WC12 Symposia Detail

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Thursday, June 19
Friday, June 20
Saturday, June 21
Sunday, June 22

 

Thursday, June 19

15. Thinking Fast and Slow: Recent Theoretical Developments in the Study of Implicit Cognition
Symposium (10:30am-Noon)
Components: Conceptual analysis, Literature review, Original data
Categories: Theory & Philo., Related FC approaches, RFT, Relational Elaboration and Coherence (REC) Model; Propositional Model
Target Audience: Beg., Interm., Adv.
Location: Excelsior Bay & Lafayette Bay

Chair: Sean Hughes, National University of Ireland Maynooth (NUIM)
Discussant: Ian Stewart, National University of Ireland Galway (NUIG)

Over the past twenty years, researchers from nearly every corner of psychological science have devoted considerable time and energy to the study of a phenomenon known as implicit cognition. Much of this work has centered on the finding that people can think, feel and behave in ways that are beyond their control, outside of their awareness, that defy their intention and that occur in the blink of an eye. Perhaps more importantly, these ‘automatic cognitions’ influence the way we subsequently behave: they shape our decisions, warp our judgments and bias the way we respond to both ourselves and others. In this session we reflect on a number of functional/cognitive theories and methods that are currently shaping our understanding of thinking fast and slow. Hughes will begin with an overview of this research area and offer the Relational Elaboration and Coherence (REC) model as a new RFT-inspired account that contextual behavior scientists can use to further our understanding of this class of behaviors. Barnes-Holmes will then consider an RFT-inspired measure known as the Implicit Relational Assessment Procedure (IRAP) and discuss just what it does and does not measure. Finally, De Houwer will close the session by drawing attention to the fact that (under certain conditions) developments at the cognitive (propositional) level may feed into and drive developments at the functional (RFT) level and vice-versa.

• Holding on to our Functional Roots when Exploring New Intellectual Islands: A Voyage through Implicit Cognition Research
Sean Hughes, National University of Ireland Maynooth

Over the last twenty years contextual behavioral scientists have focused their attention on a whole host of complex psychological phenomena. This voyage into uncharted waters has brought with it exciting new developments at the methodological and theoretical levels as well as increased contact with different traditions occupying foreign intellectual islands. One such (cognitive) tradition living on a foreign island (mentalism) has discovered an exciting new class of behaviors typically referred to as ‘implicit’ or ‘automatic’ cognition. In the current talk I provide a brief overview of this research literature as well as the conceptual, theoretical and methodological tools that have typically been used to understand this phenomenon. Thereafter, I offer the Relational Elaboration and Coherence (REC) model as a RFT inspired means for contextual behavioral scientists to explore this domain from a purely functional perspective.

• Why the IRAP is NOT a Measure of Implicit Cognition
Dermot Barnes-Holmes, National University of Ireland Maynooth

The phrase “implicit cognition” simply serves to orient behavior-analytic researchers towards a particular domain in psychological research and thus neither word can be considered a technical term. Technically speaking, therefore, the IRAP is not a measure of implicit cognition. Rather the IRAP is more appropriately considered a measure of the probabilities in previously established patterns of brief and immediate arbitrarily applicable relational responding. The current paper will reflect upon the possible pros and cons of using a popular or “trendy” verbal stimulus to label a new functional-analytic procedure or measure.

• Implicit Cognition: A functional-Cognitive Perspective
Jan De Houwer, Ghent University

Whereas most cognitive psychologists subscribe to the position that automatic (implicit) behavior is mediated by the automatic spreading of activation along associations in memory, I put forward the idea that automatic behavior is mediated by propositional knowledge. Unlike associations, propositions contain information about how events are related (e.g., A causes B, A is an effect of B, …). I review several studies showing that automatic responses can be moderated by relations cues, at least under certain conditions. At the cognitive level, these findings support propositional theories of implicit cognition. At the functional level, these findings show that relational responding can be automatic and reveal the need for the further development of measures such as the IRAP that can capture automatic relational responding.

Educational Objectives:
1. Describe the current state-of-the-art in implicit cognition research. 2. Outline a new RFT inspired (REC) model and procedure (IRAP). 3. Discuss the relation between the functional and cognitive traditions in this research area.

 

17. The Power of Therapeutic Relationship: an Approach to Why and How People Change in Functional Analytic Psychotherapy (FAP)
Symposium (10:30am-Noon)
Components: Conceptual analysis, Original data
Categories: Performance-enhancing interventions, Clin. Interven. & Interests, Functional Analytic Psychotherapy
Target Audience: Interm.
Location: Lake Calhoun

Chair: Daniel W. M. Maitland, Western Michigan University
Discussant: Jonathan Kanter, University of Washington

One of the biggest questions in the mainstream of clinical psychology is the role of therapeutic relationship in client outcomes. This symposium provides three data-based examples of the Functional Analytic Psychotherapy approach to this topic. We present four research studies exploring how the interaction between the therapist and the client can be maximized to produce client improvements both in and out of the session. Specifically, we discuss the importance of: (a) the therapist’s active vs. passive role, (b) different therapeutic actions throughout the therapeutic process, and (C) the use of several forms of verbal behavior to shape clinically relevant behavior. Results suggest explanations for the mechanism of the therapeutic relationship from a contextual behavioral perspective and provide support for FAP in particular.

• How does FAP work? The differential effect of therapist behavior on client behaviors in and
Amanda M. Muñoz-Martínez, M.S., Fundación Universitaria Konrad Lorenz (presented by Jonathan Kanter)
Natalia Esparza Lizarazo, Fundación Universitaria Konrad Lorenz

Functional Analytic Psychotherapy’s mechanism of therapeutic action has been described in terms of behavioral principles such as reinforcement, discriminative control, and functional equivalence. This talk presents two experimental single-case research designs in which these principles were differentially emphasized. The first study involved a crossover design that demonstrated variation in the frequency of client problems and improvements when the therapist focused solely on evoking behavior (Rule 2 in FAP) versus evoking and reinforcing behavior (Rules 2 and 3 in FAP). The second study used a simple A-B design with follow-up. Results showed parallel changes in the behavior of the clients in and out of session only after application of Rule 2 and Rule 3. We will discuss methodological issues, the importance of increased research on mechanisms of change in FAP, and the relevance of the therapeutic relationship. Educational Objective: Plan researches in FAP which integrate coherently methodological and theoretical issues from a contextual science.

• What Kind of Talk Matters in Functional Analytic Psychotherapy? A Single-Case Experimental
Alessandra Villas-Boas, University of São Paulo
Sonia Beatriz Meyer, University of São Paulo
Jonathan Kanter, University of Washington

All psychotherapeutic interventions involve relational transformations of function at a fundamental level. FAP focuses on two processes within this verbal framework. First, Rules 1-4 involve verbal behavior to shape improvements in clinically relevant behavior. Then, Rule 5 helps the client develop effective rules to describe the shaping process that previously occurred. One question in FAP is if Rule 5 is necessary. A single-case experimental design, A-B1-BC1-B2-BC2 is being conducted with two clients: A is baseline; B represents FAP shaping strategies (Rules 1–4); and BC represents FAP shaping strategies plus verbal descriptions of the contingencies (Rule 5). An increase in the frequency of in session improved behavior was observed in Phase B, suggesting a positive impact of Rules 1–4. In Phase BC, the frequency of the clients’ descriptions of contingencies increased, but there is not enough data to conclude that Rule 5 impacted behavior out-of-session.

• Evaluating the Efficacy of FAP for Enhancing Social Connectedness in a Distressed College Student Population
Daniel W. M. Maitland, Western Michigan University
Rachel A. Petts, Western Michigan University
Christopher A. Briggs, Western Michigan University
Julissa A. Duenas, Western Michigan University
Justin A. Moore, Western Michigan University
Scott T. Gaynor, Western Michigan University

Functional Analytic Psychotherapy (FAP) is a radical behavior form of therapy. This therapy focuses on contingently responding to clinically relevant behavior as it occurs in the room. To date, little research been conducted exploring the differential impact of FAP compared to other therapeutic conditions. The current study investigates the differences between FAP and a watchful waiting condition in a distressed population recruited from a large Midwestern university. Participants in this study scored one standard deviation below the mean on a measure of social intimacy and met diagnostic criteria for Social Anxiety Disorder, General Anxiety Disorder, a Major Depressive Disorder, Avoidant Personality Disorder, or Dependent Personality Disorder. Participants were then given 6 sessions of FAP or 6 sessions of a watchful waiting condition. Data presented will highlight the impact of FAP on measures of social intimacy and the differential impact compared to the watchful waiting condition. Currently 13 participants are enrolled in the study, it is expected that 20-30 will be available for the presentation at the conference

Educational Objectives:
1. Analyze the research process and the use of different methodological approaches to exploring FAP process and outcomes. 2. Discuss the importance of the therapeutic relationship to create client changes, and how to assess this mechanism. 3. Plan research in FAP which integrates methodological and theoretical issues from a contextual behavioral science perspective.

 

18. ACT for Parents
Symposium (10:30am-Noon)
Components: Original data
Categories: Clin. Interven. & Interests, Clin. Interven. & Interests, parents
Target Audience: Beg., Location: Lake Nokomis

Chair: Meredith Rayner Ph.D., Parenting Research Centre and Murdoch Children's Research Insitute
Discussant: Louise Hayes, Ph.D., Univeristy of Melbourne

ACT and parenting is a growing area of research and clinical interest. Current research from several aspects of parenting are presented including evaluations of parent interventions, emotional regulation and expression, psychological flexibility, and maternal mental health. The first paper presents data from a pilot of a five-session ACT parenting workshop with parents of children with severe emotional and behavioral difficulties in a day-treatment school setting. The second paper presents a model of the proposed relationships between maternal and child depressive symptomatology by assessing psychological flexibility, perceived parental social support, and family environment in mother-child dyads. The third paper presents preliminary data from a group intervention to reduce the long term traumatic emotional responses to the child’s illness in parents of children diagnosed with a life threatening illness or injury. The final paper explores the relationship between emotion regulation, expression, and mental health outcomes in a sample of low-income mothers.

• ACT for Parents: An Open Trial with Parents Raising a Child with Severe Emotional and Behavioral Problems
Lisa Coyne Ph.D., Suffolk University/The New England ACT Institute
Mitch Abblett, Ph.D., The Manville School/Judge Baker Children’s Center at Harvard Medical School

The present study presents the pilot a five-session ACT parenting workshop with parents of children aged 5-17 with severe emotional and behavioral difficulties in a day-treatment school setting. We expected that parents would find the program acceptable and feasible. Further we anticipated that those who reported post-program increases in acceptance and mindfulness would also report reduced parenting stress, distress, improved quality of life, improved parenting efficacy, and increased reliance on positive, rather than maladaptive, parenting strategies. We also explored the relationship between improvements in parent functioning and their relationship to parent and teacher-reported child behavioral and emotional functioning. The first wave (n=7) is completed and the second wave (N = 8) is underway. Data includes parent stress/distress, quality of life, perceptions of parenting and child behavior problems, ACT processes and treatment feasibility and acceptability (baseline, post-treatment, and 3-month follow-up). Study strengths and weaknesses, as well as implications for future work, will be discussed.

• The role of social support and psychological flexibility in the transmission of depression from mother to child
Alysha D. Thompson, Ph.D, Suffolk University
Lisa W. Coyne, Ph.D., Suffolk University

This research examines the contribution of parental emotion coping and social support to child depression. Participants were 348 mother-child dyads (children ages 11-14). Child self-report measures assessed depressive symptoms, psychological flexibility, and perceived parental and peer social support. Mother self-report measures assessed, depressive symptoms, psychological flexibility, and family environment. This study aimed to create a comprehensive model of the proposed relationships and to assess the influence of psychological flexibility, perceived parental social support, and maternal depressive symptomatology on child depressive symptomatology. Structural equation modeling was utilized to test the goodness of fit of the proposed model. Results indicated maternal depression significantly predicted maternal experiential avoidance, parent social support, and child depression. In addition, maternal psychological flexibility mediated the relationship between maternal symptoms of depression and parent support, parent support mediated the relationships between maternal and child symptoms of depression and maternal and child psychological flexibility.

• Take A Breath: Increasing psychological flexibility and reducing traumatic emotional response in parents of a child with a life threatening illness or injury
Meredith Rayner Ph.D., Parenting Research Centre and Murdoch Childrens Research Institute
Frank Muscara Ph.D., Murdoch Childrens Research Institute

The diagnosis of a child with a life threatening injury or illness places severe stresses on parents and has been linked to high parental risk of Acute Stress Disorder and Post Traumatic Stress symptoms. This paper presents preliminary data from an RCT of an ACT group intervention to increase parental flexibility and reduce the long term traumatic emotional responses to the child’s illness in parents of children diagnosed with a life threatening illness or injury. The groups are delivered online using web-conferencing to increase accessibility for this population of parents who have illness and treatment related barriers to attendance. Quantative data are presented along with data from semi structured interviews.

• The Role of Emotion Regulation and Expression on Mental Health Outcomes for Racial-Ethnic Minority Mothers
Marie-Christine André, M.A., Suffolk University, Department of Psychology
Carlos Rivera, B.S., Suffolk University, Department of Psychology
Jadig Garcia, M.A., Suffolk University, Department of Psychology
Lisa Coyne, Ph.D., Suffolk University, Department of Psychology

Although emotion regulation and expression are hypothesized as important in psychopathology, studies examining these processes in diverse populations are scarce. Thus, this study aimed at exploring the relationship between emotion regulation, expression, and mental health outcomes in a diverse sample of low-income mothers. Mothers completed the Emotion Regulation Questionnaire and the Depression, Anxiety, Stress Scale. Mothers and children's teachers completed the Emotion Regulation Checklist about the children's regulatory skills. Although no significant difference in emotion expression was observed between the groups, Latina mothers were significantly more likely to use suppression as a strategy compared to African-American mothers (p <.01). Expression of negative emotions and depressive symptoms were positively correlated for the African-American mothers (p<.01), but not for the other two groups. Expression of positive emotions and the use of cognitive reappraisal were positively correlated for the whole sample (p <.01). Additional results and implications for acceptance-based interventions will be discussed.

Educational Objectives:
1. Describe the role of social support and psychological flexibility in the transmission of depression from mother to child. 2. Utilize outcomes/implications of current pilot studies to design and implement similar programs in your own institution/facility. 3. Discuss how emotional regulation and expression relates to mental health outcomes for racial-ethnic minority mothers.

 

19. PTSD: ACT, Mindful and Compassionate Approaches
Symposium (10:30am-Noon)
Components: Conceptual analysis, Literature review, Original data, Didactic presentation, Case presentation
Categories: Clin. Interven. & Interests, Prevention & Comm.-Based, Performance-enhancing interventions, Beh. med., Theory & Philo., Repetitive Thought, PTSD, shame, compassion, Posttraumatic Stress Disorder
Target Audience: Beg., Interm. Location: Cooks Bay

Chair: Michael Skolnik Discussant: Olga Berkout, M.A., University of Mississippi

With a growing focus on Post-traumatic Stress Disorder (PTSD) due to an alarming growth in our returning veterans, we are wise to turn our efforts toward increasing our knowledge in this area. 3 researchers focused on using ACT, mindfulness, and compassion-focused approaches when examining new approaches for alleviating the suffering in PTSD individuals will discuss their studies and findings.

• Immune-Spectrum Disease and Repetitive Thought in Female Veterans
Elizabeth A. Mullen-Houser, Ph.D., University of Iowa, Department of Psychology
Susan K. Lutgendorf, Ph.D., University of Iowa, Departments of Psychology, Obstetrics and Gynecology and Urology
Anne G. Sadler, Ph.D., Iowa City VA Health Care System; University of Iowa Department of Psychiatry
Michelle A. Mengeling, Ph.D., Iowa City VA Health Care System; University of Iowa Department of Internal Medicine
James C. Torner, Ph.D., University of Iowa Departments of Epidemiology & Neurosurgery and Surgery
Brian L. Cook, D.O., University of Iowa Department of Psychiatry and VISN 23 Mental Health, Department of Veterans Affairs
Skylar Johnson, M.S., Iowa City VA Health Care System
Brenda M. Booth, Ph.D., Central Arkansas Healthcare System and University of Arkansas Department of Psychiatry

Female veterans are at risk for stress-related physical disorders given high rates of trauma exposure and a heightened physiologic stress response. Identification of modifiable risk factors for stress disorders is necessary to develop evidence-based interventions that help minimize the emergence and impact of veteran illness. The present study used structural equation modeling to investigate the contributions of maladaptive repetitive thought (RT), posttraumatic stress symptoms, depression, childhood trauma and health behaviors to immune-spectrum disease and functional disability. Female Reserve or National Guard veterans (N = 643) completed a computer-assisted telephone interview through the Iowa City VA. Results indicated that physical disease was associated with greater depression and childhood trauma after accounting for covariates. Unexpectedly, higher maladaptive RT was associated with less physical disease, although only when depression was included as a covariate. Maladaptive RT parsed for negative affect associated with depression may conceptually resemble adaptive RT. Adaptive RT has previously been found to be protective of physiologic disease response. Interventions which promote adaptive RT, such as mindfulness and values clarification, may protect female veteran health.

• Developing a Compassion-Based Therapy for Trauma-Related Shame and Posttraumatic Stress
Teresa Au, M.A., Boston University, VA Boston Healthcare System
Brett Litz, Ph.D., Boston University, VA Boston Healthcare System

Interpersonal trauma survivors often suffer from shame and self-blame, which heighten the sense of internal threat that maintains PTSD. However, current evidence-based treatments for PTSD primarily target fear responses arising from life-threat trauma and fail to directly address shame. We will describe a compassion-based therapy that we have developed to reduce trauma-related shame and PTSD symptoms. For six weekly individual therapy sessions, participants engage in experiential exercises designed to promote self-compassion in response to shame in everyday contexts as well as shame directly related to a traumatic experience. We will report preliminary results from our multiple baseline study evaluating the efficacy, feasibility, and acceptability of this therapy for individuals struggling with shame and posttraumatic stress after a potentially traumatic event. We will also provide details on the study’s multiple baseline design as a time- and cost-effective method for evaluating novel treatments.

• Acceptance and Commitment Therapy for improve the quality of life in people with Complex Post Traumatic Stress Disorder.
Nathalia Vargas Ph.D., Mexico Association for Contextual Behavioral Science
Michel Reyes Ph.D, Mexico Association for Contextual Behavioral Science

The objective of this study is to evaluate the effectiveness of a group treatment model based on acceptance and commitment therapy for improve the quality of life of the participants with complex PTSD. The sample is 30 patients randomized at two groups of 15 patients each one; they were assessed with the Clinician-Administered PTSD Scale (CAPS), the posttraumatic Stress Disorder Check list (PCL-V) and Quality of Life WHOQOL- Bref. It is a clinical trial with measurements pretest -test -posttest with follow up over six months with a control group. This study is in progress and preliminary results will be presented

Educational Objectives:
1. Describe both maladaptive and adaptive repetitive thought, including ACT-related interventions that are associated with increasing adaptive repetitive thought. 2. Discuss the association of repetitive thought with physical disease, especially in the female veteran population and the theoretical rationale for using compassion-based therapy to reduce trauma-related shame and posttraumatic stress. 3. Implement experiential exercises to promote self-compassion in traumatized individuals and describe the ACT characteristics and benefits for the improve the quality of life, compare and assess with the usual treatment (Prolonged Exposure Therapy).

 

29. Promoting Exposure Therapy in Practice and Research: The Role of ACT and Citizen Science
Symposium (2:45-4:15pm)
Components: Original data
Categories: Clin. Interven. & Interests, Superv., Train. & Dissem., Exposure Therapy
Target Audience: Beg., Interm. Location: St. Croix I

Chair: Brooke M. Smith, Utah State University
Discussant: Brian Thompson, Portland Psychotherapy Clinic, Research, and Training Center

Exposure therapy is widely recognized as a highly effective and empirically supported treatment for a number of anxiety disorders. However, negative beliefs about exposure therapy, both in the professional and lay communities, may lead to its underutilization in many treatment settings (Olatunji, Deacon, & Abramowitz, 2009). In addition, researchers have begun to investigate the various processes through which exposure may impact client outcomes (Twohig, Whittal, & Cox, 2010) and methods of promoting exposure therapy in both clinical and research contexts. The papers presented in this symposium discuss empirical work addressing the impact of treatment rationale on treatment utilization, as well as a research protocol designed to promote investigation into the various processes of change underlying exposure therapy.

• The Impact of ACT versus CBT Rationale for Exposure Therapy
Joanna J. Arch, Ph.D., University of Colorado at Boulder
Michael P. Twohig, Ph.D., Utah State University
Brett J. Deacon, Ph.D., University of Wyoming
Lauren N. Landy, M.A., University of Colorado at Boulder
Ellen J. Bluett, M.S., Utah State University

Exposure provides a potent treatment for anxiety disorders. Yet exposure therapy suffers from a “serious public relations problem” (p. 172, Olatunji, Deacon & Abramowitz, 2009) and is highly underutilized in most treatment settings. Further, exposure has been employed recently within mindfulness and acceptance based treatments such as ACT, shifting how the process and aims of exposure are framed. As evidenced within the behavior change and treatment credibility literatures, differences in framing and rationale can impact whether people are willing to engage in an intervention. No research to date, however, has examined how different ways of framing exposure – that is, different treatment rationale for exposure – may impact willingness to engage in it. In this study, we explore how systematically varying the treatment rationale for exposure, based on components of ACT and CBT such as fear reduction versus fear acceptance, testing thoughts versus defusing from thoughts, and so forth, impacts willingness to consider exposure therapy and treatment credibility. This internet based study will recruit a large (n = 964) adult sample randomized to receive different exposure therapy rationale. Our goal is to inform whether framing exposure in more ACT versus CBT terms impacts ratings of treatment willingness and credibility. We will also examine baseline moderators of these ratings, including anxiety and depression symptoms, trait acceptance, and anxiety sensitivity, to explore the possibility of treatment matching. Our findings will inform practical considerations of how different rationale for exposure therapy impact willingness to engage in this powerful yet underused treatment for anxiety.

• Does Exposure Framing Matter? Comparing Models of Exposure in a Brief Intervention for Social Anxiety
Ellen J. Bluett, M.S., Utah State University
Lauren N. Landy, M.A., University of Colorado at Boulder
Michael P. Twohig, Ph.D., Utah State University
Joanna J. Arch, Ph.D., University of Colorado at Boulder

Exposure therapy is considered a first line treatment for various anxiety disorders, but only a subset of anxious individuals are treated with exposure. One potential target for narrowing this gap is the framing of exposure therapy. Exposure is typically presented from a fear-reduction perspective. This study investigates how alternative perspectives based in Acceptance and Commitment Therapy might impact engagement in and effectiveness of exposure. A brief exposure intervention was presented from one of four perspectives: (a) fear reduction (b) psychological flexibility (c) personal values, and (d) active control. 53 socially anxious individuals from Utah State University and the University of Colorado at Boulder participated. Results revealed that all active conditions evidenced significantly more improvement in self-reported social anxiety (Liebowitz Social Anxiety Scale-Self Report; Liebowitz, 1987) pre-post than did control condition, b = -2.23, t(73) = -2.50, p = .02. Psychological flexibility or values frameworks are viable options for framing exposure.

• Exposure Procedure Research within a Post-Tribal Practice-Research Network
Kelly Koerner, Ph.D., Evidence-Based Practice Institute

Various change processes are hypothesized to distinctly produce the improvements seen as a result of undergoing exposure procedures. For example, Twohig et al (2010) found that processes of change in exposure treatments for OCD were at least somewhat distinct from each other, but treatment packages impacted multiple processes. This line of research highlights how single-case experimental design may offer important insights into how therapist behaviors impact client change processes. In this presentation, Koerner describes a research protocol in which a distributed network of therapists and clients can use experimental multiple baseline design to understand how specific session level therapist interventions move client change processes in exposure therapy. "Citizen science" projects such as this tackle scientific problems by recruiting volunteers to make a meaningful contribution to research.

Educational Objectives:
1. Explain the results of a study on rationales for exposure therapy. 2. Discuss the effects of rationales for exposure from an ACT model. 3. Describe how a distributed network of therapists and clients using single case designs study change processes in exposure therapy.

 

32. Inside the Belly of the Beast: Does the Implicit Relational Assessment Procedure Really Do What it’s Supposed to Do?
Symposium (2:45-4:15pm)
Components: Conceptual analysis, Literature review, Original data
Categories: RFT, Related FC approaches, IRAP
Target Audience: Beg., Interm., Adv.
Location: Excelsior Bay & Lafayette Bay

Chair: Sean Hughes, National University of Ireland Maynooth (NUIM)
Discussant: Jan De Houwer, Ghent University

Since its inception, the IRAP has stimulated a rapidly growing body of work on implicit cognition, or from an RFT perspective, relational responses that are low in derivation and complexity. We now know that this procedure captures a wide range of behaviors that self-report measures fail to pick up on and predicts meaningful real-world outcomes such as substance abuse, clinical fears and obsessive-compulsive tendencies. Given the rising popularity of the measure it seems important to take a step back and consider a host of questions that determine our confidence in the above outcomes. For instance, is it possible to fake how one responds on the IRAP? What does it mean to say that the IRAP effect is reliable and what influence do contextual factors (such as the specific stimulus relations assessed) play on the outcomes obtained? In this session we ‘lift the lid’ on the IRAP and explore a number of conceptual and methodological issues that any researcher who uses this tool needs to know. Topics will include recent studies on “fakeability” and reliability, a functional analysis of the IRAP effect, and the challenges and pitfalls of the traditional psychometric concept of reliability from a functional contextual perspective.

• Mirror Mirror on the Wall: is the IRAP Reliable, Relativistic and Fakeable at all?
Sean Hughes, National University of Ireland Maynooth
Ian Hussey, National University of Ireland Maynooth

Since its inception, the IRAP has stimulated a rapidly growing body of empirical work on implicit cognition - or from an RFT perspective - relational responses that are low in derivation and complexity. We now know that the procedure captures a wide range of behaviors that self-report methodologies fail to pick up on and predicts meaningful real-world outcomes such as substance abuse, clinical fears and obsessive-compulsive tendencies. Given the rising popularity of the measure it seems important to take a step back and consider a host of questions that determine our confidence in the above outcomes. For instance, is it possible to fake how one responds on the IRAP? What does it mean to say that the IRAP effect is reliable and what influence do contextual factors (such as the specific stimulus relations assessed) play on the outcomes obtained? In this talk we take a closer look at these three questions and discuss their potential impact on past, present and future IRAP research.

• Back to Basics: Units of Analysis, RFT and the IRAP
Dermot Barnes-Holmes, National University of Ireland Maynooth
Ian Hussey, National University of Ireland Maynooth
Yvonne Barnes-Holmes, National University of Ireland Maynooth

The IRAP was developed in response to the question “How do we catch relational frames in flight”. As such, it was originally conceptualized, programmed and developed by relational frame theorists to capture the strength or probability of previously established patterns of relational framing. On balance, it appears from informal discussions with both students and colleagues that the relationship between the IRAP and RFT remains somewhat unclear. The current paper aims to clarify this relationship and to describe more precisely than hitherto exactly how the IRAP provides a measure of what it was designed to measure – relational framing in flight.

• The Many Faces of Reliability: Implications for the IRAP and other Implicit Measures
Maarten De Schryver, Ghent University
Sean Hughes, National University of Ireland Maynooth

Within mainstream psychology, reliability refers to a family of statistics that determine just how precise we are when measuring behavior in specific situations. Many of these statistics are based on the assumption that if people complete the same test under the exact same conditions (e.g., if they were ‘brainwashed’) the amount of variance that they share would reflect our measurement precision. Researchers use these reliability measures to make claims about behavior and this is particularly the case with regard to procedures like the IRAP and IAT. Upon closer inspection, however, many of the underlying assumptions of reliability statistics fail to hold true - and perhaps more importantly - are incompatible with the philosophical foundations of contextual behavior science. With this in mind, we will discuss the notion of reliability as it applies to the IRAP and other implicit measures from a traditional psychometric and then functional contextual perspective. The challenges and pitfalls in confounding these two approaches will be highlighted and effective strategies for future work outlined.

Educational Objectives:
1. Discuss methodological issues like the fakeability, reliability and relativity of the IRAP effect. 2. Describe what the IRAP measures from a functional contextual point of view. 3. Outline issues and challenges when using the notion of reliability to evaluate outcomes like the IRAP effect.

 

33. Perspective Taking, Empathy, and Self as Context: Empirical Investigations
Symposium (2:45-4:15pm)
Components: Original data
Categories: RFT, Prevention & Comm.-Based, Children, Adolescents
Target Audience: Interm., Adv.
Location: Spring Park Bay

Chair: Louise McHugh, University College Dublin
Discussant: Tim Weil, University of South Florida

Arguably, nothing in human psychology is as important as the abilities to understand oneself and to take the perspective of others. The current symposium comprises of three papers on the training of deictic relational responding. The first paper presents a multiple baseline design on a deictic training protocol with three children diagnosed with Autism Spectrum Disorder using wireless app technology. The second paper discusses an analogue model of the effects of cyber exclusion and the preventative impact that self as context training has on cyber exclusion. The final paper covers a deictic training intervention with adolescents. The adolescents were trained in deictics, emotional deictics, and self as context, respectively. The impact of the training on well-being was tested at pre, post, and three week follow-up. Together the findings from the three papers support the utility of training perspective taking, empathy, and self as context across different populations.

• Training perspective taking and empathy in children diagnosed with ASD using wireless technology
Louise McHugh, University College Dublin
Corinne Ginty, University College Dublin
Aisling McGee, University college Dublin
Anita Munnelly, University College Dublin
Ian Stewart, National University of Ireland Galway

Children learn to relationally frame their own behaviour as different from that of others by learning three key deictic relations: “I versus YOU”, “HERE versus THERE” and “NOW versus THEN”. They learn to respond appropriately to questions such as ‘What are YOU doing HERE?’, ‘What am I doing NOW?’, ‘What was I doing THEN?’ etc. As they learn to respond to these questions they see that whenever they are asked about their own behavior they always answer from the point of view of ‘I’, ‘HERE’ and ‘NOW’ and that this perspective is consistent and different from that of other people. For example, if you ask me about my behavior, I will always answer from the position of ‘I’, ‘HERE’ and ‘NOW’ in response to your question asked by YOU, THERE (where you are) and THEN (when you asked – a few seconds ago). The current paper presents data from a multiple baseline design deictic wireless app intervention that trained three children diagnosed with ASD in deictic relational responding. The findings indicated that the deictic training generalized to (1) theory of mind tests and (2) perspective taking questions about cartoon characters that had not been directly trained.

• Testing a self as context intervention for preventing the negative effects of cyber exclusion
Ann Zedginidze, University of Wisconsin - La Crosse
Anita Munnelly, University College Dublin

Previous studies have found that social exclusion can cause distress to those excluded. One method used to study social exclusion is through a virtual ball-toss game known as Cyberball. In this game, participants may be excluded from or included in the ball-toss game and typically report lower feelings of self-esteem, control, belonging and meaningful existence following exclusion. The current experiment sought to explore the effect of a self as context intervention on cyber exclusion. 30 participants were randomly assigned to either a self as context induction or a relaxation control. Post intervention all participants played cyberball. Changes in mood and self-esteem were measured from pre to post cyberball game. The findings indicate the find the while the cyberball game had a negative impact on the mood and self esteem of the participants in the relaxation group, the negative impact of cyberball did not emerge post self as context intervention.

• Training Self-Flexibility in Young People
Orla Moran, University College Dublin
Louise McHugh, University College Dublin

Recent data indicates that three quarters of all mental health problems in Ireland emerge before 25 years of age and the emergence of these problems can be linked to a dysfunctional sense of self. Widespread empirical evidence indicates the importance of self-development during adolescence (12-25 years). With this in mind, the present study aimed to develop and implement a Flexible Self Intervention, specifically for adolescents. 150 participants (M= 16 years) were recruited from Irish secondary schools. The Flexible Self Intervention involved three interactive sessions with short video clips and audio recordings. Session one involved training perspective relational frames (I-YOU, HERE-THERE, NOW-THEN). Session two involved empathy training via the transformation of emotional functions using deictic relational frames. Session three involved deictic Self-as-Context training. Process measures of mindfulness and cognitive avoidance, and outcome measures of self-esteem, self-compassion, anxiety, well-being, emotional acceptance, empathy and reaction to ostracism, were examined at pre, post and 3 week follow-up. The findings indicated that the intervention had positive outcomes in terms of general well being and self esteem for the adolescents from pre intervention to follow up.

Educational Objectives:
1. List new research in the area of deictics 2. Design better deictic interventions 3. Demonstrate the ability to apply RFT principles within ACT

 

34. Shame Behind Labels: Conceptualization, Assessment and Treatment of Health Related Stigmatization
Symposium (2:45-4:15pm)
Components: Conceptual analysis, Original data
Categories: Clin. Interven. & Interests, Prevention & Comm.-Based, Psychological Flexibility, Deictic Relational Responding
Target Audience: Beg., Interm., Adv.
Location: Lake Calhoun

Chair: Emily Squyres, University of Louisiana at Lafayette
Discussant: Akihiko Masuda, Ph.D., Georgia State University

Health-related outcomes are often complicated and even threatened by the stigma that accompanies diagnosis. Papers in this symposium will explore applications of the CBS perspective to the conceptualization, assessment, and treatment of health-related stigmatization. The first paper will consider the role that social categorization and deictic relational responding play in self-stigma among the obese. The second paper will discuss the results of an ACT intervention on stigma among those with HIV. The third paper will discuss the cultural adaptation of the Substance Abuse and Self-Stigma Scale in Puerto Rico, using a Latino population living with HIV.

