Robert M. Anthenelli, MD, University of California at San Diego
Sarah Hohl, M.P.H., Fred Hutchinson Cancer Research Center
Jonathan B. Bricker, Ph.D., Fred Hutchinson Cancer Research Center

Background: We previously pilot tested the first ACT smoking cessation intervention for smokers with bipolar disorder, delivered in combination with nicotine replacement therapy, and found promising end-of-treatment quit rates: 40% for face-to-face counseling and 33% for telephone counseling. To follow up on these preliminary findings, we qualitatively assessed participants’ receptivity to the intervention and how they implemented ACT skills in the quitting process. Method: We conducted semi-structured interviews with 10 participants who completed the ACT treatment. Two coders applied descriptive coding and an inductive content analysis approach to interviews. Results: Participants generally perceived ACT to have been helpful in their quitting process, as themes consistent with acceptance, defusion, present moment, self-as-context, values and committed action emerged from the interviews. Conclusions: The intervention was well-received by participants, and it helped them implement the core ACT change processes. Potential methods of refining the intervention based on participant feedback will be explored.

Educational Objectives:
1. Demonstrate knowledge of the acceptability of a web-based Acceptance and Commitment Therapy Smoking Cessation Treatment for Individuals with Posttraumatic Stress Disorde symptoms. 2. Describe why ACT-based interventions may be well-suited for smokers with SAD and identify at least one possible intervention target for smokers withSAD. 3. Describe how smokers with bipolar disorder implement ACT processes as part of a targeted treatment for smoking cessation.

 

23. Beyond the couch: Functional contextual applications for community mental health and behavior change
Symposium (2:45-4:15pm)
Components: Original data, Didactic presentation
Categories: Prevention and Community-Based Interventions, Clin. Interven. & Interests, HIV, Stigma, Refugees, Mindfulness, IPA
Target Audience: Beg., Interm.
Location: St. Helens

Chair: Daniel S. Steinberg, M.A., University of North Texas
Discussant: Anthony Biglan, Ph.D., Oregon Research Institute

Community public health is increasingly becoming an area of focus for psychologists. Rather than being concerned exclusively with the care of the individual, psychologists in the 21st century might work to assist communities to facilitate community decision-making and to assess the well-being of community members (Biglan and Smolkowski, 2002). To this end, psychological studies have been examining community issues, with a focus on community-wide issues and integration of interventions at the community-level. Three papers will be presented, each with qualitative data addressing a relevant community-level issue. The first is a study on stigma in younger men with HIV in an area with an active PrEP program, the second examines the physical and mental health benefits of community gardening in a refugee population, and the third explores mindfulness in public health interventions broadly, with a specific example of using mindfulness to increase antiretroviral adherence in adolescents living with HIV.

• The Changing Context of Stigma for Gay Men Living with HIV: Preliminary Findings
Matthew D. Skinta, Ph.D., ABPP, Palo Alto University
Benjamin Brandrett, University of California
Erin Margolis, Palo Alto University

Stigma has been a target of great importance in the field of HIV treatment and prevention, as it creates barriers to testing, regular medical contact, and adherence to anti-retroviral therapy regimens. Historically, stigma, shame, and fear of seroconversion have also created a de facto divide within sexual minority mens’ communities. This presentation will focus on ongoing data collection exploring the experience of young gay men (<40 years old) living with HIV in an urban area that has had one of the longest roll-outs of pre-exposure prophylaxis. Utilizing interpretive phenomenological analysis (IPA), a qualitative method that emphasizes the experience and behaviors of individuals grounded within a particular context, we will share preliminary themes in these men’s experiences. Discussion will also focus on the similarities between IPA and functional analysis in extrapolating important areas to consider in clinical and public health work.

• “As the seeds grow, so our minds grow too”: Mindfulness and cultural connections in community gardening among Bhutanese refugees
Monica M. Gerber, M.S., University of North Texas
Danielle N. Moyer, M.S., University of North Texas
Jennifer L. Callahan, Ph.D., ABPP, University of North Texas

Since 2008, almost 85,000 Nepali Bhutanese refugees have been resettled in the United States (Refugee Processing Center, 2015). Many refugees struggle to adapt to new lifestyles, economy, language, and social structures (APA, 2010; Pumariega, 2005). Unfortunately, mental health providers, typically operating from a Western perspective, have found it difficult to address the needs of this population (APA, 2010). In response to this challenge, refugee resettlement agencies throughout the country use community gardens to promote psychological healing, self-sufficiency, community engagement, and a return of human dignity. Nepali Bhutanese culture, typically communal in nature, strongly emphasizes the present moment and family functionality over individual experience (APA, 2010; Dutton, 2011). This paper will present data from an exploratory mixed methods study on community garden among Bhutanese refugees. Quantitative results will be briefly discussed, while qualitative themes of mindfulness and connection to cultural roots will be provided in depth.

• Integrating mindfulness based approaches to public health interventions: Looking at the methodological and practical issues
Stephanie V. Caldas, M.S., Johns Hopkins Bloomberg School of Public Health
Julie A. Denison, MHA, Ph.D., Johns Hopkins Bloomberg School of Public Health

Mindfulness-based strategies have gained popularity in the last few decades in clinical settings, and research has generated a rigorous body of empirical evidence to support its effectiveness at the individual level. This research shows the potential impact of mindfulness-based interventions on multiple health and behavioral outcomes in different settings, including schools and the community (Smout et al., 2008). However, there is a dearth of research that investigates the integration of mindfulness-based techniques as part of larger public health interventions. Research is needed to address the particular methodological and practical issues involved in the implementation of clinically developed techniques by community health workers. This paper will use a case of increasing ART adherence in adolescents living with HIV as a framework to discuss and understand these issues. Particularly, the challenges of interdisciplinary collaboration between clinical psychology and public health will be discussed.

Educational Objectives:
1. Analyze the impact of community context on HIV-related health and wellness. 2. Describe the facilitators and challenges of integrating mindfulness into community based public health interventions. 3. Describe observed benefits of community gardening in a refugee population, while highlighting the importance of community consultation and flexibility in program development and research with diverse populations.

 

25. Examining the Intersections: Stigma, Culture, and Minority Status from a Contextual Behavioral Science Perspective: Diversity Committee Sponsored
Symposium (2:45-4:15pm)
Components: Conceptual analysis, Literature review, Original data, Didactic presentation
Categories: Functional contextual approaches in related disciplines, Clin. Interven. & Interests, Prevention & Comm.-Based, Superv., Train. & Dissem., Prof. Dev., Theory & Philo., Psychological flexibility, Minority Stress Theory, HIV/AIDS, ACT, Sexual Minority Women, Immigrants
Target Audience: Beg., Interm.
Location: Cascade 1B

Chair: Kayla N. Sargent, M.A., Georgia State University
Discussant: Khashayar F. Langroudi, M.A., ASPP at Argosy San Francisco

Minority group members experience psychological distress and diagnostic disorders at disproportionately high levels relative to the general population (Syymanski & Stewart, 2010). Minority statuses themselves reflect social categories that are applied to groups of people based upon social differences such as sex, race, ethnicity, health (e.g. HIV/AIDS status), religion, size, ability, sexual orientation, expression of gender, and immigrant status. It is theorized that minority status itself is an incomplete and indirect predictor of heath disparities (Meyer, 2003). Instead, psychological and health disparities observed in marginalized communities result from well-learned verbal and sociocultural processes (Masuda et al., 2012), impacting those with HIV positive (Gonzalez et al., 2009), sexual minority (Yadavia & Hayes, 2012), and diverse ethnic statuses (Pascoe & Richman, 2009). This symposium seeks to highlight research that examines the direct predictors of minority outcomes, such as self-concealment, acculturation, and social support as well as offer a contextual behavioral framework for influencing adaptive changes both within these communities and in their broader cultural contexts.

• Examining Psychological Flexibility and Minority Stress in Sexual Minority Women
Kayla N. Sargent, M.A., Georgia State University
Akihiko Masuda, Ph.D., Georgia State University

Sexual minority women have unique experiences relative to majority populations (Selvidge, Matthews, & Bridges, 2008), and they are traditionally understudied and underserviced in our scientific and social communities. According to Minority Stress Theory (Meyer, 1995; Meyer, 2003), holding minority identities leads to sociocultural contexts in which experiences of prejudice, internalized sexism and heterosexism, as well as self-concealment. Psychological flexibility models have been used as a framework for predicting and influencing these contexts. Our sample of female college students (n=1555) demonstrates that self-reported lesbian or bisexual minority status (p < .001), but not ethnic minority status (p = .993), psychological distress (p < .001), and self-concealment (p < .001) predicted higher levels of psychological inflexibility, whereas mindfulness predicted less inflexibility (r2 = .51, p < .001). Application of these findings within a psychological flexibility framework will be discussed.

• The Perceived Social Support and Immigrants’ Acculturation Dynamics: The Impact of Support from Ethnic vs. the Wider Community
George Gharibian, Ph.D., Institute for Multicultural Counseling and Education Services

Factors impacting Immigrants’ acculturation dynamics and in turn the stress related to poor acculturation have been explored and examined in numerous research studies. One of these factors includes the immigrants’ perceived social support in the host country. Social support can be perceived from either immigrants’ ethnic community or support from the wider community. However, there are very limited studies that explore the differences between these two types of social supports. This research examines the acculturation dynamics of a group of first generation immigrants in the US and their perceived social support either from one’s ethnic or the wider community. This study hypothesizes that the perceived social support from the wider community have a stronger impact on better acculturation than the perceived support from one’s ethnic community. A bi-dimensional acculturation theory is considered in this study in which four acculturation categories of integration, assimilation, separation, and marginalization are identified. Additionally, analyses are made on acculturation dynamics and factors such as cultural background, the age at the time of immigration, education, marital status, income, physical or mental health concerns. In conclusion, the results of the findings are discussed and recommendations have been made.

• Using ACT to address HIV Stigma and promote Collective Empowerment in Ethnoracial Communities
Kenneth Fung, MD, University of Toronto
Josephine Wong, Ph.D., University of Toronto

Ethnoracial minorities often face discrimination at an interpersonal level and systemic level. These challenges are compounded when they have HIV/AIDS, where homophobia, sexism, racism, and xenophobia lead to intersecting marginalization. We will report on The Community Champions HIV/AIDS Advocates Mobilization Project, a community-based research, which evaluated ACT and Social Justice Capacity Building (SJCB) to decrease HIV/AIDS stigma among People Living with HIV (PLHIV) and Community Leaders (CL) from ethnoracial communities. A total of 35 PLHIV and 31 CL completed the interventions. Pre, post, and 9-month post-intervention quantitative data indicated that HIV stigma was reduced. Our qualitative data showed that experiential activities enhanced stigma reduction and collective empowerment by increasing their understanding of unique and common experiences of marginalization; promoting empathy and compassion for self and others; and inspiring hope and commitment for change. Finally, we will report on the project’s impact, including spin-off participant-driven initiatives and related research studies.

Educational Objectives:
1. Examine a framework for predicting and influencing minority stress related outcomes (e.g., stigma, self-concealment) in sexual minority women. 2. Describe the use of ACT related strategies to address HIV/AIDS stigma and promote collective empowerment in ethnoracial communities. 3. Describe the impact of the perceived social support of one's ethnic community in compared to the wider community on the acculturation dynamics of first generation US immigrants.

 

27. How to implement case study in the era of evidence-based practice in psychology (EBPP): Some new methods of measuring, graphing, and analyzing: Japan Chapter Sponsored
Symposium (2:45-4:15pm)
Components: Original data, Case presentation
Categories: Clinical Interventions and Interests, Superv., Train. & Dissem., Prof. Dev., EBPP
Target Audience: Beg.
Location: Elliott Bay

Chair: Takashi Muto, Ph.D., Doshisha University
Discussant: Steven C. Hayes, Ph.D., University of Nevada, Reno

As you know, evidence-based practice in psychology (EBPP) is the integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences. And the purpose of EBPP is to promote effective psychological practice and enhance public health by applying empirically supported principles of psychological assessment, case formulation, therapeutic relationship, and intervention (APA, 2006). The purpose of this symposium is to promote implementation of evidence-based psychological PRACTICES in ACBS, through showing some new contrivance of measuring, graphing, and analyzing OUR real therapy-processes. This symposium has three parts as below: 1) Measuring the therapy processes with HIGH-TECH and LOW-COST devices, for example, a small-and-easy-operating activity meter, GPS logger, and action-camera, 2) making graph of your data, in particular, making CUMULATIVE graph, and 3) analyzing and evaluating your single-case data with STATISTICAL tools. Moreover, Dr. Steven Hayes will discuss the above JAPAN-WAY.

• Measuring clients' daily behavior with some high-tech devices
Kohei Hashimoto, B.A., Doshisha University

True behavioral therapists are eager to collect data on client’s BEHAVIOR in order to conduct precise pre-treatment assessments and evaluate the running treatment. We introduce three high-tech devices which enable many therapists to measure client’s behavior. (1) Active Pro HJA-750c (Omron Corporation) is a triaxial accelerometer which can measure various kinds of physical activity data. Firstly, we’ll explain what does physical activity means. Next we’ll show how to use this device and what we can measure with this device. (2) Super Trackstick (Telespial Systems) is a GPS logger: We can grasp client’s range of lives. We’ll show how to use this device and visualize the client’s real data. (3) Kodak PIXPRO SP360 (Eastman Kodak Company) is a potable camera which can be used as session recorder. We’ll propose that this recorder be the less stimulative device. We’ll show the real image and explain how to process the movie.

• Why do we make cumulative-graph of clients’ longitudinal data?
Asako Sakano, M.A., Doshisha University

The modern clinician is accountable for an improvement of clients to various people. As its method, we suggest creating and showing cumulative-graph of clients’ longitudinal data. Our presentation contains the following four topics. (1) What is the cumulative record?; we will briefly explain about its definition, required element, and history. (2) How to make a cumulative record; we will show the procedure of creating it using client’s real data of physical activity. (3) Strengths of the cumulative record; we will explain that the cumulative record make it easy for many people to capture the change of clients over time visually and intuitively. In this topic, we will compare a line graph of measured values and that of accumulated value. (4) Application of the cumulative record; we will show a new kind of cumulative record which includes an element of behavioral variation using client’s real data of valued action.

• Statistical analysis of single-case data: Useful tools for clinical activities
Naoki Manpuku, B.A., Doshisha University

Compared to group-designs, it’s likely that you are less familiar with statistical methods for single-case designs. This works as barrier to analyzing outcomes of your clinical activities. However, a lot of statistical analysis for single-case designs is proposed and we can use them more easily. We suggest how to use these statistical tools and what kinds of data are appropriate to make use of them. Our presentation consists of three following topics. (1) How to analyze client’s responses from questionnaire; this is commonly used in clinical settings and we will introduce a statistical method for it. (2) Examining cumulative records; this makes it easy to understand the change of clients over time and we will explain about a statistical tool of cumulative data. (3) Introducing a new index; statistical analysis for practical settings is developed and we will show a recent index of single-case research.

Educational Objectives:
1. Measure the date of therapy-process in clinical setting. 2. Design the cumulative graph of your data of therapy-process in clinical setting. 3. Evaluate your data of therapy-process in clinical setting with statistical analysis.

 

28. Expanding the reach of contextual behavioral science to older adult populations: Washington Chapter Sponsored
Symposium (2:45-4:15pm)
Components: Conceptual analysis, Original data, Didactic presentation
Categories: Clinical Interventions and Interests, Beh. med., Older adults, gerontology
Target Audience: Beg., Interm.
Location: Puget Sound

Chair: Susan M. McCurry, Ph.D., University of Washington, School of Nursing, Seattle, WA
Discussant: Helen Bolderston, Ph.D., Bournemouth University, Bournemouth, Dorset, England

Globally, the number of individuals 60 years and older is expected to more than double by 2050. The U.N. International Plan of Action on Ageing (MIPAA) focuses on three priority areas: older persons and development; advancing health and well-being into old age; and ensuring enabling and supportive environments. This symposium presents three culturally diverse lines of research relevant to these priority areas and the contextual behavioral science community. Dr. Gillanders from the United Kingdom examines the relationship between psychological flexibility and the gerontological theory of Selection, Optimisation, and Compensation. Dr. McGowan presents data on an ACT-informed variation of CBT for insomnia that has been piloted with U.S. veterans with a variety of medical morbidities. Ms. Souza presents data from a Seattle-based participatory research study examining contextual challenges identifying and serving homeless older adults with cognitive impairment. Combined, the papers illustrate the complexity of serving this diverse and growing clinical population.

• Psychological flexibility in an aging population: Exploring the impact of age on psychological flexibility, the use of selection, optimisation and compensation strategies, and their relationship with living well
Dr. Victoria Thomson, Mental Health Older Adult Service, NHS Borders, Melburn Lodge, Borders General Hospital, Melrose, UK
Dr. Paul Graham Morris, Clinical Psychology, School of Health in Social Science, University of Edinburgh
Dr. April Quigley, Mental Health Older Adult Service, NHS Borders, Melburn Lodge, Borders General Hospital, Melrose, UK
Dr. David Gillanders, Clinical Psychology, School of Health in Social Science, University of Edinburgh

Background: Gerontological theories have been useful in adapting second wave CBT for working with older people, yet there have been few investigations of the relationships between constructs of the psychological flexibility model, constructs from gerontology, such as the Selection, Optimisation and Compensation (SOC) model and indices of wellbeing in older people. Method: A community sample of 203 people, aged 55 to 98 years, completed measures of psychological flexibility, SOC, wellbeing and distress. Correlation, multiple regression, and conditional process modelling was used to analyse the data. Results: A range of theoretically predicted relationships support the potential of the ACT model in older people, and also suggest a coherent integration between psychological flexibility and selection optimisation compensation theory. Discussion: Change and adaptation in older people can readily be conceptualised through a contextual behavioural science approach in ways that support and enhance current gerontological theory, leading to more developmentally targeted treatment strategies.

• Acceptance and the behavioral changes to treat Insomnia (ABC-I): A novel approach to treating insomnia among older adults
Sarah Kate McGowan, Ph.D., VA Greater Los Angeles Healthcare System
Lavinia Fiorentino, Ph.D., Moores Cancer Center, University of California-San Diego, San Diego, CA, USA
Najwa Culver, Ph.D., VA Greater Los Angeles Healthcare System
Morgan Kay, Ph.D., VA Greater Los Angeles Healthcare System
Jennifer L. Martin, Ph.D., VA Greater Los Angeles Healthcare System and David Geffen School of Medicine, UCLA

Insomnia is a common and often severe problem, especially among individuals with complex medical and psychiatric conditions. Cognitive behavioral therapy for insomnia (CBT-I) is an effective treatment; however, adherence to treatment recommendations is challenging, particularly among those with comorbidities. Interventions that enhance adherence and retention in insomnia therapies are needed. Acceptance and the Behavioral Changes to Treat Insomnia (ABC-I) is a novel treatment that incorporates elements of Acceptance and Commitment Therapy (ACT; Values, Committed Action, Acceptance, Mindfulness, Cognitive Defusion, Self as Context) with the behavioral interventions of CBT-I (Sleep Education, Sleep Restriction, Stimulus Control). In two pilot trials of ABC-I with older Veterans, one among women Veterans (N=4; age M=56.4years) and the other among male Veteran s (N=3; age M=72.7years), participants demonstrated significant improvements from pre- to post-treatment in the therapeutic direction on sleep outcomes. These results suggest the need for further research examining ABC-I as an alternative to CBT-I in older adults with insomnia disorder.

• Creating nurturing environments for homeless older adults with cognitive impairment: An exploration of barriers and opportunities
Anita Souza, Ph.D., University of Washington, School of Nursing, Seattle, WA, USA
Susan M. McCurry, Ph.D., University of Washington, School of Nursing, Seattle, WA, USA
Francesca Martin, Ph.D., Compass Housing Alliance, Seattle, WA
Robert M. Bowery, M.A., Compass Housing Alliance, Seattle, WA

Background: The number of older adults with cognitive impairment experiencing homelessness is rapidly increasing in urban communities. Creating environments attuned to both past influences and present needs of these individuals is complex for housing providers, social service agencies, and health professionals. Method: A community-based participatory process was utilized to develop and validate a semi-structured interview conducted with 10 homeless service providers in Seattle, WA. Points of service included shelters, transitional housing units, hygiene centers, and day programs. Interviews were recorded, coded, and analyzed for thematic content utilizing Dedoose. Results: The paper will present data on variables identified by service providers that influence organizational capacity to create a nurturing environment that supports the wellbeing of this population. Discussion: Creating nurturing environments for older homeless adults with cognitive impairment begins with cultural change amongst service providers and health care professionals. Functional contextualism provides a framework to begin examining and addressing these challenges.

Educational Objectives:
1. Assess how ACT can be integrated with Gerontological theory in theoretically coherent and clinically practical ways. 2. Assess the components of ABC-I and its application with older individuals. 3. Describe the challenges of developing nurturing environments for older homeless adults with cognitive impairment.

 

33. Exploring Psychological Flexibility Repertoires with the Implicit Relational Assessment Procedure
Symposium (4:30-5:45pm)
Components: Conceptual analysis, Original data
Categories: Clinical Interventions and Interests, Theory & Philo., IRAP
Target Audience: Beg., Interm., Adv.
Location: Vashon 1

Chair: Travis Sain, Southern Illinois University
Discussant: Dermot Barnes-Holmes, Ghent University, Belgium

Acceptance and Commitment Therapy (ACT) and the Implicit Relational Assessment Procedure (IRAP) bear conceptual roots in the same theory of human cognition and behavior – Relational Frame Theory (RFT). In spite of this commonality, conceptual and empirical works specific to each currently have little in common. This symposium contains a collection of studies that may be viewed in one of at least two ways – as studies of ACT components involving measurement of relational repertoires, or as IRAP studies exploring possible avenues into clinically relevant behavior. These studies examine idiographic, “orthogonal”, and otherwise unconventional approaches to IRAP stimulus selection, and also use the IRAP both as an independent variable as well as a measure of dependent variables. We offer this symposium in the hopes of refining our future research, promoting research innovations and activities in other labs, and sparking debate about the reticulated model of contextual behavioral science.

• Me-Flexible, Me-Not-So-Flexible: A Preliminary Investigation of a Psychological Flexibility IRAP
Ryan Kimball, Southern Illinois University
Anke Lehnert, M.A., Southern Illinois University
Chad E. Drake, Ph.D., Southern Illinois University

Recent research has demonstrated the potential to measure experiential avoidance using the IRAP (Hooper, Villatte, Neofotistou, & McHugh, 2010; Drake, Timko, & Luoma, under review). The current study was designed to address some methodological limitations of existing studies, to broaden the scope beyond experiential avoidance, and to explore innovations in IRAP stimulus selection. 106 college students initially completed questionnaires designed to acquire specific information regarding their personal values and coping strategies which would serve as the IRAP stimuli. This idiographic approach was hypothesized to improve IRAP psychometrics for reliability and validity. Results revealed a combination of flexible and inflexible biases, as well as some support for convergent validity with self-reports, including a replication of counter-intuitive effects reported by Drake, et al. (under review). Future work in this area may benefit from further refinements of methodology as well as careful consideration of the expected relationship between psychological flexibility and IRAP performance.

• Get Out of Your Mind and Into the IRAP: Testing the Effectiveness of the IRAP as a Defusion Intervention
Travis Sain, M.A., Southern Illinois University
Samuel Kramer, M.A., Southern Illinois University
Chad E. Drake, Ph.D., Southern Illinois University

Previous research with the Implicit Relational Assessment Procedure (IRAP) has demonstrated the IRAP’s sensitivity to changes in psychological distress produced by defusion exercises (e.g., Kishita, Muto, Ohtsuki, & Barnes-Holmes, 2014). No known study has examined the IRAP’s potential as a defusion intervention itself, which could generate a program of research on the effectiveness of defusion activities, similar to that of Masuda, Hayes, Sackett, and Twohig (2004) with the Milk exercise. Two experiments utilized the IRAP as a defusion assessment instrument and intervention by altering IRAP stimuli, with the first assessing biases toward Abraham Lincoln and Adolf Hitler (N = 120), and the second assessing biases toward known individuals selected idiographically by participants (N = 150). Results revealed tentative evidence for changes from pre to post-assessment, and a number of possible confounds may provide suggestions for future studies with this paradigm while raising conceptual issues about the nature of the IRAP.

• Not all Trial-Types Are Created Equal: Investigating an Orthogonal Approach to Stimulus Arrangement with a Racial Attitudes Implicit Relational Assessment Procedure
Kail Seymour, M.S., BCBA, Southern Illinois University
Travis Sain, M.A., Southern Illinois University
Chad E. Drake, Ph.D., Southern Illinois University

The Implicit Relational Assessment Procedure (IRAP) proved useful for investigating implicit attitudes, including those for racial evaluations (Barnes-Holmes, Murphy, Barnes-Holmes, & Stewart, 2010; Drake et al., 2015). Many IRAP stimulus presentation permutations remain unexamined, including some potentially relevant to social and/or clinical concerns. In this study, racial categories (i.e., Black people; White people) and evaluative words (e.g., smart, stupid) were paired using standard IRAP (SIRAP), as well as an “orthogonal” (OIRAP), configurations. While both contained “White people-positive evaluation” and “Black people-negative evaluation” trials, the OIRAP presented previously unexplored trial-types: “Black people-White people” and “positive evaluation-negative evaluation”. . Self-report measures were also administered. Psychology research pool participants (n = 158) were quasi-randomly assigned to one of four condition orders. The SIRAP primed stereotypical race attitudes in subsequent OIRAP trials; bias decreased in SIRAP trials following OIRAP trials. These differences and other findings will be discussed along with future potential research directions.

Educational Objectives:
1. Describe the counter-intuitive results revealed for validity in this study. 2. Describe the IRAP stimulus selection strategy embraced for the defusion conditions in these studies. 3. Describe the four trial-types of an orthogonal IRAP containing stimuli for racial categories and evaluative words.

 

39. Challenges in the application of ACT in clinical psychiatric settings: Empirical data and clinical experiences: Psychosis SIG Sponsored
Symposium (4:30-5:45pm)
Components: Original data, Didactic presentation
Categories: Clinical Interventions and Interests, Superv., Train. & Dissem., Psychosis, body dysmorphic disorder, autism
Target Audience: Beg.
Location: Puget Sound

Chair: Andreas Larsson, Ph.D., Karolinska Institutet, Department of Clinical Neuroscience & Centre for Psychiatry Research and Education
Discussant: Roger Vilardaga, Ph.D., University of Washington

Conducting research in clinical psychiatric settings presents significant challenges. Patients’ suffering is often severe, and organizational aspects might hinder the implementation of structured psychological treatment. In this symposium, empirical data are presented from three different projects concerning ACT for different diagnoses – psychosis, body dysmorphic disorder (BDD) and high functioning autism spectrum disorder (ASD). The first talk concerns training inpatient ward staff in using the ACT model with psychosis patients. Data suggest slight positive changes in psychological flexibility for patients and staff. The second talk describes the evaluation of an ACT group treatment intervention for BDD outpatients, with results showing significant reductions in BDD symptomatology. The third talk covers a research project on ACT adapted for students and psychiatric outpatients with ASD, where data indicate reduced levels of stress and autistic core symptoms. Presenters will share their data, as well as common clinical experiences of implementing ACT in clinical psychiatric contexts.

• Implementation of ACT training in a psychiatric ward: Clinical experiences and staff-patient outcomes
Mårten Tyrberg, M.Sc., Ph.D. student, Stockholm University; Västmanlands Hospital, Västerås, Sweden
Per Carlbring, Department of Psychology, Stockholm University
Tobias Lundgren, Ph.D., Karolinska Institutet and Department of Psychology, Stockholm University

Psychiatric ward staff members report low job satisfaction, and suffer from burnout to a higher degree compared to other fields. Furthermore, reports from both patients and staff indicate institutional aimlessness and lack of care content beyond medication and containment. Attempts at implementing various psychosocial interventions based on cognitive behavior therapy (CBT) have shown promise, but little systematic outcome data has been presented. This pilot study investigated the feasibility and effects of a 12-hour training in acceptance and commitment therapy (ACT), a CBT based psychotherapy model, on staff (n=20) and patients (n=9). The context was a psychiatric inpatient ward specializing in psychosis. The staff members of a neighboring unit acted as non-randomized controls. Mean difference scores suggest slight positive changes in psychological flexibility for patients and staff post-intervention. Results are discussed in light of methodological and institutional limitations, and clinical experiences.

