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

Session 116

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

Reuben Lowe, B/A Hons, Healthscope

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

• The Matrix for Sports Performance  

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

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

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

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

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

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

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

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

• ACT with Chronic Illnesses  

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

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

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

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

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

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

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

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

• Experiential Avoidance and Problematic Health Behavior  

Anne I. Roche, MA, University of Iowa

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

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

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

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

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

Lisa DeHahn Jade, MS, Southern Maine ACT Community

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

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

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

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

• The Transition from Clinician to Supervisor  

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

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

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

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

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