• Sticks & Stones: The Social Context for Learning Self-Stigma Amongst the Obese
Emily Squyres, University of Louisiana at Lafayette
Emily Sandoz, Ph.D., University of Louisiana at Lafayette

Humans readily engage in social categorization on the basis of both physical and arbitrary features of the individual. Once these categories, or stimulus classes, are formed, functions are easily transformed among members of the classes. Preliminary research has shown, for example, that arbitrary stimuli can easily acquire stigma functions when derived as equivalent to obese. The most basic form of social categorization is the distinction of “I” from “you” and, by extension, “us” from “them.” It is commonly assumed that functions of outgroup and ingroup members diverge in such as way as to protect the self from taking on aversive functions. This is not the case, however, for obese individuals, who demonstrate explicit and implicit weight bias. This conceptual paper will explore the learning history that might contribute to self-stigma among the obese. Particular attention will be paid to the transformation of function across deictic relations that might result in such self-stigmatization, and the social context that might control it.

• Using ACT to address HIV/AIDS Stigma in Ethnoracial Communities
Kenneth Fung, M.D., FRCPC, M.S., Toronto Western Hospital
Josephine Wong, Ph.D., Ryerson University

HIV stigma impedes HIV prevention, testing, and care, and leads to discrimination and suffering. This is an especially important issue in ethnoracial communities who face intersectional marginalizations. The Community Champions HIV/AIDS Advocates Mobilization Project (CHAMP) is a community-based research project by CAAT* which evaluated the use of ACT and Social Justice Capacity Building (SJCB) to decrease HIV/AIDS stigma among People Living with HIV/AIDS (PHAs) and non-PHAs Community Leaders (CL) from ethnoracial communities. 35 participants received SJCB only and 31 received ACT+SJCB. Participants had significantly decreased stigma; increased valued living; and increased readiness to engage in HIV championship post-intervention and at 9-month follow-up. There were no group differences by participant type (PHA vs CL) or by intervention (SJCB vs ACT+SJCB) based on quantitative data. Qualitative data documented different impact of the two interventions. Activity logs captured personal and collective meaningful activities that included improvements in self-care, resilience, and HIV championship. (* Committee for Accessible AIDS Treatment)

• Measuring Stigma: A Cultural Adaptation of the Substance Abuse and Self-Stigma Scale in the Latino Population
Coralee Pérez Pedrogo, Ph.D., University of Puerto Rico
Sugeily Rivera- Suazo, MSW, University of Puerto Rico
Gabriela Román-Colón, B.A., University of Puerto Rico
Jason B. Luoma, Ph.D., Portland Psychotherapy Clinic, Research, and Training Center
José Noel Caraballo, Ph.D., University of Puerto Rico
Carmen E. Albizu-García, M.D., University of Puerto Rico

Self-stigma refers to the effects of social stigma on the individual with the stigmatized attribute, which may include self-devaluation, and fear of being identified as part of a socially stigmatized group. It is a barrier to treatment access and adherence for substance use disorders and HIV/AIDS. The experiences of self-stigma among incarcerated Latinos with SUD and HIV, a population in which both conditions are over-represented, and its impact on treatment entry, retention, and outcomes are not well understood. A first step in our research agenda involves the cultural adaptation of the Substance Abuse and Self-Stigma Scale in Puerto Rico. Through an iterative process that included literature review, translation and back-translation, bilingual assessment panel, in-depth interviews, and focus groups, changes were made to the measure. We present results from individual interviews and focus groups with 20 participants recruited at a community treatment center for drug users with and without HIV/AIDS. Using qualitative methods with emphasis on content and semantic equivalence we obtained a culturally adapted measure which is relevant and responsive to our context. We will present methodological challenges for adaptation and measurement of the construct as well as suggestions assesses convergent validity. This study aspires to contribute to the progress of research on self-stigma among Latinos with HIV and a SUD given the absence of appropriate measures for the construct. 1 University of Puerto Rico, Medical Sciences Campus
2 Portland

Educational Objectives:
1. Create a culturally sensitive self-stigma measure 2. Describe the use of ACT strategies to address HIV/AIDS stigma in PHAs and non-PHAs in the service of personal values and HIV championship 3. Discuss the systematic process of translating and a self-stigma measure focusing on conceptual and cross-cultural equivalence

 

35. Community-Based Applications of Contextual Behavioral Sciences
Symposium (2:45-4:15pm)
Components: Conceptual analysis, Didactic presentation
Categories: Prevention & Comm.-Based, Clin. Interven. & Interests, Org. Beh. Management, Superv., Train. & Dissem., Theory & Philo., RFT, Autism, Intentional Cultural Change, dissemination, Future oriented behavior
Target Audience: Beg., Interm., Adv.
Location: Lake Nokomis

Chair: Whitney Skold, M.A., The Chicago School
Discussant: J. Neil Mulholland, Ph.D., University of Alberta, Alberta Health Services

This symposium emphasizes the theme of this year’s conference; disseminating contextually-based sciences to large groups. The participants of this symposium have specialized in community-based outreach, and will discuss their work and possible future directions for ACBS as an organization. A broad variety of areas for community outreach will be discussed, including, autism, ACBS and advocacy, functional contextualism and future oriented behavior, and environmental issues related to mental health. The panelists will share their views on each topic, and bring their prolific knowledge regarding community-based work to the discussion.

• Maximizing ABA-treatment outcomes for children with autism through an organization-wide adoption of ACT
Evelyn R. Gould, M.S. BCBA, Center for Autism and Related Disorder, Inc.
Jonathan Tarbox, Ph.D. BCBA-D, Center for Autism and Related Disorder, Inc.

Rapid increase in prevalence of autism spectrum disorder (ASD) has resulted in an increasing demand for evidence – based treatment. Applied Behavior Analysis (ABA) is currently the treatment of choice for ASD. This paper will discuss how Acceptance and Commitment Therapy (ACT) might be implemented at various different levels within the context of ABA treatment services, in the service of achieving best outcomes for every child. At the practitioner level, ACT training might improve staff well-being and productivity, decrease burn-out and increase retention, and foster stronger, more empathetic parent-practitioner partnerships. At the parent level, ACT might improve behavioral parent training outcomes, and the well-being and mental health of parents. At the client level, ACT might improve client outcomes were verbal processes play a role in problematic patterns of behavior. Implications will be discussed in relation to current and future research and practice.

• Enhancing Wellbeing Through Contextual Behavioral Science: What Actions Can ACBS Take to Advance This Goal?
Anthony Biglan, Oregon Research Institute

This paper examines the role of advocacy organizations in bringing about cultural change. Intentional cultural change requires well organized, well-funded, organizations that can articulate the need for specific cultural changes, organize a constituency that favors the change, and influence policies and practices that bring about the changes. This paper will explore the question of whether ACBS should engage in advocacy relevant to its mission. Specifically, it has been suggested that “…the ultimate purpose of behavioral science is to change the world in a positive and intentional way.” (Hayes, Barnes-Holmes, & Wilson, 2012). This paper will describe advocacy actions that ACBS could take that could advance this goal. They include: (a) articulation and media advocacy about the value of societies promoting psychological flexibility; (b) identification of policies that would foster psychological flexibility and the nurturance of human wellbeing; (c) advocacy for policies that would leverage cultural change (d) joining and/or creating coalitions of organizations that are working for societal change that is consistent with our vision; (e) training members and organizations in increasing their advocacy skills.

• How to show love and hope on a large scale? Whys and hows of ACT dissemination in Poland.
Stanislaw Malicki, University of Social Sciences and Humanities (SWPS), Warszawa, Poland

Although traditional, bio-medical model of psychiatry affirms the influence of the environment on mental health, it sets an individual apart from the environment and draws relations between the two. Contextualism, in turn, sees the individual as a part of the environment and the environment as a part of the individual. The two constitute a basic and inseparable unit of analysis. This view gains special importance in light of the culturally mediated role of language in maintaining psychological suffering and promoting mental health. The paper describes a strategy for promoting mental health on a large scale in Poland. The strategy is based on the “act-in-context” model of mental health and focuses on creating social contexts that promote psychological flexibility and connectedness instead of treating individuals as those who “have” problems. The core of the strategy is building of a network of self-help groups run on the basis of unified model, which are focused on compassion/self-compassion and connectedness as the context of change.

• Can a Functional Contextual Analysis Improve Our Ability to Act in Light of the Future?
Anthony Biglan, Oregon Research Institute
Yvonne Barnes Holmes, National University of Ireland Maynooth

Despite extensive knowledge about diseases, natural disasters, environmental degradation, and a wide range of other problems, we often fail to take action that that would prevent or mitigate these problems. This paper will argue that our current scientific understanding of how to act in light of the future is limited. It will offer a theoretical analysis of future-oriented behavior at both individual and organizational levels. Specifically, the paper draws on a functional contextualist account of human language and cognition, Relational Frame Theory (RFT), and its integrated therapeutic approach, Acceptance and Commitment Therapy (ACT), and extends this framework to analyzing the evolution of the practices of groups and organizations. This framework can provide an understanding of how human behavior may be modified in the present to improve human wellbeing in the future at individual, organizational, and even national levels.

Educational Objectives:
1. Describe components of an ACT-based approach to improving outcomes for children with autism, through intervention at the practitioner, parent and child level. 2. Identify areas of future research related to improving outcomes of Applied Behavior Analysis (ABA) treatment for children with autism, through ACT-based intervention. 3. Enumerate the role of advocacy organizations in achieving cultural change.

 

39. Technology-Based ACT Interventions to Support Large Scale Behavior Change

Symposium (4:30-5:45pm)
Components: Conceptual analysis, Literature review, Original data, Didactic presentation
Categories: Clin. Interven. & Interests, Clin. Interven. & Interests, Prevention & Comm.-Based, Edu. settings, Superv., Train. & Dissem., Technology, Web/mobile app-based interventions
Target Audience: Beg., Interm., Adv.
Location: Elk Lake

Chair: Michael E. Levin, Ph.D., Utah State University
Discussant: Kelly Koerner, Ph.D., Evidence-Based Practice Institute

Providing psychosocial interventions through web/mobile technologies is a powerful method for supporting behavior change at a public health level. The benefits are numerous, including enhanced cost effectiveness for reaching and treating people in need at the population level, reducing training and fidelity concerns, and reaching those who may not otherwise seek treatment (i.e., due to access, cost, stigma). An increasing number of researchers, providers and organizations have been working on developing such technology-based interventions and this area has recently been growing rapidly in the ACBS community. This symposium will present research from three contextual behavioral science laboratories on delivering ACT through technologies including websites, mobile apps and video conferencing. Dr. Bricker will present on a pilot RCT which compared an ACT mobile app for smoking cessation to another evidence-based app. Dr. Herbert will then present on a series of studies testing ACT-based treatment for anxiety disorders delivered through videoconferencing. Next, Dr. Levin will present recent projects developing and implementing web and mobile-based ACT as an adjunct to face-to-face therapy. Dr. Koerner will lead a discussion of issues and future directions regarding the development, testing and use of technology-based ACT interventions.

• First randomized controlled trial of smartphone-delivered Acceptance & Commitment Therapy (ACT)
Jonathan Bricker, Ph.D., Fred Hutchinson Cancer Research Center & University of Washington
Jaimee Heffner, Ph.D., Fred Hutchinson Cancer Research Center
Roger Vilardaga, Ph.D., University of Washington & Fred Hutchinson Cancer Research Center
Julie Kientz, Ph.D., University of Washington

Introduction: Smartphone apps for changing behavior are ubiquitous. But to date, there are no trials of smartphone-delivered ACT for any behavior outcome. And despite the fact that there are over 400 smartphone applications (“apps”) for quitting smoking, no outcome studies for a general population of adults have been reported on this rapidly growing intervention technology. To address this urgent need, this pilot trial compared an app based on Acceptance & Commitment Therapy (ACT) with the National Cancer Institute’s Quit Guide app which is based on US Clinical Practice Guidelines. Methods: We nationally recruited 196 adult smokers (at least 5 cigarettes/day) wanting to quit within the next 30 days and had iPhone access. Participants were randomized to either an ACT or QuitGuide app. Results: ACT participants opened their app an average of 37 times (vs. 15 for QuitGuide; p = .0001). Regarding receptivity, 86% of ACT participants reported their app was organized (vs. 67% for QuitGuide; p =.003) and 54% reported it was useful for quitting (vs. 38% for Quit Guide; p =.070). ACT participants, but not Quit Guide participants, increased their acceptance of cravings from baseline to follow-up (p =.039 for ACT vs. p = .154 for Quit Guide). The quit smoking outcomes will be presented. Conclusion: This first RCT of smartphone-delivered ACT showed that the ACT app was well-utilized, well-received, and operated consistent with theory.

• ACT-Based Treatment of Anxiety Disorders via Videoconferencing
James D. Herbert, Ph.D., Drexel University
Marina Gershkovich, Drexel University
Erica K. Yuen, Ph.D., University of Tampa
Elizabeth M. Goetter, Ph.D., Massachusetts General Hospital
Evan M. Forman, Ph.D., Drexel University

Despite the effectiveness of exposure-based treatments for anxiety disorders, only a minority of those with anxiety disorders receive any treatment at all, and only a small percentage of those who receive treatment receive a scientifically-supported psychotherapy. Remote treatments, in which interventions are delivered using technologies to patients located at a physical distance from the therapist, hold promise in bridging the gap between patient needs and evidence-based treatment. Videoconferencing is a particularly promising method of remote treatment delivery. We adapted ACT-oriented, exposure-based interventions for anxiety disorders for delivery in a videoconferencing and web-based formats. Pilot studies of social anxiety disorder and obsessive compulsive disorder demonstrated that the programs were well received by patients, and resulted in large within-group effect sizes that met or exceeded those of published trials of traditional face-to-face treatment. We provide an overview of these trials, including lessons learned regarding clinical applications, and discuss directions for future research.

• Using adjunctive web/mobile ACT technologies to augment clinical practice
Michael E. Levin, Ph.D., Utah State University & Contextual Change LLC
Jacqueline Pistorello, Ph.D., University of Nevada Reno & Contextual Change LLC
Steven C. Hayes, Ph.D., University of Nevada Reno & Contextual Change LLC
John Seeley, Ph.D., Oregon Research Institute
Crissa Levin, M.A., Contextual Change LLC
Kristy Dalrymple, Ph.D., Alpert Medical School of Brown University & Department of Psychiatry, Rhode Island Hospital
Brandon Gaudiano, Ph.D., Alpert Medical School of Brown University & Psychosocial Research Program, Butler Hospital
Jack Haeger, Utah State University

One promising direction for implementing web/mobile-based ACT interventions is to integrate them as an adjunct to other face-to-face services. This may simultaneously enhance web/mobile intervention effects by providing guidance and support for program usage while improving face-to-face services. This presentation will describe a series of projects seeking to develop and test adjunctive ACT web/mobile app programs integrated within other clinical services. The primary project to be discussed is a guided self-help prototype ACT website designed for college counselors to use with their student clients. Results from an open trial will be presented in which 30 CCC counselors and 82 of their student clients used the ACT program. Results indicated high program satisfaction for both counselors and students and significant improvements in process and outcome measures among students. Two earlier stage projects will also be discussed: a values-focused adjunctive website for depressed/anxious clients being treated by a psychiatrist and an adjunctive mobile app to support clients’ use of ACT skills learned in therapy. These projects will be discussed in relation to issues in developing and implementing web/mobile-based ACT programs as well as how these technologies can advance contextual behavioral science.

Educational Objectives:
1. Discuss the utilization of smartphone-delivered Acceptance and Commitment Therapy and its application to smoking cessation. 2. Assess the effectiveness of ACT-based treatments for anxiety disorders delivered via videoconferencing, and will appreciate common clinical issues that arise with such applications. 3. Describe innovative ways to develop and integrate web/mobile-based ACT with other face-to-face treatment services.

 

40. Recent Data on ACT for the Treatment of Eating Disorders across Multiple Settings
Symposium (4:30-5:45pm)
Components: Original data
Categories: Clin. Interven. & Interests, Eating Disorders, treatment outcome
Target Audience: Beg., Interm., Adv.
Location: Crystal Lake

Chair: Ellen J Bluett, M.S., Utah State University
Discussant: Emily K. Sandoz, Ph.D., University of Louisiana, Lafayette

Eating Disorders are notoriously difficult to treat. Acceptance and Commitment Therapy is gaining popularity as a promising treatment. While varied treatment settings across the world are beginning to utilize ACT for eating disorders, empirical evidence is at inception. This symposium offers a first look at outcome data on the use of ACT across a variety of settings and eating disorder diagnoses. Specifically, this symposium highlights findings from a small treatment trial on ACT for college students with problematic emotional eating, treatment outcomes of ACT in a family therapy context for individuals with anorexia nervosa, as well as the results of an effectiveness trial on ACT as part of a larger treatment program in a residential treatment facility. Attending this symposium will inform individuals of the current state of the research on ACT for eating disorders.

• Acceptance and Commitment Therapy for Individuals with Problematic Emotional Eating: A Case-Series Study
Mary L. Hill, M.A, Georgia State University
Akihiko Masuda, Ph.D., Georgia State University
Makeda Moore, Georgia State University

Emotional eating (EE) is an often problematic eating behavior characterized by eating when not hungry in response to difficult emotions. Acceptance and commitment therapy (ACT) has shown promise in treating a variety of disordered eating concerns. This case-series design presents a description of ACT for EE and the outcomes from two adults with problematic EE who voluntarily participated in 10 weekly sessions of ACT. The average number of EE episodes per week across both participants at pre-treatment was 9, which decreased to 2 per week at follow-up. Both participants also showed improvement in body image flexibility, a theoretically consistent process of change, and these improvements were maintained at 3-month follow-up. The results are discussed as well as implications for clinical practice and future research.

• Outcomes for an ACT-Based Family Intervention for Adolescent Anorexia Nervosa
Rhonda M. Merwin, Ph.D., Duke University Medical Center
C. Alix Timko, Ph.D., University of the Sciences
Nancy L. Zucker, Ph.D., Duke University Medical Center & Duke University

Anorexia nervosa (AN) often emerges in adolescence and may have devastating consequences for growth velocity and bone health. Intervention must occur quickly and often before the adolescent is ready for change. Recently, empirical support for inclusion of the family in treatment has emerged; however, there is only one model of intervention (“Maudsley”), and thus a need for treatment alternatives. We conducted an open trial of an ACT-based family treatment for adolescent AN. Treatment consisted of 20 sessions over 6 months. Fifty-one adolescents were enrolled at 2 sites with 47 completing baseline assessment. Of these, 23 (48.9%) met criteria for full recovery at treatment end, 14 (29.8%) met criteria for partial recovery, and 10 (21.3%) did not recover. On average, adolescents achieved 97.19% (SD=4.60) of their ideal body weight with a range of 82%-100%. All subscales of the Eating Disorder Examination were significantly improved, with corresponding increases in adolescent and parent acceptance (all ps<.05).

• Examining the Effectiveness of ACT for Eating Disorders in a Residential Setting
Ellen J. Bluett, M.S, Utah State University
Michael Twohig, Ph.D., Utah State University
Tera Lensegrav-Bensen, Ph.D., Avalon Hills Residential Eating Facility
Benita Quakenbush-Roberts, Avalon Hills Residential Eating Facility

Some individuals are nonresponsive to outpatient treatment for eating disorders, making residential treatment a viable option. A longitudinal effectiveness study was conducted at a multi-disciplinary residential treatment setting whose primary modality is ACT. Data was collected over a ~7 year period on adult and adolescent females diagnosed with anorexia nervosa (46.6%) bulimia nervosa (17.4%), or eating disorder not otherwise specified (36.0%). Two-hundred and sixty four patients completed measures on eating disorder severity, depression, anxiety, and quality of life. Analysis show significant improvements on all measures. Results for eating disorder showed that 68% with AN were responders, 47% with BN were responders, and 58% of those with ED-NOS were responders. Across disorders 69.49% were classified as responders on the BDI-II and 29% on the EDQOL. Further analyses are underway.

Educational Objectives:
1. Describe ACT as a treatment for eating disorders. 2. Present the most recent data on ACT for eating disorders in a variety of settings. 3. Discuss future research for ACT and eating disorders.

 

44. Designing and Delivering ACT Interventions for Individuals with Medical Conditions: Transdiagnostic Principles and Key Processes of Change
Symposium (4:30-5:45pm)
Components: Original data, Didactic presentation
Categories: Beh. med., Clin. Interven. & Interests, psychological and physical distress tolerance; resilience
Target Audience: Interm.
Location: Excelsior Bay & Lafayette Bay

Chair: Megan Oser, Ph.D., Brigham and Women's Hospital, Harvard Medical School
Discussant: Joseph Ciarrochi, University of Western Syndey

The purpose of this symposium is to conceptually, empirically, and pragmatically explore ACT interventions for chronic medical conditions with the goal of identifying key change processes, relevant methodological approaches, and necessary modifications to treatment delivery. The impact of ACT group formats will be investigated in three different medical populations: multiple sclerosis, diabetes, chronic pain, and in a heterogeneous group of patients with both psychiatric and medical conditions. Collectively, data from these studies show promise that ACT can be readily modified to fit the needs of medical patient populations and that willingness to allow physical or psychological distress is a key change process. First, Vowles et al will discuss how relinquishing attempts to control pain while increasing values-based activities reduces pain-related disability. Pakenham et al will discuss change processes and outcomes from two intervention studies evaluating an ACT-based resilience program modified for multiple sclerosis and diabetes. Lastly, Oser et al will discuss preliminary data from an ACT group for individuals with medical and psychiatric comorbities highlighting proximal changes and optimizing ACT for multi-problem medically ill populations. Dr. Joseph Ciarriochi, an expert in promoting resilience using ACT processes, will serve as discussant to tie together the presented studies, highlight key areas for future inquiry, and discuss implications of implementing ACT for those struggling to live with chronic medical conditions.

• Acceptance and Commitment Therapy for Chronic Pain: A Diary Study of Treatment Process in relation to Reliable Change in Disability
Kevin E. Vowles, Ph.D., University of New Mexico
Brandi Fink, University of New Mexico
Lindsey L. Cohen, Georgia State University

Often, it is assumed that pain reduction is a necessary precursor to disability reduction in those with chronic pain. Conversely, Acceptance and Commitment Therapy (ACT) posits that pain reduction is not necessary – rather, it is hypothesized that pain responses must change, including reducing unsuccessful struggles for pain control and increasing valued activities (Vowles et al., 2014). To test this hypothesis, we examined how weekly ratings of struggles for pain control and valued activity, in a clinical sample of pain patients (n = 21) completing an interdisciplinary course of ACT, related to the presence or absence of reliable disability change three months after treatment. Overall, 48% of patients evidenced reliable disability reduction. Further, 81% showed the expected change pattern – when pain control attempts decreased and valued activities increased, reliably reduced disability typically occurred, while the absence of this pattern was associated with no reliable change. Pain intensity change was unrelated to reliable change. Results suggest possible requirements for treatment success. Vowles, K. E., Witkiewitz, K., Sowden, G., & Ashworth, J. (2014). Acceptance and Commitment Therapy for chronic pain: Evidence of mediation and clinically significant change following an abbreviated interdisciplinary program of rehabilitation. Journal of Pain, 15, 101-113.

• Preliminary evaluation of an ACT group for patients with psychiatric and chronic medical conditions
Megan Oser, Ph.D., Brigham and Women's Hospital, Harvard Medical School
Vanessa Alvarez, M.A., Suffolk University
Gabe Gruner, LICSW, Brigham and Women's Hospital

Given the transdiagnostic nature of ACT(1,2), we evaluated an ACT group intervention for a heterogeneous group of individuals with medical and psychiatric conditions (N = 20). Treatment completers (n=10) did not differ from non-completers on baseline measures of depression, experiential avoidance, anxiety sensitivity, and distress tolerance. Distress tolerance significantly improved from pre- to post-treatment (t(9) = -2.32; p = .05). Experiential avoidance decreased by 3.4 points, on average, as measured by the AAQ-II (t(9) = .78; p = .46) and sensitivity to anxiety decreased an average of 3.3 points (t(9) = .71; p = .49). Patients screening positive for depression decreased from pre (80%) to post-treatment (60%) (Z = 0.98; p = .16). Improvements were observed on all measures; however, only distress tolerance significantly improved from pre- to post-treatment. Findings will be discussed in terms of clinically significant change, suggestions for refining ACT for medical patients with psychiatric comorbidities, and the incubation period of capturing improvements(2). 1. Levin, M.; Hildebrandt, M.; Lillis, J; Hayes, S. (2012). The Impact of Treatment Components Suggested by the Psychological Flexibility Model: A Meta-Analysis of Laboratory-Based Component Studies. Behavior Therapy 43(4), 741–56. 2. Clarke, S., Kingston, J., Wilson, K.,Bolderston, H., & Remington, B. (2012). Acceptance and Commitment Therapy for a heterogeneous group of treatment-resistant clients: A treatment development study. Cognitive and Behavioral Practice 19(4), 560-72.

• Evaluation of an ACT Resilience Training Program (READY) for People with Diabetes or Multiple Sclerosis
Kenneth I. Pakenham, Ph.D., University of Queensland
Alyssa Ryan, B.A., University of Queensland
Matthew Mawdsley, B.A., University of Queensland
Felicity Brown, Ph.D., University of Queensland

This presentation reports on two intervention studies that evaluate a group ACT resilience training program called READY with two illness populations: diabetes and multiple sclerosis (MS). 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 illness characteristics, the full 11 x 2 hour weekly session program was used with the diabetes sample (n=20), and a modified program was used with the MS sample (n=30). Both studies had pre- and post-intervention and follow-up assessments, and a single intervention condition design. Preliminary analyses on the diabetes data showed pre- to post-intervention improvements in resilience t(19)=-3.00, p<.01, quality of life t(19)=-4.33, p<.01, anxiety t(19)=2.19, p<.01, depression t(19)=3.57, p<.01 and stress t(19)=3.26, p<.01, which were maintained at follow-up. Scores on measures of ACT processes significantly increased: psychological flexibility t(19)=0.65, p<.01, mindfulness t(19)=0.51, p<.05, values t(19)=0.56, p<.05. Results of final analyses will be reported. Burton, N.W., Pakenham, K.I., & Brown, W.J. (2010). Feasibility and effectiveness of psychosocial resilience training: A pilot study of the READY program. Psychology, Health and Medicine, 15, 266-277.

Educational Objectives:
1. Utilize ACT processes to target resilience, tolerance of distress, and psychological flexibility in the context of chronic illness. 2. Design ACT interventions to manage unique challenges of medical patient populations. 3. Identify two key processes in the treatment of chronic pain and identify how patterns of change in these processes relate to change in disability.

 

48. Pain and Contextual Medicine Jointly Sponsored Symposium: When the Body Hurts: Pain's Many InterACTing Functions
Symposium (4:30-5:45pm)
Components: Original data
Categories: Clin. Interven. & Interests, Beh. med., Pain and Contextual Medicine
Target Audience: Beg., Interm.
Location: Cooks Bay

Chair: Joel Guarna, Ph.D., Mercy Hospital, Eastern Maine Healthcare System
Discussant: Stephen Z. Hull, M.D., Mercy Hospital, Eastern Maine Healthcare System

Chronic pain is a global problem. A systematic review (19 included studies) of published cross-sectional surveys (65 surveys, 34 countries, 182,019 respondents) authored by Elzahaf RA, et al. (Curr Med Res Opin. 2012 Jul;28(7):1221-9) places the prevalence of chronic pain worldwide at 30.3% ± 11.7%. The human and economic cost of chronic pain is enormous. In the United States alone the economic cost of chronic pain was estimated in 2010 at $560-635 billion dollars. The three studies presented in this symposium, co-sponsored by the Pain SIG and the Contextual Medicine SIG represent a spectrum of the relationship between pain and the role of contextual behavioral science in the alleviation of the suffering of patients with chronic pain, addressing the impact of pain on chronic illness; elucidating the relationship between gender, affective disturbance, pain, experiential avoidance, and quality of life; and demonstrating the benefits of ACT on symptom severity and pain interference.

• Pain matters! Implications for acceptance-based interventions with women with co-morbid chronic illnesses
Abbie O. Beacham, Ph.D., Xavier University, Cincinnati, OH, USA
Stacy Lorenz, M.A., Xavier University, Cincinnati, OH, USA

Chronic pain and chronic illnesses are among the most prevalent and costly in health care. Effective behavioral interventions are vital for medical/functional outcomes. Perceived illness-related disability and life satisfaction along with acceptance-based factors are associated with positive outcomes. Less understood are women with co-morbid chronic illness (CI) symptoms including pain. We compared women in online CI groups with “chronic/recurring pain a primary concern” (CIp; n=281; Mean age=51.53) with those without (CIn; n=109; Mean age=54.89). Women were primarily married/partnered (64.8%), white/non-Hispanic (90.5%) and well educated (Mean years=15.2). Mean number CI’s was CIp=2.71 (SD=1.46) versus CIn=1.55 (SD=0.85). Pain Mean= 5.46/10 (SD=1.91). CIp’s were more overweight/obese (p=.013), smoked more, exercised less, “drank more alcohol because of illness” than CIn (10% versus 5%); higher Disability, Negative Affect and Experiential Avoidance; lower Satisfaction, CI Acceptance, Mindfulness and Positive Affect [F(6,205)=6.89; p<.001]. CI interventions should differentiate between those with versus those without pain to enhance outcomes.

• Is the quality of life of chronic pain patients impacted by the presence of psychiatric symptoms, gender and experiential avoidance?
Maria Stavrinaki, M.S., Department of Psychology, University of Cyprus, Nicosia, Cyprus
Michaela Paraskeva-Siamata, M.S., Department of Psychology, University of Cyprus, Nicosia, Cyprus
Vasilis Vasiliou, M.S., Department of Psychology, University of Cyprus, Nicosia, Cyprus
Orestis Kasinopoulos, M.S., Department of Psychology, University of Cyprus, Nicosia, Cyprus
Despina Hadjikyriacou, Ph.D., Department of Psychology, University of Cyprus, Nicosia, Cyprus
Maria Karekla, Ph.D., Department of Psychology, University of Cyprus, Nicosia, Cyprus

Several individual difference risk factors, including comorbid psychiatric problem, and gender have been linked with chronic pain patients diminished QOL. Experiential avoidance was found to moderate symptom presentation in pain patients; however its relation to QOL has not yet been examined. The present study explored differences between 3 levels of anxiety and depression (non-clinical, sub-clinical and clinical levels) on physical and mental QOL in 74 chronic pain patients. Individuals with clinical anxiety levels had significantly lower physical and mental QOL compared to the other two levels. Individuals with clinical depression presented with significantly lower physical and mental QOL but did not differ from sub-clinical levels. There was no significant interaction between gender and anxiety or depression on QOL. EA was found to be a significant moderator only of depression levels on QOL. Implications of the results in regards to the treatment of individuals with chronic pain will be discussed.

• Acceptance and Commitment Therapy (ACT) for Chronic Pain: A Pilot Study of Adolescents with Neurofibromatosis Type 1 (NF1)
Staci Martin, Ph.D., Neurobehavioral Group, Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
Pam Wolters, Ph.D., Neurobehavioral Group, Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
Mary Anne Toledo-Tamula, M.A., Neurobehavioral Group, Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
Andrea Baldwin, PNP, Neurobehavioral Group, Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
Shawn Nelson Schmitt, Ph.D., Neuropsychology Resident, Alpert Medical School of Brown University
Brigitte C. Widemann, M.D., Pediatric Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD

Research supports ACT’s effectiveness among adolescents with chronic pain in weekly sessions (Wicksell et al., 2009). This study extends that work through a brief ACT workshop in the NF1 population. Participants included adolescents (12-21 years) with NF1 and chronic pain that interfered with functioning, and their parents. Adolescents and parents completed baseline measures of pain interference, pain intensity, functional disability, pain acceptance, depression, and anxiety, then participated in a 2-day workshop (three 2-hour sessions). A telephone session occurred one month post-intervention; measures were completed again three months post-treatment. Ten adolescents and six parents have provided 3-month data to date. Pre-post comparisons showed lower patient-reported pain intensity and less parent-reported pain interference (ps<.05) and marginally greater acceptance of their child’s pain (p=.06). No changes emerged in functional ability or mood. Findings suggest that a brief ACT intervention may be effective for helping adolescents with NF1 and chronic pain and their parents.

Educational Objectives:
1. Describe the features distinguishing women with chronic illness AND pain from those where pain is not a primary concern. 2. Describe the relationships between gender, affective disturbance, pain, experiential avoidance, and quality of life. 3. Assess the effectiveness of brief ACT intervention on pain and acceptance in a population of adolescents with neurofibromatosis type 1.

 

Friday, June 20

55. Online Acceptance and Values-Based Brief Interventions for Well-Being: Results and Experiences
Symposium (10:30am-Noon)
Components: Original data
Categories: Clin. Interven. & Interests, Prevention & Comm.-Based, acceptance and commitment therapy; web interventions; university students, wellbeing, stress, depression
Target Audience: Beg.
Location: Crystal Lake

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

This symposium will present four randomized controlled studies investigating the effectiveness and acceptability of iACT-based interventions. Two presentations will report results of trials with college students and two with people from the general population. In the first study, a brief ACT-web based intervention was compared to web-based psycho-education and a waiting-list control group for preventing mental health problems in students and increasing wellbeing. In the second study, a web-based iACT intervention included two face-to-face meetings and written feedback from coaches and was compared to a waiting-list control group. The third trial compared the effects of a six weeks iACT with weekly contact via internet with a six sessions ACT face-to-face treatment for participants reporting depression symptoms. The fourth study compared a six weeks iACT with weekly contact via internet, but without face-to-face contact, with a waiting list control group. We will discuss results, and our experiences while also pointing out possible pitfalls in delivering web-based interventions.

• Preventing Mental Health Problems in College Students through Web-Based ACT
Michael E. Levin, Ph.D., Utah State University
Steven C. Hayes, Ph.D., University of Nevada Reno
Jacqueline Pistorello, Ph.D., University of Nevada Reno
John Seeley, Ph.D., Oregon Research Institute

Mental health problems are prevalent among college students and innovative approaches are needed that can help prevent the incidence/worsening of these problems. Promising results were found with initial feasibility research testing a web-based ACT prototype consisting of two sessions targeting values and acceptance. This presentation will report the results of a larger randomized trial with 228 college students comparing the web-based ACT prototype to a psychoeducation website for preventing mental health problems. Results indicated significantly lower user engagement and satisfaction ratings with ACT in this trial and that ACT did not outperform the psychoeducation website on outcome or process measures. However, changes in ACT processes were predictive of improvements in outcome irrespective of condition. Furthermore, ACT program usage variables were predictive of improvements in psychological flexibility processes. Results will be discussed in relation to lessons learned with ACT program development and implementation as well as future directions in this area.