• Acceptance and commitment therapy (ACT) and high-functioning autism spectrum disorder (ASD): A functional contextual approach to conceptualize and treat associated symptoms
Johan Pahnke, M.Sc., Ph.D. student, Karolinska Institutet, Department of Clinical Neuroscience & Centre for Psychiatry Research and Education
Johan Bjureberg, M.Sc., CPF, Karolinska Institutet
Timo Hursti, Department of Psychology, Uppsala University
Sven Bölte, KIND (Center for Neurodevelopment Disorders at Karolinska Institutet), Stockholm City Council
Tatja Hirvikoski, Ph.D., KIND (Center for Neurodevelopment Disorders at Karolinska Institutet), Stockholm City Council
Benjamin Bohman, Ph.D., Karolinska Institutet, Dept. of Clinical Neuroscience & Centre for Psychiatry Research and Education
Gerhard Andersson, Linköping University and Karolinska Institutet
Tobias Lundgren, Ph.D., Karolinska Institutet, Dept.of Clinical Neuroscience & Centre for Psychiatry Research and Education

Autism spectrum disorder (ASD) is a neurodevelopmental disorder associated with depression, anxiety and stress, and decreased quality of life. ACT processes target core difficulties in ASD, such as psychological inflexibility, although not yet evaluated for this population. Study 1: Using a quasi-experimental design we evaluated an adapted ACT-protocol for 28 students with ASD (aged 13–21). Levels of stress, hyperactivity, and emotional distress were significantly reduced and pro-social behavior was increased. Study 2: Using an open trial design the ACT treatment was evaluated for adults (n=10; age range 25-65 years) in an outpatient psychiatric context. Levels of stress were significantly reduced and quality of life increased. Study 3: Using an RCT design we evaluated the ACT treatment for 40 adults with ASD in an outpatient psychiatric context. Preliminary data showed significantly reduced stress and psychiatric symptoms, and increased psychological flexibility and quality of life. Autistic core symptoms were also reduced.

Educational Objectives:
1. Discuss ways of handling organizational challenges in implementation of psychological treatments. 2. Describe common obstacles in conducting clinical research in psychiatric settings. 3. Compare different diagnostic groups and identify similarities in treatment interventions.

 

Friday, June 17

45. Helping the helpers: ACT interventions for healthcare providers
Symposium (10:30am-Noon)
Components: Original data
Categories: Behavioral medicine, Org. Beh. Management, Workplace interventions
Target Audience: Beg.
Location: Vashon 1

Chair: Dayna Lee-Baggley, Ph.D., QEII Health Sciences Centre
Discussant: Patricia Robinson, Ph.D., Mountainview Consulting Group

Research shows that one third to half of North American and European physicians and nurses experience burnout (Canadian Medical Association, 2003; Hildebrandt, 2013; Medscape, 2016; Solar et al., 2008). In fact, US physicians suffer more burnout than any other American workers (Shanafelt et al., 2012). Despite these rates, physicians and nurses are often the less likely to seek help (e.g., Rosvold & Bjertness, 2002). Acceptance and mindfulness based workplace interventions have been shown to improve employees’ well-being and to decrease burnout (e.g., Lloyd, Bond, & Flaxman, 2013). This symposium highlights interventions based on Acceptance and Commitment Therapy (ACT) being offered to healthcare providers. Presenters will provide information on the nature of their programs, adaptations from other workplace interventions needed for a healthcare setting, and data on effectiveness. As an international expert in ACT in primary care settings, our discussant, Patricia Robinson, will discuss bringing ACT to a population in need of interventions yet often reluctant to seek personal help.

• Professional Resiliency Program for Healthcare Providers
Dayna Lee-Baggley, Ph.D., QEII Health Sciences Centre
Jill Chorney, Ph.D., Dalhousie University

We will present data on an empirically supported workplace program designed to improve the health and well-being of healthcare providers. Our Professional Resiliency Training Program is adapted from an evidence-based workplace program based on Acceptance and Commitment Therapy (ACT), designed to increase employee well-being by learning skills to work with negative feelings, thoughts, and sensations and to move toward valued behaviours (Flaxman, Bond, Livheim, Hayes, 2013). Although the Professional Resiliency Training Program has been demonstrated to be effective across a number of different workplace environments (see Bond, Hayes & Barnes-Holmes, 2006), there is less evidence of its effectiveness in hospital settings. We provide preliminary pre and post data of healthcare providers from a tertiary level hospital in Canada drawn from a larger randomized clinical trial currently in progress. Adaptations to the program made for a healthcare setting will also be discussed.

• Spirited Primary Care: A Brief Intervention for Primary Care Providers
Melissa Baker, Ph.D., HealthPoint
Patricia Robinson, Ph.D., Mountainview Consulting Group

We will provide intervention materials for a 3-session class designed to be acceptable to primary care providers, particularly those that self-identify work stress as a significant problem. Data concerning acceptability and revisions to the curriculum will be provided. Additionally, data on the Primary Care Provider Stress Checklist and the Primary Care Provider Acceptance and Action Questionnaire (Robinson, Gould, Strosahl, 2011) will also be provided. We will also share recommendations about changes to the system of care that are likely to enhance provider resilience.

• Professional Resiliency Training for Pediatric Providers: A Pilot Program
Sarah T Trane, Ph.D., Gundersen Health System
Jennifer Kleven, MD, Gundersen Health System

We will discuss the implementation of a pilot program designed to address physician and nurse practitioner resilience in a large health system. Participants included outpatient primary care and hospital based pediatric specialty providers with a range of years in practice from 1-34 years. Preliminary data using the Maslach Burnout Inventory (MBI; Maslach & Jackson, 1981, Maslach et al. 1996) and the ProQOL (Stamm, 2009) will be presented on our baseline (n=24) and post-intervention samples, noting that practitioners were free to choose to participate voluntarily in the program. There were anywhere from 3-15 practitioners within each group, with modal number attending at about 10 participants. The provider resiliency training program was adapted from an evidence-based workplace program based on Acceptance and Commitment Therapy (ACT; Flaxman, Bond, Livheim & Hayes, 2013) as well as published resilience intervention used with physicians (West, 2012), and designed to increase well-being by learning skills in mindfulness, boundaries, self care and valued actions. The opportunities and challenges within a busy healthcare environment will be discussed as well as ideas to improve overall psychological flexibility of health care providers.

Educational Objectives:
1. Describe the content of ACT program for healthcare providers. 2. Describe adaptations needed in providing ACT to healthcare providers. 3. Review data on the effectiveness of ACT programs for healthcare providers.

 

46. Using Psychological Flexibility to Reach Across the Barriers of Prejudice: Examinations of Obesity, Race, and Sexual Orientation Stigma
Symposium (10:30am-Noon)
Components: Original data
Categories: Clinical Interventions and Interests, ACT, psychological flexibility, stigma, obesity, sexual orientation, gender identity
Target Audience: Beg., Interm., Adv.
Location: Vashon 2

Chair: Regan M. Slater, Ph.D., Pittsburg State University
Discussant: Matthew Skinta, Ph.D., ABPP, Palo Alto University

The effects of stigma can be detrimental, not only to the person who is stigmatized, but also to the person holding the stigmatizing beliefs as it can prevent connection and understanding among people (Byrne, 2001; Masuda, Price, Anderson, Schmertz, & Calamaras, 2013). Psychological flexibility has been examined in relation to stigma in several areas including psychological disorders (Masuda et al., 2007), substance abuse counseling (Hayes et al., 2004), and obesity (Lillis, Hayes, Bunting, & Masuda, 2009). The data-based papers presented in this symposium offer an examination of the impact of psychological flexibility on stigma in three areas: obesity, race, and sexual orientation. This symposium addresses stigma from the perspective of the person being stigmatized, as well as from the stigmatizer. Implications for further application of psychological flexibility in these three areas will be discussed, and future directions in these and similar areas will be offered.

• When Thin Still Isn’t Good Enough: Residual Obesity Stigma and Psychological Flexibility
Emily R. Squyres, M.S., Louisiana Tech University
Lore M. Dickey, Louisiana Tech University

Given that the current ideal body shape is “thin,” it should not be surprising that overweight and obese individuals are stigmatized on a daily basis due to their weight (Puhl & Brownell, 2003). It seems like the only avenue that these individuals have in order to gain public approval is to lose weight. However, research has shown that obesity stigma extends to previously obese individuals who have lost weight and are now considered to be “thin” (Latner, Ebneter, & O’Brien, 2012). In the current study, participants read one of several vignettes about an individual who either: a) had a history of being thin and was currently thin, b) had a history of being obese and was currently thin, c) had a history of being obese and was currently obese, or d) had a history of being obese and was currently very thin. The relationship between residual obesity stigma across various body weights and psychological flexibility will be discussed.

• No Spice, No Rice: Developing a Measure of Sexual Racism
Yash Bhambhani, M.A., University of Mississippi
Maureen K. Flynn, Ph.D., Metropolitan State University of Denver
Kelly G. Wilson, Ph.D., University of Mississippi
Kate Kellum, Ph.D., University of Mississippi

Research on sexual racism is proliferating (Callander, Newman, & Holt, 2015; Han et al., 2015; Rudder, 2009). Researchers have found acceptability of online sexual racism to be linked to a lower multicultural attitude (Callander et al., 2015), and experiencing sexual racism to predict risky sexual behavior (Han et al., 2015). Researchers have studied sexual racism only qualitatively or with a few unstandardized questions. The aim of the present study was to develop a quantitative measure of sexual racism and evaluates its factor structure, reliability and validity. Relationship of sexual racism with psychological flexibility and other constructs were explored. The constructed scale can be useful in both clinical cases, and research contexts that aim to reduce racist attitudes.

• Psychological flexibility as a moderator between Hispanic undergraduates’ attitudes towards LGBTQ individuals and willingness to engage in behaviors that help the LGBTQ community
Maureen K. Flynn, Ph.D., Metropolitan State University of Denver

Although acceptance of LGBTQ individuals is increasing, they continue to experience negative responses from society. LGBTQ individuals can internalize such negative responses, which can lead to psychological difficulties (e.g., Meyer & Dean, 1998; Szymanski, Kashubeck-West, & Meyer, 2008). Interventions targeting psychological flexibility have been shown to decrease stigmatizing attitudes towards substance abusers (Hayes et al., 2004) and people with mental illness (Masuda et al., 2007). Psychological inflexibility is also related to attitudes towards other ethnicities (Levin, Luoma, Lillis, Hayes, & Vilardaga, 2014). The aims of this study were to examine 1) the relationship between psychological flexibility and homophobia and transphobia and 2) whether psychological flexibility moderates the relationship between negative attitudes towards LGBTQ individuals and willingness to engage in behaviors that help the LGBTQ community among Hispanic college students. In the current study, 237 Hispanic undergraduates completed a series of web-based surveys. Results and implications will be discussed.

Educational Objectives:
1. Explore and assess psychological flexibility and residual obesity stigma from the perspective of the stigmatizer. 2. Discuss why studying sexual racism is important and brainstorm strategies/interventions to reduce sexual racism. 3. Discuss and assess whether psychological flexibility is 1) related to homophobia and transphobia and 2) moderates the relationship between negative attitudes towards LGBTQ individuals and willingness to engage in behaviors that help the LGBTQ community.

 

49. Meta-Analysis in Contextual Behavior Science: A Symposium of Synthesis
Symposium (10:30am-Noon)
Components: Conceptual analysis, Literature review
Categories: Clinical Interventions and Interests, Other, Meta-Analysis
Target Audience: Beg., Interm., Adv.
Location: Cascade 1B

Chair: Fredrick Chin, M.A., University of Nevada, Reno
Discussant: Michael E. Levin, Ph.D., Utah State University

Meta-Analysis is a statistical technique used to combine data from several research studies to provide a quantitative review of the literature in a particular field. Meta-analyses use a common metric, or effect size, from several studies to tell a coherent story about the research studies analyzed. The resulting aggregate review provides a broad overview of the research findings within a given field, and play a pivotal role in establishing the overall efficacy of psychotherapy treatments. Though several meta-analyses have evaluated the application of contextual behavioral therapeutic approaches across broad domains (e.g. A-Tjak et al., 2015; Hayes, Luoma, Bond, Masuda, & Lillis, 2006), it is worthwhile to evaluate outcomes within a given functional problem with greater precision and depth. The current symposium plans to provide an in depth analysis of specific, novel areas in contextual behavior science. The topics reviewed will be Acceptance Commitment Therapy for substance use disorders, acceptance/ mindfulness for Type 2 Diabetes, and Functional Analytic Psychotherapy single-subject research.

• An Initial Meta-analysis of ACT for Substance Use Disorders
Eric Lee, M.A., Utah State University
WooLee An, Utah State University

In the past decade, multiple studies have examined the effectiveness of Acceptance and Commitment Therapy (ACT) for substance use disorders relative to other active treatments. The current meta-analysis examined the aggregate effect size when comparing ACT to other treatments (e.g., CBT, pharmacotherapy, 12-step, treatment as usual) specifically on substance use outcomes. A total of 10 randomized controlled trials were identified through systematic searches. A significant small to medium effect size was found favoring ACT relative to active treatment comparisons following treatment. Effect sizes were comparable across studies for smoking cessation (k = 5) and for other drug use disorders (k = 5). Based on these findings, ACT appears to be a promising intervention for substance use disorders. The current state and future directions of ACT for substance use disorders will be discussed.

• Mindfulness and Acceptance for Type 2 Diabetes: A Meta-Analysis
Leah Bogusch, M.A., Bowling Green State University
William H. O'Brien, Ph.D., Bowling Green State University

Among individuals with Type 2 Diabetes Mellitus (T2DM), diabetes-related distress is associated with decreased medication adherence and increases in blood glucose. Mindfulness and acceptance may be associated with reductions in diabetes-related distress and improved health outcomes in this population. The present study provides a quantitative review of 1) all studies utilizing mindfulness or acceptance interventions among individuals with T2DM in order to improve HbA1c, blood glucose, or self-management of blood glucose and 2) all cross-sectional studies examining relationships between mindfulness and acceptance, diabetes-related distress, and HbA1C, blood glucose, or self-management of blood glucose among people with T2DM. A literature search yielded 10 treatment-outcome and 14 cross-sectional studies. Meta-analytic results of mindfulness and acceptance-based interventions revealed a small, but reliable, impact on improving HbA1c and fasting blood glucose in comparison to control groups (d = .1822, CIbootstrap: -0.3364 to -0.0325).

• A Meta-Analytic Review of Functional Analytic Psychotherapy Single-Subject Research
Sonia Singh, M.A., Bowling Green State University
William H. O'Brien, Bowling Green State University

Functional Analytic Psychotherapy (FAP) is a contextual behavior therapy that utilizes basic behavioral principles to implement in-session change with the idea that these changes will generalize to outside-of-session settings. The therapist uses specific techniques designed to reduce problematic in-session behavior (CRB1s) and increase adaptive in-session behavior (CRB2s). A majority of the published studies in FAP are single-subject design. The current study synthesized data from FAP single-subject investigations using single-subject meta-analytic techniques. Percentage of non-overlapping data (PND) was calculated for graphed outcome data. The reliable change index (RCI) was calculated for questionnaire outcome data. Results indicated that cumulative PND for CRB1s was 57.76% and fell in the “moderately effective” range, and for CRB2s was 81.06% and fell in the “fairly effective” range. The overall RCI for was 4.03 which indicates that pre-post changes on questionnaire outcome data are large and statistically reliable.

Educational Objectives:
1. Articulate the synthesis of Acceptance and Commitment Therapy treatment/outcome studies for substance use disorders. 2. Describe acceptance and mindfulness related constructs and interventions within the context of Type 2 diabetes. 3. Demonstrate the quantification of efficacy for Functional Analytic Psychotherapy single-subject design research studies.

 

51. Incorporating ACT-based Interventions into University Classrooms: University Student Mental Health SIG Sponsored
Symposium (10:30am-Noon)
Components: Conceptual analysis, Literature review, Original data
Categories: Educational settings, Prevention & Comm.-Based, Depression, Anxiety
Target Audience: Beg., Interm.
Location: Cascade 2

Chair: Wanda L. Smith, Ph.D., McMaster University, Private Practice
Discussant: Jaqueline Pistorello, Ph.D., University of Nevada, Reno

As college educators, we want our students to live rich and meaningful lives. We want to expand our Reach of the foundational life skills needed to live such lives. This symposium focuses on the use of well-designed ACT-based interventions in university classrooms to enhance the psychological flexibility of students. This symposium contributes by describing an introduction level course that uses ACT-based personal goal setting, evaluating a university course aimed at promoting student psychological flexibility and describes a the effects of a brief versus an extended ACT intervention in a university classroom. Collectively, we offer different perspectives and approaches for incorporating ACT-based interventions into university classrooms. This symposium addresses implications for educators as they implement interventions for improving psychological flexibility. The discussion will attempt to integrate findings and suggest future directions.

• How to Give ACT Away 1.5 million People at a Time
Cody Christopherson, Ph.D., Southern Oregon University

Approximately 1.5 million US students enroll in an introduction to psychology course every year (Cush, & Buskist, 1997) and introduction to psychology is the second most popular college course in the US (National Center for Education Statistics, 2004). Most student will start and end their formal contact with scientific psychology with this course. Therefore, this is the single greatest direct contact that Psychologists will ever have with the general public who do not seek therapy and a prime opportunity for introducing contextual behavioral science and ACT broadly. In this presentation, I will demonstrate an incorporation of ACT into the applied component of the Introduction to Psychology curriculum. Specific components of ACT include contact with the present moment, values identification/clarification, and committed action. ACT activities can be easily adapted & incorporated into units on Psychopathology, Psychotherapy, Motivation & Emotion, Industrial & Organizational Psychology, or Health Psychology.

• Using ACT as a Tool to Holistically Prepare College Students
Anna Whitehall, M.A., Washington State Unviersity
Denise Yost, Ph.D., Washington State University
Laura Hill, Ph.D., Washington State Unversity

College is a time and place to holistically prepare emerging adults to be successful contributors to society in both discipline and life skills. Human Development (HD) 205 is an undergraduate communication and life skills course that focuses on developing students’ abilities to foster successful personal and professional relationships using psychological flexibility and values-based decision-making. Over the course of six semesters, we measured psychological flexibility in over 1,800 HD205 students using the Acceptance and Action Questionnaire. Paired pre- and post-semester participation surveys show small increases in psychological flexibility with trivial to small effect sizes of 0.03 (p = .53) to 0.12 (p = .03) in three of six semesters. Semesters with decreased psychological flexibility scores coincided with significant changes in course delivery methods, likely accounting for some of the observed variability among semesters, an area for future research. In additional to within-semester changes, changes in psychological flexibility from beginning-to-end of semester predict higher GPA 3 years later.

• Comparison of brief versus extended Acceptance and Commitment Therapy exercises introduced in a university classroom
Sarah Kupferschmidt, M.A., McMaster University and Mohawk College
Heather Poole, Ph.D., McMaster University
Wanda L. Smith, Ph.D., McMaster University and Private Practice

University students are increasingly suffering from anxiety and stress (Twenge et al, 2010). ACT has been shown to decrease stress and anxiety even when presented as a brief intervention in groups (Zettle & Rains, 1989; Bach & Hayes, 2002). We compared the effects of ACT on university students when training exercises were infused into two university classrooms on different schedules; one class received the training over 10 sessions (distributed training), the other class had the exercises compressed into two sessions at the end of the term (massed training). Students were assessed on various stress and ACT-relevant measures on the first and last days of class. Over the course of the semester, test anxiety decreased in both groups and Five-Facet Mindfulness Questionnaire – Observing subscale scores increased. Perceived Stress increased in students receiving massed ACT training, but remained stable in the distributed ACT training. Student feedback on the ACT activities was overwhelmingly positive. These results support ACT as a promising method for reducing student stress; different delivery schedules will be discussed.

Educational Objectives:
1. Prepare to seamlessly incorporate elements of ACT into an Introductory Psychology curriculum. 2. Demonstrate potential public health effects of incorporating ACT into a classroom setting. 3. Describe and compare the effects/impact of a brief and an extended ACT intervention in a university classroom.

 

53. Working Together: How Clinicians, Trainers, and Language Researchers can Increase the Reach of Psychosocial Interventions in an Era of Integrated Care
Symposium (10:30am-Noon)
Components: Conceptual analysis, Original data, Didactic presentation
Categories: Supervision, Training and Dissemination, Clin. Interven. & Interests, RFT, Other, Integrated Care
Target Audience: , Interm.
Location: Puget Sound

Chair: Douglas M. Long, Ph.D., Alpert Medical School of Brown University
Discussant: Kirk Strosahl, Ph.D., Mountainview Consulting Group

As psychosocial interventions are implemented in primary care settings, clinician skills can inform innovations in training and assessment methods that improve care efficiency and quality. This symposium will begin with process and outcome data from a four-week Focused Acceptance and Commitment Therapy (FACT) group implemented as part of routine clinical care in a Veterans Affairs integrated primary care setting (N = 51). A study will then be presented that investigated clinician perspectives on efforts to expand reach and efficiency through trainer-led and self-paced online trainings in Behavioral Activation (BA) that demonstrated differential improvements in skill (N = 80). Finally, data from a new method of training outcome assessment called Therapist Agreement with Sensitivity to Context (TASC) will be shared in demonstration how of a research strategy informed by Relational Frame Theory (RFT) can empower experiential trainings that influence how therapists “see” and “hear” their clients (N=398).

• The Efficacy of Focused Acceptance and Commitment Therapy Group Psychotherapy in a Veterans Affairs Integrated Primary Care Setting
Natalie G. Glover, Ph.D., VA Puget Sound Health Care System
Patrick D. Sylvers, Ph.D., VA Puget Sound Health Care System; University of Washington, Department of Psychiatry and Behavioral Sciences
Erika M. Shearer, Ph.D., VA Puget Sound Health Care System
Mary-Catherine Kane, Ph.D., VA Puget Sound Health Care System
Peter C. Clasen, Ph.D., University of Washington, Department of Psychiatry and Behavioral Sciences
Amee J. Epler, Ph.D., VA Puget Sound Health Care System
Jennifer C. Plumb-Vilardaga, Ph.D., VA Puget Sound Health Care System
Jordan T. Bonow, Ph.D., VA Sierra Nevada Health Care System
Matthew Jakupcak, Ph.D., VA Puget Sound Health Care System; University of Washington, Department of Psychiatry and Behavioral Sciences

Focused Acceptance and Commitment Therapy (FACT) is an abridged version of ACT, a trans-diagnostic approach to psychotherapy that views psychological rigidity as a ubiquitous phenomenon underlying psychopathology and behavioral problems. While there is a growing body of research on the efficacy of FACT for a variety of populations and disorders, there is little research to date on the efficacy of FACT when delivered in the group therapy milieu. This presentation will describe outcomes related to changes in psychological flexibility, health and mental health status, and symptom reduction among 51 Veterans who attended a four-week FACT group as part of routine clinical care in a Veterans Affairs integrated primary care setting. This project showcases an efficient and cost-effective treatment strategy that can be implemented in primary care settings to facilitate improvements in mental and physical health as well as overall quality of life.

• What Worked and How to Make it Better: Therapists’ Qualitative Feedback on Self-Paced Versus Trainer-Led Behavioral Activation Online Training
Ajeng J. Puspitasari, Ph.D., Indiana University
Jonathan W. Kanter, Ph.D., University of Washington
Jennifer C. Plumb-Vilardaga, Ph.D., VA Puget Sound Health Care System
Jordan T. Bonow, Ph.D., VA Sierra Nevada Health Care System

Online training is an initial strategy to disseminate evidence-based psychotherapies that allows broader reach and may be cost-effective. Two versions of online Behavioral Activation (BA) training were compared and those receiving trainer-led training showed significantly higher BA skills gain, although both groups showed significant improvements in skills. In the context of this previous trial, trainees (N = 80) who were randomly assigned to either the self-paced or trainer-led BA online training provided qualitative feedback on the specific features and overall quality of the training as well as future recommendations for the trainings. This qualitative study will be a foundation for future BA online trainings that further incorporate users’ perspectives. Results will also be relevant for other evidence-based psychotherapy online training.

• Therapist Agreement with Sensitivity to Context (TASC): Monitoring and Enhancing Clinical Training Outcomes
Douglas M. Long, Ph.D., Alpert Medical School of Brown University
Steven C. Hayes, Ph.D., University of Nevada, Reno

One desirable outcome of clinical training is for therapists to “see” and “hear” their clients in ways that help to create new opportunities for intervention. Therapist Agreement with Sensitivity to Context (TASC) is an assessment method that seeks to track this process as it develops. TASC involves quantitative comparisons between trainer and trainee verbal responses to videos of simulated therapy sessions. This presentation will describe data from a web-based ACT TASC prototype that was distributed to 209 participants in intensive experiential ACT workshops conducted by expert trainers and 189 undergraduates who had no training in ACT. This project illustrates a research design strategy that can be generalized to other therapy models, provides one empirical avenue by which Relational Frame Theory (RFT) can guide model development, and allows for the routine evaluation of training efforts in professional organizations and clinical practice settings.

Educational Objectives:
1. Describe the efficacy of Focused Acceptance and Commitment Therapy in a Veterans Affairs integrated primary care setting. 2. Describe how qualitative feedback from users can inform online training in evidence-based psychotherapy. 3. Describe how Therapist Agreement with Sensitivity to Context (TASC) may provide a clinically relevant method of tracking educational outcomes.

 

56. Conceptual Developments in RFT
Symposium (10:30am-Noon)
Components: Conceptual analysis, Original data
Categories: Relational Frame Theory, RFT, Relational Frame Theory, Learning
Target Audience: Interm., Adv.
Location: Mercer/Denny

Chair: Yvonne Barnes-Holmes, Ghent University
Discussant: Dermot Barnes-Holmes, Ghent University

There are a number of exciting and fundamental conceptual developments of RFT underway. These build firmly upon existing well-supported RFT concepts. The first paper in this symposium lays out the broadest and most fundamental expansion of RFT since the 2001 book. The MDML is a multi-dimensional, multi-level model of the different types of relational response, and the different dimensions along which these interact and can be assessed. The scond paper explores the merits of the concept of environmental regularities as a definition of learning and as a means of carving up learning research. This paper proposes that environmental regularities may unlock new empirical (and conceptual) possibilities for future RFT research. The third paper is empirical and describes three studies that represent the first attempt to systematically manipulate levels of derivation and complexity in an experimental setting. The results demonstrate how these two core concepts interact.

• A multi-dimensional multi-level framework for RFT
Dermot Barnes-Holmes, Ghent University

In a recent chapter (Barnes-Holmes, Barnes-Holmes, Hussey, & Luciano, 2016) we proposed a framework for analyzing the dynamics of arbitrarily applicable relational responding by conceptualizing such behavior in terms of multiple dimensions and multiple levels, and abbreviated the name of the framework, the MDML. The current paper will present an up-dated version of the MDML, the aim of which is to focus on those features of Relational Frame Theory that seem most in need of emphasis as we move forward with the reticulating model of basic and applied science that serves to characterize contextual behavioral science itself.

• Using the Concept of Environmental Regularities to Refine Our Understanding of Learning and Accelerate Research on RFT
Sean Hughes, Ghent University
Jan De Houwer, Ghent University

Although learning is a core concept in psychology, opinions often differ about what it means to say that learning has occurred. In this presentation we revisit and extend the work of De Houwer, Barnes-Holmes, and Moors (2013) who argued that learning can be conceived of as the impact of regularities in the environment on behavior. More specifically, we explore the merits of the concept of environmental regularities not only for the definition of learning but also as a way to carve up the realm of learning research. We will show how this concept can be useful not only in an analysis of learning research that predates the development of Relational Frame Theory (RFT) (i.e., Learning 1.0) but also in an analysis of learning as conceived of from the perspective of RFT (i.e., Learning 2.0). We believe that environmental regularities may unlock new empirical (and conceptual) possibilities for future work on RFT.

• Examining the Impact of Relational Complexity and Levels of Derivation on the Speed and Accuracy of Relational Responding
Sean Hughes, Ghent University

In a recent paper Hughes, Barnes-Holmes, and Vahey (2012) argued that the complexity of a relational response and the degree to which it has been previously derived can vary along continua from low to high. They also argued that these two factors may influence the speed and accuracy (or indeed any other property) of relational responding. The current work represents a first attempt to systematically manipulate levels of derivation and complexity in an experimental setting. In three different studies participants completed a relational training and testing procedure: in each case complexity was held constant within participants while levels of derivation were manipulated between participants. Results demonstrated that the speed with which a relational response was emitted depended not only on its (relational) complexity but also on levels of derivation. As levels of derivation increased the differences in response speed due to complexity decreased. Open questions and potential directions for future research are discussed.

Educational Objectives:
1. Demonstrate how the concept of environmental regularities can be used to improve the definition of learning . 2. Showcase how the concept of environmental regularities can help accelerate the study of Arbitrarily Applicable Relational Responding (AARR). 3. Highlight growing emphasis on relational coherence, complexity, and derivation in RFT. 4. Demonstrate conceptual developments within RFT.

 

61. RFT & Rule Governed Behavior: Conceptual and Empirical Developments
Symposium (2:45-4:15pm)
Components: Literature review, Original data
Categories: Relational Frame Theory, Clinical Interventions and Interests, RFT, Systematic Review, Pliance,Tracking, Augmenting, Pain, RFT, Rules, Valuing
Target Audience: Beg., Interm.
Location: Vashon 1

Chair: Yvonne Barnes-Holmes, Ghent University
Discussant: Jonathan Tarbox, FirstSteps for Kids

Rules are a critical concept in human learning, but have proven hard to define precisely and manipulate experimentally. The first paper in this symposium explores the utility of, and evidence for, the concepts of pliance, tracking, and augmenting. The paper systematically reviews their empirical basis and how each has been operationalized. The conclusions suggest that the data lags far behind theoretical and clinical applications, and the paper offers key directions for future research. The second paper is empirical and presents a study that systematically compares a derived versus instructed rule in a match-to-sample task, to determine the extent to which these might differentially influence resistance to new contingencies. The findings indicate differential effects for rules that are instructed directly versus those that are derived. The third paper, also empirical, presents four studies, again on the insensitivity effect, and explores the potential impact of three variables: pliance vs. tracking; social vs. self-generated; and pain vs. non-pain related consequence). The results suggest differential influences of these variables on insensitivity. The fourth paper, also empirical, examines the impact of derived values functions on behavioral flexibility and contingency insensitivity. The data suggest that insensitivity varies in terms of the salience of derived values functions.

