Invited Plenary Address: The Art and Science of Thought Suppression by Daniel Wegner Abstract: So how can we suppress an unwanted thought? This talk looks into why thought suppression is difficult—and what can make it easy. Suppression can be difficult because the mental mechanisms involved include a search for the very thing we don’t want to think—and this ironically increases our sensitivity to the thought and promotes its return. Suppression can be easier, however, when we sidestep such ironic monitoring. Successful indirect strategies can be found in relaxation and body awareness, self-disclosure and social relationships, and practice in avoiding direct suppression. Scientific studies of thought suppression can inform the art of thought suppression in everyday life.
About: For decades, Harvard Professor Daniel M. Wegner has been a fellow traveler of the ACT/RFT community. His work on the paradoxical effect of mental control has supported our research and clinical insights, enriching our pool of knowledge on this specific topic with an independent and rich perspective. Daniel M. Wegner’s work is not only supportive to ACT/RFT; in his book The illusion of conscious will (Wegner, 2002), he questions the common sense idea that conscious will is the cause of action, a position that pretty much aligns with our behavioral tradition. Plus, if you haven’t been in one of Dr. Wegner talks, this is an opportunity you won’t regret. He expertly combines scientific rigor with the investigation of highly relevant topics in a very amenable and refreshing fashion.
Invited Address: Emotion Regulation and ACT by James Gross Abstract: One cannonical distinction in the field of emotion research is the distinction between emotion generation and emotion regulation. This distinction fits comfortably with folk theories which view emotions as passions which arise unbidden and then must be controlled by reason. For example, a child may get angry when a sibling gets a treat but she does not (emotion generation). The child then may need help calming down after the upset (emotion regulation). But is it really possible to distinguish between the processes (and brain regions) implicated in emotion generation versus emotion regulation? In the first part of this talk, I will make the case that such a distinction is (often) both possible and useful. In the second part of this talk, I will then spell out how emotion regulation research makes contact with ACT.
About: James Gross is a pioneer in the field of emotion research. He earned a degree in philosophy from Yale and a doctorate in clinical psychology from the University of California, Berkeley. He is currently director of the Stanford Psychophysiology Laboratory. His work has foci in emotion regulation strategies, the neural correlates of mindfulness and cognitive behavior therapy interventions, and mindfulness training with children and families. Gross’s work is an exemplar of experimental laboratory research that has direct relevance to clinical work and everyday life.
Invited Plenary Address: Improving CBT: Problems and Prospects by G. Terrance Wilson, James Herbert and Kelly Wilson Partial Abstract (G.T. Wilson): Obstacles to improvement can be grouped into misconceptions about “evidence-based treatment ” and the applicability of research findings to clinical practice on the one hand, and gaps in our current knowledge about treatments, mechanisms of change, and reliable means of training competent practitioners. I criticize the APA notion of evidence-based practice, summarizing the well-documented limitations of subjective clinical judgment and emphasizing the need for high quality treatment guidelines (e.g., NICE). Treatment research priorities include identifying predictors, moderators, and mechanisms of change. Other needs are the development of practical and valid measures of treatment integrity, and innovative research on dissemination and implementation of effective treatments. Ways in which transdiagnostic models and therapy manuals enhance individualization of treatment and address comorbidity are noted.
About G. Terrance Wilson: Dr. Wilson is currently Professor and Oscar Krisen Buros Professor of Clinical Psychology at Rutgers University. A former President of the Association for Behavioral and Cognitive Therapies (1980-81), and twice a Fellow at the Center for Advanced Study in the Behavioral Sciences at Stanford, California (1976-77; 1990-1991), Terence Wilson is a distinguished guest at this year’s ACBS conference. Dr. Wilson has been a faculty member at Rutgers University since 1971. Currently, he is the Coordinator of the Rutgers Clinical Psychology Program, and is the Director of the Rutgers Eating Disorders Clinic. His research has focused on the application of social learning theory to the analysis and treatment of clinical problems. In particular, he has made significant contributions to our understanding of the psychological mechanisms of change in treatments for eating disorders. He continues to seek more effective theory-driven interventions for treatment-resistant patients.