• Internet-based guided self-help ACT intervention for enhancing the psychological well-being of university students: A randomized controlled clinical trial
Panajiota E. Rasanen, M.S., University of Jyväskylä, Finland
Päivi Lappalainen, M.A., University of Jyväskylä, Finland
Raimo Lappalainen, Ph.D., University of Jyväskylä, Finland

University students often experience psychological distress. A web-based psychological intervention, aiming at enhancing the wellbeing of university students could be an effective and practical alternative in reaching the needs of the university population. Finnish university students (N = 68; 19-32 years old) were randomized to receive either a blended 7-week web-based Acceptance and Commitment Therapy (ACT) intervention, named The Student Compass or to a waiting list control condition. Participants were offered two face-to-face meetings, completed exercises online in the course of five weeks and received personal weekly written feedback via the website from their randomly assigned trained student coaches. The results showed that the iACT coach-guided self-help intervention was well-accepted by the participants, it was significantly effective in promoting the general well-being of the students and life satisfaction while it also significantly reduced their self-reported stress and depression compared to the participants in the control group.

• A randomized controlled trial of internet-delivered ACT in the treatment of depression: Efficacy and participant experiences
Päivi Lappalainen, M.A., University of Jyväskylä, Finland
Raimo Lappalainen, Ph.D., University of Jyväskylä, Finland

We developed a 6- week web-based Acceptance and Commitment Therapy program for depression with weekly contact via internet. The impact of the program was investigated in two randomized controlled trials. The first trial compared a 6- week face-to-face ACT-treatment to an ACT-based Internet program (iACT) including two assessment sessions (pre and post). The second trial compared iACT without face-to-face contact to a waiting-list control condition. Outpatients reporting mild to moderate depression symptoms (n=38 study 1; n=39 study 2) were randomized to either approach. In the iACT interventions the results showed a clear reduction in most measures at post-treatment as well as at 18-month follow-up (study 1). Clients were satisfied with treatment and would recommend the treatment to others. The Internet-delivered iACT treatment was well-accepted by the clients. Internet-delivered ACT with or without face-to-face sessions but combined with weekly contact via Internet is possibly an alternative for self-referred mild-to-moderate depression clients.

Educational Objectives:
1. Explain how ACT can be adapted to a web-based intervention. 2. Describe and discuss how to promote wellbeing and alleviate psychological problems in student and other populations through ACT web-based interventions. 3. Discuss potential pitfalls in developing and implementing online ACT interventions based on recent randomized trials.

 

59. Delivering Acceptance and Commitment Therapy in Community-Based Settings: Potential Applications and Preliminary Findings
Symposium (10:30am-Noon)
Components: Literature review, Original data
Categories: Clin. Interven. & Interests, Clin. Interven. & Interests, Prevention & Comm.-Based, Short-term interventions
Target Audience: Beg., Interm.
Location: St. Croix II

Chair: Kristy L. Dalrymple, Ph.D., Warren Alpert Medical School of Brown University
Discussant: Robyn D. Walser, Ph.D., National Center for PTSD, Veterans Affairs Palo Alto Health Care System

Although several studies have demonstrated the efficacy of ACT, more research is needed to examine its effectiveness in community-based settings. To do so, modifications may be necessary to enhance its feasibility/acceptability in such settings. One modification is brief and/or intensive applications, which if found to be effective, have the potential to broaden the reach of ACT due to their short duration. The development and preliminary findings of short/intensive applications of ACT in three different community-based settings will be presented. The first presentation will discuss the development and initial outcomes of an ACT-based partial hospitalization program with a heterogeneous patient population. The second will present results from a one-day application of ACT to address depression and anxiety in patients at risk for vascular disease in a primary care setting. The third will discuss results from a one-school-day ACT intervention for adolescents at risk for drop-out, substance abuse, and depression/anxiety at an alternative high school.

• Development and Pilot-Testing of an Acceptance-Based Partial Hospitalization Program
Theresa A. Morgan, Ph.D., Rhode Island Hospital and the Alpert Medical School of Brown University
Kristy L. Dalrymple, Ph.D., Rhode Island Hospital and the Alpert Medical School of Brown University
Catherine D'Avanzato, Ph.D., Rhode Island Hospital and the Alpert Medical School of Brown University
William D. Ellison, Ph.D., Rhode Island Hospital and the Alpert Medical School of Brown University
Diedre Gale, M.A., Rhode Island Hospital
Sarah McCutcheon, B.A., Rhode Island Hospital

Acceptance and Commitment Therapy (ACT) may be particularly efficacious for comorbid and more severe populations (e.g., Dalrymple et al., in press; Wolitzky-Taylor et al., 2012). However, more research is needed to examine the application and effectiveness of ACT in routine clinical settings. Several challenges exist in applying ACT to partial hospitalization programs, where treatment is brief (5 days on average), group composition changes frequently, and patients are receiving concurrent medication treatment. This presentation will discuss the development and pilot-testing of the Acceptance- and Mindfulness-Based Partial Hospital Program at Rhode Island Hospital. Preliminary data from 58 patients show that 92% were very to extremely satisfied with the program, with another 5.8% moderately satisfied. Depression, anxiety, and anger significantly decreased from pre- to post-treatment (all ps < 0.01). Data collection is ongoing; other findings will be presented, including changes in psychological flexibility, valuing, and mindfulness. Limitations and future directions will be discussed.

• One Day ACT Intervention Targeting Mental Health Risk Factors for Vascular Disease
Lilian Dindo, Ph.D., University of Iowa Carver College of Medicine, Dept of Psychiatry
Jess Fiedorowicz, M.D., Ph.D., University of Iowa Carver College of Medicine, Dept of Psychiatry

Depression and anxiety are commonly present in those at risk for vascular disease, and independently contribute to risk of vascular events and mortality. Effective and accessible treatments that target these clinical symptoms and address related health behaviors are needed for this group. Patients at risk of vascular disease with clinically significant anxiety or depression were randomly assigned to a 1-day Acceptance and Commitment Training plus Illness Management (ACT-IM; N= 26) or to Treatment as Usual (TAU; N= 14). Assessments of quality of life, depression, and anxiety were completed at baseline and over a 6-month follow-up period. At 6-month follow up, participants in the 1-day ACT-IM condition exhibited significantly greater improvements in depressive and anxiety symptoms than patients in TAU. Results suggest that a 1-day ACT-IM workshop is a promising approach for the treatment of depression and anxiety in those at risk for vascular disease.

• Intensive Acceptance and Commitment Therapy with At-Risk Adolescents
Emily Kroska, B.A., University of Iowa, Department of Psychology
Rosaura Orengo-Aguayo, M.A. James Marchman, Ph.D., University of Iowa, Department of Psychology

Given the success of Acceptance and Commitment Therapy (ACT) interventions across multiple mental and physical health conditions, community-based and prevention research is increasingly indicated. Emerging research suggests ACT may be particularly effective in younger age groups (e.g., Horowitz & Garber, 2006; Metzler et al., 2000), which are common targets for primary and secondary interventions. The present study reports on the effectiveness of intensive group intervention with at-risk adolescents. Participants include approximately 120 students aged 14-18 identified as at-risk by the school district and sent to an alternative high school. Subsequently, participants will engage in a one-school-day intervention consisting of ACT-based experiential activities and discussion. Multi-method outcome assessment will include self-report, teacher report, and objective secondary data. Longitudinal follow-up at four intervals (1-, 3-, 6-, and 12-months) will assess changes in a wide variety of health behaviors, psychiatric symptoms, and academic performance. Preliminary results (1- and 3- month follow-ups) will be presented. Implications of the study findings for the use of ACT with at-risk adolescents will be discussed.

Educational Objectives:
1. Describe the application and initial effectiveness of ACT in a partial hospital setting. 2. Report how a one-day ACT intervention can be effectively implemented in a primary care setting. 3. Discuss the effectiveness of a one-school-day ACT intervention for at-risk adolescents in a school setting.

 

62. Contextual Behavioral Science and Social Work
Symposium (10:30am-Noon)
Components: Conceptual analysis, Literature review, Didactic presentation
Categories: Related FC approaches, Clin. Interven. & Interests, Prevention & Comm.-Based, Beh. med., Theory & Philo., Social Work
Target Audience: Beg., Interm., Adv.
Location: Spring Park Bay

Chair: Matthew S. Boone, LCSW, University of Arkansas at Little Rock School of Social Work
Discussant: Julie Hamilton, LMSW, ACSW, CAADC, University of Detroit Mercy, School of Dentistry/Private Practice

Social work and Contextual Behavioral Science (CBS) have a lot to offer one another. Though CBS has historically focused on direct interventions with individuals and groups, there is an emerging trend within CBS towards larger scale interventions. Social work has always focused on interventions at the individual and group levels (i.e., "micro" and "mezzo" practice, in social work parlance) as well as the organizational, community, and societal levels (i.e., "macro" practice). CBS offers the profession of social work a coherent and comprehensive model of intervention development, with a clearly articulated philosophy of science as its foundation, a focus on grounding interventions in basic principles, and a growing emphasis on identifying evidence-based processes of change. The profession of social work offers CBS a discipline which is firmly grounded in a contextual understanding of human suffering; to social workers, problems never exist solely within the individual, but rather emerge in the dynamic interaction between individuals and their historical, environmental, and cultural contexts. In social work, this is called the "person-in-environment" perspective. This symposium will explore the intersection of CBS and social work at multiple levels: philosophy, theory, and intervention.

• Social Work and Functional Contextualism Are a Natural and Effective Match
Joanne Steinwachs, LCSW, Private Practice, Denver, Colorado

Social work as a profession has struggled to find a theory that works effectively to inform all levels of practice, micro, mezzo and macro. Although in the past, social workers were regularly trained in radical behaviorism, the limits of Skinner's approach perhaps narrowed its applicability to all social work areas of practice. This presentation makes the argument that functional contextualism is a more effective fit for social work practice and values.

• Mindfulness for Millions: Promoting CBS Through the Practice of Social Work
Matthew S. Boone, LCSW*, University of Arkansas at Little Rock School of Social Work

Though social workers make up the largest group of mental health providers in the US, social workers also serve as case managers, program developers, advocates, community organizers, educators, and policymakers. These diverse roles create a demand for effective interventions which are scalable across multiple levels and contexts. ACT has proven effective and flexible at the individual level. But when behavior change processes are understood as individual-level evolutionary processes, and when ACT is framed as a method of generating better selection criteria (i.e. values) for more adaptive behavior, then the psychological flexibility model can be understood as just one way of harnessing processes of change that also occur at the genetic, cellular, group, and cultural levels. In the face of this scalability, social work would do well to adopt a CBS approach to research and intervention, and the profession of social work would be a perfect fit for the dissemination of CBS interventions.

• Population-Based Health Care and Brief Intervention Competencies in Integrated Health Settings
Patricia J. Robinson, Ph.D., Mountainview Consulting Group, Inc, Zillah, WA
Brian Mundy, LCSW, Institute for Community Living, New York, NY

Population-based health care suggests that much is to be gained in clinical and cost outcomes when resources are focused on helping all people maintain optimal health as long as possible, rather than attending exclusively to people in acute need of services. The emergence of integrated health care in new delivery systems offers behavioral health workers opportunities to effectively serve large and diverse populations via brief intervention models supporting behavior change. The Brief Intervention Competency Assessment Tool, or BI-CAT, is a tool for enhancing understanding and developing a broad range of skills supportive of excellence in brief practice. Presenters will discuss the Primary Care Behavioral Health (PCBH) model and the four skill domains and 20 fundamental competencies that support working briefly with clients.

Educational Objectives:
1. Identify the commonalities between contextual behavioral science and the theory and practice of social work. 2. Assess the viability of drawing on functional contextualism and contextual behavioral science to guide the progress and practice of social work. 3. Describe contextual behavioral science-informed interventions which are a good fit for social work practice.

 

63. Refining Experiential Avoidance: Validity and Utility Across Concerns, Cohorts, and Cultures
Symposium (10:30am-Noon)
Components: Conceptual analysis, Literature review, Original data
Categories: Clin. Interven. & Interests, Theory & Philo., Experiential Avoidance
Target Audience: Interm.
Location: Lake Calhoun

Chair: Tamara M. Loverich, Ph.D., Eastern Michigan University
Discussant: Victoria M. Follette, Ph.D., University of Nevada, Reno

Difficulties in emotion regulation are of great interest to health professionals who are invested in preventing and changing a wide range of related problematic behaviors and consequences. The 3 diverse studies that are the focus of this presentation utilized multiple measures of Experiential Avoidance (EA) and found important differences in the strength of its relationships with meaningful clinical outcomes depending on how it was measured. Samples include 738 college students, 60 adult child-parent dyads, and 115 Asian and Majority college students. Parents and their adult children and people of different ethnicities appeared to utilize EA differently. While EA appeared useful in better understanding weight, trauma, and acculturative stress and dissonance-related difficulties, there are nuances to the measurement of the construct, and how it relates to other emotion regulation variables and excessive behaviors, that are important to improving emotion regulation research and clinical intervention.

• Weight-Related Experiential Avoidance, Binge-Eating, and Food Addiction
Ashley A. Wiedemann, M.S., Eastern Michigan University
Tamara M. Loverich, Ph.D., Eastern Michigan University

It has been suggested that binge eating may be a form of experiential avoidance (EA). However, few studies have examined the relationship between EA, and binge eating, and none have compared the primary EA measures in the context of overweight. The purpose of this investigation therefore is to explore the role of EA in weight status and disordered eating behavior. Undergraduate students (n=738) complete an online survey that included the following measures: MEAQ, AAQ-II, AAQW, a measure of binge eating and disordered eating, and the Power of Food Scale (PFS). Contrary to our expectations, EA displayed a low correlation with binge eating and BMI. Weight-related EA displayed the strongest (though moderate) correlations with disordered eating habits, binge eating, and the PFS. Relationships among EA measures and eating behavior and implications for research and treatment will be discussed.

• Experiential Avoidance in Families: Factors Related to Resilience Post-Trauma
Meaghan Lewis, M.S., Eastern Michigan University
Tamara M. Loverich, Ph.D., Eastern Michigan University

Experiential avoidance is receiving increasing conceptual and empirical review in the development and maintenance of posttraumatic stress disorder (PTSD) and appears to underlie engagement in topographically dissimilar problem behaviors (Kingston, Clark & Remington, 2010; Kumpula et al., 2011). The present study sought to test a conceptual model in which parent experiential avoidance, PTSD symptom severity, and problem behaviors predicted exacerbated excessive behaviors in their adult children. Overall, in 60 dyads, parents and adult children evidenced relations between levels of problem behaviors, PTSD symptom severity, and experiential avoidance measured by the AAQ-II. Interestingly, experiential avoidance assessed using the recently validated MEAQ was not associated between dyadic members. Findings suggest experiential avoidance appears linked in parents and children, but given differences in measures, the form of experiential avoidance (e.g., behavioral avoidance, suppression) may be an individual difference characteristic. Conceptual and measurement implications will be discussed.

• Ethnic variation in emotion regulation: Implications for assessing internalizing and externalizing symptoms in culturally diverse populations
Joohyun Lee, M.S., Eastern Michigan University
Tamara M. Loverich, Ph.D., Eastern Michigan University

Emotion regulation has become an important construct in clinical psychology due to its perceived link to various mental health outcomes. However, a small but growing literature suggests there are ethnic differences in how different facets of emotion regulation affect functioning. This study evaluates the role of emotion regulation deficits in internalizing/externalizing problems among individuals of Asian (N = 67) and non-Asian (N = 48) descent. Emotion regulation deficits were found to be concomitants of psychological maladjustment for both groups even after accounting for culture-specific risk factors. However, comparative results revealed that Asian-American participants were more likely to report emotional non-acceptance than their non-Asian counterparts. Furthermore, the relationship of Experiential Avoidance (EA) with the study’s outcome variables differed as a function of ethnicity. Implications for research and intervention will be discussed.

Educational Objectives:
1. Describe the experiential avoidance construct and its factors. 2. Compare experiential avoidance outcomes as a result of conceptual and measurement variance. 3. Utilize advances in experiential avoidance to improve research in the domains of PTSD, overweight and acculturative stress.

 

64. Mind the Gap: Capitalizing on Values and Psychological Flexibility Principles to Reach Diverse Populations
Symposium (10:30am-Noon)
Components: Conceptual analysis, Original data
Categories: Clin. Interven. & Interests, Prevention & Comm.-Based, Multicultural/Diversity, Parenting, Children, PTSD Target Audience: Beg.
Location: Lake Nokomis

Chair: Rebecca Hamblin, M.A., University of Mississippi
Discussant: Akihiko Masuda, Ph.D., Georgia State University

The foundation of ACT on nomothetic principles (i.e. Behavior Analysis and RFT), in combination with a strong emphasis on context, lends itself to flexible idiographic application across individuals, organizations, and cultures. The United States is home to millions of immigrants and refugees from countries all over the world, many of whom have experienced significant trauma and psychosocial stressors such as war, disaster, and persecution. During the resettlement process, separation from family and culture, discrimination, and acculturative stress all serve to exacerbate the already high risk of emotional distress for these groups. Ethnic minority and economically disadvantaged persons in the U.S. have historically been underserved in mental health care and may have attenuated treatment gains compared to their majority peers. Refugee and immigrant families face even greater barriers to access and effectiveness of treatment, including non-fluency in English and discrepancies in cultural values and practices that threaten acceptability of traditional psychotherapy programs. This symposium will explore programs using ACT principles to reach groups of individuals and families from around the world in partnership with community organizations. Implications for large-scale implementation and policy will be discussed.

• Lessons from the Field: Parenting and Grandparenting Mindfully Together in a Chinese Immigrant Population
Lisa W. Coyne, Ph.D., Suffolk University/New England ACT Institute
Grace Gu, B.A., Suffolk University/New England ACT Institute
Jessica Pan, B.A., Suffolk University/New England ACT Institute

Chinese immigrant families of young children have unique issues that may negatively impact, and should certainly shape both program development and service delivery. It is especially important that any mental health services developed for young children of Chinese immigrants must be mindfully culture-specific. The current program evaluation project had the goals of incorporating ACT principles into an evidence-based parenting program and adapting this program to a Chinese immigrant and Chinese-American population. We have developed a 5-session protocol called “Parenting and Grandparenting Mindfully Together,” and are in our second wave of an open trial of this approach. We evaluated: 1) effectiveness of a culturally adapted comprehensive treatment package in an open trial; and 2) child and family progress and outcome for referred children. Project strengths and limitations, as well as issues around cultural adaptation (e.g., cultural equivalence, issues of assessment, contextual factors), service utilization and delivery, and implications for future work will be discussed.

• Connecting Cultures with ACT: An Eight Module Group Program for Refugee Survivors of Torture and Trauma
Karen M. Fondacaro, Ph.D., University of Vermont/ New England Survivors of Torture and Trauma
Emily Mazzula, Ph.D., University of Vermont/Connecting Cultures
Diane Gotlieb, Ph.D., University of Vermont/Connecting Cultures

This group intervention for refugee survivors of torture utilizes an ACT framework to target post-traumatic suffering. The value-driven and strength-based nature of ACT, allows for a respectful collaboration using mindfulness, metaphors and strategies that easily transcend cultural bounds. Within the ACT framework, this culturally sensitive intervention focuses on eight modules: 1) Safety/ Present Moment; 2) Values /Definition of Torture and Trauma and Post Traumatic Stress; 3) Coping & Committed Action; 4) Cognitive Fusion; 5) Observing Self–Life line; 6) Acceptance; 7) Narrative Exposure to the Traumatic Events; and 8) Good-bye Celebration. Pre-post intervention data collected from refugee torture and trauma survivors from Bhutan and Somalia (N=40) will be presented. Relationships among trauma and torture types, PTSD, anxiety, and depression symptomology, and psychological flexibility will also be presented. Lessons from the field and implications for large-scale implementation will be discussed.

• Global Parenting Skills: Examination of an ACT Model of Parenting Practices to Address the Needs of Refugee Children and Families
Rebecca J. Hamblin, M.A., University of Mississippi
Anne E. Brassell, B.A., University of Vermont
Olga V. Berkout, M.A., University of Mississippi
Karen M. Fondacaro, Ph.D, University of Vermont
Rex L. Forehand, Ph.D., University of Vermont

Behavioral parenting programs in immigrant (non-refugee) populations have shown attenuated treatment gains for parents with high levels of distress despite inclusion of cognitive restructuring techniques to address parental psychopathology. Given the unique psychosocial histories of refugee families, high levels of distress, and cultural variability in values and parenting practices, modification and examination of parenting programs for refugees is warranted. This paper describes such a parenting curriculum delivered to Bhutanese refugee parents. Global Parenting Skills is based on an empirically supported behavioral curriculum and is enhanced with checks for cultural acceptability, values-driven committed action and mindfulness, a module addressing parental psychopathology using ACT principles, and a module addressing children’s internalizing symptoms within an acceptance-based framework. This paper presents pre- to post treatment changes and three-month maintenance in parenting practices and child psychopathology, as well as predictors and moderators of treatment response including parental psychological flexibility and use of acceptance strategies in the context of parenting.

Educational Objectives:
1. Describe unique needs and challenges for immigrant and refugee populations in need of mental health care in the United States. 2. Apply values-based principles to interventions with multicultural populations. 3. Discuss strengths and limitations of using the ACT model with diverse populations with high psychosocial needs.

 

65. Addressing the Needs of the Hispanic Population: Examination of ACT Relevant Constructs
Symposium (10:30am-Noon)
Components: Conceptual analysis, Original data
Categories: Clin. Interven. & Interests, Hispanic, AAQ
Target Audience: Beg., Interm., Adv.
Location: Cooks Bay

Chair: Olga Berkout, University of Mississippi
Discussant: Karen Fondacaro, University of Vermont

The Hispanic population represents a growing proportion of the United States. Despite this, a number of our empirically supported intervention and assessment strategies have been examined primarily within Caucasian samples. The speakers in this symposium strive to add to the literature by examining ACT relevant constructs among Hispanic participants. Hispanic individuals within the U.S. face a number of stressors related to acculturation and often present with unmet mental health needs (Chavez, Shrout, Alegria, Lapatin, & Canino, 2010). Adding to the ACT literature among this population will help bridge the gap in reaching underserved individuals. In line with this effort, we present an examination of the psychometric properties of the Acceptance and Action Questionnaire-II (AAQ-II; Bond et al., 2011), the psychometric properties of AAQ health domain variations, and a discussion of psychological dysfunction and acculturation among Hispanic individuals.

• Psychological flexibility and the generational trend toward worse health in U.S. Hispanics
Stephanie Caldas, University of Louisiana at Lafayette
Matthieu Villatte, Ph.D., Evidence-Based Practice Institute
Rick Perkins, University of Louisiana at Lafayette
Emily Sandoz, Ph.D., University of Louisiana at Lafayette
Stephen J. Caldas, Manhattanville College

Research shows a generational trend towards increased risk for mental disorders in the U.S. immigrant Hispanic population. This phenomenon is known as the Hispanic Paradox, because Hispanic immigrants, despite being at a higher risk for the development of mental disorders, fare better than U.S.-born Latinos and even non-Hispanic Whites in many aspects (Alegría et al., 2008). However, this advantage weakens with time spent in the United States. Given this information, there is an opportunity for preventive public health. An account of the components of Hispanic culture, the process of immigration, and acculturation will be given from the perspective of psychological flexibility. Based on preliminary data, this paper offers a functional interpretation of the existing research regarding the Hispanic community and mental health in order to both explain the inherent strengths found in Hispanic culture.

• Examining the Psychometric Properties of the Acceptance and Action Questionnaire-II in a Hispanic Sample
Olga V. Berkout, M.A., University of Mississippi
Maureen K Flynn, Ph.D., University of Texas – Pan American

Acceptance and Action Questionnaire II (AAQ-II; Bond et al., 2011) is a widely utilized measure of avoidance and psychological flexibility. AAQ-II has received psychometric support among primarily Caucasian participants (Bond et al., 2011; Fledderus et al., 2012). However, the psychometric properties of this measure have not been examined among a Hispanic sample. Given the cultural differences within this population, validation of psychological measurement instruments would ensure that constructs are adequately assessed (Dura-Vila & Hodes, 2012). The current study examines the psychometric properties of the AAQ-II within this population. Factor structure of the AAQ-II, internal consistency reliability, and relations to measures of cognitive fusion, acceptance, and present moment awareness will be examined. Multiple indices of model fit will be used to assess the appropriateness of the single factor structure found among Caucasian participants (Bond et al., 2011). Gender differences and comparison to extant norms within Caucasian samples will also be discussed.

• Examination of the Psychometric Properties of Weight-related Adaptations of the Acceptance and Action Questionnaire in a Hispanic Sample
Maureen K. Flynn, Ph.D., University of Texas – Pan American
Olga Berkout, M.A., University of Mississippi
Louelynn Onato, University of Texas – Pan American

Treatment development research in ACT focuses on both outcomes and mechanisms of action. The Acceptance and Action Questionnaire (AAQ; Hayes et al., 2004; Bond et al., 2011) has widely been used to demonstrate treatment outcome mediation by psychological flexibility. There are several domain specific variations of the AAQ (e.g., diabetes). In some studies, the AAQ did not mediate outcomes but the domain specific AAQ did (e.g., Gregg et al., 2007). AAQ adaptations assessing psychological flexibility in relation to weight-related issues have utilized primarily Caucasian participants. The aim of the current study was to explore the psychometric properties of these measures in a Hispanic sample. The following questionnaires were examined: Food Craving Acceptance and Action Questionnaire, Acceptance and Action Questionnaire for Weight-related Difficulties, Body Image Acceptance and Action Questionnaire, Acceptance and Action Questionnaire – Exercise, and Physical Activity Acceptance and Action Questionnaire.

Educational Objectives:
1. Describe the role of psychological flexibility in the Hispanic/Latino population, as it relates to factors such as generation status, ethnic identity, and perceived discrimination. 2. Discuss the utility of the Acceptance and Action Questionnaire II within a Hispanic population 3. Describe the psychometric properties of weight-related ACT measures in a Hispanic sample.

 

75. The Good, the Bad, and the Ugly: How Rules and Instructions Influence Our Behavior for Better or Worse
Symposium (2:45-4:15pm)
Components: Conceptual analysis, Literature review, Original data
Categories: Theory & Philo., Related FC approaches, RFT, Functional-Cognitive Perspective
Target Audience: Beg., Interm., Adv.
Location: St. Croix I

Chair: Sean Hughes, National University of Ireland Maynooth (NUIM)
Discussant: Dermot Barnes-Holmes, National University of Ireland Maynooth (NUIM)

Learning via instruction is a fundamental avenue through which humans adapt to the world around them. Rules and instructions allow us to set and achieve goals, respond to consequences that are extremely abstract in nature as well as profit from other people’s experiences. But this ability comes at a very real cost: rules have a dark side. They can cause us to become stuck in problematic ways of behaving and may to play a role in psychopathologies such as addiction (“I need to smoke in order to feel good”), self-harm (“I always cut myself when I do poorly at school”) and suicide (“My pain will stop after I kill myself”). This collection of talks will introduce the functional and cognitive approaches to learning via instructions, and in doing so, tackle issues that are currently occupying attention in both of these areas. Hughes will open with an emphasis on the functional (RFT) level and consider some of the empirical and conceptual controversies that have shaped our understanding of this phenomenon to date. Kissi will then explore recent work on the adaptive and maladaptive consequences of rule-following while De Houwer will close by examining how recent advances at the cognitive level may accelerate development at the functional level and vice-versa.

• Learning via Instructions and Rules: What We Know and Where We Need to Go…
Sean Hughes, National University of Ireland Maynooth

The capacity for rules (or instructions) to influence how we think, feel and behave is a widely accepted although poorly understood phenomenon. While the positive and negative consequences of rule-following are relatively well-established, remarkably little is known about the origins of this behavior or the basic functional processes that underlie its operation. In the current talk we take the audience on a journey through the functional literature – weaving our way through the empirical and conceptual controversies that have shaped our understanding of this phenomenon to date. We stop and consider the origins of socially or self-generated rules and demonstrate how they can come to exert a significant influence on normal and abnormal behavior. We conclude our talk by equipping the audience with a map for the road ahead – identifying key directions for future work in this area.

• The Adaptive and Maladaptive Consequences of Rule-Following
Ama Kissi, Ghent University
Sean Hughes, National University of Ireland Maynooth
Jan De Houwer, Ghent University
Geert Crombez, Ghent University

Rules enable humans to efficiently adapt to the world around them. They allow us to set and obtain (abstract) goals, delay responding and cope with events before they occur. Research also indicates that rule-following can have detrimental effects: it can prohibit us from contacting important changes in the way the world is organized. This rule-based insensitivity effect appears to be moderated by the type of rules involved and plays an important role in various psychological problems. Yet existing work on the maladaptive consequences of rule-following in healthy versus non-healthy participants has yielded mixed results. In this talk we explore how the type of rule (pliance and tracking), its accuracy and prior effectiveness guide adaptation to the environment and offer several recommendations for future research in this area.

• Learning via instructions: A Functional-Cognitive Perspective
Jan De Houwer, Ghent University

Learning can be defined functionally as changes in behavior that are due to relations between events in the environment (De Houwer et al., 2013). Based on a cognitive propositional theory of learning, one can predict that learning via instructions about events can be functionally similar to learning via the experience of those events. I review studies on mere exposure, evaluative conditioning, fear conditioning, and operant conditioning via instructions that confirmed this prediction. In some cases, however, differences were observed. Although cognitive propositional theories have thus led to interesting novel findings, progress at the cognitive and functional level is hampered by a lack of understanding of how instructions and experience relate at the functional level.

Educational Objectives:
1. Identify current issues and future directions in the study of rule governed behavior. 2. Discuss the impact of rule-type, accuracy and prior efficacy on adaptation to the environment. 3. Assess the utility of the functional-cognitive framework for stimulating empirical and theoretical development in this area.

 

76. Making Addiction Treatment Powerful: New Empirical Results on Contextual Processes in Treating Substance Use
Symposium (2:45-4:30pm)
Components: Original data
Categories: Clin. Interven. & Interests, RFT, Addiction, Clinical Trials, Contextual Processes
Target Audience: Beg., Interm., Adv.
Location: St. Croix II

Chair: Jonathan Bricker, Ph.D., Fred Hutchinson Cancer Research Center & University of Washington
Discussant: Gregory Madden, Ph.D., Utah State University

Treating addiction is challenging. Patient engagement waxes and wanes. Relapse rates are high. Adding to the challenge is the fact that the majority of patients with substance use have co-occurring mental disorders, including depression, PTSD, and psychoses. To address these challenges, contextual behavior theory now focuses on the potential power of avoidance as a clinically changeable process leading to successful cessation and reduction of addictive substances. Our focus will be on the two most common substances of abuse: tobacco and alcohol. First, Dr. Bricker will present results from the first randomized trial of telephone-delivered ACT for smoking. Second, Dr. Kelly will present results from an open trial of ACT for smoking cessation among veterans with PTSD. Turning to alcohol outcomes, Dr. Luoma will show the role of shame and avoidance in alcohol use from an observational study of community adults. Finally, Dr. Vilardaga will share results from an observational study on the role of overt and relational avoidance in alcohol, tobacco, and other drug use among patients with serious mental illness (e.g., psychoses). Tying the talks together will be Dr. Hayes, who will highlight their common empirical thread of avoidance and related contextual processes in making treatments for addictions more potent, powerful, and enduring.

• Randomized Trial of Telephone-Delivered Acceptance and Commitment Therapy vs. Cognitive Behavioral Therapy for Smoking Cessation: A Pilot Study
Jonathan B. Bricker, Ph.D., Fred Hutchinson Cancer Research Center & University of Washington
Terry Bush, Ph.D., Alere Wellbeing
Susan M. Zbikowski, Ph.D.,, Alere Wellbeing
Laina D. Mercer, M.S., Fred Hutchinson Cancer Research Center
Jaimee L. Heffner, Ph.D., Fred Hutchinson Cancer Research Center

Objective: Randomized trial of telephone-delivered Acceptance and Commitment Therapy (ACT) versus Cognitive Behavioral Therapy (CBT) for smoking cessation. Method: Participants were: (1) 121 uninsured South Carolina State Quitline callers who were adult smokers (at least 10 cigarettes/day) wanting to quit within the next 30 days; (2) randomized to five sessions of either ACT or CBT telephone counseling; and (3) offered two weeks of nicotine replacement therapy (NRT). Results: 100% of ACT participants reported their treatment was useful for quitting smoking (vs. 87% for CBT; p =.03). At the three-month follow-up, ACT participants had significantly higher levels of acceptance of cravings to smoke than CBT participants (M = 2.41 for ACT vs. 2.13 for CBT; on a scale of 1 to 5; p = .046). In turn, higher levels of acceptance of cravings to smoke at the three-month follow-up predicted a 4.6 times higher odds of quitting at the six-month follow-up (OR = 4.6; 95% CI = 1.5-14.2; p = .009). Cessation outcomes overall, and among those depressed at baseline, will be presented. Conclusions: ACT is feasible to deliver by phone, highly acceptable to quitline callers, and impacts avoidance processes that contribute to successful smoking cessation.