• A Systematic Review of Research on Pliance, Tracking, and Augmenting
Ama Kissi, Ghent University
Sean Hughes, Ghent University
Geert Crombez, Ghent University
Jan De Houwer, Ghent University
Dermot Barnes-Holmes, Ghent University

Three types of rule-governed behavior - pliance, tracking, and augmenting - have enjoyed widespread theoretical and therapeutic appeal within the RFT and ACT literatures. Yet, to the best of our knowledge, the assumptions underpinning, and the distinctions between pliance, tracking, and augmenting seem to be rooted more in theory than in data. With this in mind, we conducted a systematic review to determine whether (a) empirical work corroborates the functional distinction between pliance, tracking, and augmenting, and (b) how each of these classes of rule-governed behavior has so far been operationalized. Our review indicates that the empirical literature currently lags far behind theoretical and clinical applications and that existing work on this topic could be improved in several notable ways. We conclude our talk by identifying what we consider to be key directions for future research in this area.

• The Impact of Derivation on Persistent Rule-following
Colin Harte, Ghent University
Yvonne-Barnes-Holmes, Ghent University
Dermot Barnes-Holmes, Ghent University
Ciara McEnteggart, Ghent University

Almost since its inception, Relational Frame Theory (RFT) has grappled with the impact of rules and instructions on derived relational responding. And yet, few basic experimental studies have investigated this important and complex phenomenon. In the current basic match-to-sample study, participants were given either a direct rule for responding or were required to derive the correct rule via a pre-experimental derivation training task. During the main task, the contingencies for correct responding changed without warning, and a second experimental manipulation varied the number of trials presented prior to the contingency change (i.e., 10 or 100). Our key aims, therefore, were to explore potential differences in terms of direct or derived rule-following and of short vs extended rule-following upon participants’ ability, or resistance, to adjust to the new task contingencies. Preliminary findings show some differences in rule-following across the four conditions and are discussed in terms of the relationship between persistence of rule-following and derivation.

• The Dark-Side of Rule-Governed Behavior: An Empirical Investigation of the Insensitivity Effect
Ama Kissi, Ghent University
Sean Hughes, Ghent University
Jan De Houwer, Ghent University
Geert Crombez, Ghent University

Within the RFT and ACT literatures psychological and health-related problems are often argued to stem from an over adherence to ineffective rules which prohibit contact with other contingencies in the environment (i.e., “the insensitivity effect”). Across four studies we investigated whether this insensitivity effect was moderated by three variables: the type of rule involved (pliance vs. tracking), the source of the rule (socially vs. self-generated) and the consequences of rule-following (pain vs. non-pain related consequences). In each case participants completed a conditional discrimination (MTS) task consisting of six blocks of trials. During the first three blocks socially provided rules were consistent with programmed contingencies. Then, unknown to participants, these rules became inconsistent with programmed contingencies during the second set of blocks. Results suggest that the insensitivity effect may be moderated more by the source of the rule (self-vs. social) than the type of rule involved (pliance vs. tracking). Open questions and future directions will be discussed.

• Values and Behavioral Flexibility: What are the effects of valuing on sensitivity to contingencies of reinforcement?
Gina Q. Boullion, M.S., University of Louisiana at Lafayette
Nolan R. Williams, University of Louisiana at Lafayette
Emily K. Sandoz, Ph.D., University of Louisiana at Lafayette

Contacting one’s values and engaging in behavior consistent with those values has been associated with improved physical and mental health (Nygren et al., 2005), increases in quality of life (Plumb & Hayes, 2008), and increases in overall well-being (Reker et al., 1987), among others. Values have long been vital to the psychological flexibility model (Hayes, Wilson, & Stroushal, 2012) and the topic of countless papers in the CBS community; however, relatively little investigation has been done in regards to how valuing effects behavioral variability and sensitivity to changing contingencies. It is thought that holding rigid ideas about what values one “must” pursue and how one must pursue them can create fused values, which can result in inflexible behavioral repertories and lowered ability to contact present contingencies of reinforcement (Plumb et al, 2009). The current study examined the impact of derived values functions on behavioral flexibility and sensitivity to changing contingencies of reinforcement. Preliminary data suggest that contingency sensitivity varied, depending on which derived values functions were made salient. Implications of contingency sensitivity in the presence of values and future directions will be discussed.

Educational Objectives:
1. Describe the current state of the research on pliance, tracking, and augmenting. 2. List 2 ways in which valuing effects behavioral variability. 3. Analyze the impact of values on sensitivity to reinforcement.

 

62. Self-Compassion and its Implications for Mental Health: Empirical Evidence and a Contextual Framework
Symposium (2:45-4:15pm)
Components: Conceptual analysis, Original data, Case presentation
Categories: Clinical Interventions and Interests, Theory & Philo., Self-Compassion
Target Audience: Interm., Adv.
Location: Vashon 2

Chair: Joanna J. Arch, University of Colorado Boulder
Discussant: Kristin D. Neff, University of Texas at Austin

This symposium aims to inform both the empirical and theoretical understanding of self-compassion – a topic of growing interest to researchers and clinicians alike. We pair two empirical papers with a theory-driven paper to demonstrate the contextual behavioral science conceptualization, measurable correlates, and biopsychological outcomes of self-compassion across experimental, community, and clinical settings. Specifically, the two empirical presentations focus on the implications of self-compassion for responding to social stressors (3 studies) and the specific correlates linking self-compassion to well-being (relative to compassion for others, 1 study). Thus, the empirical work addresses self-compassion’s link to well-being and potential to optimize social stressor responding. The final paper situates self-compassion within contextual behavioral science, showing how self-compassion informs case conceptualization and treatment particularly within the context of negative social emotions such as shame. Collectively, this symposium contributes to specifying the benefits, correlates, conceptualization, and clinical application of self-compassion.

• Comparing compassion for self and others: Impacts on personal and interpersonal well-being
Marissa Knox, University of Texas at Austin
Kristin D. Neff, Ph.D., University of Texas at Austin

To date almost no research has compared compassion for self versus others as they impact wellbeing. This study examined self-reports of self-compassion and other-compassion in a sample of community adults (N=1366) and Buddhist meditators (N=172). We found that among community adults, 6% displayed more self-compassion than other-compassion, 76% displayed more other-compassion than self-compassion, and 16% displayed the same levels of each. Results were almost identical among Buddhists. In both samples self- and other-compassion were only weakly correlated. In the community sample, self-compassion predicted most of the significant variance in personal wellbeing (e.g., happiness, life-satisfaction, depression, anxiety, stress, empathetic distress), while other-compassion was a stronger predictor of interpersonal outcomes (e.g., altruism, perspective-taking, and forgiveness). The Buddhist sample had similar results, except that self-compassion was the stronger predictor of perspective-taking and forgiveness, and both equally predicted empathetic distress. Few interaction effects were found. Implications of findings for interventions will be discussed.

• The Impact of Brief Self-Compassion Training on Responses to Social Stressors
Joanna J. Arch, Ph.D., University of Colorado Boulder
Lauren Landy, M.A., University of Colorado Boulder

Across three studies, we evaluate the impact of brief self-compassion (trained or induced) on social stressor responses. In Study 1, women (n=104) randomized to brief self-compassion training showed lower subjective anxiety and sympathetic responses to a social performance stressor, relative to rigorous control conditions. In Study 2, during recovery from a challenging social feedback task, adults with or without social anxiety disorder (SAD; n=57) were randomized to a self-compassion-induction or waiting period. Adults in the self-compassion condition reported lower anxiety, and those with SAD benefitted similarly as those without SAD. In Study 3, currently ongoing, we evaluate whether a self-compassion induction mitigates our finding that adults with SAD incorporate negative social feedback more quickly into their sense of self than positive social feedback. To the extent that self-compassion functions as a form of flexible perspective taking, these collective findings inform contextual behavioral approaches for addressing social anxiety and enhancing well-being.

• Contextual Behavioral Science, Perspective Taking, and Self-Compassion
Jason Luoma, Ph.D., Portland Psychotherapy Clinic, Research, & Training Center

This paper aims to contextualize the other papers in this symposium for the ACBS audience through the presentation of a contextual behavioral science (CBS) framework on self-compassion. From a CBS perspective, self-compassion relies centrally on the flexible use of perspective taking (i.e., deictic framing) and the effective transformation of emotional functions. From this vantage point, self-compassion can be seen as a form self-to-self relating, wherein a person responds to their own behavior with the same repertoires of caregiving and cooperation that one might apply to a friend or loved one. As such, self-compassion is a fairly complex cognitive task that requires the person to be able to observe their own behavior and access evolved caregiving responses and associated emotions that primarily evolved in response to others, but instead apply them to oneself. Examples of how this process is relevant in a clinical context will be provided.

Educational Objectives:
1. Describe how brief training in self-compassion effects responses to social performance stress. 2. Distinguish the well-being correlates of self-compassion and compassion from others. 3. Situate self-compassion within a contextual behavioral science framework.

 

63. Improving Outcomes and Better Understanding Processes: Using Smartphone Technologies in Clinical Research
Symposium (2:45-4:15pm)
Components: Original data
Categories: Clinical Interventions and Interests, Prevention & Comm.-Based, smart phone technologies
Target Audience: Beg., Interm., Adv.
Location: St. Helens

Chair: Andrew Gloster, University of Basel
Discussant: Todd Kashdan, George Mason University

Innovations in technology and their widespread use in the general population, such as with smart phones, has introduced new ways for psychologists to examine phenomena, access individuals in remote areas or hard to reach populations, and intervene. These new technologies allow for studying processes of treatments with the aim of improving outcomes. Event Sampling Methodology (ESM) is an ecologically sensitive methodology that captures events in participants’ chosen environments and in close proximity to when an actual behavior of interest occurs. The first paper in this symposium will present the use of smart phone technology to assess individuals diagnosed with MDD, Social Phobia and controls, using a one-week ESM paradigm. Results will be presented with suggestions about how better to promote well-being and pro-social activity in the flow of daily life while testing contextual behavioral theory. The second paper, examines the impact of enhancing face-to-face Acceptance and Commitment Therapy (ACT) smoking cessation with the use of treatment related text messages vs. providing only date and time of next session information. Data will be presented that shows that receiving content-related text messages leads to a decrease in CO exhalation levels when compared to the general text messaging suggesting that the use of ACT content messages leads to a higher utilization of taught techniques and thus improved treatment outcomes. The third study, will present data on how the receptivity and cessation outcomes of a smoking cessation are achieved with an ACT-conistent smartphone application.

• The Ups and Downs of a Flexible Life: Using ESM to Capture Daily Fluctuations of Emotions and Behaviors in Participants with Depression, Social Anxiety, & Controls
Andrew Gloster, Ph.D., University of Basel
Andrea Meyer, Ph.D., University of Basel
Roselind Lieb, Ph.D., University of Basel

Introduction: Event Sampling Methodology (ESM) assesses events in participants’ chosen environments, close to the occurrence of the behavior. ESM is ecologically sensitive while limiting recall bias. As such, ESM offers unique advantages to testing contextual behavioral predictions such as how psychological flexibility changes as a function of context and how this affects well-being. Method: Using smartphones, a one-week ESM paradigm with assessments every three hours assessed participants diagnosed with MDD (n=87), Social Phobia (n=41), and controls (n=87); [67% female]. Results: Over 90.4% (n=8240) of prompted assessments were completed. Preliminary models indicate that state levels of psychological flexibility moderated the relationship between stress and frequency of interacting with other people. Models will further differentiate between diagnostic groups, test for outcomes of pro-social behavior and well-being. Conclusions: These data offer suggestions about how to promote well-being and pro-social in the flow of daily life while testing contextual behavioral theory.

• Does the use of treatment content text message reminders enhance the utilization of ACT techniques and improve smoking cessation outcomes?
Maria Karekla, Ph.D., University of Cyprus
Andria Christodoulou, M.A., University of Cyprus

Introduction: Acceptance and Commitment Therapy (ACT) makes use of an individual’s values to motivate a change in behavior and has been shown quite effective for smoking cessation. Innovations in smart phone technology have led to individualized text messaging based interventions with the potential to attract and engage previously hard-to-reach groups, adolescents. However, to date differences between providing treatment-related content text messages vs. simple date and time of next appointment reminders has not been evaluated. This study aimed to compare the use of content specific (with an emphasis on linking smoking cessation to values) vs. general text messages in combination to ACT smoking cessation among adolescents. Method: 118 smokers were randomly assigned to one of two groups: an ACT relevant content SMS plus ACT group (8 sessions) vs. a general SMS plus ACT group smoking cessation. Carbon Monoxide (CO) exhalation levels and other smoking and ACT related variables were tested pre and post treatment. Results: Repeated measures ANOVAs indicated a significant reduction in CO upon completion of the intervention compared to pre-intervention levels, with the ACT-content SMS group having significantly lower post-intervention CO levels than the general SMS group. However, the groups did not differ on ACT related measures at post intervention. Conclusions: Both groups responded similarly to the learning of ACT content but differed only in their application of information to achieving smoking cessation, providing support for the importance of enhancing treatment content with regular text messages in-between sessions.

• Single Arm Trial of the SmartQuit Acceptance & Commitment Therapy Smartphone Application for Smoking Cessation
Jonathan Bricker, Ph.D., Fred Hutch Cancer Research Center & University of Washington
Wade Copeland, M.S., Fred Hutch Cancer Research Center & University of Washington
Jaimee Heffner, Ph.D., Fred Hutch Cancer Research Center & University of Washington

Introduction: There are 500 English-language smartphone applications (“apps”) for quitting smoking, downloaded over 3.2 million times in 2012-2013. Their ubiquity makes apps a potentially helpful cessation aid, especially for smokers who are hard to reach. We explored this potential through evaluating the receptivity and cessation outcomes for the SmartQuit app that follows Acceptance & Commitment Therapy (ACT). Methods: Participants were 99 adult smokers (at least 5 cigarettes/day) who were 78% female and 60% unemployed. Results: The follow-up data retention rate at the 2-month follow-up was 85%. Regarding receptivity, 85% of participants were satisfied with the app, 82% found ACT exercises useful, and 93% reported the app was easy to use. The quit rates at the 2-month follow-up were 21%. Among program completers, the quit rates at 2-month follow-up were 33%. Conclusion: SmartQuit was well-received and showed promising quit rates among the challenging population of primarily low SES female smokers.

Educational Objectives:
1. Describe how technologies can be use to promote outcomes. 2. Describe how ACT consistent variables unfold in daily life and in individually applied interventions. 3. Explain the relationship between process and outcome using ecologically sensitive data.

 

65. Processes of Change
Symposium (2:45-4:15pm)
Components: Conceptual analysis, Literature review, Original data
Categories: Prevention and Community-Based Interventions, Clinical Interventions and Interests, Edu. settings, Org. Beh. Management, Theory & Philo., RFT, Cognitive defusion, coping with stress, anxiety, component analysis, resilience, mindfulness, values, non-clinical
Target Audience: Beg., Interm., Adv.
Location: Cascade 1B

Chair: Rebecca Schneider, M.A., University of Colorado Boulder
Discussant: Chad E. Drake, Ph.D., Southern Illinois University

Understanding processes of change can shed more light on the progression of psychological inflexibility as well as guide more targeted interventions. Coping with stress, negative thoughts, and emotion has received considerable attention from different theoretical perspectives. In this symposium, we examine the process of coping from a contextual behavior perspective. For instance, individual differences in coping with stress may be better explained by cognitive defusion. We will discuss 3 studies that show how cognitive defusion may add to theories of coping in understanding how individuals relate to stress. We will also present data on a comparison of cognitive restructuring and cognitive defusion approaches to negative thoughts, including an RFT-based analysis of both techniques. A study of a mindfulness-only intervention versus an ACT intervention will be presented as well as a discussion of contexts in which each approach might be more appropriate. We will also discuss the predictive relevance of emotion regulation skills - targeted by mindfulness- and acceptance-based therapies - in the development of physical and social anxiety via a longitudinal study. Together, these studies can help us better understand and target processes that might be critical to enhancing well-being.

• Defusion or restructuring as a question of human language
Andreas Larsson, Centre for Psychiatric Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services

Humans have this amazing ability to make thoughts seem completely real. In more technical terms we have difficulty discriminating derived stimulus reactions from direct contingencies. This is one reason language place such a large role in psychopathology. For this reason a central part of psychotherapy involves providing clients with coping strategies for negative thoughts. Cognitive restructuring and cognitive defusion are two of the most common such methods. However they derive from two different theoretical outlooks, one is Acceptance and Commitment Therapy, reticulatedly related to RFT and based in functional contextualism and the other is Cognitive Therapy, a more mechanistic model. This presentation will give a common, RFT-based description of both methods and present data comparing them both. In a recent study (Larsson et al., 2015) participants were either provided with a cognitive restructuring, defusion or no instruction control technique to manage a personally relevant negative thought. Participants were reminded, via SMS messages, to use their assigned strategy in managing the thought across a five-day period. Pre- and postmeasures were the (1) believability, (2) comfort, (3) negativity and (4) willingness to experience their unwanted thought. The results indicate that both restructuring and defusion were effective in decreasing the believability and negativity, and increasing comfort and willingness to have the negative thought. Further analyses suggested that defusion tended to be more helpful than restructuring across all four domains and both delivery methods but that face-to-face delivery was more effective than online. The findings are discussed in terms of the differences in the contextual language cues provided in the different interventions for managing unwanted thoughts.

• The Longitudinal Effect of ACT-Targeted Emotion Regulation Strategies on Anxiety Levels in Youth
Rebecca Schneider, M.A., University of Colorado Boulder
Joanna Arch, Ph.D., University of Colorado Boulder
Ben Hankin, University of Denver

Objective: There is growing evidence linking emotion dysregulation to anxiety. However, few studies have examined this relationship longitudinally or developmentally. Additionally, no studies have specifically examined the predictive relevance of the emotion regulation skills taught in mindfulness- and acceptance-based therapies. We explore whether specific ACT-targeted emotion regulation processes differentially predict specific anxiety symptoms over time among children and adolescents. Methods: Initial emotion non-awareness, nonacceptance, and difficulties with goal-directed behavior (corresponding to the ACT processes of awareness, acceptance, and committed action) were assessed in a community sample (n = 312, age range = 8-16, mean age = 11.68, 59% female, 69% Caucasian). Social anxiety, separation anxiety, and physical anxiety symptoms were assessed every 3 months for 3 years. Hierarchical linear modeling was used to examine the concurrent and longitudinal effects of emotion dysregulation assessed at baseline or 18 months on anxiety. Results: After controlling for depression, age, and gender, all three processes concurrently predicted physical and social anxiety, and all but nonacceptance predicted separation anxiety. Only difficulties with goal-directed behavior, however, predicted longitudinal change in separation anxiety over time with covariates. Additionally, emotion non-awareness and difficulties with goal-directed behavior predicted subsequent changes in social anxiety. Conclusions: Emotion dysregulation may serve as a potential risk factor for the development of anxiety symptoms among youth. It may be beneficial to target reductions in maladaptive strategies in prevention or intervention work.

• Transfer of fear measured with blink-startle modulation
Miguel Rodriguez-Valverde, Ph.D., University of Jaén, Spain
Monica Hernandez-Lopez, Ph.D., University of Jaén, Spain
Miguel A. Lopez-Medina, B.Sc., University of Jaén, Spain

Research on fear conditioning is key to understanding the genesis and maintenance of anxiety disorders. A still scarce but growing evidence shows that physiological fear reactions may transfer amongst physically dissimilar but symbolically related (e.g. equivalent) stimuli. The limited investigation published to date has relied on skin conductance responses as its main measure. Thus far, no published studies have analyzed this phenomenon using more emotionally sensitive psychophysiological measures, like blink startle. Participants (N=20) in this study underwent a matching-to-sample procedure for the formation of two equivalence classes (A1-B1-C1-D1 and A2-B2-C2-D2). Then, one element from each class was used in a differential aversive conditioning procedure (CS+: B1; CS-: B2) with electric shock as the UCS. Eye-blink startle (measured as EMG activity of the orbicularis oculi muscle after a burst of white noise) was the main dependent variable. Preliminary results from transfer tests show potentiation of blink startle with C1 and D1, but not with C2 and D2.

Educational Objectives:
1. Describe the evidence for ACT versus mindfulness-only group interventions on how individuals cope with stress. 2. Describe the longitudinal relationship between emotion regulation and anxiety. 3. Analyze the main psychophysiological measures used in research on the derived transfer of fear.

 

69. Promoting psychological flexibility in laboratory, exceptionally gifted children, and victims of sexual violence
Symposium (2:45-4:15pm)
Components: Conceptual analysis, Original data
Categories: Clinical Interventions and Interests, RFT, Laboratory study, exceptionally gifted children, sexual violence
Target Audience: Beg., Interm., Adv.
Location: Puget Sound

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

Promoting psychological flexibility is the main aim of acceptance and commitment therapy (ACT). This symposium presents three studies focused on promoting psychological flexibility in several contexts. The first presentation consists of a laboratory study that first modelled a pattern of psychological inflexibility in participants’ behavior and then compared a brief protocol to promote psychological flexibility versus a control condition. The second study presents the effect of a brief ACT protocol applied to exceptionally gifted children experiencing significant levels of school maladjustment. The protocol was focused on disrupting rumination and procrastination, and promoting psychological flexibility while facing with boring and unattractive tasks. Lastly, the third study shows the effect of a 4-session ACT protocol applied to adolescent who suffered conflict-related sexual violence in Colombia. Overall, the current symposium shows the several levels of analysis of the promotion of psychological flexibility via ACT interventions.

• The weakening of psychological inflexibility: Analysis of the epitaph exercise
Adrián Barbero-Rubio, Universidad de Almería
Carmen Luciano, Universidad de Almería

The Acceptance and Commitment Therapy (ACT) model is oriented to disrupt psychological inflexibility (PI) and to increase psychological flexibility (PF). Recent laboratory studies have analyzed the conditions under which ACT exercises impact on enhancing PF. However, these studies do not establish a context of PI which the conditions for its weakening can be isolated. This preliminary study analyzes these conditions by designing experimental analogs of ACT-based exercises. This study had five phases: (1) eighteen participants were randomly assigned to two groups, responded to questionnaires and were exposed to an experimental task with discomfort to capture rigid psychological reactions; (2) both groups received an Inflexibility-protocol; (3) all groups were re-exposed to the experimental task; (4) group I received a Flexibility-protocol (the epitaph exercise) dedicated to weaken the PI while group II received a control-protocol; (5) all participants repeated the experimental task. Results indicate significant effects the Flexibility-protocol on increasing task performance.

• Effect of a brief ACT protocol in improving school adjustment of exceptionally gifted children
María Belén García-Martín, Fundación Universitaria Konrad Lorenz
Katherine Barreto, 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 acceptance and commitment therapy (ACT) intervention focused in disrupting rumination and procrastination, and increase valued actions in exceptionally gifted children. A multiple-baseline designs across participants was used with 5 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.

• Use of Acceptance and Commitment Therapy with female adolescents exposed to conflict-related sexual violence: Experiences in Colombia
Melissa Schellekens, Private Practice
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz

Over fifty years of internal armed conflict in Colombia has involved unprecedented levels of conflict-related sexual violence perpetrated against women and girls, to which adolescents are particularly vulnerable. This study examined the effects of a 4-session group protocol on the values adherence behaviour and life functioning of adolescent females exposed to conflict-related sexual violence. The protocol proposed in this study incorporates elements of the DNA-V framework and an art-based process. A group of females aged between 13 and 18 participated in a randomised controlled study of the protocol. They were sourced through a local non-governmental organisation operating in regions of Colombia with high levels of conflict. The protocol appears to be an initial step toward enhancing research into ACT-based treatments for adolescents with trauma symptoms. Additional research proposed includes investigation into scaling-up use of this protocol across large numbers of adolescent females in Colombia.

Educational Objectives:
1. Model psychological (in)flexibility in a laboratory setting. 2. Apply ACT to improve school adjustment in exceptionally gifted children. 3. Explain the relevance of promoting psychological flexibility in victims of sexual violence.

 

74. Effect of brief ACT protocols focused on disrupting worry and rumination in clinical and nonclinical participants
Symposium (4:30-5:45pm)
Components: Conceptual analysis, Original data
Categories: Clinical Interventions and Interests, RFT, Worry, Rumination, Emotional Disorders, Couples
Target Audience: Beg., Interm., Adv.
Location: Vashon 1

Chair: Bárbara Gil-Luciano, Madrid Institute of Contextual Psychology
Discussant: Carmen Luciano, Universidad de Almería

The current symposium presents cutting-edge research in the application of brief acceptance and commitment therapy (ACT) protocols focused on disrupting negative repetitive thinking (RNT). RNT in the form of worry and rumination has been robustly identified as a transdiagnostic factor implicated in the onset and maintenance of emotional disorders. The symposium presents three studies in which ACT protocols were focused from the very beginning in decreasing RNT levels. The first study shows the effect of a one-session ACT protocol applied to individuals suffering from moderate emotional symptoms and experiencing dysfunctional worry/rumination for at least six months. The effect sizes of the intervention were very large. The second study aims to extend the previous findings to improving couple relationship in cases where one of the members showed high levels of RNT. The third study analyzes the effect of a 4-session protocol to treat moderate to severe depression and generalized anxiety disorders.

• Acceptance and commitment therapy to disrupt negative repetitive thinking: A randomized multiple-baseline design
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz
Diana Riaño-Hernández, Fundación Universitaria Konrad Lorenz
Juan C. Suárez-Falcón, Universidad Nacional de Educación a Distancia
Carmen Luciano, Universidad de Almería

Repetitive negative thinking (RNT) in the form of worry and rumination has been robustly identified as a transdiagnostic factor implicated in the onset and maintenance of emotional disorders. The current study analyzed the effect of a one-session acceptance and commitment therapy (ACT) protocol in disrupting RNT using a two-arm, randomized-multiple baseline design. Participants were 11 adults experiencing RNT that interfered in their functioning for at least the last six months. Five RNT-related measures were administered: a daily RNT self-register, measures of pathological worry, rumination (reflection and brooding), and frequency with negative thoughts. Ten participants showed significant reductions in at least half of the RNT measures. Effect sizes were very large in most RNT-related measures (Cohen’s d from .93 for reflection to 2.15 for worry) and in valued living (d from .77 to 2.35), emotional symptoms reduction (d = 1.71), experiential avoidance (d = 2.09), and cognitive fusion (d = 2.23).

• Improving couple relationship by reducing worry and rumination through a brief ACT protocol
Diana García-Beltrán, Fundación Universitaria Konrad Lorenz
Andrea Monroy, Fundación Universitaria Konrad Lorenz
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz

Repetitive thinking in the form of worry and rumination about the couple relationship can have a deleterious effect in couple satisfaction for several reasons such as: not being present while sharing time with the couple, doubts about continuing or breaking the relationship, maintaining toxic relationships, jealous, etc. The current study aims to explore the effect of a brief acceptance and commitment therapy (ACT) protocol in improving satisfaction with couple relationships through reducing worry and rumination. The ACT protocol was based on the study by Ruiz, Riaño-Hernández, Suárez-Falcón, and Luciano (2016) that showed very large effect sizes of a one-session protocol in disrupting general worry and rumination. A multiple-baseline design was conducted with participants who were unsatisfied with their couple relationships and showed significant levels of worry/rumination that interfered adequate functioning in this area. Results will be mainly discussed in terms of participants’ progression in having a valued couple relationship.

• Effect of a transdiagnostic ACT protocol focused on disrupting negative repetitive thinking
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz
Diana Riaño-Hernández, Fundación Universitaria Konrad Lorenz
Juan C. Suárez-Falcón, Universidad Nacional de Educación a Distancia
Carmen Luciano, Universidad de Almería

The current study aims to analyze the effect of a 4-session acceptance and commitment therapy (ACT) intervention focused on disrupting worry and rumination in the treatment of emotional disorders. Both worry and rumination usually serve an experiential avoidance function and have been robustly identified as transdiagnostic factors implicated in the onset and maintenance of emotional disorders. A multiple baseline design was implemented with participants suffering from depression and/or generalized anxiety disorder. Dependent variables were daily measures of repetitive thinking and weekly self-reports of emotional symptoms, worry, rumination, negative thoughts, valued living, experiential avoidance, and cognitive fusion. Initial results show that most participants obtained significant clinical improvements. The results will be discussed highlighting the need to conduct a randomized clinical trial comparing the effect of this protocol with a standard ACT protocol to treat emotional disorders.

Educational Objectives:
1. Describe the role of worry/rumination in the etiology and maintenance of emotional disorders. 2. Demonstrate worry/rumination as important experiential avoidance strategies. 3. Analyze the effect of ACT protocols focused on disrupting worry/rumination in clinical and nonclinic participants.