Invited Address: Evolving Psychologically Flexible Cultures by Anthony Biglan Abstract: If the findings on the value of psychological flexibility are correct, then promoting psychological flexibility in our societies would be very valuable. This presentation will present a set of challenges for the ACT/RFT community—the research and practice that seem needed if we are going to translate existing knowledge into widespread changes in people’s psychological flexibility. Does caring naturally emerge when people become skilled at defusion? Can we find ways to teach psychological flexibility at an early age? Can such flexibility be promoted through the media? Are there public policies that would foster flexibility? Is it possible to promote a pragmatic approach to public discussions as an alternative to the type of vitriolic political culture that has characterized recent American history? What is the relationship between materialism and psychological flexibility?
About: Dr. Anthony Biglan has worked for decades toward transforming behavioral scientific knowledge into widespread improvements in human wellbeing. He authored Changing Cultural Practices: A Contextualist Framework for Intervention Research, published by Context Press, and has devoted himself to this approach to cultural change, producing over 100 publications. Dr. Biglan has been a part of the Association for Contextual Behavioral Science since its inception, contributing to empirical work, and attending or facilitating numerous Acceptance and Commitment Therapy (ACT) workshops both nationally and internationally. Dr. Biglan is Senior Scientist at Oregon Research Institute and has directed the Center on Early Adolescence and Center for Community Interventions on Childrearing. He has been a researcher for more over 30 years on the prevention of adolescent problem behaviors, conducting numerous experimental evaluations of interventions to prevent tobacco, other drug use, high-risk sexual behavior, reading failure, and aggressive social behavior. He was a Fellow at the Center for Advanced Study in the Behavioral Sciences and worked with colleagues there to publish a summary of complex factors involved in preventing and treating multiple problems in youth. In addition, Dr. Biglan has been the Principal Investigator of the Teacher Wellbeing Project and Co-Principal Investigator of the Promises Network Research Consortium. He has served as a Participant on the Behavior Change Expert Panel of the Office of White House National Drug Control Policy and as a grant reviewer for the National Institute of Drug Abuse Epidemiology and Prevention Review Committee. He is Past President of the Society for Prevention Research for which he was a board member for many years and co-authored Community-monitoring systems: Tracking and improving the well-being of America’s children and adolescents, a monograph published by that society (Mrazek, Biglan, & Hawkins, 2004).
Invited Workshop: Introduction to Longitudinal Data Analysis by Robert Gallop Abstract: Longitudinal data acquisition has always been a component of psychotherapy research, but the reporting of results through longitudinal data analysis (LDA) has been advanced substantially during the past 20 years. Previously, longitudinal data would be summarized into one measure through methods such as last observation carried forward (LOCF). Then analyses would incorporate cross-sectional methods such as analysis of covariance (ANCOVA) for reporting study results. The fundamental difference with LDA methods is that they recognize that the repeated observations within subjects are correlated. This correlation has a profound impact on the resulting tests of significance. When this within subject correlation is properly incorporated, the LDA takes full advantage of all information obtained from each subject, thereby greatly increasing statistical power over methods that compare treatments cross-sectionally. At least two general approaches are available in a number of software packages for analyzing longitudinal data:
- Multilevel models adjusting for the hierarchy of clusters with nested random effects
- General Mixed Model Analysis of Variance.
The workshop will be data driven with examples from various psychotherapy studies. Recommend Reading: Hedeker, D. & Gibbons, R.D. (2006). Longitudinal Data Analysis. New York, NY: Wiley.