• A Pilot Study of an Acceptance and Commitment Therapy Smoking Cessation Treatment for Veterans with Posttraumatic Stress Disorder
Megan M. Kelly, Ph.D., Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA & University of Massachusetts
Hannah Sido, Psy.D., Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA
John Forsyth, Ph.D., University at Albany, State University of New York,
Douglas Ziedonis, M.D., M.P.H., University of Massachusetts Medical School
David Kalman, Ph.D., University of Massachusetts Medical School
Judith Cooney, Ph.D., VA Connecticut Healthcare System & University of Connecticut School of Medicine

Veterans with posttraumatic stress disorder (PTSD) have low smoking quit rates, often related to their PTSD symptoms. The present study evaluated Acceptance and Commitment Therapy for Veterans with PTSD and Tobacco Use (ACT-PT), which focuses on helping Veterans overcome emotional challenges to quitting smoking. Nineteen Veterans with PTSD who smoke participated in an uncontrolled trial of ACT-PT and received eight weeks of the nicotine patch. At the end of treatment, 37% of participants were abstinent from smoking and 16% were abstinent at the three-month follow-up. Participants had a 62% reduction in smoking at the end of treatment (p<.001) and a 43% reduction at the three-month follow-up (p=.002). PTSD symptoms significantly decreased from baseline to the end of treatment (p<.001) and the three-month follow-up (p=.025). The retention rate (74%) was good and client satisfaction ratings were high. ACT-PT appears to be a promising smoking cessation treatment for Veterans with PTSD.

• Shame, Self-Criticism, Self-Compassion, and Psychological Flexibility as Predictors of Drinking-Related Behavior
Jason Luoma, Ph.D., Portland Psychotherapy Clinic, Research, and Training Center
Paul Guinther, Ph.D., Portland Psychotherapy Clinic, Research, and Training Center
Roger Vilardaga, Ph.D., University of Washington & Fred Hutchinson Cancer Research Center

Research has shown that shame is associated with alcohol-related problems. However, the extent to which shame serves as a close temporal antecedent of drinking is not well established and factors which moderate the relationship between shame and drinking have received little attention. This paper will present data from a larger observational study aimed at extracting ecologically valid (real-world) information about drinkers’ daily drinking patterns as they relate to dispositional factors (e.g., demographics, drinking history, global tendency to endorse or express emotions, etc.), contextual factors (e.g., daily negative events and moods), and ongoing experiences of shame. The purpose of gathering this information is to help identify causal variables that lead to increased drinking among the naturallyoccurring range of low- to high-risk drinkers in a community setting, with the hope that the identification of these variables will be useful in the development of drinking interventions. The study sample consists of 88 community adults who had consumed alcohol within the past two weeks. Participants completed a baseline assessment and interview followed by a 21 day online daily diary assessing daytime and evening drinking, mood, psychological flexibility, and self-compassion. Data analyses to be presented will focus on predictors of drinking with a focus on the relationship between shame, self-criticism and drinking and negative drinking-related consequences. Potential moderators of these relationships, including self-compassion and psychological flexibility, will also be explored.

• A Process Analysis of Addictive Behaviors in Adults with Co-Occurring Disorders
Roger Vilardaga, Ph.D., Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine & Fred Hutchinson Cancer Research Center
Emily Leickly, B.A., Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine & Fred Hutchinson Cancer Research Center
Frank Angelo, M.A., Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine & Fred Hutchinson Cancer Research Center
Jessica Lowe, B.A., Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine & Fred Hutchinson Cancer Research Center
Richard Ries, M.D., Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine & Fred Hutchinson Cancer Research Center
Michael McDonell, Ph.D., Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine & Fred Hutchinson Cancer Research Center

Addictive behaviors are highly prevalent among individuals with severe psychopathology (i.e. schizophrenia, schizoaffective, bipolar, or recurrent major depressive disorders). At least 50% percent of these individuals have an alcohol use disorder, 30% an illicit drug use disorder, and up to 90% a nicotine use disorder. Co-occurring psychological disorders and addictive behaviors have dramatic costs for individuals and society. However, from a contextual behavioral perspective, there is little research examining the psychological processes underlying addictive behavior in this population. This paper will present baseline and longitudinal observational data from the 1-month induction period of a randomized controlled trial testing a contingency management intervention to treat alcohol dependence. The data comes from 63 adults recruited from a community mental health clinic in the Pacific Northwest. Consistent with prior ACT research in this population (e.g., Vilardaga et al, 2013) and with the role of overt and relational avoidance in the maintenance of addictive behavior, we expect that higher levels of experiential avoidance will be associated with higher levels of drug, alcohol or tobacco use. This paper will examine the degree in which the results provide support (or not) to our hypothesis, and will discuss its implications for future CBS research.

Educational Objectives:
1. Describe the research evidence on the impact of ACT on acceptance processes and smoking cessation. 2. Learn about new research on the role of avoidance and shame processes underlying alcohol and other substances. 3. Consider ways newest research on acceptance processes can be applied in the treatment of addictions.

 

78. A New Contextual Behavioral Model of Social Connection for Functional Analytic Psychotherapy
Symposium (2:45-4:15pm)
Components: Conceptual analysis, Original data
Categories: Clin. Interven. & Interests, Theory & Philo., FAP
Target Audience: Beg.
Location: Excelsior Bay & Lafayette Bay

Chair: Gareth Holman, Ph.D., Evidence-Based Practice Institute
Discussant: Kelly Wilson, Ph.D., University of Mississippi

Over the years, FAP has been seen as a fellow contextual behavioral traveler along with ACT, sharing a common set of values, principles and philosophy. However, FAP, perhaps because of its purely functional and idiographic approach, remains an enigma to many, particularly with respect to what the treatment approach is and how to research it. Over the last several years, we have been developing a FAP approach to social connection, a common FAP treatment target, which retains FAP’s emphasis on functional flexibility but may provide clinicians and researchers with a more concrete operationalization. In this symposium, this model will be presented. Then, two clinical-research instantiations will be presented, the first in which the social connection model was used to enhance a brief mindfulness intervention, and the second in the context of a laboratory-based process study to explore components of the model. Kelly Wilson will discuss implications.

• Awareness, Courage, Love and Social Connection: A Draft FAP Model
Jonathan Kanter, Ph.D., University of Washington
Gareth Holman, Ph.D., Evidence-Based Practice Institute
Chad Wetterneck, Ph.D., Rogers Memorial Hospital
Mavis Tsai, Ph.D., University of Washington and private practice
Robert Kohlenberg, Ph.D., University of Washington

In this talk, Jonathan Kanter will describe the working model of social connection that forms the basis of the subsequent research studies. This model integrates information from evolutionary science and neurobiology, basic contextual behavioral principles and philosophy, the logic of FAP’s 5 rules as the basis for intervention, and the rich clinical experiences of FAP’s developers to produce a working framework. Both the underlying science and the clinical instantiation of this model in terms of awareness, courage, and love will be described.

• Awareness, Courage, Love and Social Connection: A Brief Mindfulness Intervention
Robert Kohlenberg, Ph.D., University of Washington
Jianne Lo, University of Washington
Margo Derecktor, University of Washington
Elizabeth Lagbas, University of Washington
Jonathan Kanter, Ph.D., University of Washington

In this pilot randomized trial, 122 undergraduate participants were randomly assigned to receive either a standard intra-personal mindfulness intervention (involving relaxation and other components) or the mindfulness intervention enhanced with an awareness, courage, and love intervention designed to increase social connection. This intervention asked participants, after the intra-personal mindfulness component, to contemplate a significant person in their lives and what steps they might take to move closer to that person (awareness), to optionally share their contemplations in a group (courage), and to optionally give authentic feedback to each other about the sharing (love). A third group was randomly assigned to a no-intervention control. Both groups demonstrated increased mindfulness compared to the control intervention but only the enhanced intervention demonstrated improvements with respect to social connection.

• Awareness, Courage, Love and Social Connection: A Laboratory-Based Component Process Study
Adam Kuczynski, University of Washington
Jonathan Kanter, Ph.D., University of Washington
Kevin Haworth, University of Wisconsin-Milwaukee
Mavis Tsai, Ph.D., University of Washington and private practice
Robert Kohlenberg, Ph.D., University of Washington

This talk reports on two studies that attempted to isolate the impact of courage and love on social connection with undergraduates, using a laboratory-based research methodology. In both studies, participants interacted with a trained research assistant who asked the participant a series of questions requiring personal self-disclosure designed to increase closeness. In the first study, 77 participants were randomly assigned either to a no-intervention control or to the experimental condition in which they were asked to courageously respond to each question, and then received loving feedback from the research assistant. In the second study, 98 undergraduate participants were randomly assigned to either a no-intervention control, a condition in which only the questions were asked but no feedback was provided, or a condition in which the questions were asked and feedback was provided. Both courage and love components demonstrated an impact on social connection and amount of self-disclosure.

Educational Objectives:
1. Describe the developing conceptual model underlying FAP research and clinical training. 2. Describe and critically assess emerging research in light of this model. 3. Discuss the application of this research and the conceptual model to clinical situations.

 

80. Using ACT to Train the Next Generation of ACT Clinicians
Symposium (2:45-4:15pm)
Components: Conceptual analysis, Original data, Didactic presentation
Categories: Superv., Train. & Dissem., Edu. settings, Prof. Dev., Clinician Development
Target Audience: Beg., Interm.
Location: Lake Calhoun

Chair: Daniel S. Steinberg, M.A., University of North Texas
Discussant: William D. Norwood, Ph.D., University of Houston-Clear Lake

Acceptance and Commitment Therapy (ACT) research has often included investigation of mechanism and attention to ideographic processes; however, with growing mainstream acceptance and, now, over 75 randomized controlled trials firmly establishing efficacy, even more specific research questions are being asked. One particularly important area of research concerns the training of future ACT clinicians - more precisely, what ways can ACT itself can be used to facilitate this training? This symposium intends to explore several avenues for training graduate students in ACT using the very principles embodied in its philosophy. Three papers will examine: a course on ACT for doctoral students, the impact of a two-week ACT workshop prior to a master’s level practicum, and a conceptual analysis exploring mixed methods approaches to advanced graduate training. Relevant outcome data, benefits/obstacles, and implications for future graduate student training will be discussed.

• Showing Up for Class: Examining a Doctoral Level Course on Acceptance and Commitment Therapy
Danielle N. Moyer, M.S., University of North Texas
Daniel S. Steinberg, M.A., University of North Texas
Melissa L. Connally, M.S., University of North Texas
Amy R. Murrell, Ph.D., University of North Texas

Empirical support and clinician interest in Acceptance and Commitment Therapy (ACT) has grown tremendously (Smout, Hayes, Atkins, Klausen, & Duguid, 2012), increasing the need for quality training. Evidence suggests training workshops based on experiential exercises successfully increase clinician knowledge (Richards et al., 2011), while also improving psychological flexibility and decreasing burnout-related stress (Luoma & Vilardaga, 2013). Although research on the effectiveness of ACT-based workshops is growing, little is known about the effects of graduate level training. Doctoral psychology students completed measures of psychological flexibility, mindfulness, and perceived stress throughout an elective psychotherapy course on ACT; Reliable Change Index scores suggest some positive changes over time. This paper will explore these results, with particular attention paid to the advantages and obstacles of a graduate course on ACT, such as balancing didactic training and experiential learning, and the challenge of covering philosophical and theoretical foundations during the course of a semester.

• Growing Therapists 101: Psychological Flexibility and Relationship Skills in the Developing Clinician
Emmy LeBleu, University of Louisiana at Lafayette
Tracy Protti, University of Louisiana at Lafayette
Emily K. Sandoz, Ph.D., University of Louisiana at Lafayette

Quality of the therapeutic relationship is absolutely critical in predicting psychotherapeutic effectiveness. The ACT therapist attempts to create a context in which behavior change can occur, but in the therapy room much of that context is the relationship itself. This study examined skills relevant to the therapeutic relationship in the context of evaluating a therapist training program. Participants were training clinicians who were undertaking their first field placement. Participants’ training focused on building a repertoire relevant to developing a therapeutic relationship. They completed an assessment of empathy, therapist beliefs, psychological flexibility, and relationship flexibility before and after the training, as well as after their field experiences. Measures, and changes in the measures of psychological flexibility, relationship flexibility, and empathy, were examined, and compared with trainee evaluations. Results suggest that psychological flexibility contributes to empathy, with inconsistent impact on therapist skills. Implications for training targets and methods will be discussed.

• Bringing the Workshop to the Classroom – Mixed Method Training During Graduate School
Sandra Georgescu, Psy.D., The Chicago School of Professional Psychology

Including experiential (workshop like) training alongside traditional didactic approaches in a graduate academic setting comes with the typical advantages associated with experiential training and some contextual/procedural considerations. This paper will present the rationale for and procedure used to integrate theory, research and in vivo experiential practice in a 15 week graduate Advanced Intervention: CBT Group course. Conceptual and methodological issues will be addressed including the ethics of experiential training in academia, feasibility and site-specific challenges. Participants will also be directed to the preliminary (dissertation) outcome data on impact of this mixed method training approach [Spyrka, S., (2013, July). The Effects of Experiential versus Didactic Training on Stigma, Thought Suppression, and Experiential Avoidance in Graduate Students. Poster presented at the Annual ACBS World Conference, Sydney, AU].

Educational Objectives:
1. Assess the relationships between psychological flexibility, relationship flexibility, empathy, and clinician development. 2. Describe useful strategies, obstacles, and potential benefits of conducting a one-semester course on ACT for doctoral students. 3. Articulate three possible areas of consideration for the inclusion of experiential training in an academic setting.

 

81. New Applications using ACT
Symposium (2:45-4:15pm)
Components: Conceptual analysis, Original data, Didactic presentation
Categories: Clin. Interven. & Interests, Theory & Philo., Depression, Christianity and Psychology, Metaphor, Burnout, Stress, Self-Help, On-line Study
Target Audience: Beg., Interm., Adv.
Location: Lake Nokomis

Chair: Suzanne R. Gird Discussant: Ingrid Ord, Private Practice

As research using the Acceptance and Commitment Therapy model is increasing, newer applications emerge rapidly. During this symposium, 3 outcome studies exploring new uses of the model are shared and discussed. The research covers a broad base of applications (brief ACT for depressive symptoms, experiential exercises for Christians, and self-help burnout), and those in attendance will have the opportunity to learn about some of the newer technologies being used in the field.

• The Effectiveness of Brief Acceptance and Commitment Therapy for Clinical Depression
Heidi Maria Kyllönen, M.S., University of Jyväskylä
Piia Astikainen, Ph.D., University of Jyväskylä
Anne Puolakanaho, Ph.D., University of Jyväskylä
Raimo Lappalainen, Ph.D., University of Jyväskylä

Objective: As Acceptance and Commitment Therapy (ACT) is suggested as efficacious treatment for depression, a study to evaluate the impact of brief ACT on clinical depression was made. Methods: 119 depressed individuals were randomly assigned either to treatment or to waitlist control condition (WLC) group. The treatment outcomes were based on criteria for diagnosing depressive conditions by ICD-10 and on the multiple self-report questionnaires. The group differences were analyzed using hierarchical linear modeling with Mplus version 6 (Muthén and Muthén, 2012). Results: The participants in ACT group showed significant improvement in depression and larger changes than WLC, each of p < 0.001. Moreover, the diagnostic manifestation of depression in ACT-group showed favorable course with remission rate of 60.3%. In addition, clinically significant recovering rates using Jacobson methodology indicated 62.1% at post treatment, 60.3% at 6 - and 56.9% at 12 months follow-up. Conclusions: The findings indicate applicableness of brief ACT on clinical depression.

• Making a Way - metaphor and language to provide a way for engagement in ACT therapy by Christians
Grant Dewar, The University of Adelaide

ACT provides an open door to all to take effective action to enrich their lives. However we have seen a recent spate of literature regarding the accessibility of psychology to those with a Christian faith. Much work has been done by Worthington (2010), Johnson et al (2010) and Tan (2011) to open pathways for engagement by individual Christians, Christian leaders, counselors and psychologists in discussing the use of evidence based psychological interventions by Christians. This paper will present a discussion of the use of metaphor and language to provide a way for engagement in ACT therapy by Christians and those who are engaged in providing therapy to Christians. The presentation will discuss the six elements of ACT utilising the richness of Christian metaphorical representations available to teach the psychological skills needed to accept that which is out of our control, get unstuck, be willing to take perspective, get in touch with the here and now, confirm valued approaches to life and take effective action.

• Effectiveness of ACT Self-Help for Burnout: Preliminary Results from an Exclusively Online Randomized Controlled Trial
Andrew Gloster, Ph.D., University of Basel
Patrizia Hofer, B.S., University of Basel
Marina Milidou, University of Basel
Michael Waadt, Private Practice

Burnout symptoms are prevalent, associated with mental health difficulties, as well as decreased job performance and turnover. Several ACT studies targeting work-related burnout have documented positive results. Unfortunately, individual therapy – especially ACT – is not always feasible, available, or accessible. Self-help books may be viable alternatives, either as stepped-care or in their own right. These require rigorous testing, however, before they can be utilized as part of a wider health-care framework. This randomized controlled trial (RCT) aimed to examine the effectiveness of an ACT Self-Help book without any therapist or staff contact by using an exclusively online assessment platform. Uniquely, participants of this RCT were randomized to either: a) immediate treatment via the self-help book (n =64); b) a 6-week delayed treatment, but with weekly assessments about psychological flexibility (n=32); and c) a 6-week delayed treatment, but without any assessments (n=32). Preliminary post-treatment analyses indicate significant and clinically meaningful reductions in burnout symptoms and increases in psychological flexibility. Three-month follow-up results and differential timing of change across groups will be presented. Conditions that facilitate change (e.g., sensitizing participants to change processes via pointed weekly assessments before receiving the self-help book) and public health implications will be discussed.

Educational Objectives:
1. Conduct a semi-structured and videotaped ACT protocol with clients and describe the effectiveness and maintenance of gains following brief ACT for clinical depression. 2. Provide skills in identifying metaphor and language to provide a way for engagement in ACT therapy by Christians and describe Self-Help ACT for Burnout. 3. Explain conditions that facilitate and don't facilitate change and discuss health-care implications of self-help and online assessment.

 

82. For the Love of the Game: Applying the Third-Wave to Sports and Athletics
Symposium (2:45-4:15pm)
Components: Conceptual analysis, Original data
Categories: Performance-enhancing interventions, Sport
Target Audience: Beg., Interm. Location: Cooks Bay

Chair: Emily Leeming, M.A., University of Nevada, Reno
Discussant: Emily Leeming, M.A., University of Nevada, Reno

Behavior science has a long-standing history within sports and athletics. Beyond applications to improve technical proficiency, there is now a growing interest in psychological skills applied to sports. Third-wave behavioral approaches to athletic are a natural fit. Athletes, looking for a competitive edge are coming to recognize the benefits of incorporating psychology into training. This symposium will offer conceptual directions for the integration of contextual behavior science to areas of sports and fitness. Recent empirical investigations will present the applicability of ACT and MAC approaches to competitive and recreational sport. As well, psychological flexibility component analyses on athletic populations will be included in this symposium.

• Evaluation of the Effectiveness of the Mindfulness-Acceptance-Commitment (MAC)
Mitch Plemmons, B.S., Appalachian State University
Joshua Broman-Fulks, Ph.D., Appalachian State University
Kurt Michael, Ph.D., Appalachian State University
James Denniston, Ph.D., Appalachian State University

The Mindfulness-Acceptance-Commitment (MAC) approach is a program designed to enhance sport performance through mindfulness and acceptance-based techniques. Although gaining popularity in the field of applied sport psychology, there is little empirical support behind the MAC approach, with only four case studies, two open trials, and one randomized controlled trial examining its efficacy. Moreover, none of these studies have examined the effectiveness of the MAC approach when applied to recreational athletes. The purpose of the present study was to examine the effects of the MAC approach on recreational golfers. Twenty amateur golfers were randomly assigned to the MAC group intervention or a non-intervention control group. Baseline and post-intervention measures of golf performance and mindfulness were administered. Results indicated that the individuals who underwent the MAC approach improved in golf performance and mindfulness levels over the course of the study, but did not differ significantly from the control group. Several potential explanations for these findings are discussed, as well as directions for future research.

• Psychological coaching of a floorball team with acceptance- and value –based group intervention
Raimo Lappalainen, Department of Psychology, University of Jyväskylä, Finland
Vilhelmiina Välimäki, Department of Psychology, University of Jyväskylä, Finland
Annika Kettunen, Department of Psychology, University of Jyväskylä, Finland
Niilo Konttinen, Kihu - Research Institute for Olympic Sports, Jyväskylä, Finland

Acceptance, mindfulness and value –based approaches provides a useful perspective to sport psychology. On the bases of clinical studies it could be expected that athletic performance enhancement may be achieved by developing a mindful, non-judging, state of mind. These processes in combination with a clarification of valued goals and enhanced attention to external cues may have a positive impact in athletic performance. More studies are needed to investigate the effect of acceptance and value approaches within sports. A women’s Floorball team (n = 25; age m = 23.52; sd = 1.08, floorball experience m = 9.24 years, sd = 0.80) was offered an ACT-based group intervention. Intervention lasted over six weeks (one session/week), and included about 30 experiential exercises adjusted to sports, and home practice. The players were instructed to apply ACT methods both during the training hours and matches. During the training the coaches were instructed to cue the players to use the methods. The effects of the intervention were measured at Pre, Post and at 10 week Follow-up using both questionnaires and observations from the coaches. The players were also interviewed individually after the intervention. Another team playing at the same league was used as a comparison group (n = 25; age m = 19.48; sd = 0.46, floorball experience m = 9.40 years, sd = 0.60). The presentation will describe results and experiences of the project.

• ACT for Athletes: an Randomized controlled trial and the AAQ for hockeyplayers: AAQ-H, a psychometric evaluation
Tobias Lundgren Ph.D., Stockholm University
Emil Jader, Stockholm University

The research interest on acceptance, mindfulness and values based skills training for athletes has been growing during the last 10 years but there is a lack of well-designed outcome studies available in the literature (Gardner & Moore, 2009). The aim of the study presented in this symposium was to develop and evaluate a brief 4-session skills training ACT intervention for hockeyplayers. The study employed a randomized controlled two group design with an ACT group and waitlist control. Outcome measures were goals, assists on ice and an expert group rating of performance. The preliminary results show a significant interaction effect on all outcome measures in favor of the ACT group. Final results and follow up will be presented at the conference. Experiential avoidance and psychological flexibility is at the core of psychopathology and has shown to correlate with behavior effectiveness. In this study the AAQ was adjusted to hockey-players and the psychometric properties of the instruments was evaluated. The preliminary results show that AAQ-H predicts outcomes on ice and has good criterion related validity. Results will be presented at the conference.

• Game On: Towards Prediction and Influence of Mental Toughness
Emily Leeming, M.A., University of Nevada, Reno
Steven C. Hayes, Ph.D., University of Nevada, Reno

“Mental toughness,” is said to be a distinguishing feature between good athletes and great athletic champions but this concept has yet to be studies with scientific rigor in athletics and performance. This symposium paper will discuss how advancements within contextual behavior science, may allow for prediction and influence of behavior identified as “mentally tough.” Athletes were exposed to three kinds of specific statements designed to increase performance during demanding training tasks: two were suggested by traditional sports psychology (a statement to focus on the task and a statement to distract from the high demand), and one suggested by relational frame theory (a statement to focus on willingness to persist in the face of aversive emotions). The willingness statement led to great performance. We are currently conducting a larger trial. Implications and future directions from these time-series investigations will also be discussed.

Educational Objectives:
1. Summarize the MAC approach and will be able to explain its application and effectiveness in enhancing athletic performance. 2. Describe the process used to create psychological flexibility for hockey players. 3. Describe s methodology for comparing components of traditional sport psychology and contextual behavior science in athletics.

 

86. Tools for Clinical and Research Targets in the Areas of Interpersonal Functioning and Intimacy: Concepts and Measures from Functional Analytic Psychotherapy
Symposium (4:30-5:45pm)
Components: Original data
Categories: Clin. Interven. & Interests, Intimacy
Target Audience: Beg.
Location: Lake Calhoun

Chair: Chad T. Wetterneck, Ph.D., Rogers Memorial Hospital
Discussant: Frank Bond, Ph.D., Goldsmiths University of London

While multiple measurement strategies are important to a full contextual behavioral science strategy, most research on psychological flexibility and experiential avoidance has been conducted with the AAQ or AAQ-II, self-report questionnaires that have demonstrated utility across a range of research and clinical settings. Functional Analytic Psychotherapy (FAP) is an idiographic approach located within the contextual behavioral tradition, and often targets intimacy and problems with intimacy as a transdiagnostic functional category relevant to a range of clinical populations. Research on client outcomes in FAP is sparse, and, while the available research is supportive, measurement has not focused on intimate responding specifically. A primary problem is that a relevant, self-report measure of changes in a client’s intimate relating as targeted in FAP has yet to be published. This symposium is designed to present data on three measures with FAP consistent targets and to describe the clinical and research uses for each.

• The Functional Idiographic Assessment Template Questionnaire (FIAT-Q): Data for an Assessment used in Contextual Behavioral Interventions
Glenn M. Callaghan, Ph.D., San Jose State University
Chad T. Wetterneck, Ph.D., Rogers Memorial Hospital
Daniel Maitland, M.A., Western Michigan University
Angela Smith, M.A., University of Houston
Eric Lee, B.A., Houston OCD Program
Throstur Bjorgvinsson, Ph.D., Houston OCD Program & Mclean Hospital

The Functional Idiographic Assessment Template (FIAT) system and questionnaire (FIAT-Q) is a functional assessment of client problem behaviors, provides a nomenclature for those, and suggests behavioral interventions. The system moves away from classic nosology and toward identifying problems using clinical behavior analytic terminology, grounding client problems in psychological principles and providing clinicians a structure to both gather data and guide their interventions in the context of evidence based practice. The FIAT-Q have been translated into different languages, and data on the FIAT-Q have recently begun to come forward. This talk presents both the factor analytic findings and data for the FIAT-Q from several non-clinical and clinical populations. Psychometrics are provided for both the FIAT-Q and a newly developed short form. Strengths and weaknesses of this approach to assessment in the context of contemporary contextual behavioral interventions are discussed with suggestions for where this system might be headed in future iterations.

• Exploring Behavior Analytic Constructs of Intimacy: The Development and Use of the Functional Analytic Psychotherapy Intimacy Scale
Chad T. Wetterneck, Ph.D., Rogers Memorial Hospital
Rachel C. Leonard, Ph.D., Rogers Memorial Hospital
Lindsey Knott, M.A., Houston OCD Program
Sonia Singh, M.A., Houston OCD Program
Eric Lee, B.A., Houston OCD Program
Jonathan W. Kanter, Ph.D., University of Washington

Functional analytic psychotherapy often targets issues with intimacy, defined as behavior exchanges that are vulnerable to interpersonal punishment. Although existing measures examine similar constructs to FAP’s conceptualization of intimacy, the literature lacks a FAP-consistent self-report measure that adequately captures intimacy-related behavior with the capacity to assess behavior change, suggest interventions, and aid in clinical outcome research. The Functional Analytic Psychotherapy Intimacy Scale (FAPIS) was developed for both clinicians and researchers to assess intimacy-related behavior from a behaviorally-based perspective. This talk will present results on the psychometric development in two non-clinical samples and utility of the measure in two clinical samples. The FAPIS is psychometrically sound and provides relevant clinical information about the relationship between psychopathology and intimacy in a number of clinical populations. Future directions for the use of the FAPIS will be discussed.

• Social Connection as a Cross-Diagnostic Contextual Behavioral Treatment Target
Jonathan W. Kanter, Ph.D., University of Washington
Chad. T. Wetterneck, Ph.D., Rogers Memorial Hospital
Gareth Holman, Ph.D., Evidence-Based Practice Institute
Glenn M. Callaghan, Ph.D., San Jose State University
Mavis Tsai, Ph.D., University of Washington
Robert Kohlenberg, Ph.D., University of Washington

In ACT, FAP, and many other treatments, social connection emerges as an important value that drives the work of treatment, establishing important goals as well as a framework for therapeutic action. Social connection, in fact, is empirically established as relevant across the spectrum of depressive, anxiety and personality disorders and as a significant factor with respect to physical health and mortality. We have been developing a model of social connection, and a self-report measure based on this model, using FAP’s framework of awareness, courage, and love as the basis of effective social connection across diverse relational contexts. This talk presents an overview of this model and the measure. Data collection to validate and establish the construct validity of this measure is ongoing and the latest data will be presented, including relations of social connection to psychological flexibility, mindfulness, perspective-taking, self-compassion, loneliness, emotional intelligence, and quality of life.

Educational Objectives:
1. Demonstrate the need to study transdiagnostic interpersonal constructs and how they interact with other clinical variables. 2. Describe the concepts and methods for assessing interpersonal functioning and intimacy from a contextual behavior analytic perspective. 3. Learn to implement and interpret measures of interpersonal functioning and intimacy for clinical and research purposes.

 

87. Using Contextually-Based Approaches for Educational Training
Symposium (4:30-5:45pm)
Components: Conceptual analysis, Literature review, Original data, Didactic presentation
Categories: Edu. settings, Theory & Philo., RFT, Supervision Training, Dissemination, Children with learning disabilities
Target Audience: Beg., Interm., Adv.
Location: Lake Nokomis

Chair: Juha Nieminen, Ph.D., Institute of Behavioural Sciences, University of Helsinki
Discussant: Martin Brock, University of Derby

Using various methods of contextually-based models (Relational Frame Theory and ACT), the researchers examined the efficacy of using these approaches to increase the functionality of children with learning disabilities and graduate students. The authors of the papers will share their findings, and compare and contrast the results. A discussion will follow.

• The Transtheoretical Appeal of ACT in Graduate Psychology Training
Frank Masterpasqua, Ph.D., Institute for Graduate Clinical Psychology, Widener University

Graduate training in clinical psychology has traditionally been divided into schools of thought that rarely share common perspectives on theory or practice, e.g. psychodynamic, CBT, humanistic. Based on five years of teaching ACT in the classroom, as well as using it as a framework for supervision I describe how students from seemingly divergent perspectives readily assimilate ACT philosophy and practice into their practices. I will describe how ACT can provide a common landscape of discourse among these three major schools. For instance, ACT's behavioral and empirical roots appeal to students who aim to practice CBT, and they are willing to consider how contextual science adds to the more traditional cognitive interventions. Psychoanalytic students see commonalities between the psychoanalytic construct of mentalizing and attachment theory and ACT's emphasis on curiosity and present moment awareness. Humanistically oriented students recognize values-motivated behavior and a transcendent sense of self in ACT theory and practice. With these and other examples, I will make the case as to how, as well as being transdiagnostic, ACT can be understood as being transtheoretical.

• RFT based training for learning disabilities: an exploratory study
Margherita Gurrieri, IESCUM, Italy
Melissa Scagnelli, IULM University, Milan, Italy
Davide Carnevali, IULM University, Milan, Italy
Giovambattista Presti, University Kore, Enna, Italy
Paolo Moderato, IULM University, Milan, Italy

Poor outcomes are often observed with trainings in children with learning disorders. Relational Frame Theory (RFT) provides both a theoretical and an applied framework to understand language and other related cognitive repertoires including reading and spelling. 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. We trained dyslexic and dysgraphic kids who were able to tact (D) pictures to match in a frame of coordination printed words in uppercase letters (A) with pictures (B) and pictures (B) with printed words in lower case letters (C). Each stimulus class included three members. So, after testing for the basic mutual and combinatorial entailment relations, we tested also other combinatorial relations namely A-D (reading printed words in uppercase letters), C-D (reading printed words in lowercase letters) and D-A and D-C (choosing uppercase and lowercase printed words conditionally to an auditory stimulus) relations. With an additional training kids were able to write under dictation too (D-E). Correct responses ranged between 95 to 100% in three consecutive testing trials thus demonstrating the formation of a five-member class. Other stimulus control strategies were used to address problems with particular sign-sound relations that are considered critical for Italian speakers and a sign of dyslexia. Pre-post treatment changes in standardized tests for dyslexia demonstrate an overall effect beyond trained stimuli.

Educational Objectives:
1. Describe reactions of graduate students from different perspectives to ACT's theory and practice. 2. Discuss areas of commonality that ACT provides to the three major approaches to psychotherapy. 3. Explain an RFT based interpretation of reading, writing under dictation, copying and writing under self-dictation and understand the strong connection between the basic analysis and the application in the educational and rehabilitation fields, and compare traditional cognitive based models of rehabilitation with a contextual approach.

 

88. Aspects of Adolescents
Symposium (4:30-5:45pm)
Components: Literature review, Original data, Didactic presentation
Categories: Edu. settings, Clin. Interven. & Interests, Prevention & Comm.-Based, Beh. med., Edu. settings, Superv., Train. & Dissem., adolescence, research, mindfulness, avoidance, cognitive fusion, thought suppression
Target Audience: Beg., Interm.
Location: Cooks Bay

Chair: Mary Bell, MSW, Trillium Health Partners
Discussant: Sheri Turrell, Ph.D., Trillium Health Partners, Ontario, Canada

This symposium will examine several studies focusing on the mental health needs of adolescents. The studied shared and discussed include: The correlation between emotional and mood challenges and the core concepts of ACT; components of emotional awareness and social relationships, and an ACT integrated inpatient program.

• The Pearl in the Oyster: An exploratory study about correlations between anxiety, depression, somatization, dissociation and the main ACT concepts in Adolescence
Emanuele Rossi, Private Practice, AISCC
Erika Melchiorri, Private Practice, AISCC

Patrizia Violini, Private Practice, AISCC Nicoletta Ristè, Private Practice, AISCC Elisa Lijoi, Private Practice, AISCC

• What came first - emotional awareness or good relationships? Exploring the connection between emotional awareness and social wellbeing during adolescence
Claire Rowsell, Ph.D. Candidate, Clinical Psychology, University of Wollongong
Joseph Ciarrochi, Ph.D., University of Western Sydney
Frank Deane, Ph.D., Illawarra Institute for Mental Health, University of Wollongong
Patrick Heaven, Ph.D., Australian Catholic University

Emotional awareness is a key component of mindfulness and contact with the present moment. It is also important for mental and physical health, and social wellbeing. Social relationships are important throughout the lifetime, however, they are of particular significance during adolescent development. Therefore, understanding how emotional awareness develops and influences social wellbeing is essential for developing appropriate interventions to improve socio-emotional wellbeing. This presentation will review past and current research on the connection between emotional awareness and social functioning during adolescence and discuss two longitudinal, empirical studies. The first study assesses the link between emotional awareness and peer nominated friendships during high school. The second study examines the relationships between emotional awareness and social support from Grade 9-12. This presentation aims to discuss the current research, interventions and clinical implications.