 

78. Investigating the effects and processes of brief ACT interventions with different populations
Symposium (4:30-5:45pm)
Components: Original data
Categories: Clinical Interventions and Interests, Prevention & Comm.-Based, Edu. settings, ACT, brief interventions, youth, university students, wellbeing, stress, depression, anxiety
Target Audience: Beg., Interm.
Location: Cascade 1B

Chair: Raimo Lappalainen, Ph.D., Department of Psychology, University of Jyväskylä, Finland
Discussant: Jacqueline Pistorello, University of Nevada, Reno

Brief psychological interventions offer several advantages, and they are used frequently in clinical practice. The form of delivery of interventions with less than 10 sessions can vary from individual and group treatments to different forms of web- and mobile-approaches. This symposium aims at describing the effects of 6-7 session ACT interventions. Three studies will be presented describing interventions offered to adolescents (15-20 years old, n = 160), young adults (19-32 years old, n = 68) and middle-aged clients with depression (n = 56). The interventions were delivered either in a group format or as individual sessions combined with an internet-program and face-to-face. We will discuss the effectiveness and usefulness of these short ACT interventions to different populations and crucial psychological processes and mechanisms of change possibly explaining the effects.

• A controlled trial of Acceptance and Commitment Training (ACT) for treating comorbid psychosocial problems among inpatient youth
Fredrik Livheim, MSc., licensed psychologist, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden

Background: Youth sentenced to inpatient care is a group often burdened with severe comorbid problems. The current quasi-experimental outcome study investigated the possible effects of an ACT group-based intervention as an adjunct to treatment as usual (TAU). Method: This study involved 160 Swedish youth (15-20 years old) sentenced to institutional care. Ninety-one adolescents were in units that received ACT + TAU, and the remaining adolescents were in units that received TAU, only. The ACT group-based intervention consisted of 6 sessions á 2 hours. Results: The ACT groups as an addition to TAU significantly lowered youth levels of anxiety, depression, anger, drug- and alcohol use, conduct problems, hyperactivity, criminality and increased psychological flexibility, prosocial behaviours and Self-Concept. Conclusion: This 12-hour ACT group-based intervention could be an effective tool in enhancing the well-being of youth with psychosocial problems.

• Mindfulness as a mediator of change in wellbeing, stress, and symptoms of depression: Results from a guided online ACT-based program for university students
Panajiota Räsänen, MSc., Licensed Psychologist, Department of Psychology, University of Jyväskylä, Finland
Asko Tolvanen, Department of Psychology, University of Jyväskylä, Finland

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

• Fast improvement during a brief 6 –session ACT intervention: The phenomena and discussion of processes
Katariina Keinonen, Department of Psychology, University of Jyväskylä, Finland
Raimo Lappalainen, Department of Psychology, University of Jyväskylä, Finland

Objective: Sudden gains, abrupt reductions in symptom severity, have been shown to occur in various treatment settings resulting in better treatment outcome. We were interested in investigating the amount of clients showing fast improvement and whether process measures such psychological flexibility were associated with early improvement. Method: The data consisted of 56 participants with diagnosed major depressive disorder. They were offered a 6 session individual ACT intervention, and classified to (fast) improvers and non-improvers based on changes in symptoms of depression during first two weeks of intervention. Results: About 25% of the clients improved very fast (between group ES for BDI-II g =1.44 after two sessions). During the 6 –session intervention, the pattern of change was different in psychological flexibility, believability on depression thoughts and for hopefulness between the improvers and non-improvers. Conclusions: Changes in psychological flexibility could be associated with fast improvement in brief psychological interventions.

Educational Objectives:
1. Describe and discuss the effects of this ACT-intervention among Swedish incarcerated youth. 2. Identify and discuss how mindfulness skills may mediate changes in psychological wellbeing, perceived stress and symptoms of depression in an online, guided ACT program for university students. 3. Explain individual differences in interventions effects and possible psychological processes associated with these differences.

 

80. This Modern (Evaluative) World: Exploring Contemporary Approaches to Assessing and Addressing Stigmatizing Attitudes toward Psychological Struggles
Symposium (4:30-5:45pm)
Components: Conceptual analysis, Literature review, Original data
Categories: Functional contextual approaches in related disciplines, Clin. Interven. & Interests, Assessment, Stigma, Intervention
Target Audience: Beg., Interm., Adv.
Location: Puget Sound

Chair: Chad E. Drake, Ph.D., Southern Illinois University
Discussant: Chad E. Drake, Ph.D., Southern Illinois University

Verbally competent human beings readily engage in comparative and evaluative relational responding. Given the social nature of our species, these proclivities readily enter into our perspectives on self, social identity, and social classification. Of particular concern are the types of perspectives that lead to stigmatizing attitudes. While stigma may be readily recognized for group comparisons along racial, sexual, or religious categories, stigmatizing attitudes toward those who struggle with psychopathology are also common and damaging (e.g., Link, Struening, Rahav, Phelan, & Nuttbrock, 1997). This symposium will focus on mental illness stigma with an emphasis on contemporary approaches to assessing attitudes: two studies utilizing a paradigm involving evaluation of faux “tweets” via twitter.com as well as a study with the Implicit Relational Assessment Procedure. Using multiple analytic and methodological strategies, issues of predictive validity and intervention strategies will be examined.

• Judgment on the bus goes round and round: Decreasing mental illness stigma by expanding the context
Teresa Hulsey, B.A., University of North Texas
Melissa L. Connally, M.S., University of North Texas
Danielle N. Moyer, M.S., University of North Texas
Taylor Lincoln, B.A., University of North Texas
Amy R. Murrell, Ph.D., University of North Texas

Approximately 1 in 5 American adults experience mental health difficulties (U.S. Department of Health and Human Services, 2014). Yet, mental health stigma remains one of the most frequently identified barriers to seeking treatment (Corrigan, 2004). One factor that contributes to mental health stigma is the tendency to over attribute behaviors to internal factors, while under attributing behaviors to external factors (i.e., fundamental attribution error; Ross, Greene, & House, 1977). This paper will examine the impact of contextual information on stigmatizing attitudes toward an ambiguous mental health scenario. Participants (n = 483) were presented a series of faux tweets with increasingly elaborate contextual information, and their attitudes were assessed after each tweet. A mixed factor repeated measures ANOVA will explore changing attitudes toward mental health over time. The role of psychological distress, experiential avoidance, and mental health history in relation to these changes will also be examined.

• Helpers Can Be Haters, Too: Examining Substance Misuse Stigma Among Therapists with the IRAP
Trent Codd, EdS, Cognitive-Behavioral Therapy Center of WNC, P.A.
Sunni Primeaux, M.A., Southern Illinois University
Sam Kramer, M.A., Southern Illinois University
Chad E. Drake, Ph.D., Southern Illinois University
Christeine M. Terry, Seattle Psychology, PLLC

Substance misusers are more stigmatized than individuals with other health conditions (Rao et al. 2009). In addition to affecting social status, employment, and housing, stigma has also been recognized as a barrier to treatment (Gary, 2005). Unfortunately, research has shown that stigma is not only found among the general population but among mental health professionals as well (Maslach, Jackson, & Leiter, 1996). The current study examined stigma toward substance misusers among 38 mental health professionals with traditional self-report methods as well as the Implicit Relational Assessment Procedure (IRAP). Preliminary analyses revealed a mixture of IRAP effects as well as some evidence for convergence between the IRAP and explicit measures. Additionally, the IRAP was found to predict willingness to write letters of support for employment and disability applications for substance users. Future research may focus on altering the content strategy of the IRAP and/or broadening the focus of assessment.

• Three tweets to the wind: Decreasing substance use stigma in 140 characters or less
Ethan G. Lester, B.S., University of North Texas
Danielle N. Moyer, M.S., University of North Texas
Amy R. Murrell, Ph.D., University of North Texas

Substance use and misuse are highly stigmatized mental health issues in the United States (Livingston, Muilne, Fang, & Amari, 2011), despite research supporting the critical role of environmental and contextual risk factors (Stone, Becker, Huber, & Catalano, 2012). The fundamental attribution error (FAE; Ross, Greene, & House, 1977) provides one explanation for this discrepancy. The FAE is the propensity for an individual to overly attribute behavior to dispositional characteristics while ignoring potential external causes of behavior. Increasing contextual information may decrease the frequency of committing the FAE (Quattrone, 1982). After receiving contextual information via faux tweets, 483 undergraduate students responded to an ambiguous situation related to substance use. Contextual information was presented hierarchically, and participants rated their attitudes towards an individual each time. A mixed factor repeated measures ANOVA will evaluate changes in stigmatizing attitudes over time, and in relation to attributional complexity, intolerance, and mental health history.

Educational Objectives:
1. Demonstrate the relationships among contextual information, stigmatizing attitudes, distress and treatment, and experiential avoidance. 2. Describe the evidence for the predictive validity of the substance misuse IRAP. 3. Demonstrate the impact of contextual information on stigmatizing attitudes and discuss the implications for substance use stigma, specifically.

 

82. RFT & Relational Coherence
Symposium (4:30-5:45pm)
Components: Conceptual analysis, Original data
Categories: Relational Frame Theory, Theory & Philo., RFT, Experimental Analysis of Behavior, IRAP
Target Audience: Beg., Interm., Adv.
Location: Pine

Chair: Yvonne Barnes-Holmes, Ghent University
Discussant: Nic Hooper, Ph.D., University of West England

The concept of coherence has been used in psychology for a long time, but has thus far escaped behavior analytic scrutiny. And yet, coherence, defined provisionally as deriving relational responses that are congruent with one another, appears to play a key role in many complex verbal behaviors. The first paper in this symposium highlights recent efforts to explore the reinforcing properties of relational coherence. The results suggest that coherence has appetitive properties and that contextual factors influence the relative reinforcing value of coherence. The second empirical paper determines whether incoherence is aversive. The results show strong pereferences for contextual coherence, in terms of both facial expression and the AAQ. The third paper, also empirical, explores the IRAP’s use of the response options “True” and “False” as relational coherence indicators (RCIs), and determines whether these influence IRAP performances. The findings indicate that Crels and RCIs should not be considered as functionally equivalent, and the use of different types of response options requires systematic analysis.

• Chasing Coherence: Recent Refinements in a Reinforcer Assessment Paradigm
Sean Hughes, Ph.D., Ghent University
Michael Bordieri, Ph.D., Murray State University

Coherence, preliminary defined as deriving relational responses that are congruent with one another, is argued to play a key role in many complex verbal behaviors. While previous accounts of coherence have been mainly conceptual in nature (e.g., the relational elaboration and coherence model; Barnes-Holmes, Barnes-Holmes, Stewart, & Boles, 2010), recent empirical work has sought to investigate relational coherence in the laboratory (Bordieri, Kellum, Wilson, & Whiteman, 2016; Wary, Dougher, Hamilton, & Guinther, 2012; Quinones & Hayes, 2014). In this paper we highlight some recent efforts to explore the reinforcing properties of relational coherence. Results from a series of studies suggest that coherence has appetitive properties for many participants and that contextual factors can manipulate the relative reinforcing value of coherence. Our findings partially support the assertion that coherence is a reinforcer for verbally competent humans. Implications for future research and paradigm development will be discussed.

• Analytical Perspective of Coherence
Zaida Callejón, Ph.D. candidate, Universidad de Almería
Carmen Luciano, Ph.D., Universidad de Almería
Juan Carlos López-López, Ph.D. candidate, Universidad de Almería

The current study aimed to check the reinforcing function of coherence. Specifically, this study analyzed if the incoherence experience is felt as an aversive event. Nine undergraduate students participated and followed the next sequence: (1) Firstly, they received conditional discrimination training for the formation of three 5-member equivalence classes. Subsequently, (2) they were exposed to a 24-trial block to assess mutual and combinatorial relations providing feedback to establish three contexts defined on the basis of different contingencies: a) coherent feedback based on the previous training was provided contingent to participants’ responses; b) consequences were randomly assigned as incoherent context; c) without feedback. During this phase, the response latency and participants’ facial expressions were recorded. In addition, participants were asked to rate their experiences of discomfort and sense of control on each context. Finally, (3) participants were exposed to a test of derived relations along with a choice procedure to determine their preferences based on the different context previously trained as a, b, or c. Results showed that most of participants (88%) preferred coherent context. During incoherent trials, an increased response latency and facial expressions of discomfort were detected. Moreover, the AAQ-II negatively correlated to selecting incoherent context (r = -.631). The findings suggest that coherent context, in which sense making is likely, is the most preferred.

• The Similarities and Differences between “Similar” and “Different” and “True” and “False” in Relational Frame Theory: Analyzing Relational Contextual Cues versus Relational Coherence Indicators using the IRAP
Emma Maloney, Maynooth University
Dermot Barnes-Holmes, Ghent University

Early studies using the Implicit Relational Assessment Procedure (IRAP) involved using relational contextual cues (Crels) as response options. A large number of IRAP studies, however, have also employed relational coherence indicators (RCIs), the two most common being “True” and “False”. The untested assumption was that the nature of the response options should have no impact on IRAP performance. The current study addressed this gap in the literature. Undergraduate participants were exposed to two IRAPs, one employing the Crels “Similar” and “Different” and the other employing the RCIs “True” and “False”. When participants first completed an IRAP using the Crels and then completed a second IRAP using the RCIs there was a significant reduction in the effect and it also became non-significant (from zero). This finding indicates that Crels versus RCIs should not be considered functionally equivalent and the use of different types of response options requires careful and systematic analysis.

Educational Objectives:
1. Describe recent refinements and limitations of an experimental preparation designed to assess relational coherence. 2. Evaluate the reinforcing properties of coherence and discuss the influence of contextual factors. 3. Analyze empirically the reinforcing function of coherence and assess if the incoherence experience is felt as an aversive event.

 

Saturday, June 18

89. RFT & Experimental Analyses of Psychological Suffering
Symposium (10:30am-Noon)
Components: Conceptual analysis, Original data
Categories: Relational Frame Theory, Clin. Interven. & Interests, RFT, IRAP, clinical applications of RFT, obesity
Target Audience: Interm., Adv.
Location: Vashon 2

Chair: Yvonne Barnes-Holmes, Ghent University
Discussant: Yvonne Barnes-Holmes, Ghent University

RFT-based empirical analyses of various aspects of psychological suffering are greatly in demand and this symposium represents further moves in that direction, in terms of phobia, hearing voices, obesity, and body image. The first paper presents two IRAP studies as a measure of spider fear, approach, and avoidance. The results show that in the context of a live spider (but not a molt), the IRAP predicts spider approach, and provides evidence of the separation of fear, avoidance, and approach at the implicit level. The second paper uses the IRAP to understand voice hearing. The results indicate that both non-clinical and clinical voice hearers show implicit negativity to voices, while accepting positive voices and avoiding negative voices. The demonstrates the utility and precision of the IRAP in this domain. The third paper again uses the IRAP in three studies that manipulate food deprivation with clinically obese and normal-weight participants. The results show that automatic food-related cognition is moderated by weight status and food deprivation. The fourth paper presents the The Body Image Flexibility Assessment Procedure (BIFAP) as a measure of psychological flexibility with body image and reviews the data thus far, including convergence with the IRAP.

• An RFT analysis of the derived transformation of Spider Fear, Avoidance and Approach, measured by the Implicit Relational Assessment Procedure (IRAP)
Aileen Leech, Ghent University
Dermot Barnes-Holmes, Ghent University
Lara Madden, National University of Ireland Maynooth

Over 20 years ago, behavioral researchers began to use the derived transformation of functions as a paradigm to explore how verbally-able humans come to both fear and avoid stimuli in the absence of direct stimulus pairings. The current research examined the use of the Implicit Relational Assessment Procedure (IRAP) as a measure of spider fear, approach and avoidance. The research comprised 2 studies. Study 1 employed two IRAPs, one targeting spider fear, the other targeting spider approach/avoidance. The FSQ and a BAT using a spider molt were also employed. The data showed that both IRAPs failed to predict performances on the BAT. Study 2 was similar to Study 1, but used a live spider. Results here, however, showed that the IRAP did predict performance on the BAT, and provided evidence of the separation of fear, avoidance and approach at the implicit level.

• Towards a Relational Frame Theory Understanding of Voice Hearing
Ciara McEnteggart, Ghent University
Yvonne Barnes-Holmes, Ghent University
Dermot Barnes-Holmes, Ghent University
Jos Egger, Radboud University

The current study used the Implicit Relational Assessment Procedure (IRAP) as a step towards a more functional-analytic approach to understanding of voice hearing, by exploring the potentially different implicit reactions of clinical and non-clinical groups to voices. In doing so, we attempted to parse out emotional versus behavioral responses toward voices (n=55) using a Valence and an Acceptance IRAP. Both non-clinical and clinical voice hearers showed implicit negativity in the Valence IRAP, and clinical and non-clinical voice hearers implicitly accepted positive voices and avoided negative voices in the Acceptance IRAP. Furthermore, acceptance of positive voices correlated with high psychological inflexibility, and acceptance of negative voices correlated with overall voice acceptance. The current study demonstrates the utility and precision of the IRAP in this domain, and it is through this precision that we may begin to look at the functional-analytic processes at work in voice hearing experiences.

• Obesity, Food Restriction, and Implicit Attitudes to Healthy and Unhealthy Foods: Lessons Learned from the Implicit Relational Assessment Procedure
Ian McKenna, Maynooth University
Sean Hughes, Ghent University
Dermot Barnes-Holmes, Ghent University
Maarten De Schryver, Ghent University
Ruth Yoder, St. Columcille’s Hospital, Loughlinstown
Donal O'Shea, St. Columcille’s Hospital, Loughlinstown

It has been argued that obese individuals evaluate high caloric, palatable foods more positively than their normal weight peers, and that this positivity bias causes them to consume such foods, even when healthy alternatives are available. Yet when self-reported and automatic food preferences are assessed no such evaluative biases tend to emerge. We argue that situational (food deprivation) and methodological factors may explain why implicit measures often fail to discriminate between the food-evaluations of these two groups. Across three studies we manipulated the food deprivation state of clinically obese and normal-weight participants and then exposed them to an indirect procedure (IRAP) and self-report questionnaires. We found that automatic food-related cognition was moderated by a person’s weight status and food deprivation state. Our findings suggest that the diagnostic and predictive value of implicit measures may be increased when (a) situational moderators are taken into consideration and (b) we pay greater attention to the different ways in which people automatically relate rather than simply categorize food stimuli.

• The Body Image Flexibility Assessment Procedure: Development of a Behavioral Measure of Body Image Flexibility
Emily K. Sandoz, Ph.D., University of Louisiana at Lafayette
Jessica Auzenne, University of Louisiana at Lafayette
Nolan Williams, University of Louisiana at Lafayette
Grayson Butcher, University of Louisiana at Lafayette
Gina Boullion, University of Louisiana at Lafayette

Assessing private events has always presented a challenge to behavior analysis (see Wolf, 1978). Assessing responses to private events (e.g., psychological flexibility and its components) complicates that challenge even further (e.g., Hayes et al., 2004). The Body Image Flexibility Assessment Procedure (BIFAP) was developed as a behavioral measure of psychological flexibility with body image. The BIFAP presents a series of tasks that train, using principles of RFT, body image and values functions to arbitrary stimuli, then assess the flexibility of responding to compound stimuli with body image and values functions. The current series of studies will review the development of the BIFAP along with the convergence between BIFAP performance and two other measures of body image flexibility –a Body Image Implicit Relational Assessment Procedure (IRAP; Barnes-Holmes et al., 2006), which assesses brief immediate relational responses to body image stimuli, and daily self-reported body image flexibility via Ecological Momentary Assessment. Aspects of both divergence and convergence will be discussed in terms of validity of the BIFAP, and the complexity of assessment of private events.

Educational Objectives:
1. Explain what the IRAP can tell us about the separation of implicit fear, approach, and avoidance. 2. Describe a behavioral conceptualization of body image flexibility. 3. Design an IRAP to assess an individual's relationship with food and body image. 4. Describe convergence and divergence among approaches to assessing body image flexibility.

 

90. RFT & Education
Symposium (10:30am-Noon)
Components: Conceptual analysis, Literature review, Original data
Categories: Relational Frame Theory, Edu. Settings, Children, IRAP
Target Audience: Interm.
Location: St. Helens

Chair: Thomas Szabo, Ph.D., Florida Institute of Technology
Discussant: Thomas Szabo, Ph.D., Florida Institute of Technology

While RFT has seen increasing application to psychological therapy, its potential benefits in remedial education remain largely untapped. This symposium presents three areas of research that attempt to tackle this important gap. The first paper investigates the potential of, and preliminary data from, PEAK -- a comprehensive remedial learning package designed to establish derived relational responding and its precursors in individuals who display deficits in these critical developmental repertoires. The second paper represents one of the first RFT studies to establish problem solving skills in people who do not have them. Problem solving is taught via multiple exemplar training to children with autism. The effects of the intervention are evaluated in a multiple baseline across learners, and although the required duration of training differs across individuals, the treatment is generally effective and results in the generalized ability to solve novel problems. The third paper is one of a small number of IRAP studies conducted with children, and specifically measures psychological flexibility in 10-year olds. The IRAPs assessed attitudes toward happiness and sadness, and whether these emotions were perceived as barriers to performing valued activities. The results show a positive bias toward happiness and an indication that neither emotion is perceived as a barrier, interpreted here as evidence of high psychological flexibility.

• Using RFT to teach higher order language and cognition skills to children with autism
Jacob H. Daar, M.A., Southern Illinois University
Mark R. Dixon, Ph.D., Southern Illinois University

Since its inception, practitioners of behavior analysis have striven to understand all aspects of human behavior. One of the more daunting tasks has been the study of the complex human repertoires of verbal behavior. While some progress has been made in this area, traditional conceptualizations of verbal behavior have yielded few applied successes in producing repertoires that extend beyond the most basic of verbal operants. One contemporary approach, Relational Frame Theory (RFT), provides a promising base for launching behavior analysis into a greater understanding and more effective practice of teaching verbal behavior. The current talk will report upon a series of the studies that sought to establish language skills in children with Autism Spectrum Disorder by establishing and building upon repertoires of arbitrarily applicable derived relational responding. Demonstration of the acquisition of complex skills, such as perspective-taking, temporal referencing, inclusion through hierarchical relations and more, will be presented with an emphasis on teaching procedure, the transfer of non-arbitrary relational training to arbitrarily applicable relations, and program adjustment. Implications for future research and the inclusion of RFT based programming in current early intervention and language acquisition curriculums will be discussed.

• Evaluation of a Relational Frame Theory Approach to Teaching Problem-Solving Skills to Children with Autism
Jonathan Tarbox, FirstSteps for Kids
Lisa Stoddard, FirstSteps for Kids
Ashely Farag, FirstSteps for Kids
Erica Christin, FirstSteps for Kids
Amanda Mury, FirstSteps for Kids

Problem solving is a complex behavior that has been the subject of very little previous behavioral conceptual or empirical research. Skinner defined a problem as a situation in which a consequence would be reinforcing, if only the individual possessed the behavior needed to bring it about. Colloquially speaking, a problem is a situation in which one knows what one wants but one does not know what to do to get it. Skinner suggested that the behaviors one engages in that eventually result in making the effective terminal response available are, themselves, to be considered problem-solving behaviors. Problem solving, then, in large part, involves talking to oneself about potential future behaviors and what their outcomes might be. Put another way, problem solving involves deriving multiple rules about potential future actions and their consequences. Relational Frame Theory (RFT) provides a practical analysis of rule-deriving, based on conditional relating and multiple exemplar training. Despite the utility of this analysis, little to no RFT research of which we are aware has attempted to establish problem solving skills in people who do not have them. Children with autism have documented difficulties with problem solving and could therefore benefit from such research. In the current study, Problem solving was taught via multiple exemplar training to children with autism. The component behaviors include identifying the problem, explaining why it’s a problem, creating multiple possible solutions, selecting the solution most likely to be effective, implementing the solution, self-monitoring the success of the solution, and altering the solution if it is not successful. The effects of the treatment were evaluated in a multiple baseline across learners. The required duration of training differed across individuals but the treatment was generally effective and resulted in the generalized ability to solve novel problems.

• Using the IRAP as a measure of psychological flexibility in children
Gloria Torres-Fernandez, M.Sc., University of Jaén, Spain
Monica Hernandez-Lopez, Ph.D., University of Jaén, Spain
Miguel Rodriguez-Valverde, Ph.D., University of Jaén, Spain

The IRAP is a useful method for the measurement of implicit attitudes in several domains. Nonetheless, there is nearly no published research about its implementation with children. This study explores its applicability for measuring psychological flexibility in 10-year old children. Forty-three participants performed two IRAP tasks. The first one assessed attitudes towards emotions of happiness and sadness; the second one assessed whether these emotions were perceived as barriers to performing valued activities. Participants also completed explicit measures of psychological flexibility (AFQ-8Y) and emotional intelligence (EQi-YV). Results show a positive bias towards happiness with the first IRAP. The second IRAP shows no evidence of bias (neither being happy nor being sad were perceived as barriers for performing valued activities). The results from IRAP 2 can be interpreted as indicative of a high degree of psychological flexibility, although they do not correlate with AFQ-8Y scores. These findings point to the IRAP as a potentially useful tool to investigate psychological flexibility.

Educational Objectives:
1. Describe an RFT analysis of problem solving behavior as rule deriving. 2. Describe Skinner's behavioral conceptual analysis of problems and problem solving. 3. Describe an RFT-based intervention to teach children problem solving skills.

 

92. Analyses of the relational processes that improve the effect of metaphors and defusion exercises
Symposium (10:30am-Noon)
Components: Conceptual analysis, Original data
Categories: Relational Frame Theory, Clin. Interven. & Interests, Metaphors, Defusion
Target Audience: Beg., Interm., Adv.
Location: Cascade 1B

Chair: María Belén García-Martín, Fundación Universitaria Konrad Lorenz
Discussant: Carmen Luciano, Universidad de Almería

Research based on relational frame theory (RFT) can be very useful to improve the effect of the techniques used in acceptance and commitment therapy (ACT) such as metaphors and defusion exercises. The current symposium presents studies that try to advance in this direction. The first study shows an analogue study with a pain tolerance task. The main independent variable was the presence or absence of common physical properties to the discomfort experienced during the task in a metaphor that highlighted the benefit of tolerating pain in order to advance in a valued direction. The second study shows the result of a brief ACT protocol with physicalized metaphors versus the same protocol without physicalizing the metaphors. Lastly, the third study presents an experimental analysis of the transformations of functions involved in defusion exercises using the performance on an attentional task as the dependent variable.

• Increasing the effect of metaphors by including common physical properties with the discomfort
Marco Sierra, Fundación Universitaria Konrad Lorenz
Lorena Flórez, Fundación Universitaria Konrad Lorenz
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz
Diana Riaño-Hernández, Fundación Universitaria Konrad Lorenz
Carmen Luciano, Universidad de Almería

This study aims to extend the findings of the basic relational frame theory (RFT) study by Ruiz and Luciano (2015) concerning analogy aptness. These authors found that analogies with common physical properties (CMP) were considered as more apt than purely relational analogies. In this study we try to advance in the clinical implication of the previous finding by designing an analogue study using the cold-pressor as a pain tolerance task. Eighty participants were exposed to a pre-intervention cold-pressor task and then were randomly assigned to four conditions: (1) a metaphor involving personal values and CMP with the discomfort experienced during the task, (2) a metaphor with values but without CMP, (3) a metaphor without values and with CMP, (4) a metaphor without values and without CMP. Subsequently, participants were re-exposed to the cold-pressor task. Results will be discussed highlighting the promotion of metaphor efficacy by incorporating CMP.

• Do we need to physicalize metaphors?: An experimental study with a 1-session ACT protocol
Lorena Flórez, Fundación Universitaria Konrad Lorenz
Marco Sierra, Fundación Universitaria Konrad Lorenz
Francisco J. Ruiz, Fundación Universitaria Konrad Lorenz
Diana Riaño-Hernández, Fundación Universitaria Konrad Lorenz
María Belén García-Martín, Fundación Universitaria Konrad Lorenz
Katherine Barreto, Fundación Universitaria Konrad Lorenz

Metaphors are a widely used clinical tool in acceptance and commitment therapy (ACT). However, the analysis of the metaphor elements that potentiate their effect is still scarce. One guideline that is often provided in ACT books and workshop is that physicalize metaphors can improve their effect. This study aims to analyze this point by applying two almost identical 1-session ACT protocols: one that only introduced metaphors verbally and one that introduced the same metaphors in a physical way. Thirty participants suffering from mild to moderate emotional symptoms and dysfunctional worry and rumination were recruited. The ACT protocols were based on the 1-session protocol conducted by Ruiz, Riaño-Hernández, Suárez-Falcón, and Luciano (2016) and focused on reducing worry and rumination levels. Primary outcomes were measure of repetitive negative thinking and emotional symptoms, whereas process measures included experiential avoidance, cognitive fusion, and valued actions.

• The effects of different types of relational framing in defusion interactions on attentional performance
Juan C. López-López, Universidad de Almería
Carmen Luciano, Universidad de Almería

The current study aimed to analyze the effects of the relational framings involved in defusion on attentional performance. Fifty-two participants completed several questionnaires and two experimental tasks which induced discomfort (pre-test). Then, they were randomly assigned to one of the following conditions: (a) Defusion I, where participants received a protocol based on framing own behavior in distinction with the deictic ’I’, (b) Defusion II also included the hierarchical framing, (c) Defusion III added the regulatory functions, (d) Defusion IV included the discrimination of defused behaviors, and (e) Control, which did not include any active component. Finally, participants were re-exposed to the experimental tasks (post-test). Results indicate that all participants’ performance increased after the intervention. However Defusion III and IV showed better results than Control condition and Defusion I and only Defusion IV showed superiority to Defusion II. The relevance of these data is discussed in terms of improving defusion interactions.

