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Past JCBS Articles Relevant to COVID-19

Currently we are living through a pandemic that is unprecedented in most of our lifetimes. While new empirical and conceptual papers are being published that focus specifically on COVID-19, we put together a small working group to sort through previous issues of JCBS that contain articles relevant to the current crisis. We will be regularly posting brief descriptions and links to several of these articles on topics such as the use of e-health interventions, self-compassion, interpersonal connection, anxiety, trauma, and stigma/prejudice. We hope that readers will find them useful. (Click here for the JCBS Special Issue on CBS Perspectives on COVID-19)

COVID-19 Workgroup Members: Staci Martin Peron, Ph.D., Maria Karekla, Ph.D., Ronald Rogge, Ph.D., Caitlyn Loucas, MA, and Stephanie Reda, BA.

Some relevant articles:

1. Raftery-Helmer, J.N., Moore, P.S., Coyne, L., & Palm Reed, K. (2016). Changing problematic parent-child interaction in child anxiety disorders: The promise of Acceptance and Commitment Therapy (ACT). Journal of Contextual Behavioral Science, 5(1), 64-69.

This article by Raftery-Helmer and colleagues from 2016 describes the interaction between parent behavior and child anxiety. The authors explain the role of ACT in helping parents accept their thoughts about their child’s anxiety and connect with values surrounding parenting. With many families staying home together during quarantine as well as the propensity for some children to experience anxiety about the coronavirus and its impact, this article is particularly relevant right now.


2. Yadavaia, J. E., Hayes, S. C., & Vilardaga, R. (2014). Using acceptance and commitment therapy to increase self-compassion: A randomized controlled trial. Journal of Contextual Behavioral Science, 3(4), 248-257.

Yadavaia, Hayes and Vilardaga (2014) presented results of a randomized trial that compared a group receiving a 6-hour ACT workshop targeting self-compassion with a wait-list control group. The intervention group improved not only in self-compassion but also in general psychological distress and anxiety, with psychological flexibility identified as a significant mediator of change. In current times, many of our clients (and many of us!) are suffering from self-criticism, e.g., pressuring themselves to be coping better than they are, to be more productive, etc. Applying some of the techniques from this study’s intervention, which are detailed in the Methods section, may be very helpful for our clients.


3. Pierce, B., Twohig, M.P., & Levin, M.E. (2016). Perspectives on the use of acceptance and commitment therapy related mobile apps: Results from a survey of students and professionals. Journal of Contextual Behavioral Science, 5(4), 215-224.

Pierce and colleagues (2016) provide a useful summary of ACT-related mobile apps for complementing in-person therapy. They found that apps were used for things like supporting out-of-session mindfulness practice, setting reminders for practicing ACT skills, and monitoring symptoms. While there were some barriers identified to using mental health apps, this article may be useful for therapists who are searching for alternative ways to help clients remotely.


4. Päivi, L., Sitwat, L., Harri, O. K., Joona, M., & Raimo, L. (2019). ACT for sleep-internet-delivered self-help ACT for sub-clinical and clinical insomnia: A randomized controlled trial. Journal of Contextual Behavioral Science, 12, 119-127.

This recent article by Päivi and colleagues examines the effectiveness of an internet-delivered ACT intervention that targets symptoms of insomnia and psychological distress. The authors found support for their intervention that was maintained over six months, and additionally highlighted the role that thought suppression might play as a central process in sleep disturbance. As increases in worry or disruptions to daily routines related to COVID-19 may reduce sleep quality, this article highlights how ACT-based support could be disseminated in an accessible and cost-effective manner without substantial therapist contact.


5. Duarte, J. & Pinto-Gouveia, J. (2017). Mindfulness, self-compassion and psychological inflexibility mediate the effects of a mindfulness-based intervention in a sample of oncology nurses. Journal of Contextual Behavioral Science, 6(2), 125-133.

Duarte and Pinto-Gouveia describe the effects of a six-week group mindfulness-based intervention in a sample of oncology nurses. Mindfulness, self-compassion, and psychological inflexibility mediated the effect of the intervention on burnout and mental health outcomes. With the current chronic physical, mental, and emotional demands being placed on healthcare and other essential workers, this article offers a timely exploration of potential mechanisms of change to treat burnout and emotional fatigue.


6. Fiorillo, D., McLean, C., Pistorello, J., Hayes, S.C., & Follette, V.M. (2017). Evaluation of a web-based acceptance and commitment therapy program for women with trauma-related problems: A pilot study. Journal of Contextual Behavioral Science, 6(1), 104-113.

Fiorillo and colleagues conducted a six-week web-based ACT program for adult women who had experienced trauma. Program targets were met with participants showing decreased psychological inflexibility, increased ACT knowledge, and improvements on measures of PTSD, depression and anxiety. Results support the efficacy of web-based interventions, which are especially useful given current travel restrictions and the traumatizing nature of the pandemic.


7. Haworth, K., Kanter, J.W., Tsai, M., Kuczynski, A.M., Rae, J.R., & Kohlenberg, R.J. (2015). Reinforcement matters: A preliminary laboratory-based component-process analysis of Functional Analytic Psychotherapy’s model of social connection. Journal of Contextual Behavioral Science, 4(4), 281-291.

In this article, Haworth and colleagues examine the role of self-disclosure and responsiveness on feelings of connectedness through the lens of Functional Analytic Psychotherapy (FAP). The authors highlight the importance of social connection, and through two studies shine light on the mechanisms through which intimate therapeutic relationships are formed. Results showed that when self-disclosure occurred and was reinforced by responsiveness, participants' feelings of connectedness increased and their depth of disclosure improved. As the ways in which we connect with others are shifting, how we choose to communicate with our loved ones deserves careful attention.