• Constructing an Interdisciplinary ACT Team: Lessons learned from a 3 year process to build inpatient services for adolescents.
James Hill, OTR/L, Rush University Medical Center

Reflections on a three year effort to establish a fully integrated interdisciplinary ACT based program for an inpatient adolescent behavioral health unit. Presentation will describe stages that include establishing a single ACT based group, advocacy for an interdisciplinary ACT based approach, development of multiple groups, as well as training and supervision efforts to establish and maintain interdisciplinary staff competency. Presentation will include data from patient and parent questionnaires, staff competency measures, and AFQ-Y measures for clients before and after interdisciplinary training.

Educational Objectives:
1. Critique current literature on the association between emotional awareness and social functioning. 2. Discuss two empirical studies and future directions for research and interventions to improve adolescents’ socio-emotional wellbeing. 3. Identify steps involved refining ACT based group interventions.

 

92. ACTive Parenting: Increasing Parental Involvement Using ACT
Symposium (4:45-5:45pm)
Components: Literature review, Original data, Case presentation
Categories: Related FC approaches, Prevention & Comm.-Based, Edu. settings, Theory & Philo., Parenting, Values, Parenting Adolescents
Target Audience: Beg., Interm., Adv.
Location: St. Croix II

Chair: Anne Brassell, University of Vermont
Discussant: Meredith Rayner, Ph.D., Parenting Research Centre and Murdoch Children's Research Insitute

It is well-documented that parental disengagement often results in children with behavioral problems, and lack of school involvement. Two studies focused on using ACT to increase the values and committed action of parents and children, decrease behavioral problems, and increase school engagement. The authors of these two studies will discuss their findings and compare and contrast results.

• Forging Your Compass: How Parenting Impacts Value Development
Kristi A. Mannon, M.S., University of North Texas
Erin K.M. Hogan, B.S., University of North Texas
Teresa C. Hulsey, B.A., University of North Texas
Rawya M. Al-Jabari, M.S., University of North Texas
Amy R. Murrell, Ph.D., University of North Texas

Emerging adults have a unique opportunity to form their identities, develop values, and notice discrepancies between their parents’ values and society (Arnett, 2000; Hauser & Greene, 1991). Previous studies indicate that parents are influential in values development (Simpson, 2001). The current two part study investigated whether parenting style and parent-child relationships influenced ACT–consistent valuing. Findings indicate female, but not male, caregivers’ parenting styles and closeness of the parent-child relationship have significant direct effects on values purity. Authoritarian parenting style (β = -.43 B = -1.70, p < .001), Authoritative parenting style (β = .12, B = .53, p < .001), and Emotional Support (β = .30, B = 6.80, p < .001) significantly predicted the degree to which young adult values are intrinsically chosen. A path analysis and goodness of fit analyses were conducted; results indicated the proposed path model was a good fit [NFI = .996, [χ2 = (2) = 2.58, p > .05]. A significant positive relationship between authoritative parenting style and quality of parent-child relationship (β = .64, B = .10, p < .001) was found with the male caregivers.

• ACT enhanced parenting intervention to promote at-risk adolescents’ school engagement
Larry Dumka, Ph.D., Arizona State University - Sanford School of Social and Family Dynamics

This paper presents ways ACT principles were implemented to strengthen a universal group-based parenting intervention already been shown to be effective (the Bridges to High School program; http://psycnet.apa.org/journals/ccp/80/1/1/) and increase large-scale dissemination. This skills-focused intervention aims to prevent school disengagement and behavioral health problems in middle school age adolescents (11-13 years old) by increasing parents’ capacity to know what’s going on with their adolescent, have effective limits, and stay connected. ACT enhancements were integrated to increase parents’ psychological flexibility in order to optimize skill learning and committed action. These enhancements are described including activities to clarify parenting values, brief mindfulness exercises to increase parents’ present moment attention when communicating with adolescents, and strategies to promote defusion to reduce parent-adolescent conflict. Data and lessons from a recent pilot of the revised program inform effective rationales and delivery methods for mindfulness activities.

Educational Objectives:
1. Describe how parenting impacts value development from an ACT perspective. 2. Utilize clients' parental relationships and learning history to aid in conceptualization of clients who are struggling with value identification and valued living. 3. Describe ACT enhancements to increase effectiveness of parenting interventions that promote adolescents’ school engagements and apply effective rationales and delivery methods for mindfulness activities in parenting interventions.

Saturday, June 21

104. Exposure & Contextually-Based Models and Health: New Approaches
Symposium (10:30am-Noon)
Components: Conceptual analysis, Literature review, Original data
Categories: Clin. Interven. & Interests, Prevention & Comm.-Based, Beh. med., Irritable bowel syndrome, Quality of Life, Headache, Physical activity, adults
Target Audience: Beg., Interm.
Location: St. Croix II

Chair: Amy Houston Discussant: Stanislaw Malicki, University of Social Sciences and Humanities

Many health-related issues are behaviorally based and driven by avoidance, lack of motivation, and problematic behavioral repertoires. The authors of four studies focusing on applying exposure and contextually-based models will discuss their findings. These studies all contribute to our understanding of issues related to health. Specifically, Irritable Bowel Syndrome (IBS), increasing physical activity, decreasing the overuse of medications, and decreasing Body Mass Index (BMI).

• Exposure and acceptance based therapy for irritable bowel syndrome – theory and treatment.
Brjánn Ljótsson, Ph.D., Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
Erik Hedman, Ph.D., Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden

Irritable bowel syndrome (IBS) is associated with impaired quality of life and high societal costs. Although some studies show large treatment effects for psychological treatments such as psychodynamic psychotherapy, hypnotherapy, stress management, biofeedback, relaxation therapy, cognitive therapy, and cognitive behavior therapy, other studies show very little effect. These interventions target different stressors such as difficult interpersonal relationships, maladaptive coping strategies, negative self-schemas, negative appraisals of daily stressors, or general life difficulties. However, recent research suggests that the primary source of stress that causes symptoms is part of the illness itself. IBS-patients have developed hypervigilance towards their own body and react with fear and avoidance in response to naturally occurring gastrointestinal symptoms, which leads to decreased quality of life and increased awareness of symptoms. I will present an exposure and acceptance based therapy for IBS that has been evaluated series of five published studies, with response rates between 59% and 65%.

• Weighing-in on BMI: psychological flexibility and impulsivity
Lauren Ostarello, Eastern Michigan University
Thomas Waltz, Ph.D., Ph.D., Eastern Michigan University
Cory Stanton, Eastern Michigan University
Keith Davis, Eastern Michigan University

There are many factors that may influence an individual’s excessive body mass index (BMI). Previous research has indicated that psychological inflexibility and impulsivity are two behavioral processes relevant to high BMI. Data discussed in this paper were derived from a large sample of college freshmen that agreed to participate in a study pertaining to freshmen life. This paper extends previous analyses of psychological flexibility and BMI using a social barriers-specific AAQ following an inquiry regarding how being uncomfortable with one’s bodily appearance interferes with pursuing social goals and aspirations. In addition, a behavioral economic measures of impulsivity, and relative rates of negative reinforcement (escape and avoidance) will be used to characterize additional behavioral processes than can contribute to high BMI. The discussion will focus on when it makes sense to weigh-in on BMI in terms of psychological flexibility and impulsivity given equifinality concerns with BMI.

• ACT - MOH (Medication Overuse Headache): an observational study
Giuseppe Deledda, Service Clinical Psycology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy
Fabio Marchioretto, Neurology Unit, Sacro Cuore - Don Calabria Hospital, Verona, Italy
Vittoria Pasetti, Service Clinical Psycology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy
Angela Di Canio, Service Clinical Psycology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy
Federica Maccadanza, Service Clinical Psycology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy
Claudio Bianconi, Neurology Unit, Sacro Cuore - Don Calabria Hospital, Verona, Italy

Background: This study explored the psychological variable on patients with MOH (Medication overuse headache),in order to develop a brief intervention ACT based. Methods: Patients were assessed at pre-treatment ACT based (3 sessions during ten day hospitalization) with standardized self-report measures (MIDAS; SCL-90; Distress Thermometer; AAQ-II; VLQ), and 1-year-follow-up. Results: Fifty two patients (mean age = 48.05 years (SD 10.81); 83% female) were recruited. Data showed high mean scores of Migraine Disability (MIDAS mean=97; SD 85.6), a high distress level (M=6.6; SD 2.4) and psychological symptoms (Somatization M=1.55 (SD 0.9); obsessive compulsive symptoms M=1.54 (SD=9.5), Depression M=1.34 (SD 0.84); Anxiety M=1.05 (SD 0.78); Sleep Disorders M=1.33 (SD 0.81)), and a low degree of acceptance (AAQ2 M=43.9; SD 12.6). Male showed higher degree of acceptance (AAQ2 M=52,5; SD 6.86) and lower psychological symptoms. Conclusions: The brief ACT - MOH, is focused on the psychological flexibility through the increase a non-judgmental attitude and willingness to experience unpleasant thoughts, feelings, and physical sensations, and on the control agenda, in order to live in the present consistently with their values.

• Towards a physically active lifestyle based on one´s own values • : The results of a randomized controlled trial among physically inactive adults •
Anu Kangasniemi, LIKES Research center for Sport and Health Sciences, Finland
Lappalainen raimo, University of Jyväskylä, Finland

Objective. This randomized controlled trial aimed to study the effectiveness of a value based intervention to promote a physically more active lifestyle among physically inactive adults. Methods. Physically inactive participants aged 30 to 50 years (n=138) were randomly allocated to a feedback group (FB, n=69) or an Acceptance and Commitment based group (ACT+FB, n=69). Both groups received written feedback of their objectively measured physical activity and were offered a body composition analysis. In addition, the participants in the ACT+FB group attended six group sessions and were given a pedometer for self-monitoring their physical activity during the 9 weeks intervention. The primary outcome was objectively measured physical activity. In addition, participants´ cognitions related to physical activity were evaluated at baseline, 3 and 6 month follow-ups. The changes in physical activity were analyzed in the mean level and rank order stability with multiple-group modeling techniques. Results. Participants in both groups improved their physical activity, thus there was no difference in the changes of physical activity between the groups at 3 and 6 month follow-ups. However, the cognitions related to physical activity improved more in the ACT+FB group compared to the FB group. Also, higher stability in physical activity at the individual level was observed in the ACT+FB group between 3 and 6 month follow-ups among the non-depressive participants. Conclusions. Acceptance and Commitment based intervention was beneficial to support the cognition related to physical activity and brought more stability to the individual level physical activity behaviour change among the non-depressive participants.

Educational Objectives:
1. Describe the mainstream psychological models of IBS and their empirical base in terms of outcome and mechanistic studies. 2. Explain the role of fear and avoidance in IBS and how exposure and acceptance interventions can be used to decrease symptoms and improve quality of life in IBS. 3. Describe the strength of the relationship between BMI and psychological flexibility and impulsivity.

 

108. Multicultural Research within Acceptance and Commitment Therapy
Symposium (10:30am-Noon)
Components: Original data
Categories: Clin. Interven. & Interests, refugees, treatment engagement, mindfulness
Target Audience: Beg., Interm., Adv.
Location: Lake Calhoun

Chair: Beate Ebert, Private Practice in Aschaffenburg, Germany
Discussant: Akihiko Masuda, Ph.D., Georgia State University

Conceptualization of psychological difficulty and intervention has historically been informed by work done primarily among Caucasian samples within Western countries. However, cultural differences may impact relationships among psychological constructs and their effect on psychological wellbeing and dysfunction. The functional contextual emphasis used within Acceptance and Commitment Therapy may be particularly relevant for understanding diverse populations. This symposium provides interested scholars with data on ACT research within a multicultural framework. Our presenters describe predictors of treatment engagement among refugees receiving an ACT informed treatment, wellbeing and psychological flexibility among healthcare workers in Sierra Leone, and psychological flexibility and mindfulness in relation to internalizing difficulties among Asian Americans.

• Reaching a Diverse Refugee Population: Treatment Engagement Among Individuals Receiving ACT Informed Interventions
Olga V. Berkout, M.A., University of Mississippi
Rebecca J. Hamblin, M.A., University of Mississippi
Karen M. Fondacaro, Ph.D., University of Vermont
Valerie Harder, Ph.D., University of Vermont
N. Doran Capuzzi, University of Vermont

Numerous evidence based interventions have been developed to address trauma and psychological distress and wellbeing. A number of individuals are unable to benefit from these due to failing to attend and engage in treatment. Clients may fail to attend therapy sessions for a number of reasons, ranging from severe psychological distress to tangible economic barriers. These challenges may be particularly salient among a refugee population. The current study examines predictors of treatment attendance and unplanned drop out in a diverse sample of refugees from a broad array of countries (e.g. Somali-Bantu, Nepali-Bhutanese, Congolese, etc.). Symptoms of depression, anxiety, and PTSD, as well as income, family size, gender, and feeling connected with community supports will be examined to determine predictors of treatment engagement difficulties. Intervention delivered uses a functional contextual framework based on the ACT approach, along with skills drawn from other evidence based practices as appropriate to client difficulties.

• Applying ACT in Sierra Leone: Examining the impact of ACT training on health professionals
Corinna Stewart, National University of Ireland
Dr. Ross White, University of Glasgow
Beate Ebert, Private Practice in Aschaffenburg, Germany
Iain Mays, University of Glasgow
Jennifer Nardozzi, Private Practice in Miami, Florida
Hannah Bockarie, commit and act, Bo, Sierra Leone

Research has indicated that mental health counseling interventions can be adapted and implemented with positive outcomes across cultures. However, the treatment gap for mental illnesses in low income countries such as Sierra Leone remains considerable. “commit and act” has been working to address this by training local health care workers in ACT. This research examined the impact of ACT training on the psychological flexibility and wellbeing of participants who attended 2-day Beginners and Advanced ACT workshops in Freetown, Bo and Makeni. Considering the traumatic experiences that significant proportions of the population have endured following the recent civil war and the daily struggles with poverty, gender-based violence, etc., it was hypothesized that a significant proportion of individuals attending the ACT training would present with PTSD symptoms and that they would score significantly lower on measures assessing value-consistent behaviour and satisfaction with life and higher on measures of psychological inflexibility.

• The Role of Psychological Inflexibility and Mindfulness in Somatization, Depression, and Anxiety among Non-clinical Asian Americans
Akihiko Masuda, Ph.D., Georgia State University
Erin C. Tully, Ph.D., Georgia State University
Amar Mandavia, B.S., Georgia State University

The present study examined whether psychological inflexibility and mindfulness, two major emotion/behavior regulation processes that have been associated with internalizing problems in general samples and that have particular relevance for Asian Americans, were related to a range of internalizing problems in a non-clinical U. S. Asian American sample. One-hundred-sixteen participants from various Asian nationality backgrounds completed a web-based survey that included the measures of interest. Results revealed that both regulation processes were uniquely and separately related to somatization, depression, and anxiety after controlling for age and gender: Greater psychological inflexibility was associated with greater internalizing problems, and greater mindfulness was associated with lower internalizing problems. Our findings suggest that both psychological inflexibility and mindfulness are useful concepts for understanding psychological adjustment of Asian Americans.

Educational Objectives:
1. Attendants will gain increased understanding of treatment barriers and predictors of engagement among refugees. 2. Attendants will assess the application and effectiveness of ACT in a west African context and consider the difficulties of measuring outcomes following ACT training using western measures and be able to critique these. 3. Attendants will understand how the psychological inflexibility model explains the range of psychological distresses faced Asian Americans.

 

109. Applications of RFT and ACT to Children with Autism and Their Families
Symposium (10:30am-Noon)
Components: Original data
Categories: RFT, Clin. Interven. & Interests, ACT, autism
Target Audience: Interm.
Location: Lake Nokomis

Chair: Angela Persicke, Center for Autism and Related Disorders; Autism Research Group

Autism Spectrum disorders present widespread challenges to children who have them as well as their families. This symposium consists of three papers that address difficulties of children and their parents. One paper presents data from several studies that used an RFT-based approach to teach children with autism to understand nonliteral language. The second paper uses an RFT approach to teaching children with autism to detect what others want when they don't say what they mean. The third paper examines the relationship between experiential avoidance in parents and depression related to child challenging behaviors.

• An RFT Approach to Teaching Children with Autism to Understand Non-Literal Language
Angela Persicke, M.A., BCBA, Center for Autism and Related Disorders; Autism Research Group
Jonathan Tarbox, Ph.D., BCBA-D, Center for Autism and Related Disorders; Autism Research Group
Megan St. Clair, M.A., Center for Autism and Related Disorders; Autism Research Group
Adel Najdowski, Ph.D., BCBA-D, Center for Autism and Related Disorders; Autism Research Group

Children with autism have documented deficits in the ability to understand complex language, especially non-literal language when the intentional meaning of the utterance does not match its literal meaning. This presentation describes three studies in which children with autism were taught to understand non-literal language in the form of sarcasm, deception, and metaphors using RFT-informed procedures. All children included in the studies learned generalized repertoires of responding that were observed across untrained exemplars and in the presence of novel people, including peers. Procedural requirements and results will be discussed in addition to implications for the use of RFT-based procedures for teaching other complex language repertoires to children with autism.

• Just Tell Me What You Really Want: Teaching Children with Autism to Infer What People Want When they Don’t Say it
Adel Najdowski, Ph.D., BCBA-D, Center for Autism and Related Disorders; Autism Research Group
Ryan Bergstrom, M.A., BCBA, Center for Autism and Related Disorders; Autism Research Group
Jonathan Tarbox, Ph.D., BCBA-D, Center for Autism and Related Disorders; Autism Research Group
Megan St. Clair, M.A., Center for Autism and Related Disorders; Autism Research Group

Skinner’s concept of the “disguised mand” is a verbal response wherein the speaker’s mand does not directly describe its reinforcer. Children with autism often have overly literal language, that is, they say what they actually mean, and therefore often have difficulty understanding the disguised mands of others. From an RFT perspective, understanding disguised mands depends on the listener’s ability to relate what is said to what the speaker actually meant, in terms of a relation of distinction. Further, to infer the true meaning of the disguised mand, the listener must relate the mand to its actual meaning in terms of coordination. The purpose of this study was to determine if a treatment package consisting of rules, multiple exemplar training, role playing, and feedback could teach children with autism to detect and respond appropriately to disguised mands. In other words, behavioral teaching procedures were used to teach children with autism to infer what people actually want when they say something different. For example, when a person says, “Mmm, those cookies look good,” what they actually mean is, “Can I have a cookie?” and a socially successful response might be to offer a cookie. Results indicated that the procedures effectively taught participants to detect and respond appropriately to disguised mands. Additionally, generalization was demonstrated to novel, untrained disguised mands and to other people who were not involved in training.

• Topography of autism spectrum disorders and parent dysfunction: The mediational role of parents’ experiential avoidance
Lisa Coyne, Ph.D., Suffolk University
Kirstin Brown Birtwell, M.A., Massachusetts General Hospital/Harvard Medical School

Independent lines of research suggest the importance of child problems and experiential avoidance (EA) in their contributions to poor outcomes (e.g., stress and depression) in parents of children with autism spectrum disorder (ASD). However, researchers have yet to fully explore the relationship between all of these factors at once, providing vital insight into the potential protective factors (i.e., non-EA coping) of parent functioning. Data from 77 parents of children with ASD was collected to evaluate the mediating role of EA in the relationship between child behaviors and parent dysfunction. Results indicated that EA (β = -.40, B = -.75, t = -8.04, p < .00) fully mediated the relationship between child internalizing symptoms (β = .06, B = .06 reduced from .56, t = .49, p = .62) and parental depression. Results will be presented in detail and implications for future clinical and research directions will be discussed.

Educational Objectives:
1. Describe RFT-based procedures related to teaching the understanding of non-literal language and implications for RFT-based approaches to teaching other complex language repertoires. 2. Describe procedures and results of a treatment protocol teaching children with autism to infer and respond to others’ indirect requests. 3. Elucidate contextual factors that are critical to tailoring ACT-based treatment approaches for families raising children with autism.

 

110. The Role of Psychological Flexibility and Its Application to College Students
Symposium (10:30am-Noon)
Components: Conceptual analysis, Original data, Didactic presentation
Categories: Clin. Interven. & Interests, Edu. settings, Theory & Philo., Procrastination, college students, "studyaholism", ACT & psychological flexibility
Target Audience: Beg.
Location: Cooks Bay

Chair: Colin Stromberg, B.A., Utah State University
Discussant: Kate Kellum, Ph.D., University of Mississippi

Many college students interact with their academic work in ways that negatively impact their well-being and/or academic success. Academic procrastination, an irrational tendency to delay in the beginning and/or completion of an academic task (Senécal et al., 2003), is regarded as an interactive dysfunctional avoidance process (Ellis & Knaus, 2002). “Studyaholism” occurs when students engage excessively with academic work at the expense of other meaningful experiences. To evaluate the theoretical basis for applying ACT to procrastination, researchers investigated the relationships between psychological flexibility and its components to academic procrastination. Two pilot clinical intervention studies were conducted to determine the utility of treating academic procrastination with ACT. To understand the function of studyaholsim, an investigation was conducted that examined the relationships of studyaholism to psychological flexibility, mental health, and values motivation. Results contribute to a functional understanding of these extreme forms of academic involvement and efficacy for treating procrastination with ACT.

• Being flexible academically: • The application of the ACT model to the understanding and treatment of procrastination
Frédérick Dionne, Ph.D., Université du Québec à Trois-Rivières
Noémie Carbonneau, Ph.D., Université du Québec à Trois-Rivières
Joel Gagnon, B.A., Université du Québec à Trois-Rivières
Alexandre Marseille, B.A., Université du Québec à Trois-Rivières
Charles Bélanger, B.A., Université du Québec à Trois-Rivières

Academic procrastination is regarded as an interactive dysfunctional avoidance process (Ellis & Knaus, 2002), and thus ACT would appear to be particularly suitable for the prevention and treatment of this self-defeating problem (Ellis & Knaus, 2002). However, to our knowledge, no study has yet used the ACT model to better understand and treat procrastination. This paper has two purposes. First, it presents a study on the relationships between ACT variables and procrastination. The results of this study in a sample of 282 undergraduates show that academic procrastination is negatively and significantly related to three dimensions of psychological flexibility, namely mindfulness, acceptance and action, and cognitive defusion. However, when the three dimensions are considered simultaneously in a regression analysis, mindfulness emerges as the only significant predictor of academic procrastination. Second, this paper presents a pilot clinical study that evaluated the content, feasibility and efficacy of a three-session ACT intervention using the Matrix with procrastinators (N=16). In sum, the ACT model is applicable to understanding and treating procrastination.

• Letting Go of Putting Off: Flexibility-Based Intervention for Procrastination
Ashlyne Mullen, B.S., University of Louisiana, Lafayette
Emily K. Sandoz, Ph.D., University of Louisiana, Lafayette

Ninety-five percent of college students procrastinate (O’Brien, 2002), often leading to poor grades (van Eerde, 2003) and anxiety (Rothblum, Solomon, & Murakami, 1986). People seek to avoid aversive stimuli, therefore the more aversive a situation, the more one will avoid (Steel, 2007). This includes avoidance of a task or situation, and experiences associated with that task. Rather than changing ineffective behavior, many suppress or avoid negative experiences, often resulting in ineffective functioning (Hayes, Luoma, Bond, Masuda, & Lillis, 2006). This process, experiential avoidance, is at the core of the psychological flexibility model and is linked to psychopathology (Hayes & Gifford, 1997). Given that procrastination is an avoidant behavior, applying this model can be a useful treatment method. The current study examines the impact of a flexibility-based intervention on procrastination with college students at risk for failing. Preliminary data suggests that using psychological flexibility techniques decreased procrastination while increasing well-being.

• “Studyaholism” in College Students: The Role of Psychological Flexibility and Values Motivation
Jose Arauz, M.A., Suffolk University
Jacqueline Pistorello, Ph.D., University of Nevada, Reno

Some college students report studying too much, to the exclusion of other activities. Within society as a whole, workaholism has been hypothesized to vary in its effects on the individual, depending on the function of the behavior. The present study sought to explore if “study-aholism,” as the counterpart of workaholism among college students, would vary in its association with mental health depending on the function of the behavior. A total of 690 college students completed questionnaires measuring psychological flexibility, tendency towards studyaholism (adapted from an established workaholism scale), general mental health, and values motivation. Results indicated students scoring higher on a studyaholism scale also a) scored higher on psychological distress and b) scored lower on psychological flexibility. Psychological flexibility, but not value motives, contributed significantly to the association between study-aholism and psychological distress.

Educational Objectives:
1. Apply ACT theory and practice to academic procrastination. 2. Assess the strength of evidence of ACT for procrastination. 3. Describe the relationships of studyalohism to psychological flexibility and how they relate to mental health.

 

116. Acceptance and Commitment Therapy: Compassionate Treatment for Underserved Groups
Symposium (2:45-4:15pm)
Components: Conceptual analysis, Original data, Didactic presentation, Case presentation
Categories: Prevention & Comm.-Based, Performance-enhancing interventions, Underserved Groups
Target Audience: Beg.
Location: Elk Lake

Chair: Victoria Follette, Ph.D., University of Nevada Reno
Discussant: Akihiko Masuda, Georgia State University

While ACT has been used with a range of psychological symptoms and with various populations, there is still a great deal to be learned about working with a range of underserved populations. This work creates some unique challenges in that accessing sufficient numbers of individuals and working with a range of community organizations can present barriers to implementing programs that can be formally assessed. This symposium presents some preliminary data as well as qualitative descriptions of work in the community that can lead to more empirical research. Lappalainen presents some unique data on work with deaf clients. In that language is central to basic tenets of ACT, his discussion of the special needs of delivering the treatment in sign language. Mundy presents some interesting data in working with homeless individuals. He includes infusion of ACT values as not only a method for treating clients but also supporting staff interactions. Finally, Gonzalez will present data from working with Latinas in a primary care setting, with an emphasis on how ACT can be adapted to address special cultural issues. Masuda will comment on the implications of this work and future directions.

• Pilot Implementation of Acceptance and Commitment Therapy in sign language: Training counselors to apply ACT using sign language
Raimo Lappalainen, University of Jyväskylä, Department of Psychology, Finland
Leena Hassinen, University of Jyväskylä, Department of Psychology, Finland

This study evaluated the implementation of Acceptance and Commitment Therapy in sign language in a rehabilitation center for deaf clients. 16 clients and 9 staff members participated in this pilot study. Staff members received a very brief training in Acceptance and Commitment Therapy (ACT) including 16 hours lectures, 15 hours supervision, and study material. Each staff member treated 1-2 clients 8 -10 times. As part of the study several ACT metaphors and exercises were translated into the Finnish sign language. The study indicated that counselors with limited knowledge of psychological interventions were able to deliver an ACT intervention using sign language after a brief training. The intervention was well accepted both by the clients and by the counselors. However, due to problems with the assessment methods translated into the sign language, it was difficult to draw conclusions of the effects of the intervention on clients’ wellbeing. Limitations and experiences of the used approach will also be discussed.

• Utilizing Functional Contextualism in the Implementation of Trauma-Informed Care in Homeless Shelters
Brian Mundy LCSW, Institute of Community Living NYC

The need for trauma-informed care in homeless shelters is clear: roughly 85% of persons who struggle with homelessness have been exposed to severe trauma. Trauma-informed organizations seek to prevent re-traumatization by emphasizing safety and operating on the understanding that traditional service delivery approaches may exacerbate the vulnerabilities of trauma. The implementation of trauma-informed care at two NYC homeless shelters has been aided by a functional contextualist approach. For the past two years the presenter has been partnering and assisting all levels of staff — from security to social workers — with lowering cycles of reactivity through training, organizational support, utilization of present moment awareness, contextualization of relationships in trauma histories, facilitation of staff and client dialog sessions, and the creation of innovative peer involvement programs. Pre and post data on critical incidents demonstrating decreases in frequency and types will be presented.

• Lessons from the front line: Using ACT with a Latino population in a community health care setting
Frances R. Gonzalez, University of Nevada Reno
Victoria Follette, University of Nevada Reno

The Latino population is the largest ethnic group in the United States, and is also the fastest growing (Census, 2010). This community faces many challenges, including low SES, increased barriers to health care and higher rates of both physical and psychological symptomology. The current paper will be examining the results of a needs assessment among a small sample of the Latino community in Northern Nevada. With the results of the study we hope to gain insight on the physical and mental health care needs of this community. Topics addressed will be depression, anxiety, PTSD, psychological flexibility, cultural factors, barriers to care, and physical health disparities (Bridges, Andrews, & Deen, 2012; Ayon et al., 2010). The paper will also address special clinical considerations and adaptations needed to the Acceptance and Commitment Therapy in order to address the needs of the Latino population.

Educational Objectives:
1. List cultural considerations in using ACT in a Latino population. 2. Discuss unique aspects of using ACT in deaf clients where Finnish sign language was used to implement therapy. 3. Describe the use of ACT in a facility for homeless clients. Includes infusion of ACT values as not only a method for treating clients but also supporting staff interactions.

 

117. On Motivation and Activation: Exploring New Self-Report Measures of Values
Symposium (2:45-4:15pm)
Components: Original data
Categories: Clin. Interven. & Interests, Values, Committed Action, Self-Report Measures
Target Audience: Beg., Interm., Adv.
Location: Crystal Lake

Chair: Anke Lehnert, B.S., Southern Illinois University Carbondale
Discussant: Daniel J. Moran, Ph.D., MidAmerican Psychological Institute

Third-wave approaches to therapy emphasize and facilitate values awareness, conviction, and engagement. In spite of the centrality of this component in the psychological flexibility model, few relevant measures are available, and the existing measures have not been well validated as research or clinical tools. Such measures would be indispensable to measuring clinical outcomes as well as mechanisms of action. This symposium explores the content and psychometrics of two new measures of this domain of treatment. The Perceived Life Significance Scale (PLSS) measures an overall sense of purposefulness in life, while the Valued Time and Difficulty Questionnaire (VTDQ) is a derivative of the original Valued Living Questionnaire that assesses committed action. These talks will report on data speaking to the utility of these measures across a variety of populations and their potential for future work in the validation of values-oriented measures.

• Exploring the Psychometrics of a Committed Action Measure with an Undergraduate Sample
Chelsea K. VanderWoude, Southern Illinois University
Katherine Cooper, Southern Illinois University
Chad E. Drake, Ph.D., Southern Illinois University Carbondale

Emerging third-wave behavioral therapies recognize the importance of values-based intervention, but few values measures are available. Wilson, Sandoz, Kitchens, & Roberts (2010) have published on the psychometric properties of the Valued Living Questionnaire (VLQ). Other related measures include the Personal Values Questionnaire-II (PVQ-II), the Survey of Guiding Principles (SGP), and Card Sorting as measures of client values. In addition to lacking robust information regarding psychometrics, these measures do not explicitly assess one’s engagement in values-consistent action. The Valued Time and Difficulty Questionnaire (VTDQ) is a measure of committed action developed for use in clinical contexts. The ten domains assessed by the VTDQ were drawn from the VLQ. This presentation will report psychometric data on this measure with a large sample of undergraduates, including exploration of the factor structure. Reference: Wilson, K. G., Sandoz, E. K., Kitchens, J., & Roberts, M. (2010). The Valued Living Questionnaire: Defining and measuring valued action within a behavioral framework. The Psychological Record, 60(2), 249-272.

• Exploring Cultural Differences in Distress, Experiential Avoidance, and Committed Action.
Sam Kramer, M.A., Southern Illinois University
Lindsay Blankenship, Southern Illinois University
Chad E. Drake, Ph.D., Southern Illinois University
David Dalsky, Ph.D., Kyoto University
Takashi Muto, Ph.D., Doshisha University
Takashi Mitamura, Ph.D., Kyoto-Bunkyo University

Previous research has revealed interesting cultural differences in acceptance-based coping and distress among culturally diverse samples (Cook & Hayes, 2010). The current study sought to investigate cultural differences in reports of distress, avoidance, and committed action among an American and Japanese sample. Additionally, this study sought to examine the psychometric properties of the Valued Time and Difficulty Questionnaire (VTDQ), a measure derived from the Valued Living Questionnaire (Wilson, Sandoz, Kitchens, & Roberts, 2010). Self-reports were administered to 188 American and 223 Japanese university students. Correlational analyses and t-tests were employed to compare and contrast responses to the questionnaires. Results revealed significant differences between the two samples on all measures, with the Japanese sample scoring higher on measures of distress and lower on measures of time spent engaging in valued goals. These results will be discussed in light of possible factors that may drive cultural differences with self-report measures of psychological flexibility. Reference: Cook, D., & Hayes, S. C. (2010). Acceptance-based coping and the psychological adjustment of Asian and Caucasian Americans. International Journal of Behavioral and Consultation Therapy, 6, 186–197.

• The Perceived Life Significance Scale as an Experientially-Based Measure of Valued Living
Rachel Hibberd, Ph.D., Durham VA Medical Center
Kaylin Jones, M.A., University of Missouri - St. Louis
Brian Vandenberg, Ph.D., University of Missouri - St. Louis

A recent literature review identified life significance, or the perception of value attributed to an aspect of life experience, as an important but understudied dimension of "meaning" in the study of trauma and bereavement (Hibberd, 2013). In ACT terms, life significance represents an experiential connection with what's meaningful, as contrasted with definitions of meaning that emphasize the use of verbal relational networks used to "make sense" of one's life experiences. Although originating from a stress and coping perspective, life significance is conceptually and theoretically similar the way that values and valued behavior has been described by the ACT community. This presentation will discuss the utility of a recently-developed measure of life significance, the Perceived Life Significance Scale (PLSS), as a measure of the experiential component of valued living. Research supporting the validity of the PLSS will be briefly discussed, as well as suggestions for future contextual-behavioral research applications of the measure.

Educational Objectives:
1. Describe the three subscales of the Valued Time and Difficulty Questionnaire. 2. Describe the relationship between the three subscales of the VTDQ and measures of psychological distress and experiential avoidance. 3. Describe the development and utility of a novel measure intended to capture the experiential component of valued living: the perception of value associated with daily life experiences, relationships, or activities.