About: Robert Gallop, Ph.D. is Associate Professor of Statistics at West Chester University, West Chester, PA. Dr. Gallop has expertise in longitudinal data analysis using multi-level modeling in psychotherapy outcome trials, has additional interests in psychometrics and mediational analysis, and has provided consultant support as a statistician for NIMH-funded grant projects for nearly a decade. He has co-authored over 40 publications including outcome studies for treatment for addictions, depression, and borderline personality disorder, prevention of relapse, prevention of symptom development, and the importance and role of therapist adherence, competence, and therapeutic alliance. Additionally, he has produced numerous papers on the proper statistical procedures for power analyses and effect size calculations in therapeutic outcome studies and suggestions for the proper procedures in multilevel modeling in psychotherapy research. Gallop's expertise also includes simple explanations and recommendations for common but sometimes complex statistical concepts and analyses.
Invited Pre-Conference Workshop: Functional Analytic Psychotherapy by Robert Kohlenberg & Mavis Tsai Abstract: Functional Analytic Psychotherapy (FAP) is a third-wave behavioral treatment in which the therapist enters mindfully into the therapeutic relationship and responds genuinely in the moment to shape up more workable client repertoires. The developers of FAP and the authors of its first treatment manual, Mavis Tsai, Ph.D. and Robert Kohlenberg, Ph.D., will be offering a two-day pre-conference workshop entitled Functional Analytic Psychotherapy (FAP): New Frontiers in Awareness, Courage, Love, and Behaviorism on June 19 & 20. The workshop will demonstrate how sound behavioral principles can be brought to bear in bringing about curative change through meaningful, intense, and intimate therapeutic interactions. About: Mavis Tsai, Ph.D., is a psychologist in independent practice and a clinical instructor at the University of Washington where she is involved in supervision and research. Her interests include PTSD, disorders of the self, power issues in marital therapy, incorporating Eastern wisdom into psychotherapy, racism and minority groups, and women’s empowerment. She has led numerous workshops nationally and internationally and is known for her engaging interpersonal style as well as her behaviorally informed multi-modal approach to healing and growth that integrates mind, body, emotions, and spirit. Robert Kohlenberg, Ph.D., ABPP, is a professor of psychology at the University of Washington. He has presented “Master Clinician” and “World Round” sessions at the Association for the Advancement of Behavior Therapy and has presented FAP workshops both in the US and internationally. He has received research grants for FAP treatment development, and his current interests are identifying the elements of effective psychotherapy, the integration of psychotherapies, and the treatment of co-morbidity.
Invited Lecture: Translating Processes in Contextual Behavioral Science into the Creation of More Nurturing Cultures by Anthony Biglan The ultimate goal of contextual behavioral science could be to increase the prevalence of wellbeing in entire populations. Choosing this goal would ensure that our scientific work contributes, not just to the alleviation of individuals’ psychological and behavioral problems, but to the creation of nurturing environments in which fewer people have problems and many more become caring and productive members of their communities. Such an outcome is a realistic prospect thanks to the substantial progress that has been made in contextually oriented behavioral sciences. The progress includes the development of a wide array of effective preventive interventions, which were identified in the recent report of the Institute of Medicine. These family and school-based interventions have been shown to reduce the incidence of antisocial behavior, anxiety and depression, substance use, risky sexual behavior, child abuse, marital conflict, and stress-related problems. At the same time, research on Relational Frame Theory and Acceptance and Commitment Therapy (ACT) has pinpointed basic verbal processes that subserve all of these problems and clinical research on ACT shows that modifying these processes can ameliorate a wide variety of psychological and behavioral problems.
This presentation will review the evidence supporting the above assertions and provide a synthesis of the two lines of work that can form the basis for creating nurturing cultures that not only reduce the burden of psychological, behavioral, and health problems, but significantly increase the proportion of people who are able to live productive lives in caring relationships with others.
