Acceptance and Commitment Therapy Processes and Mediation: Challenges and How to Address Them

Arch, Joanna J.; Fishbein, Joel N.; Finkelstein, Lauren B.; Luoma, Jason B.

doi:10.1016/j.beth.2022.07.005

Cited by 31 publications

(10 citation statements)

References 95 publications

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“…The criticism partly relates to the definition of psychological flexibility; it is a way of responding—a ‘middle‐level term’ that is the result of the Open, Aware and Active skills. The criticism also relates to the scales used to measure psychological flexibility, which are imprecise in what they are measuring and have poor psychometric properties (Arch et al, 2022). It has been suggested that, instead of focusing on one mechanism of change resulting from the combined ACT skills, it would be more productive to investigate the separate ACT processes and to draw on existing non‐ACT literature to shed light on potential mechanisms of change (McLoughlin & Roche, 2022), for example, emotional differentiation and regulation (Fogarty et al, 2015; Hill & Updegraff, 2012).…”

Section: Lingering Questionsmentioning

confidence: 99%

Acceptance and commitment therapy for psychosis: Current status, lingering questions and future directions

2023

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PurposeAcceptance and Commitment Therapy for psychosis (ACTp) is a contextual behavioural intervention that promotes psychological flexibility by fostering active acceptance, cognitive defusion, values construction and committed action to enhance well‐being and recovery. Multiple studies have shown that ACTp is acceptable and efficacious, but questions remain as to its distinction from similar approaches and the conditions under which it would be implemented most effectively.MethodsWe present the current evidence for processes and outcomes of ACTp and summarise the qualitative findings of experiences of service users in ACT programmes. We compare ACTp with other cognitive behavioural therapies and mindfulness‐informed interventions for psychosis.ResultsAcceptance and commitment therapy for psychosis is promising as a pragmatic, process‐driven intervention model. Further efforts are needed to investigate psychological flexibility in the context of psychosis with observational, experimental and intervention studies that will inform model scope and treatment refinement. Additionally, implementation research is the necessary next step, including how support persons can be trained in ACTp. Lower intensity and technology‐assisted approaches have the potential to reduce barriers to accessing ACTp and extend impact.ConclusionsOver the last 20 years, ACTp has demonstrated meaningful effects in individual and group formats in a range of settings, targeting outcomes such as rehospitalisation, depression, psychotic symptom distress and impact. Future work should focus on how best to integrate ACTp with other current evidence‐based interventions for psychosis.

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Section: Lingering Questionsmentioning

confidence: 99%

Acceptance and commitment therapy for psychosis: Current status, lingering questions and future directions

2023

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“…Studies demonstrating that PF mediates associations between ACT and treatment outcomes (for a meta-analysis, see Stockton et al, 2019) also provide evidence for this conceptualization. However, some researchers have considered this existing evidence as weak by arguing that its quality is dampened by the same methodological issue that affects PF’s standing as a unique construct: flawed measurement (Arch et al, 2022). Most importantly, the PF measures that are traditionally used as mechanisms of change have not yet been examined for longitudinal invariance, a critical gap in the literature.…”

Section: Unidimensional Measurement Of Pfmentioning

confidence: 99%

Confirmatory measurement modeling and longitudinal invariance of the CompACT-15: A short-form assessment of psychological flexibility.

Hsu¹,

Hoffman²,

Kroska³

2023

Psychological Assessment

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The Comprehensive Assessment of Acceptance and Commitment Therapy Processes (CompACT;Francis et al., 2016) is a recently developed measure of psychological flexibility (PF) possessing several advantages over other measures of PF, including multidimensional assessment and relative brevity. Unfortunately, previous psychometric evaluations of the CompACT have been limited by their use of exploratory factor analysis to assess dimensionality, coefficient α to assess reliability, and a lack of attention to measurement equivalence in assessing change over time. The present study used confirmatory factor analysis (CFA) and item factor analysis (IFA) to examine the dimensionality, factor-specific reliability, longitudinal measurement invariance, and construct validity of the CompACT items in a longitudinal online sample of U.S. adults (N = 523). Converging evidence across CFA and IFA confirmatory latent variable measurement models provides support for the reduction of the 23-item CompACT to a 15-item short form with a more stable factor structure, acceptable reliability over large ranges of its three latent factors, and measurement equivalence of its items in assessing latent change over time. Results also support the construct validity of the CompACT-15 items based on its relations with theoretically relevant measures. Overall, the CompACT-15 appears to be a psychometrically sound instrument with the potential to contribute to research and intervention efforts. Public Significance StatementPsychological flexibility (PF) involves present-moment awareness and the pursuit of one's values even when facing difficult situations and emotions. Using two kinds of confirmatory factor measurement models, this study examined the psychometric properties of a measure of PF: the Comprehensive Assessment of Acceptance and Commitment Therapy Processes (Francis et al., 2016). Results suggest a more psychometrically sound short form-the CompACT-15-has strong potential to contribute to research and intervention efforts.

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“…Over the last decade, the replication crisis in psychology (Open Science Collaboration, 2015) and unsuccessful large-scale attempts at replication (Klein et al, 2022) have illuminated methodological and statistical practices that hinder the progress of science at a meta-level. These practices undermine the credibility and trust of results published in psychology and range from relatively accepted traditions, such as an over-reliance on null hypothesis significance testing (Greenwald, 1975) and small sample sizes (Arch et al, 2022), to practices widely acknowledged as harmful, such as reporting exploratory results as confirmatory or p-hacking to obtain statistically significant findings (Simmons et al, 2011).…”

Section: Transparency and Reproducibility In The Journal Of Contextua...mentioning

confidence: 99%

Transparency and Reproducibility in the Journal of Contextual Behavioral Science (preprint)

Lear¹,

Spata²,

Tittler³

et al. 2023

Preprint

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Acceptance and Commitment Therapy Processes and Mediation: Challenges and How to Address Them

Cited by 31 publications

References 95 publications

Acceptance and commitment therapy for psychosis: Current status, lingering questions and future directions

Acceptance and commitment therapy for psychosis: Current status, lingering questions and future directions

Confirmatory measurement modeling and longitudinal invariance of the CompACT-15: A short-form assessment of psychological flexibility.

Transparency and Reproducibility in the Journal of Contextual Behavioral Science (preprint)

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