 

121. CANCELLED - Mindfulness and Behavior Change at Work: New directions
Symposium (2:45-4:15pm)
Components: Conceptual analysis, Original data
Categories: Org. Beh. Management, Prof. Dev., Mindfulness
Target Audience: Interm. Location: St. Croix II

Chair: Paul Atkins, Australian National University

This is a collection of papers from the Leadership, Organizations and Public Policy Sig group. The first paper explores the application of a mindfulness program to a university setting to increase wellbeing, work engagement and performance. The second paper extends recent work showing that self-discrimination in natural language predicts well-being 6 and 12 months later (Atkins and Styles, submitted JCBS) by exploring the relationships between self-discriminations and other-discriminations. This qualitative study provides a way of better understanding the quality of relationships within organizations and links to initiatives to increase prosocial behavior. The third study broadens the level of intervention to include not just ACT but effective principles of working in groups based on Ostrom's work. Outcome measures of this intervention study in the intellectual disabilities field include staff retention, inclusion in decision-making, disciplinary, and conflict resolution processes, and other indices of organizational flexibility. Together these studies explore the ways in which traditional approaches to ACT are being adapted and broadened to emphasize identity and group functioning in the workplace.

• Mindfulness Training Enhances Wellbeing, Work Engagement and Performance of University Staff
Paul Atkins, Australian National University

There is increasing interest in mindfulness training as a way of increasing flourishing in life and work. Mindfulness training has been shown to enhance not just wellbeing at work but also attention, decision making, creativity, relationships and work engagement. In this talk I present evidence regarding mindfulness training with over 200 university staff tested before, immediately after and six months after a mindfulness course for changes in wellbeing, work engagement and self-ratings of performance. The talk discusses the unique contextual demands of being either an academic or general staff member of a university, and the ways in which mindfulness appears to moderate the effects of those demands. I will also consider the how the notion of intrinsic motivation to work can be understood from a behavioural perspective.

• Perspective-taking skills and forms of identity predict wellbeing and positive relations at work
Robert Styles, Australian National University
Paul Atkins, Australian National University

The way we construct a sense of self is critical to our experience of the world. We explore the extent to which different forms of perspective taking (deictic framing) expressed in natural language predict wellbeing and positive relations. Previous work based on the idea that self-discrimination is identity demonstrated that wellbeing is predicted by the extent to which individuals know themselves as the context of their experience and are able to coherently utter value oriented self-rules (Atkins & Styles submitted). In this talk, we extend this work with a study of verbal discriminations of others and their impact upon quality of relationships in the workplace. We discuss the predictive nature of self and other discriminative language in use; and, the impact of listening/perspective taking skills. We aim to show that individuals proficient at perspective taking, i.e., deictic framing of one’s own and others behavior, and able to construct value consistent self-rules will experience increased personal wellbeing and vitality in relationships at work.

• Feeding Two Birds with One Seed: Evaluation of a Psychological Flexibility and Group Sustainability Intervention in the Workplace
Thomas G. Szabo, and Adrienne Kessler, Easter Seals Southern California
Heidi Eilers, Easter Seals Southern California
Adrienne Kessler, Easter Seals Southern California

Caregivers, therapists, and other professionals in the intellectual and developmental disabilities field have shown improved behavioral resilience and overall mental health functioning upon completing acceptance and mindfulness interventions (Noone & Hastings, 201/2011; Stafford-Brown & Pakenham, 2012). However, contingencies that favor unhealthy competition for limited resources can undermine this work over time (Sober & Wilson, 1998). Recently, psychologists teamed with evolutionary biologists and economists to generalize a set of group design principles to apply to a wide range of organizations (Wilson, Ostrom, & Coz, 2013). In this study, we will provide psychological flexibility and community design training to clinical and support staff members across seven counties in Southern California. Outcome measures include staff retention, inclusion in decision-making, disciplinary, and conflict resolution processes, and other indices of organizational flexibility.

Educational Objectives:
1. Discuss the application of ACT to the workplace. 2. Generate inquiry regarding links between RFT and other theories of workplace motivation and identity. 3. Describe how ACT is being broadened to adapt to workplace contexts including at the group level.

 

125. Precision Teaching and Contextual Science: Ground Level Applications of RFT to Improve Reading Comprehension
Symposium (2:45-4:15pm)
Components: Conceptual analysis, Original data, Case presentation
Categories: RFT, Edu. settings, Precision Teaching; Reading Comprehension
Target Audience: Beg.
Location: Lake Calhoun

Chair: Kendra Brooks Newsome, Ph.D., Fit Learning, Reno
Discussant: Claudia Drossel, University of Michigan

Reading comprehension is of paramount importance to academic success and is pivotal in the development of other academic skills. Deficits in reading comprehension, therefore, can impact a child’s ability to access an appropriate education. Reading comprehension entails complex language abilities such as prediction, inference, integrating text, and relating what is read to what is known. Thus, language abilities are at the foundation of reading comprehension, and academic abilities more generally. Research efforts aimed at assessing and strengthening language abilities to improve comprehension are sparse, however. This symposium will highlight the importance of a language foundation that is both necessary and sufficient for promoting comprehension. Relational Frame Theory serves as the guiding framework for positioning our discussion and Precision Teaching is the paradigm from which discovery initiatives arise. From this position, sufficient language repertoires require both fluency and flexibility. This data based symposium will discuss the importance of strength in foundational language necessary for relational behavior, will highlight how the RFT framework and Precision Teaching methodology can guide academic interventions for comprehension, and will discuss the relationship between relational repertoires and reading comprehension.

• A Contextualist Lens for Understanding Reading Comprehension
Kendra Brooks Newsome, Ph.D., Fit Learning, Reno
Donny Newsome, Ph.D., Fit Learning, Reno

The Center for National Education Statistics estimates that approximately two thirds of fourth graders struggle with reading comprehension. This statistic is concerning when reading is the primary means through which new information is acquired. Various factors play a role in comprehension. The most widely researched is the relationship between reading fluency and reading comprehension. More recently, the role of vocabulary and a student’s ability to apply comprehension strategies has received attention. Nevertheless, many students fail to improve on comprehension tasks despite strong reading abilities; many students also fail to benefit from strategy and piece-meal vocabulary training. These failures suggest that there are language-based operants that enable comprehension, and RFT provides a framework for inquiry to understand the kinds of languaging necessary. Precision Teaching, a measurement system and instructional technology, offers an approach focused on component-composite repertoires and provides a lens for discovery. This presentation will discuss the limitations of contemporary definitions of comprehension and research, and how integrating Precision Teaching and RFT can illuminate both the necessary and sufficient relational language foundations required for reading comprehension.

• How Curriculum Designers are Putting ‘The Purple Book’ to Work
Donny Newsome, Ph.D., Fit Learning, Reno
Kendra Brooks Newsome, Ph.D., Fit Learning, Reno
Staheli Meyer, Fit Learning, Reno

Comprehension of text is a foundational competency for success in any academic enterprise. The highly coveted ability to read has virtually no functional utility in the absence of comprehending. Luckily for teachers, most students acquire sufficient reading comprehension skills with little direct training. Our focus for the purposes of this presentation, however, is on those students who do not. The sub-set of students with severe comprehension deficits often present overarching language deficits that make common comprehension strategy training intractable, thereby compounding the problem. In the absence of well-established or widely available language enrichment curriculum, a small group of Precision Teachers has turned to Relational Frame Theory for help. Guided by the seminal 'Purple Book', this presentation will discuss and demonstrate a relational language curriculum designed to allay comprehension deficits in students with otherwise strong reading abilities. The goal of this presentation is to give a ground-level view of how RFT-based curriculum has been successfully implemented at Fit Learning in Reno, Nevada. Issues of measurement, instructional methods and prerequisites are discussed.

• Fresh Data and Discoveries: Relational Fluency, Reading Fluency and Reading Comprehension.
Donny Newsome, Ph.D., Fit Learning, Reno
Kendra Brooks Newsome, Ph.D., Fit Learning, Reno
J.J. Billet, Fit Learning, Reno
Staheli Meyer, Fit Learning, Reno

A student’s ability to comprehend what he/she reads is evidenced by effective action with respect to textual stimuli. Common tests of reading comprehension include questions about a reading passage that require the student to summarize and recall explicit details or infer new details beyond those explicitly provided. Although such assessments are a useful indicator of the student’s current comprehension repertoire, they do little to inform targeted interventions. In this data-based presentation, we will demonstrate how the treatment-utility of reading comprehension assessments may be improved via direct measurement of the component skills, such as isolated relational operants or phonemic decoding skills, involved in a broader reading comprehension repertoire. In short, direct observation of critical component skills allows for more efficient and effective interventions. Methods for component skill measurement and learning profile analysis are discussed. Both relational fluency and reading fluency are identified as critical for a functional reading repertoire.

Educational Objectives:
1. Describe contemporary approaches to comprehension, factors influencing comprehension and a contextual behavior science approach to comprehension. 2. Describe how relational frame theory can inform instructional design for reading comprehension. 3. Describe the role that relational flexibility plays in reading comprehension.

 

126. Perspective Taking: A Conceptual Analysis and Applications
Symposium (2:45-4:15pm)
Components: Conceptual analysis, Literature review, Original data
Categories: Theory & Philo., RFT, Perspective Taking, Deictic Relational Responding, Empathy
Target Audience: Interm.
Location: Lake Nokomis

Chair: John O'Neill, M.A., BCBA, Southern Illinois University
Discussant: Timothy M. Weil, University of South Florida

Empathy is the capacity to recognize emotions experienced by another and is promoted by the ability to take the perspective of another person. Connecting with others and understanding their point-of-view is of vital importance in the context of the therapeutic environment. Conceptual analysis of the therapeutic relationship and recent research has informed the Flexible Connectedness Model. Perspective, as viewed from the functional contextual approach, emerges through deictic relational responding. Instructional protocols, exclusively limited to multiple exemplar training of deictic relations, have been developed in an attempt to target the basic underpinnings of perspective taking ability. In addition to the formal introduction of the Flexible Connectedness Model, we present preliminary data on an instructional perspective taking protocol for children with autism, as well as a profile of perspective taking in older adults.

• The Flexible Connectedness Model: A Contextual Behavioral Framework for Effective Human Interaction.
Roger Vilardaga, Ph.D., University of Washington
Steven C. Hayes, Ph.D., University of Nevada, Reno
Michael Levin, Ph.D, Utah State University

Human connection is an inherent part of contextual behavioral interventions such as ACT and FAP. Despite this, the process of connecting effectively with our clients has often not been articulated from a contextual behavioral perspective. We made such an attempt in our previous accounts of empathy (Vilardaga, 2009), the therapeutic relationship (Vilardaga & Hayes, 2011), social anhedonia (Vilardaga, Estevez, Levin and Hayes, 2012) and pathological altruism (Vilardaga & Hayes, 2012). The Flexible Connectedness Model has already shown itself to be a valuable research and applied tool for the analysis of the key features of effective human interaction; and it has clear implications for the analysis and remediation of social deficits in the clinic and in the culture. However, in this symposium we will provide the first formal introduction of this model, and we will present a summary of recent research from our labs and from independent investigators supporting its promise.

• Examining Deictic Relational Responding and Social Skills in Autism.
Samantha Broderick, B.A., University of South Florida
Timothy M. Weil, Ph.D., BCBA-D, University of South Florida

Perspective taking is a pivotal behavioral repertoire essential for social interaction and reciprocity, as well as a hallmark deficit of Autism Spectrum Disorder. Mainstream cognitive developmental literature provides a mechanistic account of ASD known as Theory of Mind. Alternatively, researchers in Relational Frame Theory offer an account of perspective taking as involving deictic relational responding with respect to the self, place, and time. Studies in training deictic responding hold promising implications for individuals with ASD, but to this point have not demonstrated an effect on social interactions, more generally. This paper attempts to 1), present a conceptual/theoretical framework for understanding perspective taking as relational responding, and 2), discuss research examining the effects of multiple exemplar training of deictic frames on social interactions in children with ASD.

• A Profile of Perspective Taking in Older Adults
John O'Neill, M.A., BCBA, Southern Illinois University
Ruth Anne Rehfeldt, Ph.D., BCBA-D, Southern Illinois University

Recent findings suggest that older adults perform more poorly than younger adults on cognitive perspective taking tasks and those deficits may be significantly larger in magnitude as compared with matched control tasks. The evidence suggests that older adults may experience a decline in perspective taking ability over the years and that this particular facet may be measured and targeted for remediation independent of general cognitive functioning. We present preliminary data for a functional contextual profile of perspective taking in older adults with regards to deictic relational responding and suggest some implications for clinical practice.

Educational Objectives:
1. Provide the first formal introduction of the Flexible Connectedness Model and discuss current research supporting the model from our laboratories and from independent investigators. 2. Describe how the functional contextual account of perspective taking differs from previous accounts of perspective taking (i.e. ToM); discuss the conceptualized role of deictic framing in social interactions; implement a training protocol for improving perspective taking in children with high functioning autism. 3. Discuss the existing literature and explain the rationale for developing a profile of perspective taking in older adults. Apply this rationale to the development of an instructional protocol for this underserved population.

 

127. Mindfulness and Self-Compassion within University Settings: Application, Exploration, and Methodology
Symposium (2:45-4:15pm)
Components: Conceptual analysis, Original data, Case presentation
Categories: Edu. settings, Prevention & Comm.-Based, Meditation
Target Audience: Interm.
Location: Cooks Bay

Chair: Matthew Williams, University of Mississippi
Discussant: Maureen Flynn, Ph.D., University of Texas Pan American

In this symposium, we will explore ways in which processes relevant to the psychological flexibility model are or may be used within the university setting. Our first presenter will report on the results of on 8-week mindfulness mediation intervention for 7 college students diagnosed with ADHD. Our second presenter will show results from an exploratory moderation analysis on the relation between self-compassion and committed action (using the new Committed Action Questionnaire; McCracken, 2013). The final speaker will present single-subject regression models for student and faulty meditators in an examination of meditation in daily life. Attendees should benefit by learning about novel applications of meditation within academe and future directions for theory testing and methodology.

• Mindfulness for the Inattentive College Student Soul
Ethan G. Lester, University of North Texas
Daniel S. Steinberg, M.A., University of North Texas
Amy R. Murrell, Ph.D., University of North Texas

Adult Attention Deficit Hyperactivity Disorder (ADHD) presents a significant challenge to college students when concentration and attention skills are vital. These students report experiencing emotion dysregulation, depression, anxiety, and poor academic skills. Previous studies on mindfulness interventions for ADHD have demonstrated significant pre- to post-test improvements in self-reported ADHD symptoms and reductions in depressive and anxiety symptoms (e.g., Zylowska et al. 2008). The present study, conducted with seven college students with ADHD, examined the impact of an 8-week mindfulness intervention on self-reported levels of mindfulness and symptoms of ADHD, depression, anxiety, and stress. Reliable Change Index scores were calculated; 4 of 7 participants had significant improvements in ADHD symptoms from pre-test to post-test assessment. In addition, several other significant changes were evident. Accordingly, mindfulness seems effective for treating college students dealing with ADHD-related difficulties. The limitations of this study and future directions for similar research will be discussed.

• Investigating the Relation Between Self-Compassion and Values-Based Action in a Sample of College Students
Emily Jacobson, B.A., University of Mississippi
Emmie Hebert, B.S., University of Mississippi
A. Solomon Kurz, M.A., University of Mississippi
Kelly G. Wilson, Ph.D., University of Mississippi
Karen Kate Kellum, Ph.D., University of Mississippi

One of the central aims of the Acceptance and Commitment Therapy model is to increase patterns of values-consistent living—to help clients fully engage in behaviors that are consistent with things that matter to them. Those who are psychologically flexible tend to be more willing to engage in this type of valued living. There is also increasing evidence that self-compassion may be a useful construct for predicting healthy living and for targeting in therapeutic settings (Neff, Kirkpatrick, & Rude, 2007). The current study explored the extent to which psychological flexibility and self-compassion predict values-driven behavior in a sample of college students (N= 317). Results indicated that self-compassion significantly predicted committed action, and the relation was moderated by psychological flexibility (p=0.03). We will discuss the utility of self-compassion in predicting values-consistent behavior, and the potential usefulness of teaching self-compassionate behavior in clinical practice.

• Mindfulness Meditation: Daily Diary Methods and the Single Case
A. Solomon Kurz, M.A., University of Mississippi
Karen Kate Kellum, Ph.D., University of Mississippi
Kelly G. Wilson, Ph.D., University of Mississippi

Many group-based studies show mindfulness meditation can be beneficial for alleviating a variety of symptoms for a wide demographic of practitioners. Exciting as some of these data are, they are limited in that group analyses provide “average” results for” average” participants across standardized time periods (e.g., eight-week protocols). Largely missing from this literature are fine-grained idiographic examinations of what daily practice of mindfulness meditation looks like in terms of frequency, duration, and the influence of the practice on practitioner-specific variables. Using the dynamic-P technique (see Molenaar & Nesselroade, 2009), we will present a series of single case analyses of novice and experienced mindfulness meditation practitioners within the university setting. In addition to meditation frequency and duration, we will present variables such as mood, sleep, and social interactions. Analyses will include graphs and single-case regression-based models. We will include a brief discussion of methods as well.

Educational Objectives:
1. Explain mindfulness meditation for ADHD. 2. Discuss the benefits of self-compassion for committed action. 3. Describe the developments with daily diary methods for meditation research.

 

129. Cultural Consideration in Acceptance- and Mindfulness-Based Interventions: A Functional and Contextual Approach to Sociocultural Diversity
Symposium (4:30-5:45pm)
Components: Conceptual analysis, Original data
Categories: Clin. Interven. & Interests, Prevention & Comm.-Based, Cultural consideration
Target Audience: Beg., Interm., Adv.
Location: Elk Lake

Chair: Akihiko Masuda, Ph.D., Georgia State University
Discussant: Jennifer L. Villatte, Ph.D., NIMH Clinical Research Fellow, University of Washington

As acceptance- and mindfulness-based interventions have been applied to a wide range of settings for diverse individuals in recent years, many have become interested in the cultural consideration and cultural adaptation of these interventions. Assembling four experts in cultural competence and diversity, the present symposium addresses some of the key diversity issues, such as whether cultural adaptation is necessary for these interventions when they are applied to individuals from particular sociocultural background, whether their essential concepts and processes, such as acceptance and values, are culturally biased, and how an acceptance- and mindfulness-based intervention is tailored clients from diverse sociocultural contexts. The first presenters are Drs. Drossel and McCausland, who will present cultural adaptation of acceptance and commitment therapy informed by a functional and contextual perspective. Subsequently, Dr. Amy Murrell and colleagues will address religion and spirituality as culturally relevant variables, using clinical examples. Finally, Drs. Fung and Scalcowho will explicate cultural adaptation of ACT for Portuguese-speaking immigrants and Asian clients in Toronto.

• Functional Fidelity and Cultural Competence
Claudia Drossel, Ph.D., University of Michigan Health System Physical Medicine & Rehabilitation Division of Rehabilitation Psychology & Neuropsychology
Claudia McCausland, Ph.D., Memphis Veterans Affairs Medical Center

To promote the culturally competent implementation of treatments grounded in contextual behavioral science across sociocultural and linguistic contexts, we will contrast topographical and functional treatment fidelity, using Acceptance and Commitment Therapy as an example. We briefly will describe the functions of ACT elements and show how their effective replication asks therapists to let go of the topographical agenda, in which manual-based metaphors and exercises are expected to produce predefined outcomes. Functional fidelity relies on an ideographic approach, inherent to contextual behavioral science, that emphasizes genuine interest in and adoption of the client’s frame of reference. We will illustrate functional fidelity and show its inextricable link with cultural competence.

• Religious and Spiritual Concerns in Acceptance- and Mindfulness- Based Intervention
Amy R. Murrell, Ph.D., University of North Texas
Jonathan E. Schmalz, University of North Texas
Aditi Sinha, University of North Texas

As acceptance- and mindfulness-based treatments become increasingly utilized in varied clinical settings, it is important to consider the applicability of these models with diverse client groups. In this talk, the presenter will address religion and spirituality as culturally relevant variables, using clinical examples. The similarities between acceptance- and mindfulness-based psychotherapy and religious and spiritual traditions will also be covered. Finally, I will discuss how to handle difficulties within a functional framework, particularly focusing on ACT, when working with clients who are struggling with religious and/or spiritual issues. In this discussion, data on the development of a measure of flexible religion and spirituality and how to use it for therapeutic assessment will be briefly presented.

• Cultural competent use of ACT in Asian communities and Portuguese-speaking immigrant communities
Kenneth Fung, Department of Psychiatry, University of Toronto
Monica Z. Scalco, Toronto Western Hospital

There is considerable evidence that culture and context influence every aspect of the diagnostic and treatment process, and that language-concordant and culturally competent treatments are more effective than usual care for ethnocultural groups. Additionally, there is growing interest in developing culturally adapted psychotherapies to better meet the needs of immigrants and individuals from diverse sociocutlrual backgrounds. The paper discuss cultural adaptations of ACT and mental health care in general for Portuguese-speaking immigrants and Asian communities in Toronto, considering the cultural values, communication styles, and the socioeconomic and historical context. Dr. Fung will present a cultural competence framework and examine ACT from this perspective, using clinical examples of ACT with several different Asian communities. Dr. Scalco will present and discuss results from an ACT/CBT group at the Portuguese Mental Health and Addictions Clinic, Toronto Western Hospital.

Educational Objectives:
1. Understand functional fidelity in cultural adaption of acceptance and commitment therapy. 2. Discuss at least one way in which religion and spirituality can be functionally addressed in treatment. 3. Describe cultural adaptations to effectively use ACT for Portuguese-speaking immigrants and Asians.

 

130. Impulsive Decision Making: Connecting Behavioral Economics and Contextual Behavior Science
Symposium (4:30-5:45pm)
Components: Literature review, Original data
Categories: Clin. Interven. & Interests, Theory & Philo., Impulsivity, Mindfulness, Acceptance
Target Audience: Beg., Interm., Adv.
Location: Crystal Lake

Chair: Kate L. Morrison, M.S., Utah State University
Discussant: John T. Blackledge, Ph.D., Morehead State University

A robust set of literature has focused on an aspect of impulsive decision making in the field of behavioral economics with human and nonhuman models, referred to as delay discounting. This is the tendency to choose smaller rewards that are more immediate over larger rewards that are more delayed. Higher rates of delay discounting (i.e. more often choosing smaller immediate rewards over larger more distal rewards) is related to various impulsive behaviors: obesity, problematic pornography viewing, problematic gambling, and most prominently substance use. It is indicative of future substance use, relapse, and treatment outcomes. There has been less research on methods to shift discounting rates in order to change the related problem behaviors. This symposium will provide an easy to understand introduction to delay discounting, its relevance to the CBS community, data on its relation with experiential avoidance, and outcomes from both a mindful eating intervention and an acceptance-based intervention targeting delay discounting.

• Understanding the Behavioral Processes Underlying Acceptance and Mindfulness: The Example of Discounting
Thomas J. Waltz, Ph.D., Ph.D., Eastern Michigan University

Life is a series of choices. All other things being equal, organisms tend to choose larger over smaller outcomes. However, “all other things being equal” is seldom the case. Choices typically involve dilemmas: do you order pizza or make a healthy meal? Do you have an uncomfortable conversation with a significant other to repair your relationship, or do you quietly avoid interaction? In both examples a larger outcome (e.g., health, an improved relationship) may be forgone for relatively smaller outcomes that involve greater immediacy, less uncertainty, and less effort. The experimental analysis of this type of choice behavior is a branch of behavioral economics called discounting. This presentation will provide an introduction to discounting and its relevance to “middle level” constructs in ACT such as acceptance, defusion, and mindfulness. In addition to a historical and conceptual overview, data on the relationship between discounting and the AAQ will be presented. Educational Objective: Participants will be able to describe the functional relationships characterized by discounting and apply this analysis to therapeutic situations.

• Effects of Mindful Eating Training on Food and Money Discounting in Obese and Healthy-Weight Adults
Kelsie L. Hendrickson, M.S., Idaho State University
Erin B. Rasmussen, Ph.D., Idaho State University

The present study examined the effects of a mindful eating behavioral strategy on delay and probability discounting patterns for hypothetical food and money. In Session 1, 102 undergraduate participants (n = 73 female) completed computerized delay and probability discounting tasks for food-related and monetary outcomes, along with several self-report questionnaires. In Session 2, they were assigned to participate in a 50-minute workshop on mindful eating or to watch an educational video, and then completed the discounting tasks again. Individuals who participated in the mindful eating session discounted food-related outcomes less steeply compared to their baseline rates, suggesting a more self-controlled and less risk averse pattern of responding after the training. Those in the control condition exhibited discounting patterns that were similar to baseline. There were no changes in discounting for money for either group, suggesting stimulus specificity for the mindful eating condition. This study is the first to show that mindfulness can affect discounting patterns, at least temporarily, for food in a laboratory setting. Educational Objective: To learn about the effect of a mindful eating intervention on delay discounting.

• Altering Impulsive Decision Making with an Acceptance-Based Procedure
Kate L. Morrison, M.S., Utah State University
Gregory J. Madden, Ph.D., Utah State University
Amy L. Odum, Ph.D., Utah State University
Jonathan E. Friedel, M.S., Utah State University
Michael P. Twohig, Ph.D., Utah State University

To the extent that steep delay discounting underlies clinical disorders, it would be advantageous to find psychosocial avenues for reducing delay discounting. Acceptance-based interventions may prove useful as they may help to decrease the distress that arises while waiting for a delayed outcome. The current study was conducted to determine if a 60-90 minute acceptance-based training would change delay discounting rates among 30 undergraduate university students in comparison to a waitlist control. Measures given at pre- and post-training included a hypothetical monetary- delay discounting task, the AAQ-II, and the Distress Tolerance Scale. Those assigned to the Treatment group decreased their discounting of delayed money, but not distress intolerance or psychological inflexibility when compared to the Waitlist Control group. After the waiting period, the control group received the intervention. Combining all participants’ pre- to post-treatment data, the acceptance-based treatment significantly decreased discounting of monetary rewards and increased distress tolerance. The difference in AAQ-II approached significance. Acceptance-based treatments may be a worthwhile option for decreasing delay discounting rates and, consequently, affecting the choices that underlie addiction and other problematic behaviors. Educational objective: To conceptualize delay discounting as an underlying construct of decision making and seeing the utility of altering it with an acceptance-based intervention.

Educational Objectives:
1. Describe the concept of delay discounting. 2. Explain the relevance of delay discounting in the CBS community. 3. Discuss the current research regarding CBS interventions for delay discounting.

 

132. Digging Deep into Relational Frame Theory
Symposium (4:30-5:45pm)
Components: Conceptual analysis, Original data
Categories: RFT, Clin. Interven. & Interests, Related FC approaches, RFT, Experimental research findings, False Memories (DRIFT paradigm), Thought Suppression
Target Audience: Beg., Interm., Adv.
Location: St. Croix II

Chair: Timothy R. Ritzert, B. A., University at Albany
Discussant: Patricia Bach, Ph.D., University of Central Florida

Several studies regarding Relational Frame Theory (RFT) will be discussed. The studies focused on various aspects of RFT including: Transformation of stimulus functions, unidirectional versus bidirectional framing, The Derived Relational Intrusions Following Training (DRIFT), and derived opposite relations. The panel participants were the investigators for the research discussed, and will share their findings and engage in a discussion.

• Derived transformation of functions through hierarchical relational networks: Uni-directional or Bi-directional?
Christopher Wilson, Ph.D., Teesside University
Yvonne Barnes-Holmes, Ph.D, NUI Maynooth

The process of transformation of stimulus functions as been examined extensively in the RFT literature. However, it is only recently that studies have been conducted to examine transformation of functions through hierarchical relations such as containment and belongingness. The few studies to date that have examined this process have found some evidence to support that transformation of stimulus functions does indeed take place in this context. However, some studies have found resultant patterns of framing to be unidirectional (properties transfer only from higher- to lower-order class members), while others have found bi-directional responding (properties transfer either from higher- to lower-order or from lower- to higher-order class members) in nature. The current talk outlines a series of experiments which aimed to examine this process. The results show distinct patterns of bi-directional responding from some participants and unidirectional responding from others. We discuss why this might have occurred.

• An experimental analysis of matching-to-sample and respondent-type training as methods for producing False Memory phenomena.
Luis Jorge Ruiz Sánchez, Universidad de Almería
Carmen Luciano, Ph.D., Universidad de Almería
Paul Guinther, Ph.D., Portland Psychotherapy
Adrián Barbero Rubio, Universidad de Almería

The Derived Relational Intrusions Following Training (DRIFT) paradigm has shown to be an effective procedure to demonstrate the effect of MTS training on False memory phenomena while permitting an exploratory analysis of semantic versus associative (co-occurrence) effects (Guinther & Dougher, 2010). However, this study does not rule out the possibility that stimulus co-occurrence can influence semantic relatedness, associative strength or false memory phenomena. In fact, verbally competent adults can form equivalence relations with respondents-type procedures. The present experiment pretends: a) to explore the influence of co-occurrence effect on the formation of semantic relations and false recalls using a type-respondent training, and b) compare the effectiveness of respondent-type training versus MTS training in formation of false recall. The role of co-occurrence in the formation of false memories and the importance of instructions on subject’s performance are discussed.

• Derived thought suppression: Extending the paradigm
Ian Stewart, National University of Ireland, Galway, Ireland
Nic Hooper, University of Warwick, United Kingdom
Louise McHugh, University College Dublin, Dublin, Ireland

Previous research has demonstrated transfer of thought suppression via equivalence. This study investigated this effect with opposition relations. In Experiment 1 participants were trained and tested for two five-member same and opposite networks. They then had to suppress a target word, from one of the networks, while a number of words appeared on-screen quasi-randomly including the target, and words either in the same (target) or a different (non-target) network. Participants could remove any word by pressing the spacebar. Findings showed more frequent and faster removal of the target than other words, of trained than derived words and of target network words than others. Experiment 2 produced a similar pattern in a network of predominantly ‘opposite’ relations. In both experiments, derived opposite relations produced transfer rather than transformation of suppression functions. Experiment 3 showed this pattern too but also showed that in a non-suppression function context, transformation of functions was displayed.

Educational Objectives:
1. Describe transformation of functions through relational networks and explain some of its applications. 2. Critically discuss the challenges of examining this process empirically. Explore the influence of co-occurrence effect on the formation of semantic relations and false recalls using a type-respondent training; compare the effectiveness of respondent-type training versus MTS training in formation of false recall. 3. List RFT studies that have shown derived thought suppression and describe the latest RFT research on thought suppression, which has shown transfer of thought suppression functions through opposition relations, while showing transformation in a non-suppression context.

 

133. Contextual Behavioral Science at Work
Symposium (4:30-5:45pm)
Components: Original data
Categories: Org. Beh. Management, Performance-enhancing interventions, Perspective taking
Target Audience: Interm.
Location: Lake Calhoun

Chair: Louise McHugh, University College Dublin
Discussant: Daniel J. Moran, Quality Safety Edge

The concept of psychological flexibility emphasizes the need for flexible and varied behaviors (both private and public) that promote effective action in relation to one’s values. Likewise, organizational theorists have long emphasized the importance of flexible organizations, and their ability to adapt across dimensions such as time, range, intention and focus. Very few, however, have discussed the importance of handling, or, indeed, even acknowledging, discomfort in relation to pursuing the aims of an organization. The current symposium comprises of three papers the unifying concern of which is ACT in the workplace. Paper 1 describes how we can scale up the concept of psychological flexibility to the organizational level, thus, producing a contextual behavioral science-informed guide to creating flexible and successful organizations (and employees). Paper 2 is an empirical investigation of the impact of ACT on new graduate law students exit employability. Finally, paper 3 will look present findings from research on the effect of ACT on charismatic behavior in entry level employees in multinational corporations. Taken together the papers provide support for the utility of applying basic knowledge from Contextual Behavioral Science in the workplace.

• Open, Aware and Active: Designing the flexible organisation
Frank Bond, Goldsmiths, University of London

The concept of psychological flexibility emphasises the need for flexible and varied behaviours (both private and public) that promote effective action in relation to one’s values. Likewise, organisational theorists have long emphasised the importance of flexible organisations, and their ability to adapt across dimensions such as time, range, intention and focus. Very few, however, have discussed the importance of handling, or, indeed, even acknowledging, discomfort in relation to pursuing the aims of an organisation. This paper describes how we can scale up the concept of psychological flexibility to the organisational level, thus, producing a contextual behavioural science-informed guide to creating flexible and successful organisations (and employees).

• An empirical investigation of the impact of ACT on new graduate employability
Jonathan Dowling, University College Dublin
Frank Bond, Goldsmith, University College
Aisling Curtin, ACT Now Ireland
Louise McHugh, University College Dublin

Exit employability is the capacity to gain and retain formal employment, or find new employment upon graduation. Research has shown that both economic and psychological factors impact on exit employability. Charisma is one such factor. Charisma is defined as exceptional interpersonal skill that enables someone to inspire others and rapidly engender a deep, magnetic sense of rapport. Recent studies have attempted to enhance charisma through modelling the behaviors of charismatic leaders. This approach is referred to as Charismatic Leadership Tactics Training (CLTT). However, charisma gains from CLTT have been significant but limited relative to controls. One reason for this might be that there are interpersonal skills needed as precursors to charismatic skills. Charismatic interpersonal interaction involves complex psychological processes, such as perspective taking and emotional regulation that difficult thoughts and feelings can easily undermine. Acceptance and Commitment Training (ACT) offers tools that can help leaders navigate those difficult thoughts and emotions so that they can effectively deploy CLTT skills. The Interpersonal impACT project aimed to combine techniques from CCLT and ACT to develop an optimal charisma training package. The current paper presents pilot data on the impact of ACT with undergraduate law students in terms of their exit employability to the big five law firms in Ireland. UG law students were randomly assigned to either an ACT group or a no ACT skills training group. Significantly more UG stuents from the former package were placed in the big five law firms. ACT related gains in general well being also emerged.