Analysis of the generic features of effective preventive interventions indicates that they make family, school, neighborhood, and workplace environments more nurturing. Nurturing environments have four features: (a) they minimize biologically and socially toxic events; (b) they model and reinforce prosocial behavior; (c) they limit antisocial behavior; and (d) they promote psychological flexibility. In this talk, I will focus on how the promotion of psychological flexibility could function as the foundation for achieving the other features of nurturing environments. And I will delineate lines of research that could contribute to the goal of increasing the prevalence of wellbeing.
Psychological flexibility appears to enhance people’s caring toward others, although research on this issue remains limited. It appears that ACT interventions help people become more willing to have feelings, which, if avoided, would interfere with caring relationships. They also encourage people to make their values explicit and those values typically include closer relationships with others. (Further research is needed on whether values involving better relationships with others naturally emerge; this possibility is suggested by evolutionary analyses of the value to human groups of having positive social relationships.) Finally, ACT facilitates people acting in the service of their values, which is aided by defusion from difficult thoughts and feelings that arise when others are aversive.
Increasing individuals’ psychological flexibility has the potential to increase the proportion of the population that is caring toward others. It might also encourage others to become more psychologically flexible, as the tendency to “hold our thoughts and feelings lightly” is spread from person to person.
As the proportion of people who are psychologically flexible spreads, the tendency of social environments to be aversive should diminish and the modeling and reinforcement of prosocial behavior should increase. However, it is unlikely that this will happen solely through clinical interventions. If our ultimate goal is to affect the prevalence of psychological flexibility in society, why not open up other lines of research and practice that could contribute to this goal? This presentation will conclude with a framework for research and practice that should contribute to the spread of environments that nurture prosociality and thereby human wellbeing. The framework includes: (a) further research and effective communication of epidemiological evidence that promotes the establishment of environments that promote prosociality; (b) experimental evaluations of comprehensive interventions to promote prosociality; (c) evaluations of ACT interventions to promote social cohesion, trust, and prosociality in organizations and comity and pragmatism in public discussion; (d) the development of a surveillance system to track progress in evolving nurturing environments.
Invited Lecture: For the Benefit of My Patients, A Family Physician's Journey into ACT by Debra Gould This lecture will focus on the application of ACT in the primary care setting. The presenter will describe her experience of learning how to integrate ACT into her practice as a family physician and as a teacher in a family medicine residency program. Based on both personal experience growing up in a rural, underserved community and her professional experience, she will discuss the rationale of providing ACT via an integrated behavioral health service model and/or through training family physicians and other primary care providers in ACT technology. She will also present the practical and potential challenges associated with these activities and advocate for ACT research in primary care settings.
Invited Lecture: Balancing Clinical Innovation with the Imperative to Utilize Best Available Practices by James Herbert Clinicians have an obligation to use the best available practices in their work. For scientifically minded clinicians (including those grounded in contextual behavioral science), this means state-of-the-art technologies that are supported by the best available research. At the same time, there is a pressing and ongoing need for clinical innovation, as existing technologies are (and forever will be) far from perfect. The tension between the imperative to use current best practices and the need to innovate plays itself out in multiple domains, from front-line clinical work to clinical research. Various solutions to this problem have been offered, but the field has yet to achieve consensus. This talk will explore this issue, proposed solutions, and future directions.
Invited Lecture: Multi Professional Pain Rehabilitation Based on ACT Principles by Per-Olof Olsson, Lena Thermaenius-Spångmark, Åsa Storkamp, Anna-Maria Weingarten, Karin Granholm, Linnea Karlsson, & Joanne Dahl The aim of this paper is to show how ACT principles can be used by a multidisciplinary team consisting of a psychologist, occupational therapist, physical therapy and social worker in pain rehabilitation. The session will illustrate how the ACT core processes are used in the conceptualization and treatment of the client with chronic pain from the particular perspective of each of the team members. Preliminary results from the application of this model for groups of clients with chronic pain will be presented.