Educational Objectives:
1. Explain the potential of RFT research to improve the effect of techniques used in ACT. 2. Describe some of the relational processes responsible for the effect of metaphors according to RFT. 3. Explain the relational processes underlying the effect of defusion exercises.

 

96. Delivering ACT in Technology-Based Formats: Outcomes, Processes, and Provider Attitudes
Symposium (10:30am-Noon)
Components: Original data
Categories: Clinical Interventions and Interests, Technology
Target Audience: Interm.,
Location: Puget Sound

Chair: Kristy Dalrymple, Ph.D., Rhode Island Hospital; Alpert Medical School of Brown University
Discussant: Roger Vilardaga, Ph.D., University of Washington

Research in recent years has explored internet and mobile technology interventions as treatment options to address logistical barriers to effective treatment (Barak et al., 2008). For example, these delivery formats may be more cost-effective, reduce the risk of dropout (Hedman et al., 2011), improve adherence rates (Andersson, 2009; Carlbring et al., 2011), address varied learning styles and education levels, and provide ongoing opportunities for independent skill learning and application. Thus far, ACT-based internet and mobile interventions have demonstrated efficacy, but additional research in this area is needed to refine them and maximize their “reach.” The first presentation will discuss the development and initial outcomes of a brief, values-based internet-delivered adjunctive program for depression and anxiety. The second will present results from a smartphone-based just-in-time adaptive intervention for adherence to a weight loss diet. The third will discuss results from an ACBS member survey assessing therapist attitudes towards ACT-based mobile apps.

• Development of a Brief, Values-Based Online Adjunctive Intervention for Depression and Anxiety
Kristy Dalrymple, Ph.D., Rhode Island Hospital; Alpert Medical School of Brown University
Michael Levin, Ph.D., Utah State University
Jack Haeger, B.A., Utah State University
Emily Walsh, B.A., Rhode Island Hospital
Lia Rosenstein, B.A., Rhode Island Hospital
Brandon Gaudiano, Ph.D., Butler Hospital; Alpert Medical School of Brown University

Many studies have examined online treatments as primary therapeutic programs, but few have examined their use as adjunctive treatments in routine clinical practice. Some data suggest a stronger effect when they are used as adjunctive treatments compared to primary programs (Spek et al., 2007). Internet-based ACT treatments have shown efficacy in the treatment of a variety of problems, and have proven to be a viable therapeutic option (e.g., Lappalainen et al., 2013; Bricker et al., 2013). The aim of the present study is to develop and pilot test a 4-session values-based online program as an adjunctive treatment for depression and anxiety in routine clinical practice settings. Sixteen participants have been enrolled thus far, with data collection ongoing. Changes in depression and anxiety symptoms, valued living, and psychological flexibility over the 4 sessions will be presented. Additional results (e.g., acceptability/feasibility), limitations, and implications of the findings will be discussed.

• A Preliminary Investigation of a Just-In-Time Smartphone Application to Promote Dietary Adherence
Stephanie P. Goldstein, B.S., Drexel University
Evan Forman, Ph.D., Drexel University
Brittney C. Evans, Drexel University
Stephanie M. Manasse, Drexel University
Adrienne S. Juarascio, Ph.D., Drexel University
Meghan L. Butryn, Ph.D., Drexel University

Lack of success in weight loss programs can be attributed to poor adherence to dietary recommendations, i.e., dietary lapses. As such, we have set out to create a smartphone-based system, called DietAlert that utilizes machine learning to predict lapse behavior and deliver tailored, momentary interventions. Preliminary quantitative and qualitative results suggest that participants (current n=12) were highly satisfied with the app (M=6.42/7.00) and felt that it enhanced awareness of behaviors contributing to lapses. Currently 159 interactive interventions have been developed based on principles of acceptance and commitment therapy, dialectical behavior therapy, social cognitive theory, and the transtheoretical model of behavior change. Clarity, satisfaction and preliminary effectiveness of the intervention-capable app will be presented. Overall, results will be used to evaluate the potential of DietAlert and similar systems to meaningfully improve weight loss and other health behaviors.

• Use, preferences, and barriers with ACT-related mobile apps: Results from a survey of ACBS members
Michael E. Levin, Ph.D., Utah State University
Benjamin Pierce, Utah State University
Michael Twohig, Ph.D., Utah State University

The use of mobile apps to support mental health care is a growing trend and several ACT-related mobile apps have recently been developed. However, little is known about the use, attitudes, and needs of mental health providers in using ACT-related mobile apps. An improved understanding could inform more effective development, dissemination and implementation of ACT-related apps in clinical work. The current survey study assessed 356 ACBS members regarding their use, interest, preferences and barriers to using ACT-related mobile apps. Results suggest participants were not familiar with (65%) and rarely used these apps with clients (65%). However, the vast majority (93%) were interested in using ACT apps. Patterns were identified in terms of highly and poorly rated app features/functions as well as barriers to app use (e.g., lack of guidelines, ethical concerns, privacy). Results of the survey are discussed in the context of ongoing development and implementation efforts with ACT-related apps.

Educational Objectives:
1. Describe the development and preliminary results of a brief, values-based online adjunctive intervention for depression and anxiety in routine clinical practi. 2. Describe the phases of development for a just-in-time smartphone application that promotes dietary adherence and use this knowledge to develop similar smartphone apps for other health behaviors. 3. Explain barriers and facilitators to using ACT-related mobile apps in clinical work.

 

97. Building an Empirical Bridge: Linking Technique to Evaluation in Applications of the Matrix: Mexico Chapter Sponsored
Symposium (10:30am-Noon)
Components: Original data
Categories: Clinical Interventions and Interests, The Matrix, Research Design
Target Audience: Interm., Adv.
Location: Pike

Chair: Benjamin Pierce, M.S., Utah State University
Discussant: XXX,

The Matrix (Polk & Schoendorff, 2014) has emerged as a popular experiential clinical model among ACT therapists and practitioners, yet has received little research attention may be because its recent dissemination. Despite a variety of applications among clinicians, coaches, and consultants, the extent to which the Matrix improves outcomes as a stand-alone or adjunctive intervention remains unclear from an empirical standpoint. Further, there exist few recommendations for how to track client progress with a Matrix-based intervention, or incorporate the Matrix into a research paradigm. Therefore, this symposium presents diverse applications of the Matrix and methods for studying it in clinical and coaching applications. It attempts to bridge the gap between the technique and empirical evaluation by providing a range of examples of how to study the Matrix in practice settings. Further, it discusses the promise and challenges of conducting applied research with the Matrix model.

• Testing the Matrix as an Enhancement of ACT for People Diagnosed with BPD
Michel Reyes, Ph.D., Contextual Behavioral Science and Therapy Institute (Mexico City)
Benjamin Schoendorff, M.A., MSc., M.Ps., Contextual Psychology Institute (Quebec)
Nathalia Vargas, Psy.D., Contextual Behavioral Science and Therapy Institute (Mexico City)
Edgar Miranda Terres, MPs, CBS and Therapy Institute, Mexico City; Mexico's National Institute of Psychiatry (INPRF)
Arango, I., Mexico National Institute of Psychiatry

A pre-posttest with six months follow RCT (n=71) was conducted to test ACT Matrix clinical value as an addition to an already tested traditional ACT treatment for BPD diagnosed clients. The study consisted of two group´s receiving ACT (n=34) or ACT+Matrix (n=37) treatment. T test analysis showed statistically significant p ≤ .05) and large size effects (d ≥ .80) improvements in posttest and follow up scores compared to prestest in BPD symptom severity, psychological flexibility, emotion regulation and self-stability self-administered questionnaires. T test between groups showed statistically significant and large size effects in favor of ACT+Matrix group at posttest and follow up. Mediation analysis indicate that psychological flexibility mediated change in BPD symptoms in both groups. This results suggest Act Matrix significantly enhanced classic ACT impact, and provides evidence of ACT Matrix clinical value as a functional contextualist tool that improves psychological flexibility.

• Developing an “easy to use” visual analysis of clinical data using the Matrix
Fabián Olaz, Psy.D., Integral Center of Contextual Psychoterapies, Cordoba, Argentina

Currently, many clinicians have chosen to integrate different interventions into matrix work noticing their clients becoming more engaged and interventions becoming simpler. Olaz (in preparation) developed a simple protocol using a special worksheet developed by Schoendorff to work with depressive clients doing Behavioral Activation. I this presentation I will show an evidence-based procedure to conduct visual analyses of single-subject data using the Matrix. Specifically, I will show the results of a N=1 (ABAB) design carried out to provide evidence of a Matrix based Behavioral Activation intervention for a male client, with depressive symptomatology. Taking into consideration that visual analysis of data is the basis of single-subject research participants will learn an easy way to make visual representations and will be able to apply this procedure to their clients and to continue this Matrix research trend in clinical settings.

• Prompting the “Away-Towards” Distinction in Matrix-Based Health Behavior Change
Benjamin Pierce, M.S., Utah State University
Michael E. Levin, Ph. D., Utah State University
Benjamin Schoendorff, M.A., M.Sc., M.Ps., Contextual Psychology Institute (Quebec)

The Matrix was developed as a way to succinctly demonstrate core concepts in Acceptance and Commitment Therapy (ACT). One of these concepts is the distinction between behaviors intended to move “towards” values versus “away” from unwanted inner experiences. Despite its centrality to the Matrix, scant research has examined whether the “away-towards” distinction helps people make values-consistent choices or fosters psychological flexibility. Therefore, this study examined the utility of prompting “away-towards” discrimination in a Matrix-based coaching intervention for health behavior change. The coaching paradigm with app-based prompting will be presented, along with the results of ecological momentary intervention (EMI) data from a mixed college student and community sample. The implications of the study findings for understanding mechanisms of change within Matrix-based interventions will be discussed. Recommendations for ecologically prompting ACT processes using Matrix will be provided.

Educational Objectives:
1. Provide a variety of examples of how to monitor client progress using the ACT Matrix from diverse applications. 2. Describe current approaches to studying the Matrix from diverse methodologies and in diverse applied settings. 3. Identify possible benefits and challenges associated with conducting research on the Matrix.

 

99. Which Skills for Whom?: Identifying and Applying Mindfulness Skills in Diverse Populations
Symposium (10:30am-Noon)
Components: Conceptual analysis, Original data
Categories: Clinical Interventions and Interests, Mindfulness, Meditation
Target Audience: Beg., Interm., Adv.
Location: Mercer/Denny

Chair: Brian Pilecki, Rhode Island Hospital; Alpert Medical School of Brown University
Discussant: Dennis Tirch, The Center for Compassion Focused Therapy

Mindfulness-based treatments (MBTs) are increasingly popular for a range of medical and psychiatric problems. They have shown to provide efficacious and effective treatment, particularly for anxiety and depression (Hofmann et al., 2010) but also for overall well-being (Carmody & Baer, 2008). However, there is no consensus regarding the definition of mindfulness, which may comprise several facets or processes. This impacts both researchers—whose outcomes may be obfuscated by poor measurement/definitions—and clinicians, who may struggle to clarify targets of change. This symposium presents three investigations into specific mindfulness components across diverse populations. The first presents concurrent analyses of mindfulness skills, symptoms, and impairment in psychiatric and medical outpatients. The second presents results from an acute-care setting, assessing characteristics and treatment outcomes in patients choosing to attend meditation groups. The final presents results of an innovative mindfulness-based intervention targeting self-care in healthy adults and its impact on different aspects of mindfulness.

• Concurrent relations between mindfulness processes, psychiatric symptoms, and functioning in psychiatric and pre-bariatric surgery outpatients
Theresa A. Morgan, Rhode Island Hospital; Alpert Medical School of Brown University
Kristy Dalrymple, Rhode Island Hospital; Alpert Medical School of Brown University
Brian Pilecki, Rhode Island Hospital; Alpert Medical School of Brown University
Catherine D'Avanzato, Rhode Island Hospital; Alpert Medical School of Brown University
Kirsten Langdon, Rhode Island Hospital; Alpert Medical School of Brown University
Darren Holowka, Ph.D., Rhode Island Hospital; Alpert Medical School of Brown University
Mark Zimmerman, Rhode Island Hospital; Alpert Medical School of Brown University

Links between (1) mindfulness and psychiatric symptoms and (2) mindfulness and functioning are well-established. However, few studies examine unique contributions of mindfulness to symptoms and functioning concurrently. A single exception assessed this model only in alcohol use (Fernandez et al., 2010). We present results analyzing concurrent relations between symptoms, functioning, and mindfulness processes in two transdiagnostic samples. Participants included 1099 psychiatric outpatients and 1820 bariatric surgery candidates, each of whom completed the Five-Facet Mindfulness Questionnaire (FFMQ) as well as established measures of symptoms and psychosocial functioning. Results showed that four of five mindfulness facets (Observe, Act with Awareness, Nonjudge, Nonreact) related to symptoms and functioning in both samples. However, direct and indirect effects modeled varied between samples, suggesting differential import of mindfulness skills in each group. The fifth scale (Describe) was dropped from both models. Additional findings, limitations, and implications for the conceptualization and assessment of mindfulness will be discussed.

• Initial Results of a Daily Meditation Group for Patients in an ACT-Based Intensive Partial Care Program
Brian Pilecki, Rhode Island Hospital; Alpert Medical School of Brown University
Theresa A. Morgan, Rhode Island Hospital; Alpert Medical School of Brown University
Matthew Multach, Rhode Island Hospital
Kristy Dalrymple, Rhode Island Hospital; Alpert Medical School of Brown University
Catherine D'Avanzato, Rhode Island Hospital; Alpert Medical School of Brown University
Darren Holowka, Rhode Island Hospital; Alpert Medical School of Brown University
Mark Zimmerman, Rhode Island Hospital; Alpert Medical School of Brown University

An optional meditation group was offered to patients in an ACT-based partial hospitalization program. Adapting meditation to this severe population will be discussed, as well results related to satisfaction and acceptability. Demographic differences between patients who choose to attend will be discussed, suggesting which types of patients may mostly benefit from mindfulness training. Preliminary results show trends towards being female (78.95) and having attended at least some college (79.2%). Differences between attending and non-attending patients will show whether daily meditation has an incremental impact mindfulness skills that relate to improved treatment outcomes. Preliminary results of 107 patients suggest that despite equal baseline scores, patients who attended the meditation group had higher scores on the FFMQ (Baer et al., 2006) subscale of observing (3.1) and nonreacting (2.4) than patients who did not attend (2.7;2.0; t = -2.66, p = .01; t = -2.3, p =.03).

• The Effectiveness of a Mind-Body Training to Foster Self-Care in Health Professionals
Myriam Rudaz, Utah State University
Brooke Smith, Utah State University
Sarah Potts, Utah State University
Michael Levin, Utah State University
Michael Twohig, Utah State University

Although working as a health professional can lead to satisfaction, health professionals are also vulnerable to develop compassion fatigue and burnout. We present preliminary result of graduate students in applied programs that were randomly assigned to either a brief mind-body training using Mindfulness-Based Stress Reduction (MBSR) and values-oriented Acceptance and Commitment Therapy (ACT) or to a waitlist control group. The training consisted of one mind-body day and four booster sessions over the course of four weeks. In addition, participants were invited to use a mindfulness or values mobile app. Self-reported questionnaires measuring five aspects of mindfulness (observing, describing, acting with awareness, non-judging of inner experience, and non-reactivity to inner experience), self-care, stress, burnout, compassion fatigue/satisfaction, self-compassion, and acceptance were administered at three time points: before the mind-body day, 4 weeks after, and 8 weeks after the mind-body day. The results will be discussed in the light of feasibility and acceptance of the mind-body training for health professionals as well as which aspects of mindfulness seem to be most relevant for this population.

Educational Objectives:
1. Explain conceptual and methodological limitations in studying mindfulness. 2. Demonstrate a greater understanding of issues in adapting mindfulness-based interventions to specific populations. 3. Describe examples of future research studies needed in helping to further clarify the multi-faceted nature of mindfulness skills.

 

104. Eating Disorder Interventions
Symposium (2:45-4:15pm)
Components: Original data
Categories: Clinical Interventions and Interests, Beh. med., Anorexia Nervosa, Eating Disorders
Target Audience: Beg., Interm., Adv.
Location: Vashon 1

Chair: Ashley A. Moskovich, Ph.D., Duke University Medical Center
Discussant: Adria Pearson-Mauro, PhD, University of Colorado, Denver

Eating disorders and efforts to control weight are major issues for our population. These studies will discuss findings on two groups who struggle with these issues – people with Anorexia Nervosa and people with Type 1 Diabetes (T1D). Anorexia Nervosa (AN) is one of the deadliest psychiatric conditions and is extremely challenging to treat. According to a contextual approach, rigid rule-following might be a significant factor in the behavior of those with AN. We present data from a study on the relationship between insensitivity to contingencies and tolerance of uncertainty in adults weight-recovered from AN. In another study, we examined the effect of an ACT-based family treatment for adolescents with AN with particular attention to psychological flexibility and anxiety reduction as processes of change in adolescent and parent behavior. We also present data from studies on the impact of negative affect, distress, and avoidance related to Type 1 Diabetes (T1D) and eating disorders and proper insulin administration. We describe how we are translating these findings into an ACT-based mobile intervention to improve management in the natural environment as well as how these findings might inform practice within endocrinology clinics to reduce the incidence of EDs in this vulnerable population.

• Diabetes Distress and Avoidance: Key Contributors to Life-Threatening Eating Disorders in Type 1 Diabetes
Ashley A. Moskovich, Ph.D., Duke University Medical Center
Natalia O. Dmitrieva, Ph.D., Northern Arizona University
Nancy L. Zucker, Ph.D., Duke University Medical Center
Lisa K. Honeycutt, M.A., Duke University Medical Center
Rhonda M. Merwin, Ph.D., Duke University Medical Center

Eating disorders (EDs) are common among young women with type 1 diabetes (T1D) and incur 3-fold increased risk of early and severe diabetes-related medical complications and premature death (1-2). Studies indicate EDs in T1D do not respond optimally to conventional ED treatments (3), suggesting unique contributory factors that are not adequately addressed with extant treatments. T1D is an autoimmune disorder in which individuals survive by self-administering insulin based on current blood sugar and insulin-to-carbohydrate ratios. This is an inherently imprecise system that incurs health consequences irrespective of how well it is implemented. Among individuals with T1D, ED symptoms may function to manage distress related to living with a chronic illness in which there is little certainty or control over negative outcomes. Eighty-three adults (63 with EDs and 20 T1D controls) completed a comprehensive assessment battery, including 28-day retrospective recall of ED symptom frequency and 3 days of momentary assessment in the natural environment. We conducted a series of theoretically driven tests to identify factors accounting for the greatest variance in ED symptom severity, including traditional predictors of EDs (e.g., perfectionism) and diabetes-specific factors (diabetes distress and avoidance). Diabetes distress and avoidance were the strongest predictors, accounting for 56% variance in ED symptomatology over the past 28 days, 38% variance in metabolic control and 11-38% variance in frequency of binge eating and insulin restriction for weight loss over the 3-day period (ps< .05). We describe how these findings might inform practice within endocrinology clinics to reduce the incidence of EDs in this vulnerable population. (5R01 DK-089329-03, Merwin).

• Rigid Rule-following and Intolerance of Uncertainty in Anorexia Nervosa
Ashley A. Moskovich, Ph.D., Duke University Medical Center
Rhonda M. Merwin, Ph.D., Duke University Medical Center
Nancy L. Zucker, Ph.D., Duke University Medical Center

Anorexia nervosa (AN) is characterized by rigid rule-following (e.g., calorie limits) despite negative and potentially life-threatening outcomes (1). A neuropsychological account attributes this rigidity to neurocognitive deficits in cognitive flexibility (i.e., the inability to shift mental sets) (2). The current paper presents data suggesting that rigid adherence to rules in AN may be formulated as avoidant behavior that emerges in contexts of uncertainty. We administered the Wisconsin Card Sorting Task (WCST) to 36 adults weight-recovered from AN (AN-WR) and 38 control participants (CN). The WCST requires individuals to formulate rules (e.g., sort according to shape) and then adjust their rules in response to task contingencies. We tested the relationship between perseverative errors (i.e., failure to adjust to new contingencies) and intolerance of uncertainty. As expected, the AN-WR group made a greater number of perseverative errors relative to the CN group (p<.01). Perseverative errors were related to intolerance of uncertainty exclusively in the AN-WR group (p<.05). Findings suggest that individuals with AN may rigidly adhere to rules as a way to decrease the experience of uncertainty, but that this in turn decreases sensitivity to environmental feedback. Individuals with AN may therefore benefit from targeted interventions that increase behavioral flexibility in the presence of uncertainty.

• Psychological Flexibility as a Process of Change in the Treatment of Anorexia Nervosa
Rhonda M. Merwin, Ph.D., Duke University Medical Center
Ashley A. Moskovich, Ph.D., Duke University Medical Center
Lisa K. Honeycutt, M.A., Duke University Medical Center
Nancy L. Zucker, Ph.D., Duke University Medical Center
James D. Herbert, Ph.D., Drexel University
C. Alix Timko, Ph.D., Children's Hospital of Philadelphia
Natalia O. Dmitrieva, Ph.D., Northern Arizona University

Anorexia nervosa (AN) is the deadliest of the psychiatric conditions and remains one of the most challenging to treat (1). Outcomes have improved over the last 20 years with family based treatment (FBT), but only half the adolescents treated achieve full remission (2). This has resulted in augmentation of FBT in effort to potentiate treatment effects (3-4). However, treatment augmentations are occurring largely in the absence of data on the processes by which individuals with AN improve. We describe a series of analyses examining processes of change among adolescents with AN treated with an ACT-based family treatment. Forty-seven adolescents completed 6 months of treatment and 3 months of follow-up. We tested an increase in psychological flexibility and a decrease in anxiety (over the course of treatment) as competing hypotheses of processes of change in adolescent AN, and examined relative contribution of change in the adolescent versus change in the parents in predicting outcomes. An increase in adolescent psychological flexibility over the course of treatment predicted decreased AN symptomatology at post-treatment (ps< .05), with a similar trend at follow-up. An increase in mother psychological flexibility accounted for additional variance in adolescents’ eating concerns and predicted lower levels of parent expressed emotion (known to be associated with poor prognosis) (5-6) at end-of-treatment (ps<.05). Decreases in parent or child anxiety, in contrast, were less consistently associated with outcomes and accounted for less variance in AN symptoms.

• Using Mobile Technology to Reach Individuals with Type 1 Diabetes Intentionally Withholding Insulin to Lose Weight
Rhonda M. Merwin, Ph.D., Duke University Medical Center
Natalia O. Dmitrieva, Ph.D., Northern Arizona University
Ashley A. Moskovich, Ph.D., Duke University Medical Center
Lisa K. Honeycutt, M.A., Duke University Medical Center
Nancy L. Zucker, Ph.D., Duke University Medical Center
Richard S. Surwit, Ph.D., Duke University Medical Center
Mark Feinglos, MD, Duke University Medical Center

Individuals with type 1 diabetes (T1D) who restrict insulin to control weight are at high risk for diabetes-related complications and premature death (1-3). However, little is known about this behavior or how to effectively intervene. We used ecological momentary assessment (EMA) methods to identify real time precursors to intentional insulin restriction among 83 individuals with T1D. Participants reported emotions, eating, and insulin dosing throughout the day using their cellular telephone. Linear mixed models were used to estimate the effects of heightened negative affect (e.g., anxiety) prior to eating and characteristics of eating episode on risk of insulin restriction. Individual differences in average negative affect impacted the likelihood of restricting insulin such that a one unit increase in average negative affect above the sample mean more than quadrupled the odds of insulin restriction (OR, 6.77; p<0.01). Momentary increases in anxiety and guilt/disgust 60 minutes prior to eating further increased odds of restricting insulin at the upcoming meal (OR, 1.72–1.84; ps<.05). Insulin restriction was more likely when individuals reported that they broke a dietary rule (e.g., “No desserts.”) (OR, 11.07; p<.001). Results suggest that insulin restriction might be decreased by helping T1D patients respond effectively to heightened negative affect and encouraging patients to take a less rigid, punitive approach to diabetes management. We describe how we are translating these findings into an ACT-based mobile intervention to improve management in the natural environment (5R01 DK-089329-03, Merwin; 1 R21 DK106603-01; Merwin).

Educational Objectives:
1. Describe neurocognitive differences observed among individuals with anorexia nervosa (e.g., deficits in set-shifting) behaviorally. 2. Discuss how psychological flexibility as a process of change may inform the continued evolution of family-based treatment in adolescent anorexia nervosa. 3. Describe how findings are being translated into an ACT-based mobile intervention to reduce insulin restriction for weight control in the natural environment.

 

105. To blend or not to blend: Advantages of mixing ACT with new technologies
Symposium (2:45-4:15pm)
Components: ,Didactic presentation
Categories: Clinical Interventions and Interests, Prevention & Comm.-Based, Beh. med., Technology
Target Audience: Beg., Interm., Adv.
Location: Vashon 2

Chair: Ellen Excelmans, Psy.D., Learn2ACT, Belgium
Discussant: Michael E. Levin, Ph.D., Utah State University, Logan, Utah

Technology permeates our world: in a relatively short period of time, the internet, smartphones, and tablets have become an essential part of our lives. It is therefore not surprising that these new technologies have also started to play a significant role in mental health care. The possibilities are enormous and many of our clients are ready for change. To the ACT-therapist, however, the added value of these new technologies is not always clear. Technology surely can’t replace the therapist, but blending technology with our therapeutic work has it’s benefits. Furthermore, when direct therapy isn’t an option due to perceived stigma or logistical barriers, technology can provide an alternative method for intervention. In this symposium we present four mobile applications developed by and for ACT-therapists. We examine how these apps can enrich our therapeutic work, provide support to individuals outside of the therapy room, and also reflect on their limitations.

• Learn to Quit: Rationale, ideation, design and testing of a smoking cessation app for people with psychiatric disorders
Roger Vilardarga, Ph.D., University of Washington, Department of Psychiatry and Behavioral Sciences
Javier Rizo, B.A., Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA
Emily Zeng, B.A., Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA
Julie A. Kientz, Ph.D., Department of Human Centered Design and Engineering, University of Washington, Seattle, WA
Brian Marr, MBA, Smashing Ideas, Seattle, WA
Chad Otis, B.A., Smashing Ideas, Seattle, WA
Richard Ries, MD, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA

Smoking rates in the US have been reduced in the last decades to 17% of the general population. However, up to 88% of people with psychiatric symptoms still smoke, leading up to high rates of disease and mortality. Therefore, there is a great need to develop smoking cessation interventions that are inexpensive, have high reach and can be used in conjunction with health providers. Contextual behavioral science and digital technology design can be leveraged together to address this need. In this presentation we report the rationale, ideation, design and testing of a novel smoking cessation app for people with a diagnosis of schizophrenia, schizoaffective and bipolar disorder, and chronic recurrent depression. With the collaboration of Smashing Ideas, a leading partner in the design of digital experiences, we will describe the development of Learn to Quit, an ACT smoking cessation app that promotes quitting through Learning, Practice and Play. Funding: National Institute of Drug Abuse (1K99DA037276-01) to RV

• Learn2ACT: A 'handy' life compass
Ellen Excelmans, Psy.D., Learn2ACT, Belgium
Bart Roelands, M.E., Learn2ACT, Belgium
Richard Ries, MD, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA

Learn2ACT was developed as an answer to certain needs in our clinical practice. We were looking for a way to help our clients work on what they've learned in therapy outside the therapy room. A mobile app seemed the solution. It provides the oppurtinity to monitor and intervene in-time and in-place. We will present the functionalities of Learn2ACT and show some premilinary research data. In our research we examined the added value of the Learn2ACT app to the satisfaction and the effectiveness of an ACT group treatment. Participants of ACT groups from three mental health care services in Flanders took part in the study. A pre- and post-assessment of quality of life and psychological flexibility (OQ-45, VLQ and FIT-60) was conducted. We found that people with a positive attitude towards technology benefit the most from the app. mHealth seems to be a virtual food for someone who's hungry.

• Using mobile technology to augment therapy and provide self-help: Preliminary research findings with the ACT Daily mobile app
Jack A. Haeger, B.A., Utah State University, Logan, Utah
Michael E. Levin, Ph.D., Utah State University, Logan, Utah

Mobile applications are a promising technology for improving mental health services. These programs are readily available throughout the day, provide a convenient system to monitor and prompt skill use, and can tailor content based on clients’ responses. Thus, a mobile app could be used to integrate a high frequency/low intensity skill coaching program into clients’ daily life. In response, we developed ACT Daily, a prototype mobile app that utilizes an ecological momentary intervention design that prompts the user throughout the day to check-in with distress levels and ACT processes, followed by a recommended tailored intervention based on check-in data. Results will be presented on three studies: 1) ACT Daily as an adjunct to face-to-face ACT therapy, 2) self-guided ACT Daily as a support for individuals on a college counseling center waitlist, and 3) RCT comparing self-guided ACT Daily to a waitlist condition with depressed and/or anxious college students.