• The effect of ACT on charismatic behaviour in entry level employees
Jonathan Dowling, University College Dublin
Frank Bond, Goldsmiths, University of London
Aisling Curtin, Act Now Ireland
Louise McHugh, University College Dublin

Charisma is broadly defined as exceptional interpersonal skill that enables someone to inspire others and rapidly engender a deep, magnetic sense of rapport. Research has identified charisma as a crucial interpersonal competency involved in organisational leadership. Recent studies have attempted to enhance charisma in employees through modelling the behaviours of charismatic leaders. This approach is referred to as Charismatic Leadership Tactics Training (CLTT). However, charisma gains from CLTT have been significant but limited gains relative to controls. One reason for this might be that there are interpersonal skills needed as precursors to charismatic skills. Charismatic interpersonal interaction involves complex psychological processes, such as perspective taking and emotional regulation that difficult thoughts and feelings can easily undermine. Acceptance and Commitment Training (ACT) offers tools that can help leaders navigate those difficult thoughts and emotions so that they can effectively deploy CLTT skills. The Interpersonal impACT project aimed to combine techniques from CCLT and ACT to develop an optimal charisma training package. The present study involved rolling out the interpersonal impACT intervention with entry level employees in order to determine whether the combined training demonstrated high ecological validity by enhancing charisma in organisational populations. Preliminary data analysis suggests increases in charisma, interpersonal communication and job satisfaction for the ACT group from pre intervention to three month follow up.

Educational Objectives:
1. Describe the role and significance of CBS to Organizational Psychology. 2. Learn about new data on ACT and employability of undergraduate students. 3. Learn about new data on the impact of ACT on charisma training.

 

134. Relevance of ACT Processes in Promoting Health Behaviors: Assessment and Intervention
Symposium (4:30-5:45pm)
Components: Original data
Categories: Beh. med., Clin. Interven. & Interests, Prevention & Comm.-Based, Theory & Philo., Health behaviors, physical activity, weight
Target Audience: Interm.
Location: Lake Nokomis

Chair: Robert D. Zettle, Ph.D., Wichita State University
Discussant: Jason Lillis, Ph.D., Brown Alpert Medical School

Among the greatest challenges to the survival and flourishing of the human species are our poor nutrition, lack of physical activity, inadequate sleep, and steadily increasing rates of obesity and weight-related illness. Despite the well-documented physiological and psychological harm caused by these problems, most of us struggle to engage in the healthy behaviors that would prevent or even alleviate our most prevalent and taxing ailments. This collection of presentations seeks to explain the role of processes related to psychological flexibility (e.g., experiential avoidance, defusion, etc.) in health behaviors and weight status. The foci are assessment and description of ACT processes among those with healthy and unhealthy lifestyles, as well as interventions to influence those processes and promote health behaviors. The potential for translation of this work into systems-level intervention and public health initiatives is also discussed.

• Accepting, believing, and striving: Identifying the distinctive psychological flexibility profiles of underweight, overweight, and obese people in a large American sample
Joseph Ciarrochi, Ph.D., Institute of Positive Psychology and Education, Australian Catholic University
Baljinder Sahdra, Ph.D., Institute of Positive Psychology and Education, Australian Catholic University
Sarah Marshall, Ph.D., Institute of Positive Psychology and Education, Australian Catholic University
Philip Parker, Ph.D., Institute of Positive Psychology and Education, Australian Catholic University
Caroline Horwath, Ph.D., University of Otago

Psychological flexibility interventions such as Acceptance and Commitment Therapy have been shown to be beneficial for weight management. Flexibility is often treated as a single, global construct, but it can also be described in terms of interrelated subcomponents (e.g., avoidance, awareness, values). Are some subcomponents of flexibility of greater relevance to weight-related issues than others? We utilized a planned missing data design to administer a large survey to a nationally representative sample of Americans (N = 7884; 3748 males, 4136 females; Age: M = 47.9, SD = 16), and assessed weight status, and global psychological flexibility and its lower order components, including experiential acceptance, emotional awareness, believability of unhelpful thoughts (“fusion”), authentic valuing, and committed action. Profile analyses revealed underweight men show a "defensive but active" pattern, expressing high avoidance on multiple dimensions, high levels of fusion, but also showing high hope and willingness to experience distress when pursuing goals. Overweight men experienced deficits in emotional awareness, but showed no other sign of inflexibility. Amongst women, elements of inflexibility occurred most prominently in the severe obesity category, where there were elevated levels of procrastination and decreases in distress endurance, and diminished levels of self-esteem, hope, and progress in achieving goals. Content analyses of personal strivings indicated that underweight men and women pursued goals focused on making a favourable impression on others, whereas overweight participants pursued goals focused on avoiding something aversive. We conclude that psychological flexibility should not be treated as a unitary construct, and make specific suggestions for future longitudinal and intervention research.

• Development and Validation of the Acceptance and Action Questionnaire for Exercise
Sarah Staats, M. A., Wichita State University

Many obstacles may stand in the way of engaging in recommended levels of physical activity and thus function as health risks. One ostensible psychological barrier to exercise is experiential avoidance (EA). The purpose of this project was to develop and subsequently evaluate the psychometric properties of the Acceptance and Action Questionnaire for Exercise (AAQ-Ex) as a self-report inventory for assessing EA related to physical activity. A series of six studies suggested that the AAQ-Ex is a unidimensional measure that possesses adequate internal and test-retest reliability. Significant relationships with self-reported physical activity frequency provided preliminary support of the questionnaire’s convergent validity; however, it was not as predictive of criterion behavior that was objectively measured. Expected moderate correlations between the AAQ-Ex and measures of global EA, general life satisfaction, body image-related EA, distress tolerance, anxiety sensitivity, neuroticism, and social desirability suggest that the instrument demonstrates sufficient discriminant validity. Preliminary outcomes from a 4-week ACT intervention to promote physical activity within a medically-supervised weight loss program are discussed, and the role of EA as a mediator of health behavior change will also be summarized.

• Building Wellbeing in Diverse Populations: An Examination of ACT for Healthy Living in a Hispanic Sample
Maureen K. Flynn, Ph.D., University of Texas – Pan American
Olga Berkout, M.A., University of Mississippi

A growing body of literature demonstrates that ACT interventions have been beneficial for weight loss and behaviors related to healthy living (e.g., Forman, Butryn, Hoffman, & Herbert, 2009; Goodwin, Forman, Herbert, Butryn, & Ledley, 2012). To date, there are no published studies examining ACT’s effectiveness in this area using a Hispanic sample. Mexican Americans (40.4%) and Hispanics (39.1%) have higher obesity rates compared with non-Hispanic whites (34.3%; Flegal, Carroll, Kit, & Ogden, 2012). This study aimed to contribute to literature by examining the effectiveness of a brief, online ACT-based writing intervention aimed at promoting healthy living related behaviors (i.e., physical activity, eating, and sleep) in a Hispanic sample. Hispanic undergraduates were randomized to receive ACT or a control condition. Participants in the ACT condition completed values, defusion, and committed action writing exercises. Sleep, physical activity, eating behavior, body image satisfaction, and life satisfaction were assessed.

Educational Objectives:
1. Describe the psychological flexibility correlates of different weight categories/sub-populations and identify different ACT interventions for those sub-populations. 2. Assess levels of exercise-related experiential avoidance and explain its role in impeding physical activity. 3. Increase knowledge and understanding of an ACT intervention for healthy living behaviors in a Hispanic sample.

 

135. What's Old is New: Using Matching to Sample Paradigms to Explore Psychological Flexibility
Symposium (4:30-5:45pm)
Components: Conceptual analysis, Literature review, Original data
Categories: RFT, Clin. Interven. & Interests, Match to Sample, Measurement
Target Audience: Beg., Interm., Adv.
Location: Cooks Bay

Chair: Trinity Isaac, University of Louisiana at Lafayette
Discussant: Jonathan Tarbox, Center for Autism and Related Disorders; Autism Research Group

This symposium highlights innovative measurement strategies of core ACT processes. Through a Relational Frame Theory (RFT) lens, the studies attempt to assess the degree to which relational responding is sensitive to various changes in context. The first talk investigates an assumption underlying RFT pertaining to the reinforcing function of coherence, or “making sense.” The remaining talks describe the use of computer-based behavioral tasks designed to measure aspects of psychological flexibility. More specifically, the second presentation discusses the use of a computerized task in detecting cognitive fusion with stimuli related to the self. The third presentation describes the development of a computer-based protocol designed to measure flexible responding in the presence of aversive and appetitive stimuli. Implications for future research will be discussed with an emphasis on further development of behavioral measures of core ACT processes.

• Investigating the Reinforcing Properties of Coherence
Michael Bordieri, University of Mississippi Medical Center
Sean Hughes, National University of Ireland Maynooth
Karen Kate Kellum, University of Mississippi
Kelly G. Wilson, University of Mississippi

For several decades now, Relational Frame Theory (RFT) has unlocked important new insights into a host of complex human behaviors. This account operates from the position that derived stimulus relating is the functional ‘building block’ from which language and cognition spring forth. One of the core assumptions of RFT is that people relate stimuli in ways that “make sense” and that this coherence is (a) an essential component of relating and (b) comes to function as a reinforcer for relational responding in general (Quinones & Hayes, 2014; Wray, Dougher, Hamilton, & Guinther, 2012). The current talk will highlight several recent studies that were designed to assess the relative reinforcing properties of relational coherence. Preliminary findings reveal that coherence functions as a reinforcer for most participants as expected (although a number of key questions remain). We close the talk with a discussion of the basic and applied implications of our findings.

• Fusion with self-referential stimuli: Examining a behavioral measure
Lindsay W. Schnetzer, University of Mississippi
Michael Bordieri, University of Mississippi Medical Center
Karen Kate Kellum, University of Mississippi
Kelly G. Wilson, University of Mississippi

Defusion exercises are designed to disrupt literal interpretation of thoughts so that behavior is more sensitive to direct interaction with one’s environment. Thoughts about oneself, when taken literally, can have a particularly strong influence on behavior. Research has shown decreases in self-reported believability of self-referential stimuli after engaging in defusion exercises. Although demonstrating self-reported changes in believability is an important step in examining defusion interventions, it is worthwhile to develop a behavioral marker that can detect sensitivity to contingencies. Performance on the Matching to Sample (MTS) task can demonstrate whether relating stimuli is disrupted by one’s learning history, making it a potentially useful tool for assessing cognitive fusion. The aim of the current study was to experimentally manipulate the degree to which self-referential stimuli exert control over MTS performance. Results offer preliminary support for using the MTS procedure in this context.

• Seeing is Believing: Behavioral Measure of Psychological Flexibility
Jessica Auzenne, University of Louisiana at Lafayette
Gina Quebedeaux Boullion, University of Louisiana at Lafayette
Emmie Hebert, University of Mississippi
Shelley Greene, University of Louisiana at Lafayette
Michael Bordieri, University of Mississippi Medical Center
Emily Kennison Sandoz, University of Louisiana at Lafayette

The ability to engage in behaviors in service of one’s chosen values in the presence of the accompanying private experiences, or psychological flexibility, is central to psychological health (Kashdan & Rottenberg, 2010). Clinically, the ability to accurately assess this construct becomes important. To date, the only way to determine the status of a person’s psychological flexibility is with self-report measures. However, self-report measures are limited in their ability to always accurately reflect behavior of an individual. This paper will explore a developing computer-based behavioral measure of psychological flexibility based on RFT along with data as to its current validity and utility.

Educational Objectives:
1. Describe the development of and preliminary findings from a task that assesses the relative reinforcing strength of coherence. 2. Describe the development and utility of a behavioral measure designed to detect fusion with self-referential labels. 3. Describe the conceptualization and testing of a new behavioral measure of psychological flexibility, along with its validity and utility.

Sunday, June 22

141. ACTing with Technology: Theory and Practice
Symposium (9:00-10:15am)
Components: Conceptual analysis, Original data, Didactic presentation
Categories: Clin. Interven. & Interests, Prevention & Comm.-Based, Performance-enhancing interventions, Mobile Technology, eHealth, Context-intervention
Target Audience: Beg., Interm., Adv.
Location: Crystal Lake

Chair: Jacqueline Pistorello, Ph.D., University of Nevada
Discussant: Joseph Ciarrochi, Ph.D., University of Western Sydney

Implementing mobile technology in mental health services, using contextual behavioral principles, can serve large groups of people and has the potential to bring about large scale beneficial mental health effects in the population. It is important to understand the possibilities of mobile technology, and how it can be used in treating patients in their natural environments. The theoretical, methodological and analytic implications of these mobile tools will be discussed. Then the focus will be shifted on the practice of ACTing with technology, starting with a technological-enhanced defusion task. Some applications will be described, and the immediate effects of nontechnology and technology-enhanced defusion tasks will be evaluated. Next, a mobile ACT-intervention will be presented, which can help subjects to train with ACT in their natural environment and learn to integrate ACT into their daily lives. The feasibility and effectiveness of this intervention will be evaluated, and future developments will be discussed.

• The promise of mobile technologies and single case designs for the study of individuals in their natural environment.
Roger Vilardaga, Ph.D., University of Washington
Jonathan Bricker, Ph.D., Fred Hutchinson Cancer Research Center
Michael McDonell, Ph.D., University of Washington

Mobile technologies are growing rapidly around the world to broad demographics of society (Smith, 2012). These technologies hold great promise for their integration with Single Case Designs (SCDs) and the study of individuals in their natural environment. This paper discusses the theoretical, methodological and analytic implications of these tools for the advancement of the contextual behavioral etiology of behavioral disorders, and their remediation. We hope this paper will highlight the scientific advantages of combining mobile technologies and SCDs and encourage their adoption among CBS scientists.

• Using mobile technology to test the immediate effect of cognitive defusion in a clinical sample.
Kristy L. Dalrymple, Ph.D., Alpert Medical School of Brown University
Brandon A. Gaudiano, Ph.D., Alpert Medical School of Brown University
Lia Rosenstein, B.A., Alpert Medical School of Brown University
Emily Walsh, B.A, Alpert Medical School of Brown University
Mark Zimmerman, M.D., Alpert Medical School of Brown University

Prior studies on cognitive defusion have found that defusion tasks (e.g., vocal repetition) result in greater reductions in distress and believability towards negative self-referential thoughts relative to thought control or distraction tasks (e.g., Masuda et al., 2009; 2010). This effect also appears in participants with elevated symptoms of depression (Masuda et al., 2010), but few studies have been conducted within clinical samples. Moreover, no known studies have examined the use of mobile technology to enhance the defusion effect; for example, apps exist that electronically alter the voice (e.g., to sound like helium), which may facilitate additional defusion effects. The aim of this study was to test the immediate effects of nontechnology and technology-enhanced defusion tasks compared to a thought distraction task on self-referential negative thoughts in a sample of individuals diagnosed with a depressive disorder. Fifty-eight participants have completed the study thus far, with data collection ongoing. Results, limitations, and implications of the findings will be discussed.

• Mobile technology fostering ACT-practice in daily life.
Tim Batink, Ph.D. Cand., Maastricht University
Marieke Wichers, Ph.D., Maastricht University
Inez Myin-Germeys, Ph.D., Maastricht University
Jim van Os, M.D. Ph.D., Maastricht University

ACT teaches us to deal with our experiences in the present moment, in such a way that we can behave according to our values (Hayes et al, 1999). However, clients do have to get out of their lives and into our therapy-office to learn to work with ACT. Mobile technology can help clients to directly apply beneficial techniques in their natural environment (Heron & Smyth, 2010) and learn to integrate ACT into their daily lives. In this exploratory study, we are examining the feasibility and effectiveness of a mobile ACT-intervention combined with experience sampling (a structured diary method) in a clinical-sample from a mental health center (over 80 participants). The mobile intervention, delivered by the PsyMate (PDA), will be described and preliminary but promising results will be presented. We will conclude with future plans and applications.

Educational Objectives:
1. Provide an overview of recent methodological developments in the analysis of single case design data and their synergy with mobile technology and describe the significance of these methods for contextual behavioral scientists. 2. Describe the effect of a technology-enhanced defusion task on negative self-referential thoughts compared to a nontechnology-based defusion task and thought distraction task. 3. Apply mobile technology in Acceptance and Commitment Therapy, describing feasibility and effectiveness.

 

145. Building Within our World: The Influence Psychological Flexibility has on Well-Being in the Community
Symposium (9:00-10:15am)
Components: Conceptual analysis, Original data
Categories: Prevention & Comm.-Based, Clin. Interven. & Interests, Community
Target Audience: Beg.
Location: St. Croix II

Chair: Shiloh Eastin, University Louisiana at Lafayette

Out in the world, we have the ability to observe how individual’s abilities to adjust to the world around them either help or hinder positive movements in their life. One way to describe an individual’s level of adjustment is in terms of psychological flexibility or the ability to allow painful thoughts and feelings to be present in daily life experience without adverse effects on daily functioning. Flexibility has implications not only for individual well-being, however. Psychological flexibility as individual adjustment has broad reaching implications at the level of the community. The papers in this symposium will explore the impact psychological flexibility has on community well-being. The first paper will examine how psychological flexibility influences bystander efficacy and rape-myth acceptance on a college campus. The second paper investigates a community in the aftermath of a tragedy, looking at the effect different methods of coping have on individual functioning. The third paper considers inflexibility among the previously incarcerated and evaluates inflexibility as a predictor of criminal recidivism. The discussion on this symposium will explore how interventions focusing on psychological flexibility may play a role in the improvement and development of community programs.

• A new perspective: Psychological Flexibility, Attitudes About Sexual Violence, and Bystander Behaviors
Shiloh Eastin, University of Louisiana at Lafayette
Audra Jensen, University of Louisiana at Lafayette
Emily K. Sandoz, Ph.D., University of Louisiana at Lafayette
Amy Brown, Ph.D., University of Louisiana at Lafayette

Recently society has begun to take greater action both in spreading awareness and attempting to prevent violence against women. Sexually assaulted women, in particular stand to benefit from heightened awareness within communities of sexual violence as an issue as sexual violence often is the least discussed. Although awareness of sexual violence has increased significantly over the past years, prevention of sexual violence has not seen a corresponding decrease in occurrence. Recently, colleges have been attempting to educate and empower bystanders to confront the problem of sexual violence. Interventions aimed at bystanders benefit from a larger audience and fewer psychological barriers than interventions aimed at potential perpetrators and victims. Although these programs have promising results, there is limited research in the area. Psychological flexibility, or the ability to notice and respond to constant changes in experience with consistent, effective action towards chosen values, is one variable that has not previously been examined in conjunction with bystander attitudes or behaviors. Students at the University of Louisiana at Lafayette completed a series of questionnaires that assessed the participants’ psychological flexibility, rape myth acceptance, and bystander efficacy over a period of four weeks. Preliminary results suggest that flexibility may have an important role in bystander intervention. The relationships among psychological flexibility, rape myth acceptance, reactions to a hypothetical rape victim, and bystander intervention will be discussed.

• Find Mickey: The Impact of Community Tragedy on Valued and Avoidant Behaviors
Owen Rachal, University of Louisiana at Lafayette
Gina Q Boullion, University of Louisiana at Lafayette
Michelle Jeanis, M.S., University of South Florida
Emily K. Sandoz, Ph.D., University of Louisiana at Lafayette

Over two thousand Americans are reported missing every day. There are currently over 100,000 active missing persons in the United States. Each of these individuals is connected to not only family and friends, but an entire community that stands to be impacted by their disappearance. Currently communities are blind on how to deal with such tragedies in ways that facilitate well-being, strengthen the community, and provide support for family and friends. This study aims to clarify how a community tragedy impacts individual well-being, and how different ways of coping with tragedy might differ in effectiveness. Participants completed a series of questionnaires online that assessed their psychological flexibility, health and well-being, and the impact of the recent missing person tragedy on their lives and behaviors. The impact of the missing person’s case on the individuals of the community of Lafayette, Louisiana will be discussed in this study.

• Straying from the Straight and Narrow: Psychological Inflexibility and Recidivism among Criminal Offenders
Trinity Isaac, University of Louisiana at Lafayette
Russell Anderson, University of Louisiana at lafayette
Madison Gamble, University of Louisiana at Lafayette
Michelle Jeanis, M.S., University of South Florida
Emily K. Sandoz, Ph.D., University of Louisiana at lafayette

Those recently released from incarceration face various difficulties, including trouble finding jobs and being alienated or ostracized by the community. This limits the ability of past offenders to assimilate back into everyday life, and thus, increases chances of reoffending. Psychological flexibility focused models have been shown to be successful in alleviating numerous adverse behaviors and may offer a means of conceptualizing and intervening criminal recidivism, or reoffending, a primary target in correctional settings. The purpose of the current study is to provide an analysis of psychological inflexibility among those who criminally reoffend and psychological flexibility as a predictor of recidivism over a six-month period at the Lafayette Parish Community Corrections facility in Lafayette, Louisiana. Participants who were recently released from incarceration completed a demographic questionnaire and three separate questionnaires measuring psychological inflexibility, cognitive fusion, and likelihood of recidivism. Limitations and implications for further research and application will be discussed.

Educational Objectives:
1. Describe how improvements in psychological flexibility can impact community well-being. 2. Explain the effects of community-wide tragedy on individual functioning. 3. Assess the usefulness and limitations of EMAs (Ecological Momentary Assessments).

 

148. Recent Research on Applications of RFT to Teaching Perspective Taking to Children with Autism
Symposium (9:00-10:15am)
Components: Original data
Categories: RFT, Clin. Interven. & Interests, autism, children
Target Audience: Interm.
Location: Spring Park Bay

Chair: Megan St. Clair, M.A., Center for Autism and Related Disorders; Autism Research Group
Discussant: Emily Sandoz, Ph.D., University of Louisiana at Lafayette

Perspective taking is a socially critical repertoire of behavior, which impacts academic, social, and familial functioning in a variety of ways. Ample research has demonstrated deficits in perspective taking in children with autism, but little previous research has been published on treatments that remediate those deficits. This symposium consists of three RFT-based experiments that taught core perspective taking skills to children with autism. The symposium concludes with a discussion by Dr. Emily Sandoz.

• Improving perspective-taking repertoires in children with high-functioning autism: An RFT-based approach
Thomas G. Szabo, Ph.D., Easter Seals Southern California
Lisa Stedman-Falls, California State University at Northridge
Ashley Jensen, California State University at Northridge
Ellie Kazemi, California State University at Northridge

Perspective-taking is a requisite skill used for understanding the intentions, thoughts, and feelings of others, and it is a widely recognized deficit in children with autism. Until recently, behavior analysts have not directly addressed this deficit. In this study, we combine three behavioral teaching techniques to improve perspective taking in children with high functioning autism. Specifically, multiple exemplar training, direct instruction, and precision teaching are combined to improve emotion recognition and deictic framing repertoires. We measured performance progress in analogue environments, and then measured performance in real world settings. Using a concurrent multiple probe design across participants, this composite training procedure evaluated children’s behavior in both training and naturalistic settings. Results and future research directions will be presented.

• Using RFT to Train Complex Emotion Recognition Skills
Kerry C. Whiteman, M.A., University of Mississippi
Kate Kellum, University of Mississippi
Michael Bordieri, University of Mississippi Medical Center

This study explored a new behavioral intervention based on relational frame theory for training emotion recognition skills in children on the autism spectrum. Previous research on emotion recognition interventions for this population has demonstrated limited generalization of trained skills to novel emotion stimuli. The application of relational frame theory to interventions has been shown to be an efficient and effective way of producing generalized behaviors in both typically developing and developmentally delayed populations. Using a concurrent multiple probe design across participants, this study investigated whether the incorporation of derived relational responding into emotion recognition training for children on the autism spectrum can address some of the limitations of other approaches. Results of the training will be presented, and implications for future development in this area will be explored.

• Establishing a Generalized Repertoire of Predicting the Cause of Others’ Emotions
Angela Persicke, M.A., Center for Autism and Related Disorders; Autism Research Group
Jonathan Tarbox, Ph.D., Center for Autism and Related Disorders; Autism Research Group
Megan St. Clair, M.A., Center for Autism and Related Disorders; Autism Research Group
Adel Najdowski, Ph.D., Center for Autism and Related Disorders; Autism Research Group

Numerous studies on perspective taking have suggested that children with autism are distinctively deficit in understanding that others’ perspectives are different from their own. These studies often suggest that children with autism may be unable to learn to take another’s perspective, but current research in the field of applied behavior analysis suggests otherwise. The current study evaluated a behavioral teaching procedure in one area of perspective taking: inferring and predicting others’ emotions based on met or unmet desires. The procedure included a multicomponent training package using multiple exemplar training across scenarios in which three children with autism were asked to predict how others may feel given a met or unmet desire or non-desire and why others may feel this way. Results were analyzed using a multiple baseline across participants design and suggest that the multiple exemplar training package was effective for teaching the prediction of others’ desire-based emotions and generalization was observed across novel exemplars, people, and settings.

Educational Objectives:
1. Identify two currently suspected component skills of a perspective-taking repertoire and will be able to describe the results of a three-part intervention designed to improve social perspective-taking in children with autism. 2. Describe the preliminary findings from an RFT-based task designed to train complex emotion recognition. 3. Describe RFT-based procedures and results of a multicomponent treatment protocol for teaching the prediction and cause of others’ emotions based on met or unmet desires.

 

149. There's No I on the Road to Graduate School: The Development and Implementation of Undergraduate Research Labs in Contextual Behavioral Science
Symposium (9:00-10:15am)
Components: Conceptual analysis
Categories: Prof. Dev., Edu. settings, Superv., Train. & Dissem., Undergraduate
Target Audience: Beg., Interm., Adv.
Location: Lake Calhoun

Chair: Jade Genga, University of Mississippi
Discussant: Lindsay Martin, M.A., Drexel University

Undergraduate psychology students who are involved in activities outside their classes, such as being a teacher’s assistant or working on research with a professor, report high academic related satisfaction and academic achievement (e.g. Astin, 1993; Strapp & Farr, 2010). This symposium will discuss efforts made by three universities to get undergraduates involved in Contextual Behavioral Science research. The first presentation will include the establishment and future directions of a new undergraduate research lab from the University of Texas Pan American. The second presentation will discuss the workings of a combined undergraduate and graduate lab from the Applied Psychology Master’s program at the University of Louisiana at Lafayette. The third and final presentation will discuss the roles of undergraduate research assistants in the Doctoral Program at the University of Mississippi. Each presentation will also include outcome variables and anecdotal evidence that supports the development of undergraduate CBS research labs.

• Making a New Home: The Ongoing Development of a Contextual Behavioral Science Research Lab in South Texas
Maureen K. Flynn, Ph.D., University of Texas - Pan American

This paper will discuss the following: 1) the establishment and continued development of a brand new contextual behavioral science research lab at the University of Texas – Pan American (UTPA), 2) the role undergraduates play in the lab and how undergraduates add to the lab culture, 3) how undergraduates grow professionally and personally through their lab experience, and 4) practical considerations regarding lab development. Qualitative data related to the current undergraduate lab members and their experience in lab will also be presented.

• Making a Significant Difference: Creating a Context for the Development of Student Researchers in Psychology
Jessica Auzenne, University of Louisiana at Lafayette
Emmie Hebert, University of Mississippi
Emily K. Sandoz, Ph.D., University of Louisiana at Lafayette

For many students pursuing degrees in psychology, research brings high levels of anxiety (e.g. Wise, 1985), contributing to struggles with the very opportunities most likely to increase satisfaction and engagement with their psychology training (Lunneborg & Wilson, 1895; Strapp & Farr, 2010). The Louisiana Contextual Science Research Group (LCSRG) at the University of Louisiana at Lafayette provides a space for undergraduates in psychology to relate to research experiences with their identified values in psychology, while training openness to accompanying thoughts and feelings (e.g., anxiety and anxiety-related thoughts). In other words, the LCSRG aims to build psychological flexibility with research, through doing research on psychological flexibility. Through this functional contextual approach, students are given the opportunity to interact broadly with scientific interest and activities at all levels. Roles of undergraduate students along with other aspects of the group that makes it a beneficial part of undergraduate psychology study will be discussed.

• But Wait! There's More!: The Utility and Efficacy of an Undergraduate Research Lab at Ole Miss
Emmie Hebert, University of Mississippi
Kate Kellum, Ph.D., University of Mississippi
Kelly Wilson, Ph.D., University of Mississippi

Undergraduate students are not guaranteed admission to graduate school in psychology after obtaining their bachelor’s degree. Only about 48% of applicants are accepted into psychology master’s programs and 20% into doctoral programs (Kohout & Wicherski, 2010). These numbers get even smaller when specific fields of psychology are chosen. The Mississippi Center for Contextual Psychology (MCCP) is a research lab designed to enrich undergraduate training with a variety of research experiences to help better prepare these students for graduate school. As research assistants, the undergraduate members of the lab have the opportunity to assist in graduate student research projects, become a teaching assistant for the professors and instructors in the lab, and design and run their own projects for an undergraduate thesis. Structure of the MCCP along with outcome variables of members will be discussed.

Educational Objectives:
1. Describe how undergraduates can participate in research labs and benefit from the experience and identify practical considerations involved in lab development. 2. Assess the utility of the presenters' models for undergraduate participation in research relative to undergraduate experience and outcomes. 3. Utilize ideas and concepts from these discussion in working with undergraduates.

 

150. Disordered Eating: New Findings
Symposium (9:00-10:15am)
Components: Conceptual analysis, Literature review, Original data, Case presentation
Categories: Clin. Interven. & Interests, Theory & Philo., Eating disorder treatment, Disordered eating, Obesity
Target Audience: Beg., Interm., Adv.
Location: Lake Nokomis

Chair: Sarah Potts, Utah State University
Discussant: James Herbert, Ph.D., Drexel University

Momentum for new applications for those contending with disordered eating is growing. The recidivism rate for this group remains astoundingly high, and therefore new technologies are needed. During this symposium, several studies with be shared, discussed and compared. Several methods and constructs will be examined including increasing body image flexibility, Emotion Regulation, ACT and FAP.

• ACT and FAP in the assessment and treatment of a teen client with disordered eating problems
Katia Manduchi PH.D., Iescum, private practice, ACT Italia
Robert Allegri PH.D., Iescum Alumni, private practice
Sara Pezzola Ph.D, iescum alumni, Private practice
Andrea Compiani Ph.D., Iescum alumni, Private practice
Paolo Moderato Ph.D, Ordinary professor, Iescum, Iulm, ACBS, ABA

In this presentation we introduce assessment and treatment of a 16 years old client with a restrictive disordered eating and a BMI of 14. The therapist decided to process the conceptualization and the treatment with the 3rd wave models. The main characteristic of the treatment was working in progress with the therapeutic relationship following the 5 classes of the FIAT q as self observation and using the FAP conceptualization and the hexaflex. In the assessment, at the end of the therapy and in the follow up, were used different measures: the BIAAQ, the self observation of the 5 FIAT q classes and the change in the BMI. Clinically significant improvements where showed in all this areas also in longitudinary follow up. From the single case we can suppose that integrating both models will work even in other cases. Further researches could be an interesting approach for having better results.

• Body image flexibility as a protective factor against disordered eating behavior for women with lower body mass index
Mary L. Hill, M.A., Georgia State University
Akhiko Masuda, Ph.D., Georgia State University
Robert D. Latzman, Ph.D., Georgia State University

The current study examines the relationships among body dissatisfaction, body image flexibility, body mass index (BMI), and disordered eating behavior. The data from two-hundred-fifty-eight female participants who completed the web-based survey will be presented. Body dissatisfaction and body image flexibility were significantly related to disordered eating behavior, and BMI moderated the relation between body image flexibility and disordered eating. For those with low BMI, greater body image flexibility was associated with fewer disordered eating behaviors. Body image flexibility was not associated with disordered eating behavior among those with average or high BMI. These results suggest that greater body image flexibility may serve as a protective factor against disordered eating behaviors for those with lower BMI.

• Does Experiential Avoidance Carry Weight? A Review of Four Studies
Tamara M. Loverich, Ph.D., Eastern Michigan University
Ashley A. Wiedemann, M.S., Eastern Michigan University
Thomas J. Waltz, Ph.D., Ph.D., Eastern Michigan University

It appears obvious that emotional (internally disinhibited) eating is an exemplar of experientially avoidant behavior. As a result, recent research is replete with studies of emotion regulation variables, including experiential avoidance, as predictors, moderators and mediators of high Body Mass Indices (BMI). However, it is unclear if experiential avoidance is the most useful conceptual and empirical tool to utilize in these investigations. This paper brings together data from 4 studies to address the question of relative utility. While experiential avoidance correlated with BMI in each study (r=.08-.27), the strength of relationship varied by sample. Greater within group variability was indicated than that found in previous research. Each study included additional measures of emotion, its regulation, and/or other variables implicated in high BMI. Their added value and implications for eating and excessive behavior research will be discussed.

Educational Objectives:
1. Describe the role of body image flexibility in disordered eating behaviors among women and discuss possible application of body image flexibility in the treatment of disordered eating. 2. Describe the relationship between experiential avoidance and weight-related outcomes and discern the relative value of different ways of measuring experiential avoidance for different research questions. 3. Demonstrate an understanding of the relationship among emotion regulation variables in the context of overweight.

 

151. ACT and…: Blending Functional Contextual Models for Emotion Regulation.
Symposium (9:00-10:15am)
Components: Conceptual analysis, Literature review, Original data
Categories: Clin. Interven. & Interests, Prevention & Comm.-Based, Performance-enhancing interventions, Superv., Train. & Dissem., Theory & Philo., BPD, Nonsuicidal Self-Injury and Mechanism of change
Target Audience: Interm., Adv.
Location: Cooks Bay

Chair: Kristin Whelan, M.A., UCSD Eating Disorders Clinic, Alliant International University
Discussant: Sandra Georgescu, Psy.D., The Chicago School

For years, Dialectical Behavior Therapy (DBT) has been considered the sine qua non for the treatment of emotional dysregulation. Authors of 4 studies which focus on the efficacy of using ACT and DBT along with other functional contextual models (e.g., FAP and Emotion Regulation Group Therapy (ERGT)) for the treatment of emotional dysregulation compare and discuss their findings.