Invited Lecture: Using the Hexaflex Model to Develop Depth in a Dynamic ACT Conceptualization by Brent Ryder, Melissa Rowland & Daniel J Moran When the Hexaflex Model for conceptualization from ACT in Practice is employed on a regular basis, it can be used to incorporate client data from sessions, and then coupled with relevant therapeutic ACT interventions to yield a path for further clinical progress. Clinical improvement can become apparent in more relevant detail by applying this process. Whether an aspiring therapist, or an experienced ACT clinician, the Dynamic ACT Conceptualization should prove valuable.
Invited Lecture: Training and Assessment of Relational Precursors and Abilities (TARPA): Preliminary Findings and Future Directions by Ian Stewart The Training & Assessment of Relational Precursors & Abilities (TARPA) is a recently developed computer-based protocol for the assessment of a progression of key domains of responding critical to the development of generative language. The TARPA is comprised of ten stages as follows: (i) basic discrimination; (ii) conditional discrimination involving similarity; (iii) conditional discrimination involving non-similarity (2 comparisons); (iv) conditional discriminations involving non-similarity (3 comparisons); (v) mutually entailed relational responding; (vi) mutually entailed relational responding (3 comparisons); (vii) combinatorial entailed relational responding (2 comparisons); (viii) transfer of function [responding to a stimulus in a new and appropriate way based on it’s participation in a derived sameness relation] (2 comparisons); (ix) combinatorial entailed relational responding (3 comparisons); (x) transfer of function (3 comparisons). Each stage is further subdivided into multiple levels, and in the stages assessing derived relations (i.e., Stages 5-10), levels are subdivided into training sections and derivation sections.
A preliminary version of the TARPA has been correlated with the Vineland Adaptive Behavior Scale (VABS; Sparrow, Cicchetti & Balla, 2005). Currently ongoing research is using the most up-to-date version to assess the emergence of relational responding with typically developing children and children with autism in order to correlate performance on this protocol with level of functioning as assessed using standardized measures of language and cognition (e.g., PLS-4; Zimmerman, Steiner & Pond, 2002) as well as to gain some insight into the hierarchical structuring and other features of the protocol to aid its further development and refinement.
Invited Lecture: Pillars and Posts and Arches, Oh Boy!: What's Up With This Response Style Business Anyway? by Kirk Strosahl One of the more recent developments in ACT has been the attempt to streamline the clinical model so that it is more efficient as a case formulation method and is more accessible to non-mental health trained helping professions. A potentially useful way to do this is to move from reliance on six core processes to three basic response styles. This talk will examine progress that is being made on this front. I will define what we mean by a "response style" and then individually examine each one in terms of its clinical significance. Various attempts have been made to incorporate this idea into ACT case formulation and treatment planning models (i.e., pillars & posts, psy-flex arches, three legged stool) and I will briefly review these developments. The movement to a response style model also has significant implications for ACT/RFT research, for example, does the research support the parsimony of moving to three response styles over six core processes?
Invited Discussion: The Client's Perspective on a Preliminary Brief Group Intervention for Chronically Depressed Treatment Resistant People by Jacopo Pisaturo & Mark Webster This session will be looking at video feedback from clients who attended a preliminary brief group intervention based on the Grid/Matrix. They will be sharing their experience of the group looking at what was helpful and also not so helpful. The intervention was delivered in three 'pulses' and the rationale for this format will be presented along with the format itself. The data collected includes AAQ-II and BDI2, and it will be considered in the context of the clients' perspectives, including further narrative data.
Invited Discussion: Many Hands: Raising the Single-Case Design Collaboration! by Kelly Koerner What if we pooled efforts to carry out single-case design research? Where should we focus? What would we need? What would you like to see happen? What do you have energy for? Come help raise the barn: many hands will make it easy to start-up a collaborative practice-research network! We will be brainstorming together on a wall at the conference, come jot and chat with us and we'll see just how powerful a self-organizing passionate group can be!