8. Tavakoli, N., Broyles, A., Reid, E. K., Sandoval, J. R., & Correa-Fernández, V. (2019). Psychological inflexibility as it relates to stress, worry, generalized anxiety, and somatization in an ethnically diverse sample of college students. Journal of Contextual Behavioral Science, 11, 1-5.

This article by Tavakoli and colleagues explored the relationship between psychological inflexibility and anxiety among individuals of varying racial/ethnic groups. A difference was found between psychological inflexibility and worry among Hispanic-Americans compared to European-Americans. Results highlight the role of psychological inflexibility on anxiety and the potential for ACT interventions to increase psychological flexibility in ethnically diverse samples. Given the global impact of COVID-19 (as well as other issues in the forefront of our minds lately), this study is a reminder to incorporate sociocultural considerations for enhancing psychological wellbeing.


9. Levin, M.E., Pierce, B., & Schoendorff, B. (2017). The acceptance and commitment therapy matrix mobile app: A pilot randomized trial on health behaviors. Journal of Contextual Behavioral Science, 6(3), 268-275.

Levin and colleagues conducted a pilot RCT of an ACT-based mobile app intervention aimed at improving diet and exercise, two behaviors that many people are struggling with during quarantine. Participants randomized to the intervention rated high satisfaction with the app and displayed reasonable engagement. Program completers saw significant improvements in health behaviors compared to the waitlist condition. The authors identify the app’s shortcomings and highlight the need for future work developing mobile-based interventions, something that is extremely relevant given the restrictions of the current pandemic.


10. 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. 

Halliburton and Cooper (2015) provide a comprehensive review of existing literature examining the efficacy of ACT-related treatment for adolescents. Across a wide range of medical and psychological conditions, the authors cite evidence that ACT-based therapies are effective in reducing distress and improving functioning. As there is limited research in this area, the authors go on to suggest additional ways to make developmental adaptations to ACT strategies in order to make them more accessible and appropriate for adolescents. With many adolescents potentially having important developmental milestones impacted by COVID-19, this article is a helpful reminder of how ACT-related strategies may offer some helpful support.


11. Kenny, A., & Bizumic, B. (2016). Learn and ACT: Changing prejudice towards people with mental illness using stigma reduction interventions. Journal of Contextual Behavioral Science, 5(3), 178-185.

Kenny and Bizumic (2016) compared the efficacy of two group-based interventions (ACT vs. education) designed to reduce stigma towards individuals with mental illness. The researchers found that prejudicial attitudes decreased in both conditions but showed the largest reduction for those receiving ACT. At a time when many are facing stigma due to their ethnicity or health status, this article offers a gentle reminder of how to help others adopt an increasingly compassionate and non-judgmental approach.


12. Wetterneck, C. T., Lee, E. B., Smith, A. H., & Hart, J. M. (2013). Courage, self-compassion, and values in obsessive-compulsive disorder. Journal of Contextual Behavioral Science, 2(3-4), 68-73.

In a study by Wetterneck and colleagues (2013), higher self-compassion, courage, and valued living were associated with lower OCD severity, with courage and valued living predicting symptom severity. People with OCD may be struggling more than ever during the pandemic and this article provides input about what may be helpful to target in therapy. Moreover, the article’s implications are broadly applicable beyond just those with OCD and underscore the role that valued living has in symptom and distress reduction - especially when engagement with values may feel more restricted or challenging.


13. Whittingham, K. (2015). Connect and shape: A parenting meta-strategy. Journal of Contextual Behavioral Science, 4(2), 103-106.

Whittingham outlines a parenting strategy for targeting child misbehavior that pulls from previously distinct behavioral and social/emotional approaches, combining them into one effective parenting model. The author explains how attachment behavior can be viewed within a behavioral framework grounded in evolutionary science. The article describes key features of the Connect and Shape model and how it can be taught to parents. Given the increase in time that children are spending at home with parents, the proposed framework may be especially useful for managing child behavior during the pandemic.


14. Steger, M. F., Shim, Y., Barenz, J., & Shin, J. Y. (2014). Through the windows of the soul: A pilot study using photography to enhance meaning in life. Journal of Contextual Behavioral Science, 3(1), 27-30.

Steger and colleagues discuss how meaning in life plays an important role in psychological well-being. In this study, participants took photos of things that made their lives feel meaningful over one week and then wrote about why they found each photo meaningful. This simple intervention was associated with increases in positive affect, meaning in life, and life satisfaction, as well as decreases in negative affect. With the pandemic making it harder to connect with values in the ways we did previously, this intervention offers a creative method for helping individuals focus on meaningful life experiences. Providers may consider incorporating similar assignments into their online practices.


15. White, R.G., Gregg, J., Batten, S., Hayes, L.L., & Kasujja, R. (2017). Contextual behavioral science and global mental health: Synergies and opportunities. Journal of Contextual Behavioral Science, 6(3), 245-251.

Here White and colleagues discuss the current goals of the global mental health field, particularly the need for more accessible care initiatives. The authors highlight that a majority of the world’s population lives in areas that lack mental healthcare resources. The article discusses strategies to combat the limitations of current models of mental health services and future directions for the development of feasible, wide-reaching mental health interventions. The authors also note that contextual behavioral science is particularly suitable for meeting the needs of global mental health and discuss its potential applications. These global gaps in healthcare are only aggravated by the current pandemic and thus deserve particular attention right now. 


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