• Emotion Regulation Group Therapy for Nonsuicidal Self-Injury: A Swedish Nationwide Effectiveness Study.
Hanna Sahlin Berg, M.S., Karolinska Institutet
Johan Bjureberg, M.S., Karolinska Institutet
Erik Hedman, Ph.D., Karolinska Institutet
Jussi Jokinen, Associate Professor, Karolinska Institutet
Matthew T Tull, Associate Professor, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center
Kim L Gratz, Associate Professor, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center
Brjánn Ljótsson, Ph.D., Karolinska Institutet
Clara Hellner Gumpert, Karolinska Institutet

Nonsuicidal self-injury (NSSI) is a common and serious global health problem. Emotion Regulation Group Therapy (ERGT) is a 14-week treatment that targets NSSI and its proposed underlying mechanism of emotion dysregulation in women with borderline personality disorder (BPD) and subthreshold BPD features. ERGT has shown promising results in several trials. We will present an ongoing Swedish effectiveness study that evaluates ERGT in a nationwide multi-center within-group study design. The study therapists have different professional backgrounds and have undergone brief intensive training in delivering ERGT. To date, 85 female patients with BPD or subthreshold BPD have been enrolled in the study and started treatment. The primary outcomes of interest are reductions in NSSI on the Deliberate Self-Harm Inventory and improvements in emotion regulation, quality of life, anxiety, and depression. Post-treatment data will be presented for the full sample (N = 95 patients). Dissemination of ERGT will also be discussed.

• Functional Contextualist theory of Borderline Personality Disorder. Implications and challenges for a brief ACT+FAP intervention.
Michel André Reyes Ortega, Ph.D., Mexico Association for Contextual Behavioral Science
María de Lourdes García Anaya, M.D./Ph.D., National Institute of Psychiatry Ramón de la Fuente Muñiz
Angélica Nathalia Vargas Salinas, M.A., Mexico Association for Contextual Behavioral Science
Edgar Miranda Terrés, M.A., National Institute of Psychiatry Ramón de la Fuente Muñiz

Borderline Personality Disorder (BPD) is among the most pervasive behavioral disorders for those who suffer it, their families and public health care systems. As third wave behavioral interventions are among the most effective ones for this disorder, this paper offers a functional contextualist theoretical model of BPD; an empirical review of DBT, ACT and FAP status for its treatment; and a discussion about its principles, and possible integration to enhance brief interventions for this disorder. Finally, a reflection about Mexico interventions for BPD, its challenges and current research lines is shown. BPD clinic at the National Institute of Psychiatry Ramón de la Fuente Muñiz is offered as case study.

• ACT+FAP treatment for Borderline Personality Disorder, description, preliminary data and challenges.
Michel André Reyes Ortega, Ph.D., Mexico Association for Contextual Behavioral Science
Nathalia Vaargas Salinas, M.A., Mexico Association for Contextual Behavioral Science
Edgar Miranda Terrés, National Institute of Psychiatry Ramón de la Fuente Muñiz
Iván Arango de Montis, National Institute of Psychiatry Ramón de la Fuente Muñiz
María de Lourdes García Anaya, M.D./Ph.D., National Institute of Psychiatry Ramón de la Fuente Muñiz

Borderline Personality disorder is a pervasive behavioral disorder for the people who suffer it, their families and the institutions who assume the challenge of its treatment. This paper reviews empirical status of BPD treatments in Mexico and its limitations, describe and intervention consisting of 18 group ACT skills training sessions alternated with 18 ACT+FAP individual sessions, and show preliminary data about its efficacy in a 25 BPD diagnosed group (20 women, 5 men) of the Mexico’s National Institute of Psychiatry in comparison of a group of the same characteristics who received a DBT informed treatment. ACT+FAP group showed better and statistically significant (α=.01) results at posttest and follow up in the Borderline Evaluation of Severity Scale (p=.000), Difficulties in Emotion Regulation Scale (p=.001), Acceptance and Action Questionnaire 2 (p=.01) and the Experience of Self Scale (p=.008). Limitations of the study and challenges of this disorder treatment in México are discussed.

• Emotion Regulation as a Mechanism of Change in the Treatment of Nonsuicidal Self-Injury
Johan Bjureberg, M.S., Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
Hanna Sahlin Berg, M.S., Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
Matthew T. Tull, Associate Professor, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
Kim L. Gratz, Associate Professor, Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA
Erik Hedman, Ph.D., Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
Jussi Jokinen, Associate professor, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
Clara Hellner Gumpert, Department of Clinical Neuroscience, Karolinska Institutet, Sweden
Brjánn Ljótsson, Ph.D., Department of Clinical Neuroscience, Karolinska Institutet, Sweden

Several treatment models emphasize the central role of emotion regulation in the maintenance of nonsuicidal self-injury (NSSI). Emotion Regulation Group Therapy (ERGT) is a 14-week acceptance-based behavioral intervention that aims to reduce NSSI by improving emotion regulation. However, this proposed mechanism of change in ERGT has been insufficiently investigated. To date, 85 patients have enrolled in an ongoing Swedish multi-center effectiveness trial of ERGT for self-injuring women. Although this study does not include a control group, NSSI frequency and emotion regulation are measured weekly throughout treatment, which allows for statistical modeling of mediational effects. Findings that the effect of treatment on NSSI frequency is mediated by changes in emotion regulation and changes in emotion regulation precede changes in NSSI frequency would support the proposed causal mechanism. Data collection will be completed in May, 2014. Results of these mediational analyses will be presented for the full sample (N=95) of participants.

Educational Objectives:
1. Describe and utilize the model of dissemination we will present, as an emotion regulation group treatment became a Swedish multi-center effectiveness trial. 2. Discuss the findings of ERGT in Sweden and the cultural impact on emotion regulation and NSSI. The learner will be able to analyze BPD cases from a contextual behavioral approach, discuss empirical status of current models, apply its basic principles on a theoretically consistent way, and critique brief psychotherapeutic interventions for this disorder. 3. Describe BPD characteristics from a functional contextualistic approach, explain ACT and FAP benefits for this disorder, compare and asses treatments for this disorder elements, and critique clinical research design used in this study.

 

153. Mind Full or Mindful?: Exploring and Facilitating Mindfulness and Present Moment Processes
Symposium (10:30am-Noon)
Components: Conceptual analysis, Original data
Categories: Clin. Interven. & Interests, Edu. settings, Theory & Philo., Mindfulness, Values, Present Moment
Target Audience: Beg., Interm., Adv.
Location: Crystal Lake

Chair: Emily Allen, University of Louisiana at Lafayette
Discussant: Dennis Tirch, Ph.D., The Center For Mindfulness & Compassion Focused Therapy

Mindfulness is generally defined as the non-judgmental attentive awareness of the present moment. This awareness of the present moment results in significant improvements to both mental and physical well-being, even in small doses. Though mindfulness has its roots in ancient spiritual traditions, it has a number of empirically-supported applications in modern behavior therapy and everyday life. The development of assessment and intervention methodologies, however, remains in early stages. The papers in this symposium aim to contribute to the body of knowledge on mindfulness by exploring the shared perception of mindfulness, the impact of mindfulness for effective communication, and the relationship between engaging in the present moment and pursuing values. The first presentation will explore several models of mindfulness and implications for future research and application. The second paper will discuss the identification of present moment behaviors. The final paper will discuss the relationship between engaging in the present moment and valued living.

• The Practice of Presence: Mindfulness Meanings, Methods and Models
Owen Rachal, University of Louisiana at Lafayette
Emily K. Sandoz, Ph.D., University of Louisiana at Lafayette
Jada Horton, University of Louisiana at Lafayette

Mindfulness and mindfulness training have experienced a groundswell of scientific and lay interest during the last three decades that continues to grow. Significant research has already shown many valuable benefits stemming from increased mindfulness and the development of a mindfulness practice, but much work remains unfinished. Researchers are now actively developing models that capture the psychological and neurophysiological mechanisms involved in attaining and sustaining states of mindfulness, as well as explaining the associated benefits for practitioners. With increased understanding of these processes, therapeutic approaches that depend upon mindfulness-based interventions - including many of the third-wave behavioral therapies - can be further refined to increase efficacy and efficiency in alleviating unnecessary suffering while improving an individual's capacity for autonomy and valued living. This presentation will review possible meanings of “mindfulness” and a selection of conceptual models, discuss possible avenues of research and highlight some theoretical implications for clinicians and clients alike.

• Sharing More Than Presents: The Identification of Present Moment Behaviors and the Impact of Shared Presence on Communication
Ryan Albarado, University of Louisiana at Lafayette
Stephanie Caldas, University of Louisiana at Lafayette
Ashlyne Mullen, University of Louisiana at Lafayette
Nick Mollere, University of Louisiana at Lafayette
Emily K. Sandoz, University of Louisiana at Lafayette

Despite an extensive literature on the benefits of engaging in the present moment, clear, publicly observable signs indicating that someone is present have not been substantiated. In the context of public speaking, being present might allow for increased sensitivity to audience feedback, overall better presenting, and the facilitation of audience engagement. The studies discussed in this presentation aim to identify if agreement exists among untrained raters in the identification of present moment behaviors of subjects in videos and to investigate how present moment processes contribute to effective communication in the context of public speaking. Preliminary data suggests that untrained raters are quite capable of identifying behaviors as indicative of presence with a high degree of consistency between raters. Additionally, speaker and audience convergence of present moment ratings, as well as shared presence, predicts communication effectiveness in public speaking. Implications for future research, intervention development, and further application will be discussed.

• You Can’t Fly Without Wings: The Relationship between Present Moment and Valued Living
Emily Allen, University of Louisiana at Lafayette
Ashlyne Mullen, University of Louisiana at Lafayette
Emily K. Sandoz, University of Louisiana at Lafayette

From an ACT perspective, engaging in valued living requires one to be present and aware of their environment. Values have been described, from a behavioral perspective, as “freely chosen, verbally constructed consequences of ongoing, dynamic, evolving patterns of activity, which establish predominant reinforcers for that activity that are intrinsic in engagement in the valued behavioral pattern itself" (DuFrene & Wilson, 2006). Emerging research from a variety of disciplines supports the psychological benefits of being in contact with one’s values. The current study examines the relationship between contacting the present moment and engaging in valued living through an Ecological Momentary Assessment (EMA). This method uses text messages to take repeated self-reports of multiple behaviors over the period of time in which the researcher is interested. Pilot data indicates that there is a positive correlation between these two ACT components, supporting the notion that valued living and present moment are interconnected.

Educational Objectives:
1. Explore proposed meanings, theoretical models, and development methods of mindfulness. 2. Identify present moment behaviors and discuss the impact of shared presence on communication. 3. Understand the relationship between engaging in the present moment and the pursuit valued living.

 

155. The Integrative Contribution of Functional Analytic Psychotherapy
Symposium (10:30am-Noon)
Components: Conceptual analysis, Didactic presentation, Case presentation
Categories: Clin. Interven. & Interests, Performance-enhancing interventions, treatment integration
Target Audience: Interm.
Location: St. Croix II

Chair: Luc Vandenberghe, Ph.D., Pontifical Catholic University of Goias - Brazil
Discussant: Jonathan W. Kanter, University of Wisconsin-Milwaukee

This symposium discusses how Functional Analytic Psychotherapy (FAP) can help different treatments work, contributing to the curative potential of a variety of clinical modalities. Several experiences are presented to argue this point. FAP is shown to bring a relevant contribution to IBCT based groups for heterosexual and LGBT couples. The integration of FAP as a clinical approach to the ACT model of depression is discussed in a case study. And finally, a form of FAP enhanced group therapy for depression is presented, as it has been developed during the past decade in a Central Brazilian community setting. Bringing these three papers together, illustrates the potential for FAP principles to be used in a variety of settings and treatment modalities and the benefits the introduction of FAP can bring to these settings and treatment modalities.

• Functional Analytic Psychotherapy enhanced Integrative Behavioral Couples Therapy.
Jaimie Lusk, University of Denver
Margaret McKelvie PH.D., Private Practice, Denver, VA

Fifty percent of marriages end in divorce and relationship dissolution among LGBT populations is thought to be more frequent. Due to fear of judgment, people often remain quiet, if not isolated in their relationship distress, especially if they belong to a sexual minority. Functional Analytic Psychotherapy (FAP) provides a framework to conceptualize and shape effective interpersonal relating. Building upon Integrative Behavioral Couple Therapy (IBCT), presenters developed, delivered and evaluated a brief FAP enhanced group treatment for couple distress in a VA setting with both heterosexual and LGBT couple cohorts. The aims of the group were to increase partners' connection, and decrease perceived isolation as well as interpersonal risk avoidance. Presenters will share program evaluation data of a couples' group which included inter/intrapersonal mindfulness, experiential teaching of behavioral principles, and in vivo shaping of intimacy enhancing behaviors. Results suggest FAP enhanced couple therapy groups are a promising area for future study.

• The effectiveness of the integration of ACT and Fap in the treatment for depression: a case studyKat
Katia Manduchi Ph.D., Private Practice; Affiliated with Iescum
Robert Allegri Ph.D., Private Practice; Affiliated Iescum alumni
Sara Pezzola Ph.D., Private Practice; Affiliated Iescum alumni
Andrea Compiani, Private Practice; Affiliated Iescum alumni
Paulo Moderato Ph.D., Affiliated IULM, Iescum

Presenting a clinical case starting from the ACT model for depression (Zettle 2007), the authors integrated ACT and FAP (Kohlenberg & Tsai 1980) models.The initial assessment was done following CBT traditional measures(as BDI2, BAI) then AAQ2, VLQ and a self measurement of the 5 classes of FIAT-q. Finishing the therapy, made for the 80% on Skype, and 20% in vivo, because the client for her work was moving around in Italy, the results in the re-test showed significant improvements in: intensity of depression and anxiety, relational skills, discriminative skills and self observation. The observations in this case can be seen also in other clients: could be interesting having a larger number of clients to observe the efficacy of both models.

• Functional Analytic Group Therapy for depression in a Latin American Community Setting.
Luc Vandenberghe, Ph.D., Pontifícia Universidade Católica de Goiás

This paper describes how FAP principles have been used to promote therapeutic change in groups for depression in a Central Brazilian community setting. It describes how the group dynamics bring real life challenges and in-vivo learning opportunities into the therapy room. It further explains how functional analysis can help harness what happens in the group for therapeutic change. Examples drawn on material from a series of therapy groups for women suffering from depression show how FAP principles afford emotional depth and offer leverage for in-vivo interventions by the therapist. In conclusion, it discusses how functional analysis is used in helping clients connect to their interpersonal process, how it can be used help the therapist connect to the client’s experience and to enhance culture sensitivity.

Educational Objectives:
1. Share development and program evaluation of a FAP enhanced IBCT couples group intervention implemented at both the VA and in private practice. 2. Discuss the integration of FAP and ACT for the treatment of depression. 3. Describe the rationale and the clinical strategies developed in a Latin American community setting, using FAP principles in group therapy for depression.

 

156. OCD and Similar Disorders: Evaluating Theoretical and Empirical Support for the Use of ACT
Symposium (10:30am-Noon)
Components: Conceptual analysis, Original data, Didactic presentation, Case presentation
Categories: Clin. Interven. & Interests, Theory & Philo., OCD, processes of change, trichotillomania, adolescents, misophonia
Target Audience: Beg., Interm.
Location: Spring Park Bay

Chair: Colin Stromberg, B.A., Utah State University
Discussant: Jeff Szymanski, Ph.D., International OCD Foundation

Research supports the efficacy of Acceptance and Commitment Therapy (ACT) for the treatment of obsessive compulsive disorder (OCD); however data on mechanisms of change, quality of life, and OCD related disorders are lacking. A correlational study investigated how cognitive fusion and emotional suppression is related to OCD severity and quality of life. A case study explored the application of ACT for a person with misophonia, a disorder characterized by a hatred of sounds. In a small randomized trial, nine adolescents with trichotillomania were treated with ACT. Collectively, these studies provide evidence on the relevance of ACT processes to the treatment of OCD, explore the clinical implementation of ACT for people and disorders that are not well researched, and contribute to the evidence base supporting the efficacy of ACT for these disorders.

• The Role of Cognitive Fusion and Emotion Suppression • in Obsessive-Compulsive Disorder
Marie-Christine André, M.A., McLean Hospital, OCD Institute; & Suffolk University
Brittany Mathes, B.A., McLean Hospital, OCD Institute
Jesse Crosby, Ph.D., McLean Hospital, OCD Institute; & Harvard Medical School
Jason Elias, Ph.D., McLean Hospital, OCD Institute; & Harvard Medical School

Cognitive fusion and emotion suppression are hypothesized as crucial in maintaining psychopathology. Yet, research examining how specific obsessive beliefs, such as importance and control of thoughts (i.e., cognitive fusion) and avoidant strategies (i.e., emotion suppression) impact symptomatology and quality of life in Obsessive Compulsive Disorder (OCD) is limited. This study investigated the impact of importance of thoughts and emotion suppression on quality of life and OCD symptomatology. The sample consisted of OCD patients from a residential treatment facility who completed the Obsessive Beliefs Questionnaire, the Emotion Regulation Questionnaire, the Yale- Brown Obsessive Compulsive Scale, and the Work and Social Adjustment Scale. Results demonstrated that though importance and control of thoughts and emotion suppression accounted for 20% of the variance in OCD severity (R square change= .20), both processes accounted for 36% of the variance in quality of life (R square change= .36). Additional results, implications, and limitations will be discussed.

• Acceptance and Commitment Therapy as a Treatment for Misophonia in an Adult Female
R. Trent Codd, III, Ed.S., Cognitive-Behavioral Therapy Center of WNC, P.A.
Kate L. Morrison, M.S., Utah State University
Michael P. Twohig, Ph.D., Utah State University

Misophonia is a pattern of symptoms that is commonly confused with OCD. Individuals with misophonia experience high levels of anger and disgust in response to repetitive auditory stimuli (e.g., heavy breathing). These aversive sounds trigger impulsive urges to act aggressively toward the source of the sound (e.g., yelling) and/or avoid the source of the sound (e.g., eating meals with others). Treatments for misophonia are sparse and using ACT may increase quality of life when faced with aversive auditory stimuli. This presentation will present data from a case of individual therapy sessions using acceptance and commitment therapy for an adult female with misophonia. Measures of general functioning and life quality, emotional tolerance and acceptance, and misophonia, anxiety, depression, and anger were given at pretreatment and will be given at posttreatment and at a 3-month follow-up. The level of frustration experienced from sounds and the percentage of time spent avoiding or escaping sounds throughout each week is being tracking at each weekly session.

• Acceptance and Commitment Therapy for Adolescent Trichotillomania
Kendra Homan, M.A., Utah State University
Kate L. Morrison, M.S., Utah State University
Jesse Crosby, Ph.D., McLean Hospital, OCD Institute; & Harvard Medical School
Michael P. Twohig, Ph.D., Utah State University

Extant literature reveals that treatments for adolescent Trichotillomania (TTM) are vastly understudied. While the most supported psychosocial intervention for adolescent TTM is effective, cognitive behavior therapy involving habit reversal is not effective for a significant number of individuals. Additionally, the development of treatments for adolescent TTM is lagging behind the treatment of adult TTM which is expanding in multiple directions and testing a variety of likely effective treatment options including acceptance-based treatments. Acceptance and Commitment Therapy (ACT) is a promising option and has limited support when combined with behavior therapy for adolescent TTM, however, no study has examined the effectiveness of ACT alone for treating TTM. The purpose of this presentation is to present data on the ACT for adolescent TTM. Nine adolescents (M=13.3, SD=1.73) with TTM completed 10 sessions of ACT. While analyses are ongoing, preliminary analysis indicate that ACT alone is an effective alternative for treating adolescent TTM.

Educational Objectives:
1. Describe the role of cognitive fusion and emotion suppression in the maintenance of psychopathology for patients with severe OCD. 2. Describe issues concerning misophonia and its unique symptoms distinct from OCD. 3. Explain the potential relevance of ACT for OCD.

 

157. I Rap, You Rap, We All Love the IRAP: Manipulations of Sample Stimuli and Instructions
Symposium (10:30am-Noon)
Components: Original data
Categories: RFT, Theory & Philo., IRAP
Target Audience: Interm.
Location: Lake Calhoun

Chair: Kail Seymour, Southern Illinois University
Discussant: Kate Kellum, University of Mississippi

Historically in psychology, certain operant responses that appear to be under “automatic” stimulus control are often described as having trait-like properties; this may be due to the relative reliability and inflexibility of such responding. These responses are often labeled with the construct known as implicit bias (a.k.a. implicit attitude). The Implicit Relational Assessment Procedure (IRAP), along with other computerized measures such as the Implicit Association Test (IAT), purportedly enhance our insight into these processes by allowing us to investigate how stimuli and implicit biases interact. Thus, one important aspect of implicit bias research consists of delineating how implicit biases are affected by permutations of both stimulus presentations and instructions. In the series of studies presented herein, manipulations of different sample stimuli (specifically pictures versus words and idiographic versus nomothetic) and/or instructions (how to hide one’s implicit biases) were examined to determine what, if any, effects they have on IRAP responding.

• Seeing Versus Reading Is Believing: A Reliability Study of Sample Manipulations
Travis Sain, Southern Illinois University
Rachel Swiatek, Southern Illinois University
Chad E. Drake, Ph.D, Southern Illinois University

Previous research on the Implicit Relational Assessment Procedure (IRAP) has measured implicit bias towards text-based sample stimuli (e.g., Cullen, Barnes-Holmes, & Barnes-Holmes, 2009) and image-based sample stimuli (e.g., Nolan, Murphy, & Barnes-Holmes, 2007), but no known published studies to date have directly compared these two IRAP compositions. The current study measured relational responses among evaluative words and two historical figures – Abraham Lincoln and Adolf Hitler – using a between-subjects design. One IRAP contained the first and last name of each of these people as samples, while the other IRAP contained an image of each person as samples. All other procedural details were identical. Participants completed three consecutive IRAPs. Analyses compared both IRAP conditions for differences in respect to D scores, as well as accuracy and average latencies. Furthermore, D scores were subjected to Pearson correlations to assess for reliability over the three administrations.

• The Hitler You Know and Love: Piloting an Idiographic IRAP
Anke Lehnert, Southern Illinois University
Kelsey Schuler, Southern Illinois University
Travis Sain, Southern Illinois University
Sam Kramer, Southern Illinois University
Chad E. Drake, Ph.D, Southern Illinois University

Implicit measures of cognition such as the Implicit Association Test (IAT; Greenwald, McGhee, & Schwartz, 1998) and the Implicit Relational Assessment Procedure (IRAP; Barnes-Holmes, et al., 2006) have gained widespread popularity over the last few years. There have been attempts to use idiographic versions of the IAT to assess more personalized associations and avoid extrapersonal contamination, which researchers argue may allow for a more powerful interpretation of scores (Olzon & Fazio, 2004; Houben & Wiers, 2007). In this exploratory study, we compared scores on an IRAP configuration assessing evaluations in respect to Abraham Lincoln and Adolf Hitler with scores on an idiographic IRAP that contained names of a positively and a negatively evaluated person provided by each participant. A sample of undergraduate participants completed both versions of the IRAP and a collection of related self-report measures. Statistical comparisons of each IRAP and their relationships with self-reports will be discussed.

• Love/Hate Faked: Manipulating IRAP Performance with Instructions
Kail Seymour, Southern Illinois University
Christine Ryder, Southern Illinois University
Chad E. Drake, Ph.D, Southern Illinois University

One purported advantage of implicit measures compared to self-reports is their relative immunity to intentional efforts to distort responding. Might it be possible to purposely fake performance on an implicit measure? Although the Implicit Associations Test has been successfully faked (e.g., Kim, 2003), the McKenna, Barnes-Holmes, Barnes-Holmes, and Stewart (2007) study indicated that the IRAP may be relatively difficult to fake. The current study sought to replicate McKenna et al. using an idiographic IRAP containing names familiar to the participants as samples. Three IRAPs were administered in succession. Faking instructions were provided between the 1st and 2nd IRAPs in one condition and between the 2nd and 3rd IRAPs in another condition. D scores of each administration were subjected to t-tests to examine for any faking effects. The results have significant implications for the exploration of instructional effects on IRAP performance.

Educational Objectives:
1. Describe any differences obtained between IRAPs containing image and text samples in the first study. 2. Describe any differences obtained between the nomothetic and the idiographic IRAP in the second study. 3. Describe the instructions for faking the IRAP used in the third study.

 

158. Mindfulness in ACT: Theoretical and Practical Implications
Symposium (10:30am-Noon)
Components: Original data
Categories: Theory & Philo., Clin. Interven. & Interests, Mindfulness
Target Audience: Interm.
Location: Lake Nokomis

Chair: Devika Fiorillo, Duke University Medical Center/University of Nevada
Discussant: Victoria Follette, University of Nevada Reno

The past three decades have witnessed a growing interest in mindfulness-based approaches. Acceptance and Commitment Therapy increasing emphasizes mindfulness skills as a vehicle for present moment awareness. However, the core processes of mindfulness have not been clearly delineated. Im presents laboratory research using behavioral and self-report methods to examine convergent and divergent validity of various measurement approaches. Fiorillo presents preliminary data from a pilot study assessing the development and evaluation of an internet-based Acceptance and Commitment Therapy (ACT) program for a community sample of women who have experienced interpersonal trauma. She will focus on the acceptability of the mindfulness portion of the intervention. In addition to the assessment of treatment satisfaction and system usability, changes in psychological flexibility and overall wellbeing will be evaluated. Sherrill will present new data on women with a history of victimization. Participants were assigned to a “concrete rumination” or a control condition and Present Moment Awareness was assessed (PMA). In concrete ruminators, PMA was inversely related to trauma intrusions during written protocols and positively related to positive affectivity. Follette will discuss the theoretical and practical implications of using and evaluating mindfulness based therapy in relation to trauma survivors.

• Evaluation of a web based intervention for trauma: Mindfulness and acceptance measures
Devika Fiorillo, Duke University Medical Center
Caitlin McLean, University of Nevada Reno
Jacqueline Pistorello, University of Nevada Reno
Victoria Follette, University of Nevada Reno

Despite data to suggest that internet based interventions are feasible and effective in the treatment of various disorders, there is limited research on the applicability and efficacy of such treatments for survivors of interpersonal trauma, many of whom present with complex psychological symptomatology which extend beyond PTSD. Experiential avoidance has been theorized and shown to play a key role in explaining trauma-related difficulties and negative outcomes in relation to various forms of interpersonal trauma. The current pilot study involves the development and evaluation of an internet-based Acceptance and Commitment Therapy (ACT) treatment program for a community sample of women who have experienced interpersonal trauma. In this presentation we will focus on the acceptability of the mindfulness portion of the intervention. In addition to the assessment of treatment satisfaction and system usability, changes in psychological flexibility and overall wellbeing will be evaluated. Information regarding the nature and development of the web-based ACT treatment and initial results from this pilot study will be discussed.

• Assessing construct validity in mindfulness
Sungjin Im, University of Nevada Reno
Gideon Caplovitz Ph.D., Univeristy of Nevada Reno
Victoria Follette, University of Nevada Reno

The past three decades have witnessed a growing interest in mindfulness-based approaches. However, the core processes of mindfulness have not been delineated. The current study applied a multi-method approach since combined data from different research methods may overcome each method’s weaknesses and limitations. A total of 162 non-clinical undergraduates completed the Rapid Serial Visual Presentation (RSVP) task and online questionnaires of the Five Facet Mindfulness Questionnaire (FFMQ), Brief Symptom Inventory (BSI), World Health Organization Quality of Life instrument (WHOQOL-BREF), Acceptance and Action Questionnaire (AAQ), and Ruminative Response Scale (RRS). Results revealed that performance in the RSVP task significantly correlated with the Act With Awareness and Non-judging scales of the FFMQ (r=.27 and r=.20 respectively, all ps <.01). Scores on the FFMQ and the RSVP task performance related to other constructs in a similar way suggesting that mindfulness indexed by the FFMQ and RSVP task has good convergent and divergent validity.

• A Mindful Path to Decrease Trauma Intrusions: Utility and Implications of Present Moment Awareness
Andrew M. Sherrill, M.A, Northern Illinois University
Christine E. Valdez, M.A, Northern Illinois University
Michelle M. Lilly, Ph.D., Northern Illinois University

Third-wave approaches to PTSD treatment emphasize “being present” to increase psychological flexibility (Follette et al., 2006). However, researchers have struggled to measure present moment awareness (PMA; i.e., shifting attention to what is happening here and now; Fletcher & Hayes, 2005), and assess its clinical utility. Women with victimization histories were assigned to either a “concrete rumination” or a control condition (see Watkins et al., 2008). After manipulation, participants recalled their trauma, and then wrote down whatever information was present in their awareness (see Cacioppo et al., 1997). PMA was measured in a novel way by coding shifts in attention (e.g., sounds in the environment, interoceptive sensations) within these written protocols. In concrete ruminators, PMA was inversely related to trauma intrusions during written protocols and positively related to positive affectivity. In controls, PMA was unrelated to trauma intrusions and positively related to negative affectivity. Methodological and theoretical implications will be discussed.

Educational Objectives:
1. Describe and assess the clinical utility of present moment awareness in posttraumatic stress symptomatology. 2. Critique a multi-method approach to assessing mindfulness. 3. Discuss issues related to delivering mindfulness training using a Web based platform.

 

159. ACT Applications for Cancer Treatment
Symposium (10:30am-Noon)
Components: Original data
Categories: Clin. Interven. & Interests, Beh. med., Cancer patients, palliative care, depression
Target Audience: Interm.
Location: Cooks Bay

Chair: Jonathan Rhodes, PsyD, Linden Oaks Hospital
Discussant: Jennifer Gregg, Ph.D., San Jose State University

As ACT aims to create lives of purpose, applying the model to those struggling with issues related to their cancer diagnoses is meaningful. This symposium unpacks 3 studies which explored different aspects of cancer survival and applications to reduce the resultant suffering: managing weight loss, increasing psychological flexibility in palliative care, and targeting depressive symptoms in women surviving breast cancer.

• ACT-EAT Brief: a brief intervention based on Acceptance and Commitment Therapy for weight loss in cancer patients.
Giuseppe Deledda, Service Clinical Psycology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy
Chiara Anselmi, U.O. of Ditology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy
Federica Maccadanza, Service Clinical Psycology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy
Angela Di Canio, Service Clinical Psycology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy
Stefania Gori, 2U.O. Oncology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy

Background: The weight gain affects an high number of cancer patients, during and after the treatments. The aim is to evaluate a brief intervention four sessions of ACT – EAT for weight loss in cancer patients. Methods: The intervention consists in a set of four-monthly sessions and a follow up after 3 mounts. At the first and last encounter patients’ weight is reported and questionnaires on clinical state (RSCL, PWBQ, Distress Thermometer), eating behaviour (TFE.Q-51), psychological flexibility (AAQ-2, Bull's-eye) and the BIAAQ are administered. Results: Twenty four consecutive patients have completed the protocol. Data showed a low scores on the Body Image Acceptance (BIAAQ M=32.8; SD 11.8), high mean scores of physical symptoms (M=24.4; SD 23) and psychological symptoms (M=33.7; SD 18), and a low distress (M=3.8; SD 2.7). A high degree of acceptance (AAQ2 M=53.1; SD 10.3), consistency with the values (M=5.7; SD 1.6), psychological well being (M=83; SD 10.3), and quality of life (QoL subscale RSCL M=65.2; SD 21.2). Emerged a weight loss of 11% at fourth encounter (M=8.5 Kg (SD 4.9 kg)). Conclusions: A goal of ACT is to increase a non-judgmental attitude and willingness to experience unpleasant thoughts, feelings, and physical sensations, and to promote the awareness and promote engagement in personally valued behaviors, handling themselves with attentive care.

• The Acceptance and Commitment Therapy for increase the psychological flexibility of cancer patients in palliative care
Giuseppe Deledda, Service Clinical Psycology, Sacro Cuore-Don Calabria Hospital, Negrar, Verona, Italy

The Acceptance and Commitment Therapy proposes the hypothesis that psychological suffering is caused by the interaction between language, cognition and behavioural control. Rather than focus on the reduction of symptoms, the primary purpose is to help the person to accept their thoughts and emotions, and live in the present consistently with their values. The aim of this introduction is to address the ACT Hexaflex processes in order to increase the psychological flexibility of cancer patients in palliative care The results obtained using the ACT approach in oncology, pose a more solid basis to support the importance of a non-judgmental attitude in order to employ the energies toward what we consider most important in our lives. Changes in psychological flexibility predicted changes in distress and mood. Acceptance allows to move more freely without being stopped by distressing feelings.

• Acceptance and Commitment Therapy (ACT) in Women with Breast Cancer
Bahare Dehghani Najvani, graduate student, University of Isfahan, Iran
Mohamad Reza Abedi, University of Isfahan, Iran

Breast cancer is the most common cancer among women. Many women with breast cancer suffer from depression and psychological distress. The present study by the purpose of examining the effect of Acceptance and Commitment Therapy (ACT) on depression and psychological flexibility in women with breast cancer was performed. Among patients who had registered to participate in the research, 20 women were selected randomly and they were randomly divided to two groups of control and experiment. Research tool consisted of Beck Depression Inventory (BDI-II), Acceptance and Action Questionnaire (AAQ-II), and demographic questionnaire. Experimental group received 8 sessions of 2 hours acceptance and commitment group therapy. Follow-up stage was performed at 1 month after the last treatment session. Results showed that ACT significantly decreased scores on the BDI-II and increased score on AAQ-II compared to the control group (p<0.001). ACT may be considered to be an effective intervention approach for treatment depression in woman with breast cancer. Can be said that increasing in acceptance of thought and feeling associated with cancer and increasing in psychological flexibility that is the main goal of ACT has led to these changes

Educational Objectives:
1. Implement the protocols of brief interventions in the field of healthy lifestyles for cancer patients. 2. 2. Implement knowledge about the assessment in oncological setting; to address the ACT Hexaflex processes in order to increase the psychological flexibility of cancer patients in palliative care. 3. Implement knowledge about in the assessment in oncology; Implement Acceptance and commitment therapy among cancer patients.; emphasis on values as important domains among cancer patients.