A wave of new developments has occurred in the behavioral and cognitive therapies that focuses on processes such as acceptance, mindfulness, attention, or values. In this review, we describe some of these developments and the data regarding them, focusing on information about components, moderators, mediators, and processes of change. These "third wave" methods all emphasize the context and function of psychological events more so than their validity, frequency, or form, and for these reasons we use the term "contextual cognitive behavioral therapy" to describe their characteristics. Both putative processes, and component and process evidence, indicate that they are focused on establishing a more open, aware, and active approach to living, and that their positive effects occur because of changes in these processes.

A modular, transdiagnostic approach to treatment design and implementation may increase the public health impact of evidence-based psychosocial interventions. Such an approach relies on algorithms for selecting and implementing treatment components intended to have a specific therapeutic effect, yet there is little evidence for how components function independent of their treatment packages when employed in clinical service settings. This study aimed to demonstrate the specificity of treatment effects for two components of Acceptance and Commitment Therapy (ACT), a promising candidate for modularization. A randomized, nonconcurrent, multiple-baseline across participants design was used to examine component effects on treatment processes and outcomes in 15 adults seeking mental health treatment. The ACT OPEN module targeted acceptance and cognitive defusion; the ACT ENGAGED module targeted values-based activation and persistence. According to Tau- U analyses, both modules produced significant improvements in psychiatric symptoms, quality of life, and targeted therapeutic processes. ACT ENGAGED demonstrated greater improvements in quality of life and values-based activation. ACT OPEN showed greater improvements in symptom severity, acceptance, and defusion. Both modules improved awareness and non-reactivity, which were mutually targeted, though using distinct intervention procedures. Both interventions demonstrated high treatment acceptability, completion, and patient satisfaction. Treatment effects were maintained at 3-month follow up. ACT components should be considered for inclusion in a modular approach to implementing evidence-based psychosocial interventions for adults.

Abstract. Experiential avoidance, the tendency to rigidly escape or avoid private psychological experiences, represents one of the most prominent transdiagnostic psychological processes with a known role in a wide variety of psychological disorders and practical contexts. Experiential avoidance is argued to be based on a fundamental verbal/cognitive process: an overextension of verbal problem solving into the world within. Although cultures apparently differ in their patterns of emotional expression, to the extent that experiential avoidance is based on a fundamental verbal/cognitive process, measures of this process should be comparable across countries, with similar relationships to health outcomes regardless of the language community. This research tests this view in European countries. The psychometric properties of the Acceptance and Action Questionnaire-II, a measure of experiential avoidance, are compared across six languages and seven European countries, for a total of 2,170 nonclinical participants. Multiple group analysis showed that the instrument can be considered invariant across the language samples. The questionnaire constitutes a unidimensional instrument with similar relationships to psychopathology, and has good and very similar psychometric properties in each assessed country. Experiential avoidance reveals not just as transdiagnostic, but also as a transcultural process independent of a specific language community.

The current study aimed to provide an implicit measure of experiential avoidance (EA). Fifty undergraduate participants were exposed to an implicit (Implicit Relational Assessment Procedure: IRAP) and an explicit (Acceptance and Action Questionnaire II: AAQ II) measure of EA. Subsequently participant's response latencies on viewing a negatively affective IAP image were recorded. Participants were randomly assigned to either a thought suppression, or mindfulness group. The induction for both groups involved a 10 minute audio file that operationalized either suppression or mindfulness as a useful coping strategy for unwanted thoughts about the negatively affective IAP image. In the last stage of the experiment participants were re-exposed to both the AAQ II and the IRAP in order to determine whether the respective inductions had impacted on participant's level of EA (either explicitly or implicitly). The results indicated that the mindfulness group experienced a reduction of EA from pre to postinduction in comparison to those in the thought suppression group on the implicit measure (IRAP) but not the explicit measure (AAQ II). Results are discussed in terms of the utility of an implicit measure of experiential avoidance.

The current study assessed deictic relational responding in people with schizophrenia. A perspective-taking