• Understanding Requirements for Self-Experimentation to Tailor the Effectiveness of Mobile Interventions for Smoking Cessation
Arpita Bhattacharya, M.S., Dept. of Human Centered Design and Engineering, University of Washington, Seattle, WA
Sean A. Munson, Ph.D., Dept. of Human Centered Design and Engineering, University of Washington, Seattle, WA
Roger Vilardaga, Ph.D., Dept. of Psychiatry and Behavioral Science, University of Washington, Seattle, WA
Julie A. Kientz, Ph.D., Dept. of Human Centered Design and Engineering, University of Washington, Seattle, WA
James Fogarty, Ph.D., Dept. of Human Centered Design and Engineering, University of Washington, Seattle, WA
Jasmine Zia, MD, Division of Internal Medicine, University of Washington, Seattle, UW

Quitting smoking can be better supported with provider expertise and guidance. However, strategies that work for one individual might not work for others. Trying strategies unsystematically can lead to inconclusive results and client burden. A mobile application that walks participants through a systematic process of self-experimentation could address this need. We interviewed 28 providers to understand their smoking cessation counseling experience and obtained their feedback on low fidelity prototypes of a smoking cessation mobile application based on the concept of self-experimentation. We analyzed these interviews to identify design requirements for the application to support expertise of providers in various behavioral strategies such as ACT. Providers emphasized the need for an individualized approach to counselling and enabling clients with a tool to evaluate interventions systematically based on their own tracking data. Findings from this study will inform the design of a framework for self-experimentation that individualizes support for smoking cessation. Funding: 2015 UW Innovation Award to AB, SM, JK, and RV; NIDA (1K99DA037276-01) to RV.

Educational Objectives:
1. Describe the design and the development process of four ACT applications. 2. Apply ACT applications in therapy. 3. Explain the added value of using apps in combination with therapy and explore how apps can be used outside of therapy in a self-help format.

 

108. Substance Use and CBS
Symposium (2:45-4:15pm)
Components: Conceptual analysis, Literature review, Original data, Didactic presentation
Categories: Clinical Interventions and Interests, Prevention and Community-Based Interventions, Theory & Philo., RFT, Mindfulness, Motivational Interviewing, Substance Abuse
Target Audience: Beg., Interm., Adv.
Location: Cascade 1B

Chair: Aaron L. Bergman, M.A., M.S., Pacific University
Discussant: Don Sheeley, M.D.,

Substance abuse presents a significant economic and public health burden. To address this growing crisis, further development and understanding of effective treatment approaches are needed. Relapse following treatment for substance use disorders is highly prevalent, and craving has been shown to be a primary predictor of relapse. The results from a Mindfulness-based Relapse Prevention intervention on the relationship between cravings and relapse will be presented. In addition, data from a study examining the role of psychological flexibility and specific facets of mindfulness in predicting cravings will be discussed. Another issue in substance abuse is faced by parents struggling with a substance using child face a dearth of evidence-based practitioners and resources at a moment of tremendous need, leaving them few reasonable options. We will discuss the development of a Parent-to-Parent “shared experience” national coaching network based on the research-supported principles embedded in Motivational Interviewing (MI) and Community Reinforcement and Family Therapy (CRAFT) and present pilot data from 50 coaching cases. Last, a conceptual paper exploring the refinement of MI technology over time and accounting for them in relational frame theory (RFT) terms to show where MI is consistent or inconsistent with other CBS approaches will be presented including suggestions for increasing harmony between the two.

• Clarifying the Relationship Between Substance Craving, Mindfulness, and Psychological Flexibility
Aaron L. Bergman, M.A., M.S., Pacific University
Josh Kaplan, B.A., Pacific University
Michael Christopher, Ph.D., Pacific University
Sarah Bowen, Ph.D., Pacific University

Substance abuse presents a significant economic and public health burden. To address this growing crisis, further development and understanding of effective treatment approaches are needed. Interventions intended to increase psychological flexibility and mindfulness have demonstrated promising outcomes in addictions treatment. Psychological flexibility and mindfulness appear conceptually related, both demonstrating meditating roles between treatment and outcomes across contexts. The current study attempted to clarify the relationship between psychological flexibility and mindfulness by examining how these constructs predict craving, a primary predictor of relapse. Hierarchical liner regressions suggested mindfulness was significantly negatively associated with craving (β=-.29, p < .001), but psychological flexibility only yielded a trend-level relationship (β = .10, p=.07). Subsequent regression models examined specific facets of mindfulness. Results demonstrated Acting with Awareness (β=-.31, p < .001) and Non-reactivity (β = -.15, p=.015) accounted for variance in craving, while psychological flexibility did not (β = .07, p = .280). These findings suggest that mindful awareness and non-reactivity should be a central target for addiction intervention, above and beyond psychological flexibility. Clinical implications are discussed.

• Combining Shared Experience and Evidence-Based Models In Addiction: Development of a Parent-to-Parent Coaching Network
Jeff Foote, Ph.D., Center For Motivation and Change

Parents struggling with a substance using child face a dearth of evidence-based practitioners and resources at a moment of tremendous need, leaving them few reasonable options. “Self-help” options (typically 12-Step “Anon” programs) can provide support, but offer little in the way of evidence-based understandings or practices. We discuss development of a Parent-to-Parent “shared experience” national coaching network based on the research-supported principles embedded in Motivational Interviewing (MI) and Community Reinforcement and Family Therapy (CRAFT). Parents coach other parents in communication, positive reinforcement and self-care strategies, also incorporating their own strengths and experience, an approach found highly acceptable to other parents, potentially addressing the low penetrance of evidence-based strategies among families and extending evidence-based practices to a wider range of under-served communities. Coaching also provides a healing and self-sustaining role for parents, potentially impacting the long-term sustainability of a self-help coaching network. Pilot data on 50 coaching cases will be presented.

• Mindfulness practice moderates the relationship between craving and substance use in a clinical sample
Matthew Enkema, University of Washington
Sarah Bowen, Ph.D., Pacific University

Objective: Relapse following treatment for substance use disorders is highly prevalent, and craving has been shown to be a primary predictor of relapse. Mindfulness-based relapse prevention (MBRP) is a psychosocial aftercare program integrating mindfulness and cognitive-behavioral approaches, aimed at reducing the risk and severity of relapse. Results from a recent randomized clinical trial demonstrate enhanced remission resilience for MBRP participants versus both cognitive-behavioral and treatment-as-usual controls. The current study investigated between-session formal and informal mindfulness practice, a hypothesized primary mechanism of action in this treatment, as an attenuating factor in the relationship between craving and substance use. Method: Participants in this secondary analysis were 57 eligible adults who completed either inpatient treatment or intensive outpatient treatment for substance use disorders, were randomized in the parent study to receive MBRP, and completed relevant follow-up assessments. Results: For formal mindfulness practice at post-course, both number of days per week (p=.006) and number of minutes per day (p=.010) significantly moderated the relationship between craving at post-course and number of substance use days at 6-month follow up. Informal practice did not significantly influence the craving-use relationship in this analysis. Conclusions: These results indicate that increasing formal mindfulness practice may reduce the link between craving and substance use for MBRP participants and enhance remission resiliency.

• Integrating Motivational Interviewing into Contextual Behavioral Science
Sean P. Wright, M.A., M.S., LMHC, Lutheran Community Services Northwest

Motivational Interviewing (MI) is a widely used therapeutic approach to support behavior change that is of increasing interest to the contextual behavioral science (CBS) community. Christopher and Dougher (2009) provided a behavior-analytic account (including derived relational responding) of MI that was fundamentally sound. That account was of necessity brief on details about how MI guides the therapist to increased contextual control of therapeutic responses to client verbal behavior. Moreover, MI has continued to develop in recent years, most notably abandoning the term “client resistance” (which had historically acquired strong contextual control over therapist behavior when clients were labeled resistant) in favor of the term “discord” in order to foster more effective therapist responses. This conceptual paper explores the refinement of MI technology over time and accounts for them in relational frame theory (RFT) terms to show where MI is consistent or inconsistent with other CBS approaches. After reviewing the developments in MI over time (including the recent addition of action reflections), I highlight the strengths of MI in using deictic framing to reduce pliance and counterpliance, the benefit of transforming the stimulus function of ambivalence (changing the relational response of opposition between client change and sustain talk into a part/whole relational response), and the benefit of the therapist discriminating client responses into one of the trans theoretical model’s stages of change (Prochaska and DiClemente, 1983) in order to have effective contextual control over therapist response (stage matching). I also illustrate how MI’s focus on the content of verbal behavior is problematic as suggested by the RFT literature, particularly early work on the problems with self-rules (Hayes, 1989). Finally, suggestions for making MI more experiential are presented to increase the effectiveness of MI and harmonize it with other applied CBS approaches.

Educational Objectives:
1. Describe the relationship between psychological flexibility, mindfulness, and craving in the context of addiction treatment. 2. Describe evidence-based models (including the key elements from MI and CRAFT) for helping families deal with substance abuse issues in their children. 3. Apply RFT principles to identify how motivational interviewing techniques (OARS skills, importance/confidence ruler, etc.) attempt to transform stimulus functions of client change/sustain talk.

 

109. RFT & Deictic Relations: Experimental & Applied Analyses
Symposium (2:45-4:15pm)
Components: Original data
Categories: Relational Frame Theory, Clinical Interventions and Interests, Superv., Train. & Dissem., IRAP, perspective taking training, adults, austism, tutors, ABA
Target Audience: Interm., Adv.
Location: Cascade 1C

Chair: Ciara McEnteggart, Ghent University
Discussant: Louise McHugh, University College Dublin

The deictic relations appear to be critical to clinical applications of RFT, but more sophisicated empirical work is needed to understand these complex relations and how they operate in therapeutic contexts. The first empirical paper in this symposium uses the IRAP to investigate the strength or flexibility of deictic relations. Strong, significant IRAP effects on I-I and OTHERS-OTHERS are interpreted as inflexible deictic responding, with weaker or more flexible responding on I-OTHERS and OTHERS-I. While the data are preliminary, the current methodology may provide a useful alternative procedure for the study of deictic relations. The second paper uses the IRAP to study self-forgiveness in ABA tutors, following three conditions: training in perspective-taking, relaxation, and control. The findings help us to explore the relationship between perspective-taking and self-forgiveness. The third paper also explores self-forgiveness using the IRAP, but with ACT versus CT practitioners. These two groups show different implicit profiles on the IRAP that appear to be in line with their training histories.

• An RFT analysis of perspective-taking in a non-clinical sample using the Implicit Relational Assessment Procedure (IRAP)
Deirdre Kavanagh, Ghent University
Yvonne Barnes-Holmes, Ghent University
Dermot Barnes-Holmes, Ghent University
Ciara McEnteggart, Ghent University

Perspective-taking has been argued to be a key process in the development of “self”, particularly within Relational Frame Theory (RFT). The current study investigated the strength or flexibility of perspective-taking relations in a non-clinical sample using the Implicit Relational Assessment Procedure (IRAP). Thirty-five participants completed a simple perspective-taking IRAP that comprised four trial-types: I-I; OTHERS-OTHERS; I-OTHERS; and OTHERS-I. The results showed strong, significant IRAP effects on both the I-I and OTHERS-OTHERS trial-types, interpreted as inflexible deictic relational responding. Weaker IRAP effects on the I-OTHERS and OTHERS-I trial-types may suggest weaker or more flexible patterns of deictic responding. While the data are preliminary, the current methodology may provide a useful alternative methodology for the study of deictic responding.

• Measuring the effect of a RFT-based perspective-taking intervention on explicit and implicit self-forgiveness in ABA tutors
Diana Bast, Universidade Federal de São Carlos
Ian Stewart, National University of Ireland Galway
Celso Goyos, Universidade Federal de São Carlos
Dermot Barnes-Holmes, University of Ghent

This study will examine the effects of a RFT-based perspective-taking intervention on implicit and explicit self-forgiveness in Applied Behavior Anaysis (ABA) tutors. Forty eight ABA-trained tutors will be randomly assigned to one of three conditions: (i) perspective-taking, in which participants are trained to take perspective on past failures in their work with autistic clients; (ii) an active control (relaxation) condition; or (iii) a no-treatment control condition. All participants will be assessed both pre- and post-intervention using measures of self-forgiveness and psychological health. To measure self-forgiveness, an Implicit Relational Assessment Procedure (IRAP) will be used in addition to conventional self-report measures. Mixed group design statistics will be used to compare the effects of the interventions both within and across groups. This will be the first study to examine the effects of a function-analytically defined perspective-taking intervention on multiple indices of psychological health including implicit self-forgiveness.

• ACT & CBT Therapists: Self Compassion Behavior and Implicit and Explicit Response to Failure and Success
Annalisa Oppo, Psy.D., Sigmund Freud University, Milan Italy
Davide Carnevali, Ph.D., IULM, Milan
Francesco Dell'Orco, Ph.D., IESCUM, Milan, Italy
Chiara Manfredi, Ph.D., Studi Cognitivi, Modena, Italy
Giovambattista Presti, MD, Ph.D., Kore University, Enna, Italy

The key elements of Self-compassion as defined in the evolutionary compassion focus therapy (CFT) are conceptually related to hexaflex processes in very clear ways: Motivation to Care for Well-Being (values), Sensitivity to Suffering (Contact with the present moment), Sympathy & Empathy (flexible perspective taking), Distress Tolerance (Acceptance), Non-Judgement (defusion) and Committed Action to alleviate suffering in our lives. One of the most common way to assess Self-compassion is using explicit measures that capture, according to REC model, the Extended and Elaborated Relational Responses (EERR). However there are other form of relational responding (Brief and Immediate Relational Responding (BIRR) that can capture different aspects of the behavioral repertoire. The primary goal of this study is to analyse explicit and implicit response to self-forgiveness in therapists with different training history. Fifty-five therapists were recruited in this study: 32 ACT therapists and 23 CT therapists.CT therapists and ACT therapists reported similar scores on Self Compassion Scale. However CT therapists and ACT therapists report different implicit profile that seems to be in line with their training history. These results will be presented.

Educational Objectives:
1. Describe a new protocol on perspective taking for self-forgiveness. 2. Explain how an RFT-based intervention can impact on attitudes (implicit and explicit). 3. Describe differences in explicit and implicit tool to assess self compassion construct.

 

112. Trauma, BPD, Suicide
Symposium (2:45-4:15pm)
Components: Conceptual analysis, Original data
Categories: Clinical Interventions and Interests, Performance-enhancing interventions, Theory & Philo., Functional contextual approaches in related disciplines, Suicide, PTSD, Borderline Personality Disorder, Veterans, ACT Matrix, Emotion Regulation, Rumination, Self
Target Audience: Beg., Interm., Adv.
Location: Puget Sound

Chair: Sean M. Barnes, Ph.D., Rocky Mountain Mental Illness Research, Education, and Clinical Center
Discussant: John Donahue, Psy.D., University of Baltimore

Cognitive fusion with the content of thoughts and the conceptualized self can perpetuate symptoms of various disorders, such as BPD and PTSD. This symposium explores different approaches to understanding and treating these disorders, including, a technique from Vippasana meditation, the ACT Matrix, and Dialectical Behavior Therapy (DBT) with Prolonged Exposure (PE). The first study examined the impact of mental noting - a Vipassana meditation technique in which practitioners silently label thoughts as they arise - on participants’ experiences of suicide-related thoughts. Another study presents three-years of outcome data from the 12-week DBT-PE “Journeys” Intensive Outpatient Program at the Minneapolis VA, as well as an overview of the structure of program implementation. Additionally discussed will be how functional contextualism has been used in this program as a guiding philosophical approach to effectively integrate multiple behavioral therapies into one success treatment flexible enough to address the complexities of co-morbid conditions. A comparison between ACT alone and ACT with the Matrix for people diagnosed with BPD and reasons for different findings will be discussed. In addition, a CBS analysis of why some trauma survivors go on to develop rigid and ineffective rumination and others do not will be presented.

• Does Mental Noting Decrease Cognitive Fusion with Suicide-Related Thoughts?
Sean M. Barnes, Ph.D., Rocky Mountain Mental Illness Research, Education, and Clinical Center
Lindsey L. Monteith, Rocky Mountain Mental Illness Research, Education, and Clinical Center
Lisa A. Brenner, Ph.D., Rocky Mountain Mental Illness Research, Education, and Clinical Center
Jeri E. Forster, Ph.D., Rocky Mountain Mental Illness Research, Education, and Clinical Center
Theresa D. Hernández, Rocky Mountain Mental Illness Research, Education, and Clinical Center
Nazanin H. Bahraini, Ph.D., Rocky Mountain Mental Illness Research, Education, and Clinical Center

Cognitive fusion with suicidal ideation can perpetuate rumination, distress, and the intensity of suicidal urges (Luoma & Villatte, 2012). Mental noting is a Vipassana meditation technique in which practitioners silently label thoughts as they arise. It shares many similarities with popular ACT mindfulness and defusion exercises. The current study examined the impact of mental noting on participants’ experiences of suicide-related thoughts. We hypothesized that simulated mental noting would result in less self-reported distress and physiological arousal, and that qualitative reports would reflect greater defusion from suicide-related thoughts. Thirty-four participants who reported recently being distressed by suicidal ideation were randomized to a control group or a simulated mental noting group. Following baseline assessment, all participants were presented with their suicide-related thoughts written on note cards and were asked to read them aloud. Participants randomized to the simulated mental noting condition were asked to categorize the thoughts (e.g., “judging”, “planning”); participants in the control condition were not asked to categorize thoughts. Objective data indicated similar levels of self-reported distress and physiological arousal across groups. A lack of initial reactivity may have limited our ability to detect potential differences related to the simulated mental noting. Qualitative data is being coded to determine whether mental noting and/or viewing suicide-related thoughts on cards subjectively decreases cognitive fusion with such thoughts. Implications for the use of ACT with suicidal patients will be discussed.

• Considering the Self: Exploring the Interplay of Post-Trauma Cognitions and the Conceptualized Self
Lia Stern, M.A., Clark University
Kathleen Palm Reed, Ph.D., Clark University

Trauma-related rumination is a well-documented factor related to PTSD symptom development and maintenance (Clark & Ehlers, 2007). Research suggests that trauma-related rumination originates in early attempts to derive insight from traumatic experiences (Tait et al., 2014; Lindstrom, Cann, Calhoun, & Tedeschi, 2013). However, it remains unclear why some trauma survivors go on to develop rigid and ineffective rumination and others do not. A contextual behavioral science model of behavior change suggests that individuals who endorse a conceptualized sense of self, or rigidly defined personal narrative, will likely develop experiential avoidance when confronted with ego-dystonic experiences or emotions (Hayes, Pistorello, & Levin, 2012). Among trauma survivors, this process may become more pronounced as they try to understand why and how such horrific events have happened to them. Thus, individuals who demonstrate a more conceptualized sense of self prior to trauma exposure may be more likely to develop post-trauma ruminatory behaviors than their cognitively flexible counterparts. We propose that this rumination stems from cognitive processes related to (1) heightened emotional avoidance and/or (2) struggling to integrate the traumatic material into a rigidly bounded conceptualized sense of self.

• Comparison and mechanisms of change between two Group-Treatments for people diagnosed with BPD: ACT and a Matrix enhanced ACT treatment: Mexico Chapter Sponsored
Michel A. Reyes Ortega, Ph.D., Contextual Behavioral Science and Therapy Institute, Mexico City
Nathalia Vargas Salinas, Ph.D., Contextual Behavioral Science and Therapy Institute, Mexico City
Benjamin Schoendorff, MPs, Contextual Psychology Institute, Quebec
Edgar Miranda Terres, MPs, CBS and Therapy Institute, Mexico City; Mexico's National Institute of Psychiatry (INPRF)

A pre-posttest design was conducted to test ACT Matrix impact as an addition to an already tested 16 sessions ACT group treatment for people diagnosed with BPD. The only difference between treatments was that the ACT+Matrix group completed a Matrix as debriefing exercise after every session. ANOVA showed intragroup statistically significant differences (p≤.05) and big size effects (d≥.80) improvements in BPD symptom severity, psychological flexibility and emotion regulation self-administered questionnaires in both groups. ANOVA between groups found significant differences and medium (d≥.50) size effects in posttest in favor of ACT+Matrix group (n=14). Psychological flexibility mediated BPD symptoms change in ACT group (n=16), but not in ACT+Matrix group. These results suggest ACT Matrix enhanced ACT impact, possibly due to BPD clients neuropsychological characteristics. Future research is needed to test the hypothesis the Matrix impact on perspective taking as mechanism of change.

• Welcome to the Third Wave: Lessons Learned from Integrating DBT and PE into One Effective Treatment for Military Veterans
Ren Stinson, Ph.D., Minneapolis VA Health Care
Ethan McCallum, Ph.D., Minneapolis VA Health Care
Emily Voller, Ph.D., Minneapolis VA Health Care
Laura Meyers, Ph.D., Minneapolis VA Health Care

“The third wave reformulates and synthesizes previous generations of behavioral and cognitive therapy and carries them forward into questions, issues, and domains previously addressed primarily by other traditions, in hopes of improving both understanding and outcomes” (Hayes, 2004). To address the high rates of psychological trauma faced by military veterans the Veterans Health Administration (VHA) has prioritized the use of evidence-based treatments (EBTs) across all 1,700 sites of care. While helpful for many veterans with Post-Traumatic Disorder (PTSD), these cognitive behavioral treatments for PTSD have been less effective in treating some co-occurring conditions – for example PTSD and Borderline Personality Disorder (BPD). Research has demonstrated that integrating Dialectical Behavior Therapy (DBT) and Prolonged Exposure (PE) is an effective approach to treating co-occurring PTSD-BPD (Harned, Korslund, and Linehan, 2014). This paper presents three-years of outcome data from the 12-week DBT-PE “Journeys” Intensive Outpatient Program at the Minneapolis VA, as well as an overview of the structure of program implementation. Additionally discussed will be how functional contextualism has been used in this program as a guiding philosophical approach to effectively integrate multiple behavioral therapies into one success treatment flexible enough to address the complexities of co-morbid conditions.

Educational Objectives:
1. Describe the role and significance of the conceptualized self in post-trauma rumination. 2. Explain the benefits and limitations of the presented ACT interventions for BPD diagnosed clients. 3. Describe the role and significance of psychological flexibility in the BBP symptoms reduction.

 

119. RFT: Novel Approaches & Analyses
Symposium (4:30-5:45pm)
Components: Original data
Categories: Relational Frame Theory, RFT, Other, IRAP, Network Models
Target Audience: Beg., Interm.
Location: Vashon 2

Chair: Yvonne Barnes-Holmes, Ghent University
Discussant: Yvonne Barnes-Holmes, Ghent University

There are over 50 published studies on the IRAP, but as the measure is increasingly used for more complex and applied purposes, there is increasing need for systemtaic methodological and analytical scrutiny. The first empirical paper in this symposium determines whether response inhibition is related to performance on the IRAP. The findings show that neither response inhibition nor self reported attentional control correlate with the IRAP. These findings suggest that the IRAP is resistant to response inhibition as a source of potentially contaminating individual differences. The second paper presents three studies that investigate the impact of different types of instruction on the IRAP. The findings illustrate that type of instruction influences the strength and direction of trial-type effects, and suggest that instructions interact with the order in which IRAP blocks are presented. The third paper explores the potential use of a network analysis for analyzing IRAP data. To first illustrate a network analysis, a cross-sectional dataset are presented, followed by an IRAP dataset. The fourth paper similarly explores the Probabilistic Index (PI) is an alternative effect size measure to the D algorithm typically used in IRAP research. The PI appears to be robust against outliers, has a sound interpretation in cases of non-normality and/or heteroscedasticity, and offers a clear interpretation of the data. To examine the potential of this new scoring algorithm, IRAP data are reanalyzed, and show a systematic improvement in the estimated reliability compared to the D-score, without reducing existing correlation coefficients.

• Response inhibition and IRAP performance
Miguel A. Lopez-Medina, BSc, University of Jaén, Spain
Miguel Rodriguez-Valverde, Ph.D., University of Jaén, Spain
Monica Hernandez-Lopez, Ph.D., University of Jaén, Spain

The present study explores if the ability to inhibit prepotent responses (response inhibition) is related to performance on the IRAP. A simple, generic IRAP (samples: Pleasant/Unpleasant; targets: positively valenced words/negatively valenced words) was used with non-clinical adult participants (N=93). In addition, the Attentional Control Scale (ACS) was used as a self-report measure of attentional capabilities. A subset of participants (N=49) also underwent the stop-signal task, a specific reaction-time based measure of response inhibition. Results indicate that response inhibition does not correlate with performance on the IRAP, either with D-IRAP scores or with percentages of correct responses. Self reported attentional control (ACS scores) correlated only moderately (r=-0,23; p=0,03) with the amount of exposures to practice blocks necessary to reach the test phase in the IRAP, but not with IRAP performance during the test phase (either in terms of D scores or percentage of correct responses). These findings appear to indicate that the IRAP as a measure is resistant to response inhibition as a source of potentially contaminating individual differences.

• The Impact of Instruction Type on IRAP Effects
Martin Finn, Ghent University
Dermot Barnes-Holmes, Ghent University
Ian Hussey, Ghent University
Joseph Graddy, University of Waikato, New Zealand

The procedural variables that impact the effects generated by the Implicit Relational Assessment Procedure (IRAP) have not been subjected to a systematic experimental analysis, in spite of increasing use of the procedure in applied and clinical settings. The introductory instructions issued to participants are one such variable. The current study investigated the impact of different types of instruction across three experiments in a sample of university undergraduates. The findings of these experiments illustrate that the type of instruction influences the strength and direction of the trial-type effects that are produced by the measure. The results also suggest that the instructions interact with the order in which the IRAP blocks are presented (i.e. history-consistent first versus history-inconsistent first). These findings have implications for the assessment of relational responding.

• Exploring behavior-behavior relations by network models: An introduction and illustration using Applied Research Findings and IRAP Data
Maarten De Schryver, Ghent University
Dermot Barnes-Holmes, Ghent University

Based on graph theory, network analysis appears to be a promising method to obtain a more comprehensive view on the interaction between behaviors, and between behaviors and contexts. In a network analysis, constructs are conceptualized as networks of related observable variables and variables as 'autonomous causal entities in a network of dynamical systems'. While first introduced as an alternative measurement model (i.e. to relate observable variables to a construct), a network model seems also well-suited as a structural model (i.e. to relate constructs to one another). For illustrative purposes, we analyze a cross-sectional dataset containing information about stressors and PTSD symptoms of 445 youths gathered in Northern Uganda. A further illustration is provided using basic research data from the IRAP.

• The Probabilistic Index: A new effect size measure for the IRAP
Maarten De Schryver, Ghent University
Dermot Barnes-Holmes, Ghent University

Scoring algorithms are an important feature of implicit methodologies, such as the Implicit Relational Assessment Procedure. The IRAP currently employs an algorithm based on a D-effect size, but several authors have questioned the appropriateness of this. The Probabilistic Index (PI) is an alternative effect size measure that appears to be robust against outliers, has a sound interpretation in cases of non-normality and/or heteroscedasticity, and offers a clear interpretation of the data. To examine the potential of this new scoring algorithm, we re-analyzed data from an IRAP study using the PI and found a systematic improvement in the estimated reliability compared to the D-score, without reducing existing correlation coefficients. The PI will also likely increase the face validity of the IRAP.

• You Think You Can, You Think You Did: The Impact of Derived Causal Efficacy on Inattention and Impulsivity
Benjamin Ramos, University of Louisiana at Lafayette
Emily Sandoz, Ph.D., University of Louisiana at Lafayette

Individuals that struggle with inattention, hyperactivity, and impulsivity experience difficulties in several life domains including struggles in academia (Breslau, Miller, Chung, & Schweitzer, 2011), interpersonal relationships (Friedman et al., 2003), marital satisfaction (Eakin et al., 2004), and occupational performance (Barkley, Murphy, & Fischer, 2008). In spite of a history of academic and social failures, many individuals with ADHD maintain a self-protective bias in which they maintain high self-evaluations of causal efficacy (Owens et al., 2007). This may contribute to increased levels of inattention, impulsivity, and resulting dysfunction, as self-evaluation is rule-governed rather than a result of self-awareness and discrimination. This study aimed to examine how derived causal efficacy might impact inattention and impulsivity. Participants completed a series of Go/NoGo tasks with and without contextual cues that had derived causal efficacy functions through their relations with discriminative stimuli for high or low rates of responding. The impact of derived causal efficacy was then examined in terms of errors of omission (inattention) and errors of commission (impulsivity). Implications for behavioral interventions for ADHD will be discussed.

Educational Objectives:
1. Analyze the potential contaminating effects of individual differences on IRAP performance. 2. Discuss inattention and impulsivity as complex operant human behavior. 3. Explain the methodology and results of the study as an assessment of the role of causal efficacy in ADHD.

 

120. Expanding the Toolbox: Some Initial Research with a Collection of New ACT-Relevant Self-Report Measures
Symposium (4:30-5:45pm)
Components: Conceptual analysis, Original data, Didactic presentation
Categories: Clinical Interventions and Interests, Superv., Train. & Dissem., Psychological Measures, Values, Psychological Flexibility, Assessment
Target Audience: Beg., Interm., Adv.
Location: St. Helens

Chair: Ryan Kimball, Southern Illinois University
Discussant: Amy R. Murrell, Ph.D., University of North Texas

Although measures of ACT-relevant processes are gradually appearing, some ACT processes lack measures that are useful in a clinical setting and/or lack well-established psychometrics. The areas of values and committed action, in particular, seem to be relatively under-addressed upon review of ACT outcome studies. This seems especially problematic in light of valued action as a primary outcome focus with ACT treatment. Furthermore, psychological flexibility is a complex and multifaceted treatment target, and existing measures either focus on individual repertoires organized by the Hexaflex or an unbalanced collection of them. This symposium offers a collection of studies intended to offer additional measures to the ACT practitioner’s toolbox, as well as a review of initial data with each. Specifically, two presentations will discuss new measures of values and committed action, and one presentation will discuss a brief but comprehensive measure of the entire Hexaflex.

• Values Measure Fight Club: An Initial Comparison and Evaluation of the Valued Time and Difficulty Questionnaire
Ryan Kimball, Southern Illinois University
Sam Kramer, Southern Illinois University
Sunni Primeaux, Southern Illinois University
Chad E. Drake, Ph.D., Southern Illinois University

Although measures of values have existed for decades (Beierlein, et al., 2012; Rokeach, 1974), few measures have been developed for clinical use and/or by ACT treatment developers. The Valued Time and Difficulty Questionnaire (VTDQ) was derived from the Valued Living Questionnaire (Wilson, Sandoz, Kitchens, & Roberts, 2010) and developed within a clinical context to provide a more accessible measure of values and committed action. Self-report data was gathered via Amazon’s mTurk from a large and diverse sample (n=425). Results indicated that the three scales of the VTDQ (importance, time on valued action, and difficulty due to private events) exhibited good internal consistency and convergent validity with other values measures. Additionally, the Importance and Time scales were significantly correlated with measures of life satisfaction and quality of life. These results will be discussed as well as how the VTDQ may be used to inform treatment in a broad population.

• Last Week Tonight!: Constructing and Evaluating a Weekly Hexaflex Assessment (WHA)
Kail Seymour, Southern Illinois University
Sunni Primeaux, Southern Illinois University
Travis Sain, Southern Illinois University
Chad E. Drake, Ph.D., Southern Illinois University

The Hexaflex model of Acceptance and Commitment Therapy (ACT) emphasizes six content areas that guide treatment delivery, all of which comprise a psychological flexibility model of mental health. Current measures of psychological flexibility either measure specific areas of the Hexaflex (Gillanders, 2014; Wilson, Sandoz, Kitchens, & Roberts, 2010) or measure psychological flexibility without a balanced approach across the six areas (Bond et al., 2010). Because a brief and balanced measure of all six areas may have value for clinicians (e.g., to help structure sessions, provide a progress measure, etc.), the Weekly Hexaflex Assessment (WHA) was created by an ACT practicum team. This talk will present preliminary supportive data for the WHA from a sample of college undergraduates (n = 131) regarding internal reliability and convergent validity with other psychological flexibility measures. The results suggest a need for revision of certain items and, perhaps, a different approach to WHA item generation.

• I Can’t Get No Valued Action: Exploring the Valued Action and Satisfaction Questionnaire
Travis Sain, Southern Illinois University
Sunni Primeaux, Southern Illinois University
Chad E. Drake, Ph.D., Southern Illinois University

Acceptance and Commitment Therapy emphasizes values consistent action, but few measures developed by ACT practitioners or researchers target values repertoires. Measures that have been developed such as the Valued Living Questionnaire (Wilson, Sandoz, Kitchens, & Roberts, 2010) have limited databases, and have shown psychometric shortcomings (Vanbuskirk, et al., 2012). The current study administered the Valued Action and Satisfaction Questionnaire (VASQ), a new measure of values and committed action, to 131 participants at a mid-western American university to assess reliability and validity. Comprised of three subscales (importance, valued action, satisfaction with action), the VASQ was compared to various measures of psychological flexibility repertoires (e.g., Acceptance and Action Questionnaire) and quality of life (e.g., Flourishing Scale). Significant correlations were found between the VASQ subscales, psychological flexibility, and quality of life. Results provide evidence for further exploration of the VASQ as a measure of values and committed action.

Educational Objectives:
1. Describe the subscales of the VTDQ. 2. Identify the Hexaflex/Inflexahex repertoire for each item of the WHA. 3. Describe the psychometric properties of the VASQ.

 

122. Innovative randomized trials of Acceptance and Commitment Therapy addressing weight management
Symposium (4:30-5:45pm)
Components: Original data
Categories: Behavioral medicine, Clin. Interven. & Interests, overweight, obesity
Target Audience: Beg.
Location: Cascade 1B

Chair: Niloofar Afari, Ph.D., VA Center of Excellence for Stress and Mental Health & Department of Psychiatry, University of CA, San Diego
Discussant: Jonathan Bricker, Ph.D., Fred Hutchinson Cancer Research Center, Division of Public Health, & Department of Psychology, University of Washington

Two-thirds of Americans are overweight or obese and the prevalence is growing across the globe. A handful of studies suggest that Acceptance and Commitment Therapy (ACT) may show promise in improving weight management and emotional or other disordered eating patterns that contribute to overweight and obesity. This symposium features several recent randomized trials that use ACT in novel ways to address weight control and related eating patterns. The innovative approaches include integrating ACT with traditional weight loss protocols, using ACT to augment other weight control programs, and examining the generalizability of ACT skills from tobacco cessation to weight loss. Other unique characteristics include the delivery of ACT in workshops, brief group settings, and apps. Findings and lessons learned from these studies can guide future research on method of delivery, duration, and potential moderators in effective use of ACT for weight management and related eating behavior.

• A comparison of different approaches for utilizing Acceptance and Commitment Therapy to improve long-term weight control
Jason Lillis, Ph.D., The Miriam Hospital & Brown Medical School
Rena Wing, Ph.D., The Miriam Hospital & Brown Medical School

This paper will give an overview and results from 2 randomized trials that attempt to improve long-term weight control by adding ACT to traditional weight loss methods. The first study (n=162) integrated ACT with traditional methods and compared it to current gold standard weight loss intervention on 24-month weight loss. The second study compared the use of a back-end workshop, comparing an ACT workshop, a Self-Regulation workshop, and a self-monitoring only condition among participants who had completed a 3-month on-line weight loss program and lost at least 5% of their starting weight. Results indicate ACT could be helpful for improving long-term weight control. Potential mechanisms, advantages and disadvantages of different approaches, implications and future directions will be discussed.

• Brief ACT for binge eating as an adjunct to the MOVE! Program: The B-ACT trial for veterans
Kathryn M. Godfrey, M.S., San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology
Jessica Gundy Cuneo, Ph.D., VA San Diego Healthcare System
Jennifer Salamat, B.A., VA San Diego Healthcare System
Autumn Backhaus, Ph.D., VA San Diego Healthcare System
Niloofar Afari, Ph.D., VA Center of Excellence for Stress and Mental Health & Dept. of Psychiatry, University of CA, San Diego

The B-ACT study was a randomized controlled trial of an ACT group intervention for binge and emotional eating as an adjunct to Veterans Health Administration’s standard behavioral weight loss intervention (MOVE!). Participants who completed the 8-week MOVE! program were recruited and randomized to receive four 2-hour weekly ACT or active control groups. 150 veterans were screened for the study, and 90 were randomized. 81 participants (90%) completed at least 3 group treatment sessions and follow up assessments post-treatment, at 3 months post-treatment, and at 6 months post-treatment. Results will be presented from outcomes including self-reported binge eating, psychological flexibility, quality of life, and measured BMI. Strengths and weaknesses of the current trial, lessons learned, and next steps for ACT for binge eating as an adjunct to standard weight control services in veteran and active duty populations will be discussed.

• Change in weight and drinking in ACT vs. CBT smoking cessation app users: Results from a pilot randomized trial
Emily Y. Zeng, B.S., Fred Hutchinson Cancer Research Center, Division of Public Health, Seattle, WA
Jaimee L. Heffner, Ph.D., Fred Hutchinson Cancer Research Center, Division of Public Health, Seattle, WA
Kristin E. Mull, M.S., Fred Hutchinson Cancer Research Center, Division of Public Health, Seattle, WA
Jonathan Bricker, Ph.D., Fred Hutchinson Cancer Research Center, Division of Public Health, & Dept. of Psychology, University of Washington

Anecdotal evidence from ACT studies suggests that participants generalize smoking cessation skills to other health domains. This study explores whether users of an ACT vs. CBT-based cessation app are more likely to show changes in weight and alcohol use. Using generalized linear models, we compared changes in weight, body mass index, number of typical drinks, and hazardous drinking at two-month follow-up between ACT (n=98) and CBT app users(n=98). Although differences were not statistically significant, ACT users reported weight loss (-1.4 vs 0.2; p=0.156) and decrease in BMI (-0.3 vs -0.1; p=0.144). CBT users had a greater reduction in number of typical drinks (-0.6 vs -0.3; p=0.461) and were less likely to be a hazardous drinker (13% vs 20%; p=0.188). Given the suggestive, but inconclusive evidence of differences between treatment groups on weight change and drinking, future studies should evaluate ACT’s potential as a multiple health behavior change intervention.

Educational Objectives:
1. Describe the results of two NIH funded trials testing ACT methods for weight loss, with particular focus on the strengths and weaknesses of each approach. 2. Describe the design and results from the B-ACT trial and describe how findings are being applied to future weight control research. 3. Explain the potential for ACT to concurrently address smoking and weight control and analyze the generalizability of ACT across health domains.

 

123. Awesome Papers 1
Symposium (4:30-5:45pm)
Components: Conceptual analysis, Literature review, Original data, Case presentation
Categories: Clinical Interventions and Interests, Prevention & Comm.-Based, Behavioral medicine, Educational settings, Superv., Train., & Dissem., RFT, Other, Technology, Children, Dyslexia, Literacy Skills, Young Adults, ACT, Partial Hospitalization Program, Serious and persistent mental illness (SMI), health promotion, community-based participatory research
Target Audience: Beg., Interm., Adv.
Location: Cascade 1C

Chair: Candice Fieg, Epworth Clinic Camberwell, Melbourne, Australia
Discussant: Staci Martin, PhD, National Institutes of Health

Contextual behavioral science (CBS) approaches using Acceptance and Commitment Therapy (ACT) and Relational Frame Theory (RFT) have been employed across a large variety of problems with significant success. CBS approaches can be applied towards helping those with obsessive compulsive disorder (OCD), children with learning disorders, young adult patients with severe, comorbid, and diverse presentations of psychopathology, and people living with serious and persistent mental illness (SPMI). The first study explores the delivery of a 10-session “ACT for OCD group program” in a private not-for-profit hospital day program setting in Melbourne, Australia and will provide an overview of the program structure, and demonstrate the facilitation of experiential exercises in a group setting. The second study will present applications based on derived stimulus relations for children aged from 7 to 10 years old and diagnosed with dyslexia and dysgraphia. The third study will discuss a specialty young adult track developed from a general ACT-based program to meet the specific needs of those with severe, comorbid, and diverse presentations of psychopathology. The fourth study will present results of a pilot intervention grounded in ACT principles, delivered by peer support specialists in a community mental health setting, designed to help SPMI consumers initiate and sustain health-promoting behavior.

• Expanding our Therapeutic Tools for the OCD Toolbox: ACT for OCD Group Therapy
Candice Fieg, Epworth Clinic Camberwell, Melbourne, Australia

For some time now we have understood CBT/ERP as the first line of treatment for OCD. Increasing research is reflecting the clinical experience that treatment is not always straight forward, and many individuals with OCD either do not complete, or don't respond adequately to CBT/ERP. Emerging evidence is demonstrating that Acceptance and Commitment Therapy (ACT) is an effective approach to treating OCD and can help clients to live meaningful lives. This paper explores the delivery of a 10-session “ACT for OCD group program” in a private not-for-profit hospital day program setting in Melbourne, Australia. This paper will provide an overview of the current literature, the benefits that group therapy may offer to individuals and explore the feasibility of delivering “ACT for OCD” in a group format. The paper will provide an overview of the program structure, and demonstrate the facilitation of experiential exercises in a group setting. The paper will explore process issues and how to work with barriers that arise unique to working with a group of differing individuals at various stages in recovery.

• Can reading be an easy game?: Using RFT to improve literacy skills in children with learning disorders
Margherita Gurrieri, Psy.D., IESCUM, ACT-Italia (Italy)
Melissa Scagnelli, Psy.D., Ph.D., BCBA, IULM University, Milan (Italy)
Davide Carnevali, Psy.D., BCBA, IULM University, Milan (Italy)
Giovambattista Presti, MD, Ph.D., Università Kore, Enna (Italy)
Paolo Moderato, Ph.D., IULM University, Milan (Italy)

The prevalence of children diagnosed with learning disorders is rising year after year. A number of specific techniques have been developed by behavior analysts to teach or improve reading and writing abilities. Applications based on derived stimulus relations have been demonstrated effective in teaching reading, spelling and math skills to persons with different difficulties and learning histories, generating behaviors not explicitly taught. Ten children aged from 7 to 10 years old and diagnosed with dyslexia and dysgraphia have been exposed to a training based on a conditional discrimination procedure with arbitrary matching to sample. Data indicated that the intervention had positive outcomes in terms of accuracy from pre-intervention to follow up. Pre-post treatment and follow up scores in standardized tests for dyslexia will be discussed.

• Initial Results of a Specialty Young Adult Track within an ACT-based Partial Hospitalization Program
Brian Pilecki, Rhode Island Hospital; Alpert Medical School of Brown University
Theresa A. Morgan, Rhode Island Hospital; Alpert Medical School of Brown University
Stephanie Czech, Rhode Island Hospital
Catherine D'Avanzato, Rhode Island Hospital; Alpert Medical School of Brown University
Kristy Dalrymple, Rhode Island Hospital; Alpert Medical School of Brown University
Mark Zimmerman, Rhode Island Hospital; Alpert Medical School of Brown University

At an ACT-based partial hospitalization program, patients with severe, comorbid, and diverse presentations of psychopathology have been shown to have improved outcomes via reduces symptoms and improved functioning (D'Avanzato et al. 2013). A specialty young adult track (ages 18-26) was added to meet the specific needs of this vulnerable population. This presentation will discuss how the general ACT-based program was adapted to fit the needs of young adults. In addition, acceptability of this program will be discussed. Patients completed daily satisfaction surveys of the young adult groups and preliminary results (N = 466) suggest that on a likert-type scale from 0 to 6, young adult patients rate the groups as useful (5.0), are satisfied with the way the groups are structured (5.0), and rate the group leader as helpful (5.5). While data collection is ongoing, additional results of outcome measures on anxiety, depression, and functioning will also be reported.

• Health Self-Management Support using Acceptance and Commitment Therapy in a Community Mental Health Setting: An Intervention Delivered by Peer Support Specialists: Contextual Medicine SIG Sponsored
Adrienne Lapidos, Ph.D., University of Michigan
Mary Ruffolo, Ph.D., University of Michigan

Although not a federally designated health disparity population, people living with serious and persistent mental illness (SPMI) face some of the most profound health inequities in the nation, with life expectancies up to 25 years less than average, and elevated risk for preventable chronic conditions including diabetes and cardiovascular disease (Svendsen, 2006). There is strong need for physical health promotion within SPMI consumers’ chosen medical home, often their local Community Mental Health (CMH) agency. Peer support specialists are a rapidly growing sector of the American mental health workforce whose services can be defined as the social, emotional, and instrumental support that is provided by people who have a mental health diagnosis, for people sharing a similar mental health diagnosis. Acceptance and Commitment Therapy (ACT) has been found to improve the quality of life of people living with SPMI and in people living with medical conditions (e.g. Bach & Hayes, 2002; Dindo, 2015), and there is interest in expanding the reach of ACT beyond traditional sectors. The current paper presents results of a pilot intervention grounded in ACT principles, delivered by peer support specialists in a CMH setting, designed to help SPMI consumers initiate and sustain health-promoting behavior. The chief goal of the pilot was to determine if ACT shows promise as a feasible approach that can be added to the existing toolkit of peer-delivered practices that promote physical health. The paper will present the following (1) a brief introduction to the “scandal of premature mortality” (Thornicroft, 2011) facing the SPMI community; (2) a brief introduction to the benefits of “reverse integration,” or bringing physical health care to specialty mental health settings, (3) a detailed description of the process of training peer support specialists in ACT-consistent health promoting interventions, including use of community-based participatory research methodology, and (4) a summary of preliminary pilot data. The presentation will contain video clips of the 3 peer support specialists discussing what it was like for them to learn about ACT and to help create the ACT-consistent interventions within the communities they serve and to which they belong. This research was made possible by a grant from the Vivian A. and James L. Curtis Research and Training Center Pilot Grant Program.

Educational Objectives:
1. Explain an overview of the possible applications with children diagnosed with learning disorders. 2. Describe how ACT may complement the scope of practice of Peer Support Specialists. 3. Adapt and apply Acceptance and Commitment Therapy based interventions in a group setting for treatment of OCD.

 

124. How Does ACT Enhance Our Understanding of Exposure?
Symposium (4:30-5:45pm)
Components: Original data, Case presentation
Categories: Clinical Interventions and Interests, Exposure, Anxiety, OCD
Target Audience: Beg., Interm.
Location: Puget Sound

Chair: Eric B Lee, M.A., Utah State University
Discussant: John P Forsyth, Ph.D., University at Albany, SUNY

We all know that exposure is a critical component of anxiety and OCD work. Yet, there is still much room for improvement, as exposure processes remain unclear and many people do not benefit from or refuse exposure-based treatment. Modern approaches to exposure, such as ACT, might improve treatment outcomes by helping people better engage in exposure work. Additionally, gaining a greater understanding of processes underlying exposure could enhance therapeutic techniques, also leading to improved outcomes. The current symposium will present data on the beneficial effects of acceptance, mindfulness, and values on exposure work. Topics examined will include, “white-knuckling” (i.e., experiential avoidance) as a potential barrier to successful OCD treatment, the effect of incorporating ACT part way through traditional exposure work, and the impact of a values-based intervention on the influence of fear within exposure treatment.

• Does white-knuckling take the punch out of ERP?
Carlos E. Rivera, M.S., Suffolk University
Grace Gu, M.S., Suffolk University
Nathaniel Van Kirk, Ph.D., OCD Institute at McLean Hospital; Harvard Medical School
Lisa W Coyne, Ph.D., Suffolk University

Exposure and response prevention (ERP) is considered the gold standard behavioral intervention for obsessive-compulsive disorder (OCD). However, a number of possible barriers limit ERP’s efficacy. One potential barrier is white-knuckling, defined as a form of experiential avoidance characterized by cognitive strategies to avoid, suppress and/or distract from unpleasant experiences that emerge when a person engages in ERPs. We believe interventions that incorporate acceptance and mindfulness to traditional ERP may help diminish a person’s tendency to engage in avoidance during exposure, increasing contact with unpleasant events, therefore leading to more effective exposure intervention and outcomes. The aim of our study is to explore the relationship between mindfulness and acceptance within an ERP based treatment and how changes in experiential avoidance across treatment may impact outcome. We use data from patients with OCD and staff from an intensive residential OCD treatment facility.

• ACT & ERP for OCD: Tracking ACT Processes in a Single-Case Design Study
Brian Thompson, Ph.D., Portland Psychotherapy Clinic, Research, & Training Center

In this single case design study conducted within a private practice setting, ACT-related processes were tracked to explore whether core ACT processes are uniquely impacted by ACT interventions (e.g., Twohig, Whittal, Cox, & Gunter, 2010). One adult participant who met OCD criteria completed daily ratings of OCD (i.e., minutes ritualizing) and ACT processes (i.e., willingness; defusion; adapted from Forman et al., 2012) throughout treatment. Treatment consisted of an 18-session ERP protocol based on Foa et al. (2012). At a predetermined point, ERP was suspended, and the participant received 4 sessions of ACT (e.g., Eifert & Forsyth, 2005). Following the ACT phase, ERP was resumed until completion. Visual analyses of the graphed time series data indicated shifts from change-based to acceptance-based processes across ACT and second ERP phases. ACT core process willingness increased during ACT and second ERP phases. ACT core process cognitive defusion appeared to be less impacted.

• Transforming Fear: The Impact of a Brief Values-Based Intervention on Avoidance Behavior in an Exposure Context
Timothy R. Ritzert, M.A., University at Albany, SUNY
Augustus Artschwager, University at Albany, SUNY
Christopher R. Berghoff, University of Mississippi Medical Center
John P. Forsyth, Ph.D., University at Albany, SUNY

This study evaluated a novel, ecologically-valid values intervention designed to increase approach toward a feared stimulus using operant principles. Spider fearful participants were randomized to a values (n = 24) or control (n = 24) condition and completed a spider behavioral approach task (BAT). Values participants were reinforced for each completed BAT step, in a manner that allowed them to live the value of helping people in need. Results showed that values participants completed relatively more steps on the BAT (t[27] = 3.98, p = .001, d = 1.46). Both conditions reported similar distress levels during the task. Notably, the relation between baseline spider fear and BAT steps completed was moderated by condition (p = .010). Spider fear predicted approach behavior to a markedly lower degree in the values condition (r = -.33) relative to the control condition (r = -.82), suggesting the values intervention reduced the degree to which fear influenced behavior.

Educational Objectives:
1. Demonstrate the role of mindfulness and acceptance in behavioral exposure for OCD. 2. Describe changes in ACT-related process in combined ERP and ACT treatment for OCD. 3. Explain how and why to use values in an exposure context.

 

Sunday, June 19

127. Ecological momentary assessments (EMA) to measure ACT processes and behavioral health across populations
Symposium (9:00-10:15am)
Components: Original data, Case presentation
Categories: Behavioral medicine, Clin. Interven. & Interests, Performance-enhancing interventions, Theory & Philo., contextual assessment, ACT, technology, mobile devices
Target Audience: Beg., Interm.
Location: Vashon 1

Chair: Javier Rizo, B.A., University of Washington, Psychiatry & Behavioral Sciences
Discussant: Michael Levin, Ph.D., Utah State University, Psychology

Ecological momentary assessment (EMA) is an essential tool for contextual behavioral scientists. By allowing a more precise measurement of the antecedents, and consequences of behavior it enables a functional analysis of behavior in context. The design of these tools offers revolutionary capabilities for contextual behavioral science to better describe, understand, predict and modify behaviors. In combining both assessment and intervention, these mobile technologies could lead to improvements in behavioral health across a variety of populations. Contextual behavioral models such as Acceptance and Commitment Therapy (ACT) provide a useful perspective of behavior change in designing EMAs and interpreting data collected from mobile devices and self-report. In these 4 talks we present the development, ideation, and conceptual issues related to measuring ACT processes for behavioral health outcomes across populations.

• Using mobile technology to examine contextual predictors of outcomes in individuals experiencing psychosis following a hospital discharge
Ethan Moitra, Ph.D., Brown University
Brandon A. Gaudiano, Ph.D., Brown University & Butler Hospital
Carter H. Davis, B.A., Butler Hospital
Michael F. Armey, Ph.D., Brown University & Butler Hospital

Schizophrenia and other manifestations of psychosis are a major cause of disability worldwide. Although various pharmacological and psychosocial interventions have been developed for treating patients with psychosis, relapse rates are high and long-term recovery remains elusive for many individuals. Thus, there is an urgent need to better understand the contextual factors that contribute to psychosis and its management so that they can be better targeted in future interventions. Ecological Momentary Assessment (EMA) is a dynamic procedure that permits the measurement of variables in natural settings in real-time through the use of brief assessments delivered via mobile electronic devices. We used EMA to examine a variety of contextual factors (e.g., social support, treatments, coping strategies) in relation to fluctuations in symptoms and functioning in 55 patients with psychosis. We will present data on real-time predictors of clinical outcomes and discuss how these factors could be addressed in a contextual behavioral framework.

• Using ecological momentary assessment to examine impact of self-regulation choice on affect
Angela Cathey, M.A., Wichita State University
Roger Vilardaga, Ph.D., University of Washington & Evidence-based Practice Institute
Jeff Swails, M.A., Wichita State University
Robert Zettle, Ph.D., Wichita State University

It is widely accepted that choice of affect regulation method may impact later functioning. Despite this, few studies have examined how these processes unfold in-the-moment. Examination of these processes via Ecological Momentary Assessment (EMA) allows for cross validation of self-report measures and insight into real-time change. We examined responses to self-report measures of affect (anxiety and dysphoria) and tendency towards various self-regulation choices and compared in-the-moment reports of anxiety, dysphoria, and self-regulation. We also examined time-varying and lagged associations between affect and self-regulation choices over time. Participants were 127 undergraduates at a Midwestern university who completed self-report measures and 21 days of EMA. We will present data comparing self-report and EMA data. Data on the associations between affect and emotion regulation choice over time will also be presented. Results will be discussed in relation to a contextual behavioral framework.

• Design and integration of an ecological momentary assessment and intervention of ACT for smoking cessation in those with serious mental illness
Javier Rizo, B.A., University of Washington, Psychiatry & Behavioral Sciences
Roger Vilardaga, Ph.D., University of Washington, Psychiatry & Behavioral Sciences
Julie Kientz, Ph.D., University of Washington, Human Centered Design & Engineering
Richard Ries, MD, University of Washington, Psychiatry & Behavioral Sciences

Mobile technology allows not only implementation of ecological momentary assessments (EMA) of ACT processes and outcomes, but also ACT ecological momentary interventions (EMIs). Integrating EMAs and EMIs can be burdensome for the end user, and poses a design challenge for the researcher. As mobile phones become more prevalent across populations, they provide ripe opportunity to develop tools for both EMAs and EMIs. Understanding the factors around smoking cessation is important for creating effective mobile interventions, especially for those with serious mental illness who smoke at rates much higher than the general population. In this talk we discuss the design and implementation of an EMA feature as part of an ACT smoking cessation app for people with psychiatric disorders tested in a series of 10 Single Case Design trials. We cover our EMA design, present background mobile analytics data, and offer recommendations and lessons learned from the implementation of our chosen design.

• Contextual behavioral assessment of psychological flexibility using wearable sensors
Jennifer Villatte, Ph.D., University of Washington, Psychiatry & Behavioral Sciences
Peter Clasen, Ph.D., University of Washington, Psychiatry & Behavioral Sciences
Javier Rizo, B.A., University of Washington, Psychiatry & Behavioral Sciences

Self-reports of psychological flexibility are linked to important clinical outcomes and predict individual responses to stressful life events and psychological treatment. However, few studies have identified valid and reliable behavioral indicators of psychological flexibility or their relation to clinically relevant outcomes in real time. The current study sought to identify markers of psychological flexibility that can be assessed in real-time via contextual behavioral sensors embedded in wearable devices. For 30 days, adults with modifiable health risks wore a wristband that captured continuous sensor data (e.g., optical heart rate, GPS, accelerometer, gyrometer, barometer, altimeter, skin temperature and galvanic skin response). We examined correlations between self-report measures of psychological flexibility and wearable sensor data and tested the validity of real-time psychological flexibility markers to predict health and quality of life. We will discuss results of this exploratory study in the context of developing contextual behavioral measures using novel methodologies and analytic strategies.

Educational Objectives:
1. Describe ecologically valid predictors of clinical outcomes in psychosis and interpret them from a contextual behavioral perspective. 2. Describe ecologically assessment of affect and affect regulation and interpret them from a contextual behavioral perspective 3. Describe the process of developing ecological momentary assessments to be utilized with mobile technology, and within a contextual behavioral perspective, create more effective interventions.

 

129. Sport and CBS
Symposium (9:00-10:15am)
Components: Original data
Categories: Educational settings, Prevention and Community-Based Interventions, Performance-enhancing interventions, Beh. med., Theory & Philo., Other, Sport, psychological flexibility, self-compassion, well-being, children
Target Audience: Beg., Interm.
Location: St. Helens

Chair: Stefan Holmström, Department of Psychology, Umeå University, Sweden
Discussant: xxx Silberstein, xxx

Athletes face a number of challenges in their lives, from overtraining, and maintaining a healthy diet, to dealing with pressure. When faced with obstacles, psychological flexibility may play a key role in helping athletes stay physically and mentally healthy. We examine the relationship between psychological flexibility, self-compassion, fear of failure and if these factors can predict psychological well-being in young elite athletes. We also present a two-part study that identified needs for, developed and implemented, and assessed an ACT-based healthy eating intervention for parents of youth athletes. Data at a two-month follow up will also be discussed. Finally, we will examine the relationship between ACT components – including mindfulness – and overtraining in athletes. These studies demonstrate the importance of psychological flexibility for the health of athletes. Implications for continuing to help athletes using CBS approaches will be discussed.

• Psychological flexibility, self-compassion, and well-being among youth elite athletes
Stefan Holmström, Department of Psychology, Umeå University, Sweden
John Jansson, Department of Psychology, Umeå University, Sweden

Elite youth athletes with dual careers are under pressure to thrive in sport as well academically. Mental factors are important for development in both the short and long perspective. Psychological flexibility and self-compassion has in earlier studies been highlighted as vital aspects for enhancing athletes’ performance and their well-being. The purpose of this study was to examine the relationship between psychological flexibility, self-compassion, fear of failure and if these factors can predict psychological well-being in young elite athletes. Participants are between 16 and 19 years old and compete on junior elite level in both team and individual sports, and were enrolled at a Swedish sport academy. The results shows that psychological flexibility and self-compassion can predict psychological well-being. This point out the necessary for athletes to develop both psychological flexibility and self-compassion to enhance psychological well-being.

• Facets of mindfulness as possibly preventing factors of overtraining in elite sports
Daniel Birrer, Swiss Federal Institute of Sport Magglingen
Gareth Morgan, Swiss Federal Institute of Sport Magglingen
Philipp Röthlin, Swiss Federal Institute of Sport Magglingen

In search of optimal training gain, athletes push their training load to the extreme resulting in many being overtrained (Peterson, 2005). Overtraining represents a severe problem for the affected athlete. To date personality traits haven’t been linked to the overtraining syndrome (OTS). The data presented stems from an online survey of 155 Swiss elite athletes from 28 different sports. Using the overtraining definition of the European College of Sports Science (Meeusen et al., 2006) rigorously, 29% of the athletes were classified as having overtrained at least once in their ongoing career. Data showed that not overtrained athletes are significantly higher in global trait mindfulness. However, not all ACT components were significantly related with OTS. Further, controlling for cognitive anxiety only affected the results in a few components. Teaching athletes mindfulness and psychological flexibility might be a way to prevent undesired states of overtraining in the long run.

• Health kick: Promoting healthy eating in youth sport using an ACT-based intervention
Cassandra Pentzien, Bowling Green State University
Dara R. Musher-Eizenman, Ph.D., Bowling Green State University

Prior research has called into question the health benefit of participating in youth athletics for children (Nelson et al., 2011). This two-part study identified needs for, developed and implemented, and assessed an ACT-based healthy eating intervention for parents of youth athletes ages 8-14. Participants of Study I (N=29) responded to twelve Ecological Momentary Assessment (EMA) prompts, and indicated that youth athletes consumed significantly more fast food on game days than practice days (t(21)=3.448, p=0.002) and on game days than non-sport days (t(24)=4.440, p<0.001). Based on these results, fast food consumption on game days was targeted most centrally during the Study II intervention. Participants of Study II (N=31) attended an individual 1-hour ACT-based healthy eating intervention, which included psychoeducation and experiential components addressing defusion, values, and committed action (Harris, 2009; Miller, C’de Baca, Matthews, & Wilbourne, 2001). Theory of Planned Behavior measures were given pre-workshop, immediately following the workshop, and at two month follow up. Participant report of behavioral intention and perceived behavioral control significantly increased from pre-workshop to immediate follow up (t(30)=4.055, p<0.001; t(30)=2.170, p=0.038), and this increase was maintained at two-month follow up (t(24)=3.288, p=0.003; up (t(24)=2.066, p=0.05). Subjective norms and attitudes were also impacted by the intervention. While no significant differences were found for consumption of fast food using EMA, consumption overall decreased somewhat from Study I to Study II (t(26)=1.593, p=0.123). The results of this study suggest that brief ACT-based intervention with parents may have a positive impact on the eating habits of youth athletes.

Educational Objectives:
1. Identify the relation between psychological flexibility, self-compassion with psychological well-being among youth elite athletes. 2. Describe the health risks and benefits of participating in youth athletics. 3. Explain how a pilot brief ACT-based intervention impacted Theory of Planned Behavior variables.

 

131. Training perspective taking in children with Autism, in the laboratory, and in the clinic
Symposium (9:00-10:15am)
Components: Conceptual analysis, Original data
Categories: Clinical Interventions and Interests, RFT, Perspective Taking
Target Audience: Interm., Adv.
Location: Cascade 1B

Chair: Josh Kaplan, Pacific University
Discussant: Carmen Luciano, University of Almeria

Flexible responding to the thoughts and feelings of the self and others is an integral part of healthy social and psychological functioning. Whereas perspective taking and empathy are frequently considered to reflect innate abilities (e.g., from mechanistic and organismic approaches), from behavior analytic and functional contextual approaches they alternatively can be considered to reflect learnable behavioral repertoires. To that end, we present three empirical papers reaching across different settings and levels of application and each informed by Relational Frame theory to guide the development of effective perspective taking training techniques. The first paper focuses on interpsychic (i.e., social) perspective-taking training techniques that improve interpersonal functioning in Autistic children, the second focuses on increasing the specificity of the RFT framework in influencing derived perspective taking (e.g., Theory of Mind) in verbally competent adults, and the third paper focuses on intrapsychic perspective taking (i.e., self-as-context) in clinical settings deploying ACT and Matrix interventions.

• Teaching Components of a Perspective-Taking Repertoire to Children with Autism Using an RFT-Based Protocol and Fluency-Based Instruction
Thomas G. Szabo, Ph.D., BCBA-D, Florida Institute of Technology
Kelli Smith, Florida Institute of Technology

Perspective-taking can be viewed as a composite of coordinated verbal repertoires that include emotion recognition, awareness of others’ informational states, as well as false belief and deception detection. RFT provides an account of perspective-taking as generalized operant behavior based on a history of reinforcement for relational responding in accordance with deictic frames of I-YOU, HERE-THERE, and NOW-THEN. Children with autism provide a unique window into the processes involved in developing a finely discriminated perspective-taking repertoire because they show notable weaknesses in this skill set compared to other areas of learning. Added to that, children with autism progress in this area slow enough for researchers to track the impact of small changes in instructional technology. We taught children with autism two perspective-taking composites - deictic framing and emotion recognition - with a package intervention that included direct instruction, fluency-based instruction, and multiple exemplar training. We assessed deictic framing and emotion recognition directly, and subsequently assessed independent initiations and responses to others’ bids for social engagement. All learners showed strong improvement in the component skills that were directly taught. Additional training was needed to increase social engagement with peers.

• Contextual Control of Derived Perspective Taking Using an Operant Relational Triangulation Perspective Taking Protocol
Paul Guinther, Ph.D., Portland Psychotherapy

Under the established Relational Frame Theory deictic paradigm for understanding perspective taking behavior (Barnes-Holmes, Barnes-Holmes, & Cullinan, 2001), the deictic pairings I-You, Here-There, and Now-Then are considered to be mutually-entailed relational frames on par with non-deictic relations such as More-Less. However, a pattern of function transformation consistent with these alleged relational pairings is underspecified by the deictic paradigm (e.g., a change in the function of a stimulus that is Here does not entail any particular transformations in the function of a stimulus that is There). Empirical support for the deictic paradigm is largely grounded in the Barnes-Holmes Perspective Taking Protocol (BH-PTP; McHugh, Barnes-Holmes, O’Hora, & Barnes-Holmes, 2004), a multiple choice questionnaire that is useful in some contexts but has limited utility in demonstrating and training perspective-dependent derived relations. To remedy some of these shortcomings, I have developed an alternative relational triangulation paradigm supported by empirical demonstrations of derived perspective taking with fully specified perspective-dependent function transformations using an operant match-to-sample Relational Triangulation Perspective Taking Protocol (RT-PTP).

• The ACT Matrix as an effective cue for deictic framing
Benjamin Schoendorff, M.A., MSc., Contextual Psychology Institute, Montreal, Quebec, Canada

The Matrix delivers ACT through multiple exemplars of using a graphic visual cue. With it, experiences and behavior are sorted along two perpendicular axes. The vertical axis invites discriminating between experience observable through the five senses (including overt behavior) and inner or mental experience (including covert behavior while the horizontal axis invites discriminating between behavior under the (largely aversive) control of unwanted inner experience and behavior under the appetitive control of verbally constructed reinforcers (values). Preliminary data with BPD suggests that the ACT Matrix may lead to significantly higher effect sizes than non-matrix ACT in important variables including psychological flexibility. Whereas psychological flexibility appears as a mediator of non-matrix ACT, it may not be a mediator of matrix ACT. We will discuss how perspective-taking as a putative mediator and how the matrix may provide a powerful cue to train deictic framing, as sorting experience and behavior in its 4 quadrants leads users to acquire a “You-There-Then” perspective on their “I-Here-Now” experience.

Educational Objectives:
1. Describe how to construct deictic framing instruction and assessment exercises using direct instruction and multiple exemplars in a fluency-based protocol. 2. Explain the shortcomings of the BH-PTP and established RFT deictic paradigm of perspective taking, and weigh the merits of the alternatively proposed RT-PTP and RFT triangulation paradigm of perspective taking. 3. Describe how the ACT matrix promotes deictic framing.

 

135. Behavioral Health Applications
Symposium (9:00-10:15am)
Components: Conceptual analysis, Original data, Didactic presentation, Case presentation
Categories: Clinical Interventions and Interests, Prevention & Comm.-Based, Beh. med., Oncological patients, Self-Other, Group Therapy, Chronic Pain, resilience training for adults
Target Audience: Beg., Interm., Adv.
Location: Puget Sound

Chair: Taryn L. Gammon, M.A., California School of Professional Psychology
Discussant: Megan Oser, Ph.D., Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School

ACT and other third wave approaches are increasingly being applied in behavioral health settings. Oftentimes, these approaches are combined with other proven components from other packages to improve their effectiveness. Three conditions that commonly pose behavioral challenges to individuals diagnosed with them are breast cancer, chronic pain, and congenital heart disease (CHD). We present data from an Interpersonal ACT protocol intervention group for women with breast cancer. The protocol includes six consecutive weekly sessions and four monthly follow-up sessions on three main topics: the suffering linked to oncological disease, the side effects of therapy and the physical changes. We will also present a novel interdisciplinary program for chronic pain that integrates acceptance and self-compassion principles into a medical context. This program emphasizes building psychological and physiological resilience to manage chronic pain through self-compassion cultivation, physiological self-regulation and education, mindfulness and interoceptive training, core values clarification, and embodied mindful movement. In addition, we will report on the evaluation of a group ACT resilience training program that incorporates ACT processes to target empirically identified resilience protective factors for adults with CHD. Results from pre- and post-intervention and follow-up will be presented.

• An Intra-personal and Inter-personal level (Self-Other) Acceptance and Commitment Therapy (ACT) intervention group protocol for women with breast cancer: ACT for Health SIG Sponsored
Giuseppe Deledda, Psy.D., Service Clinical Psycology, “Sacro Cuore-Don Calabria” Hospital of Negrar, Verona, Italy
Sara Poli, Psy.D., Service Clinical Psycology, “Sacro Cuore-Don Calabria” Hospital of Negrar, Verona, Italy
Matteo Giansante, Service Clinical Psycology, “Sacro Cuore-Don Calabria” Hospital of Negrar, Verona, Italy

Aim: The aim of this paper is to present an Interpersonal ACT protocol intervention group for women with breast cancer. Method: The protocol includes six consecutive weekly sessions and four monthly follow-up sessions on three main topics: the suffering linked to oncological disease, the side effects of therapy and the physical changes. The focus of the intervention was the “Self-” and the “Self-Other” non-acceptance” and the impact of them on suffering and on the possibility to act consistently with own values (eg. act for health, act for a good relationship of love). Results and Conclusions: We observed an increase in the acceptance of Self as context, despite of the difficulty of the patients to face the encounter with own Self and the Other, which, within the group, can become the mirror of the Self. Finally patients' thoughts seem to move more freely, giving space to new and more functional repertoires.

• Integrating Self-Compassion into Interdisciplinary Chronic Pain Treatment
Taryn L. Gammon, M.A., California School of Professional Psychology

To address the need for treatment models for chronic pain that reach through disciplinary and orientation-specific barriers, a novel interdisciplinary program for chronic pain that integrates acceptance and self-compassion principles into a medical context will be presented. This program, Therapeutic Self-Care, emphasizes building psychological and physiological resilience to manage chronic pain through self-compassion cultivation, physiological self-regulation and education, mindfulness and interoceptive training, core values clarification, and embodied mindful movement. The intervention represents a practical integration of current research into the psychological benefits of self-compassion (e.g., Sirois, 2015); the effectiveness of mindfulness and acceptance-based interventions for chronic pain (e.g., Vowles, Sowden, & Ashworth, 2014); and the neurobiological correlates of pain, self-compassion, and mindfulness (e.g., Arch et al., 2014, Hallman et al., 2011; Zeidan, 2015). Research on the effectiveness of Therapeutic Self Care in a hospital setting demonstrates improvements in pain, depression, self-compassion, self-regulation, and opioid medication use among patients with chronic pain. A case example and practical applications of these skills for clinicians working with pain conditions will be discussed.

• ACT for Adult Congenital Heart Disease
Kenneth Pakenham, Ph.D., University of Queensland
Bronwyn Steele,

This presentation reports on the evaluation of a group ACT resilience training program called READY for adults with congenital heart disease (CHD). READY incorporates ACT processes to target empirically identified resilience protective factors (Burton et al, 2010). ACT processes, protective factors and the corresponding domains of human functioning are incorporated into a READY resilience framework. In view of specific CHD characteristics, a modified briefer version of the program was used (n = 17). A single intervention condition design with pre- and post-intervention and follow-up assessments was used. Preliminary analyses showed improvements in resilience F(1.34, 21.49) = 4.61, p = .034, ηp2 = .22, depression χ2 (2) = 10.08, p = .005, quality of life χ2 (2) = 7.70, p = .019, and values F(2, 32) = 3.71, p = .036, ηp2 = .19. Qualitative data from focus groups with three different stakeholders will be presented (n = 12 patients, n = 3 caregivers, n = 5 clinicians). Results of final analyses will be reported.

Educational Objectives:
1. Describe the rationale for incorporating self-compassion into mindfulness and acceptance-based interventions for chronic pain. 2. Utilize ACT processes to target resilience protective factors in the context of chronic illness. 3. Explain an ACT-based resilience training program for chronic illness.

 

141. ACT for Obesity and Weight-Related Stigma: Concept and Treatment
Symposium (10:30am-Noon)
Components: Original data
Categories: Clinical Interventions and Interests, Beh. med., Weight-Related, Health
Target Audience: Interm.
Location: Vashon 2

Chair: Sarah Potts, M.S., Utah State University
Discussant: Emily Sandoz, Ph.D., University of Louisiana Lafayette

Obesity and weight-related issues are significant public health problems in the United States affecting nearly 70% of American adults, estimating around $147 billion per year (Ogden, Carroll, Kit, & Flegal, 2014). Individuals who are obese are also often adversely impacted by the public attitude and stigma associated with being overweight (Lillis, Luoma, Levin, & Hayes, 2010). While the severity of this health problem has consistently increased and numerous treatments seek to target the problem of weight, there are few treatments that are successful in weight loss and maintenance. This suggests the importance for better understanding the relationship between weight stigma and behaviors and also for developing alternative, novel approaches to obesity and weight-related issues. Preliminary studies suggest ACT is promising as a novel and essential treatment target for overweight and obese individuals, as it highlights acceptance and willingness for experiencing psychological experiences while increasing values-consistent behavior. Three studies with original data investigating the role of weight stigma and eating concerns will be discussed.

• A randomized controlled trial for weight loss targeting individuals with high internal disinhibition: The Acceptance Based Behavioral Intervention (ABBI) trial
Jason Lillis, Ph.D., The Miriam Hospital; Brown Medical School
Heather Niemeier, Ph.D., University of Wisconsin
J. Graham Thomas, Ph.D., The Miriam Hospital; Brown Medical School
Jessica Unick, Ph.D., The Miriam Hospital; Brown Medical School
Kathryn M. Ross, Ph.D., The Miriam Hospital; Brown Medical School
Tricia Leahey, Ph.D., University of Connecticut
Katie Kendra, Ph.D., The Miriam Hospital; Brown Medical School
Leah Dorfman, Ph.D., The Miriam Hosptial

Behavioral weight control programs produce clinically meaningful weight losses; however, outcomes have high variability and maintenance is problematic. The current study, an NIH-funded RCT testing a novel approach, Acceptance-Based Behavioral Intervention (ABBI), which combines techniques from standard behavioral treatment (SBT) and Acceptance and Commitment Therapy (ACT) among individuals reporting high internal disinhibition who typically respond poorly to standard interventions. 162 overweight and obese adults (mean BMI 37.6) who reported high internal disinhibition as measured by the Internal Disinhibition subscale of the Eating Inventory were randomly assigned to treatment (ABBI/SBT). Mean weight loss at 24 months was -5.4kg for ABBI and -3.5kg for SBT. The ABBI group had a softer regain curve (4.9kg vs 7.5kg for SBT) from peak weight loss to the end of the study. Significant differences between groups were found on change in values-consistent behavior, but not weight-related experiential avoidance. Implications and future directions will be discussed.

• You’re fat!: Is psychological flexibility related to stigmatizing experiences and disordered eating for the obese?
Emily R. Squyres, M.S., Louisiana Tech University, University of Louisiana Lafayette
Emily K. Sandoz, Ph.D., University of Louisiana Lafayette
Katie Kendra, Ph.D., The Miriam Hospital; Brown Medical School
Leah Dorfman, Ph.D., The Miriam Hosptial

The public attitude towards obese individuals focuses more on negative stereotypes than underlying psychological components that lie at the heart of the struggle (Latner, O’Brien, Durso, Brinkman, & MacDonald, 2008). Many people who struggle with their weight are found to be very rigid in thought processes regarding food (Darby, Hay, Mond, Rodgers, & Owen, 2007). Perhaps it is not the content of food and body-related cognitions that is important, but the inflexibility with which they are held. The current study investigated the relationships among avoidant eating behavior, perceived stigmatization, self-stigmatization, and psychological flexibility in an obese population using Ecological Momentary assessment. Participants responded to four text messages a day for seven days, three of which were provided them with a link to the Periodic Assessment of Stigmatizing Experiences, and one text message providing a link to the Daily Eating Survey.

• Delivering acceptance and commitment therapy through guided self-help for weight self-stigma: Results from an open pilot trial
Michael E . Levin, Ph.D., Utah State University
Sarah Potts, Utah State University
Jack Haeger, Utah State University
Jason Lillis, Ph.D., The Miriam Hospital; Brown Medical School

Obesity is a prevalent and costly public health problem in the US; however, existing psychosocial interventions designed to promote weight loss are not sufficient, tending to only produce small weight loss outcomes with significant weight gain over time. Stigmatization of obese individuals is highly prevalent in our society, occurring across a range of life contexts, yet little research has sought to develop interventions in this area. Preliminary research suggests ACT is an efficacious intervention in targeting weight self-stigma in a general treatment-seeking obese sample. A guided self-help Acceptance and Commitment Therapy (ACT) treatment was used as a novel approach for individuals with weight concerns. Participants were assigned to phone coach and completed 7-weeks study by reading The Diet Trap and completing journaling and weekly quizzes. Results suggest significant sustained changes in weight-related stigma (3-month follow-up: F(9)=32.23, p<.01), among other variables. Clinical application and user-centered feedback will be discussed.

Educational Objectives:
1. Discuss role and significance of values consistent behavior within weight loss and weight-related interventions. 2. Explain role of psychological inflexibility and negative stereotypes as predictor of increased perceived self-stigma. 3. Analyze the relationship between experiences of stigmatizing events, disordered eating behaviors, and psychological flexibility for those struggling with obesity.

 

144. Awesome Papers 2
Symposium (10:30am-Noon)
Components: Conceptual analysis, Literature review, Original data, Experiential exercises, Didactic presentation, Case presentation
Categories: Performance-enhancing interventions, Clinical Interventions and Interests, Prevention & Comm.-Based, Edu. settings, Superv., Train., & Dissem., Theory & Philo., Functional contextual approaches in related disciplines, ACT Training Program on Acceptance of Autistic Children by Their Mothers, Low-intensity ACT interventions, OCD, Psychological flexibility, Outcome research
Target Audience: Beg., Interm., Adv.
Location: Cascade 1B

Chair: Felicity L Brown, PhD, Harvard University
Discussant: Douglas M. Long, Ph.D., Alpert Medical School of Brown University

As research on acceptance and commitment therapy (ACT) continues to accumulate, the need for studies on applications of ACT in more diverse settings and communities are becoming more apparent. Although there is some evidence for the applicability of ACT across cultures, more research is needed in this area. In addition, the role of psychological flexibility in therapeutic outcomes warrants further study. We present results from a study was conducted in Tehran, Iran, to evaluate the effectiveness of ACT on the acceptance of children with autism by their mothers. We will also present the development of an ACT-based guided self-help intervention for use in low-resource humanitarian settings, and describe the adaptation process, novel delivery method and results of a feasibility pilot with South Sudanese refugees living in northern Uganda. Pilot implementation results, challenges and lessons learned will be discussed. Last, data from a study involving therapists who were not generally ACT-congruent on whether psychological flexibility may be a central ingredient in change will be presented.

• The Effectiveness of Acceptance and Commitment Training Program on Acceptance of Autistic Children by Their Mothers
Ahmad Beh-Pajooh, Ph.D., Professor, University of Tehran, Iran
Sara Pazoki, M.A., Psychology University of Tehran, Iran

This study was conducted to evaluate the effectiveness of the acceptance and commitment training on the acceptance of autistic children by their mothers. The method of the study was quasi-experimental with pre-test, post-test, and follow-up design. The study population included the whole mothers whose autistic child was receiving training and rehabilitation services in Nedaye Asre Rehabilitation Center for Autistic Children, Tehran, Iran in academic year of 2015-16. Using convenience sampling, eleven mothers who had autistic child were selected as the sample group which received acceptance and commitment training in nine two-hour-sessions. As a research tool, the second edition of acceptance and action questionnaire was administered and analyzed based on data using t-test. Data analysis of the results revealed that there was a significant difference between the results of the pre-test, post-test and follow-up. The results confirmed that the acceptance and commitment training has been effective on mothers' accepting their autistic child, by increasing psychological flexibility and decreasing experiential avoidance.

• The Relationship between Psychological Flexibility and Treatment Outcomes
Melissa Daniel, Richmont Graduate University
Timothy Sisemore, Ph.D., Richmont Graduate University

This study explores changes in psychological flexibility as a result of psychotherapy, and ways that those changes may be related to the overall treatment outcome. The agent of change in psychotherapy has long been debated, but it has been commonly accepted that the therapeutic alliance is a central catalyst to change. Qualitative factors of the therapist such as warmth and acceptance have been previously explored (Wampold, 2001), but no consensus has been reached regarding the central mechanism of change within the relationship. The introduction of psychological flexibility as a therapeutic focus in ACT has raised the question of its role in the process of change. This study aims to understand whether psychological flexibility may be a central ingredient in change, or another measure of patient global distress. Data from a psychotherapy outcomes project were compiled which measured patients’ (n = 1664) global functioning, social functioning, global distress, and psychological flexibility (as measured by items from the AAQ-II) in various stages of treatment. The therapists were varied in theoretical approach, and not generally ACT-congruent therapists. Correlational analysis showed that changes in global functioning and changes in psychological flexibility were significant and strong predictors of change in symptoms (r =.73 for symptoms and .69 for functioning, exceeding predictions based on reliability., both at p < .0001). Factor analysis showed flexibility to load on a common factor of improvement, and the three items had a strong alpha of .78. Flexibility was second only to change in functioning in predicting symptom reduction, These findings support the hypothesis that increasing psychological flexibility may be a key factor in positive changes from psychotherapy, and may do so through impacting overall functioning and thus reducing symptoms. Implications for future developments in treatment and interventions from an ACT perspective are discussed.

• Development and Pilot of an ACT-Based Guided Self-Help Intervention for South Sudanese Refugees Living in Uganda
Felicity L. Brown, Ph.D., Harvard University
Wietse Tol, Ph.D., Johns Hopkins University
Kenneth Carswell, DClinPsy, World Health Organization
Mark van Ommeren, Ph.D., World Health Organization

This paper will present the development of an ACT-based guided self-help intervention for use in low-resource humanitarian settings, and describe the adaptation process, novel delivery method and results of a feasibility pilot with South Sudanese refugees living in northern Uganda. The findings of a comprehensive needs assessment indicated high levels of psychological distress and experiences of sexual and gender-based violence in this population, continued ethnic tensions, and “over-thinking”, with limited access to mental health and psychosocial services. The results of a systematic cultural and contextual adaptation process indicate support and excitement for the intervention, with changes made to ensure comprehensibility, relevance, and acceptability of the ACT intervention. Pilot implementation results, challenges and lessons learned will be discussed, along with the possible benefits of the delivery approach for generalizability of the intervention to different settings and dissemination in difficult environments.

Educational Objectives:
1. Utilize ACT for mothers who have autistic children in order to enhance the acceptance of their autistic children. 2. Describe the “active ingredient” in the therapeutic relationship from the perspective of ACT, as compared to traditional views of the therapeutic relationship and what makes therapy work. 3. Describe an adaptation process for taking interventions to new cultures and contexts, and current challenges and innovations in developing interventions that are adaptable and scalable.

 

146. Functional Analytic Psychotherapy interventions across populations: Mexico Chapter Sponsored
Symposium (10:30am-Noon)
Components: Original data
Categories: Clinical Interventions and Interests, Other, FAP
Target Audience: Interm.
Location: Puget Sound

Chair: Daniel Maitland, Ph.D., University of Washington
Discussant: Matthew Skinta, Ph.D., ABBP, Palo Alto University

Functional Analytic Psychotherapy (FAP) is a powerful intervention that has shown potential across presenting problems. FAP has also seen an increase in utilization with different demographic populations and for those seeking increase the quality of their relationships with other individuals. As the scope of the intervention increases, so does the definition of a successful intervention. This symposium provides three data-based examples of the scope of FAP as an intervention and techniques that can be used to capture variables that may be crucial in clinical outcomes. Specifically, we will be talking about FAP as an adjunct treatment for Borderline Personality Disorder, as an intervention for enhancing the relationship between two individuals, and as a general social functioning intervention. The populations utilized in these studies differed significantly showing the utility of FAP across both clinical and demographic populations. Presentations will detail both process and outcome variables that are central to FAP.

• FAP impact, and mechanisms of change, as an adjunct treatment for people diagnosed with BPD
Michel A. Reyes Ortega, Ph.D., Contextual Behavioral Science and Therapy Institute (Mexico City)
Nathalia Vargas Salinas, Ph.D., Contextual Behavioral Science and Therapy Institute (Mexico City)
Jonathan W. Kanter, Ph.D., University of Washington
Mavis Tsai, Ph.D., Private Practice

An RCT was conducted to test the impact of Functional Analytic Psychotherapy (FAP) on individuals diagnosed with Borderline Personality Disorder (BPD) who had finished treatment-as-usual at a public mental health institution in Mexico City. Participants received either 18 sessions (9 individual and 9 group) of FAP (n=22) or Social Skills Training (n=22). T-test analyses found statistically significant (p ≤ .05) and large (d ≥ .80) effects for FAP at post-test compared to pre-test in BPD symptom severity, intimacy, experience of self and emotion regulation according to self-administered questionnaires. Between-groups analyses found statistically significant and large effects in favor of FAP with the biggest differences observed with our measure of intimacy. Regression analyses found that experience of self mediated changes in emotion regulation (R2=.325), and emotion regulation mediated BPD symptom reduction (R2=.457) in the FAP group. These results suggest FAP’s possible utility as an adjunct treatment for BPD and experience of self as a possible FAP-specific mechanism of change.

• The in vivo process in FAP: The relationship to outcomes, adherence, and client experience
Lindsey E. Knott, M.A., Western Michigan University
Rachel A. Petts, M.A., Western Michigan University
Rebecca A. Rausch, Western Michigan University
Daniel W. M. Maitland, Ph.D., University of Washington
Scott T. Gaynor, Ph.D., Western Michigan University

In vivo (IV) work is a distinctive feature of FAP. IV work in FAP involves the therapist attempting to apply contingencies in session to decrease (i.e., gently punish or extinguish) problematic response classes and increase (i.e., evoke and reinforce) more adaptive response classes (i.e., a differential reinforcement procedure). A recently conducted randomized controlled trial found superior outcomes for FAP compared to watchful waiting (WW). In addition, session ratings of general adherence (a standard approach to assessing treatment fidelity in efficacy research) to the FAP rules suggested FAP sessions were unique. The present study attempts a more detailed analysis. Following Kanter et al. (2003), each turn of speech will be coded as IV (talk directed at the therapy process, therapy relationship, or in the moment interactions) or not. It is hypothesized that the IV rate will be higher in FAP than WW, providing another indicator of treatment fidelity. Also, examined will be the relationship between IV rates and coded adherence scores (to determine if the global adherence ratings offer a convenient proxy for such detailed coding), client session ratings (to determine if IV rate is linked to session evaluations), and treatment outcome (to see if IV rate is linked to change).

• The role of the vulnerability-responsiveness relation in individuals attempting to increase social intimacy
Daniel W. M. Maitland, Ph.D., University of Washington
Jonathan W. Kanter, University of Washington
Mavis Tsai, Private Practice

One of the defining characteristics of Functional Analytic Psychotherapy is that of a safe, intense, and authentic and powerful relationship between the therapist and client. One possible explanation for the development of this intense relationship is what researchers term the vulnerability-responsiveness relation. In the current study, an investigation of the application of the vulnerability-responsiveness relation will be explored in dyads who wish to become closer to one another. 32 dyads of individuals (friends, family members, romantic partners) wishing to feel more connected with one another were recruited and received a weekly training that had the dyads engage in the vulnerability-responsiveness relation. In pre, post, and follow-up assessments, the dyad’s responses were coded for the components of the vulnerability-responsiveness relation. The results show the promise of an observer based coding system for assessing interactions that include the vulnerability-responsiveness relation as well as how those codes correlate with measures of interpersonal styles.

Educational Objectives:
1. Discuss the specific benefits of incorporating Functional Analytic Psychotherapy (FAP) as an adjunct treatment for BPD diagnosed clients in contrast with traditionally used interventions. 2. Explain several approaches to determining treatment adherence to FAP principles when applied in efficacy studies and what the resulting data suggest. 3. Describe and utilize the process involved in building relationships as well as the clinical utility of this process as it relates to FAP.

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