Aspects of Exposure Therapy in Acceptance and Commitment Therapy

Gloster, Andrew T.; Hummel, Katrin; Lyudmirskaya, Irina; Hauke, Christine; Sonntag, Rainer F.

doi:10.1007/978-1-4614-3342-2_8

Cited by 12 publications

(19 citation statements)

References 46 publications

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“…This approach has traditionally been presented with decreased emotional responding to stimuli or falsification of fearful interpretations as an over-arching aim (Neudeck & Wittchen, 2012). However, in the wake of acceptance and commitment therapy (ACT; Hayes, Strosahl, & Wilson, 1999), exposure has instead been conceptualized as a route to fostering acceptance of inner experiences, increased behavioral flexibility and the pursuit of valued goal-directed behavior in the presence of aversive internal responses (Gloster, Hummel, Lyudmirskaya, Hauke, & Sonntag, 2012). In ACT, a primary goal of exposure is to increase psychological flexibility, i.e., broadening the individual's effective repertoire in the presence of feared events (Hayes, 2004).…”

Section: Accepted Manuscriptmentioning

confidence: 98%

Acceptance-Based Exposure Therapy for Body Dysmorphic Disorder: A Pilot Study

et al. 2015

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Section: Accepted Manuscriptmentioning

confidence: 98%

Acceptance-Based Exposure Therapy for Body Dysmorphic Disorder: A Pilot Study

et al. 2015

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“…Patients worked towards becoming more aware and accepting of anxiety and other uncomfortable emotions and experiences. This stance was adopted so that they could more willingly engage in important aspects of their life, irrespective of the presence of uncomfortable emotions and thoughts [27]. …”

Section: Methodsmentioning

confidence: 99%

Treating Treatment-Resistant Patients with Panic Disorder and Agoraphobia Using Psychotherapy: A Randomized Controlled Switching Trial

Gloster

Sonntag²,

Hoyer

et al. 2015

Psychother Psychosom

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Background: Nonresponsiveness to therapy is generally acknowledged, but only a few studies have tested switching to psychotherapy. This study is one of the first to examine the malleability of treatment-resistant patients using acceptance and commitment therapy (ACT). Methods: This was a randomized controlled trial that included 43 patients diagnosed with primary panic disorder and/or agoraphobia (PD/A) with prior unsuccessful state-of-the-art treatment (mean number of previous sessions = 42.2). Patients were treated with an ACT manual administered by novice therapists and followed up for 6 months. They were randomized to immediate treatment (n = 33) or a 4-week waiting list (n = 10) with delayed treatment (n = 8). Treatment consisted of eight sessions, implemented twice weekly over 4 weeks. Primary outcomes were measured with the Panic and Agoraphobia Scale (PAS), the Clinical Global Impression (CGI), and the Mobility Inventory (MI). Results: At post-treatment, patients who received ACT reported significantly more improvements on the PAS and CGI (d = 0.72 and 0.89, respectively) than those who were on the waiting list, while improvement on the MI (d = 0.50) was nearly significant. Secondary outcomes were consistent with ACT theory. Follow-up assessments indicated a stable and continued improvement after treatment. The dropout rate was low (9%). Conclusions: Despite a clinically challenging sample and brief treatment administered by novice therapists, patients who received ACT reported significantly greater changes in functioning and symptomatology than those on the waiting list, with medium-to-large effect sizes that were maintained for at least 6 months. These proof-of-principle data suggest that ACT is a viable treatment option for treatment-resistant PD/A patients. Further work on switching to psychotherapy for nonresponders is clearly needed.

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“…It is noteworthy though that exposure therapy has undergone a number of transformations. Significant changes in its administration are related to advances in the areas of cognition, fear learning and fear extinction, neuroscience and more recently acceptance‐based approaches (Wolitzky‐Taylor et al ., ; Gloster et al ., ). Each of these have resulted in further shifts in the conceptualization and optimized delivery of CBT and exposure as science‐based models of clinical practice.…”

Section: Is There a Need To Advance Cbt For Anxiety‐related Disorders?mentioning

confidence: 97%

Advancing psychotherapy and evidence‐based psychological interventions

Emmelkamp

David

Beckers

et al. 2013

Int J Methods Psych Res

144

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Psychological models of mental disorders guide research into psychological and environmental factors that elicit and maintain mental disorders as well as interventions to reduce them. This paper addresses four areas. (1) Psychological models of mental disorders have become increasingly transdiagnostic, focusing on core cognitive endophenotypes of psychopathology from an integrative cognitive psychology perspective rather than offering explanations for unitary mental disorders. It is argued that psychological interventions for mental disorders will increasingly target specific cognitive dysfunctions rather than symptom-based mental disorders as a result. (2) Psychotherapy research still lacks a comprehensive conceptual framework that brings together the wide variety of findings, models and perspectives. Analysing the state-of-the-art in psychotherapy treatment research, "component analyses" aiming at an optimal identification of core ingredients and the mechanisms of change is highlighted as the core need towards improved efficacy and effectiveness of psychotherapy, and improved translation to routine care. (3) In order to provide more effective psychological interventions to children and adolescents, there is a need to develop new and/or improved psychotherapeutic interventions on the basis of developmental psychopathology research taking into account knowledge of mediators and moderators. Developmental neuroscience research might be instrumental to uncover associated aberrant brain processes in children and adolescents with mental health problems and to better examine mechanisms of their correction by means of psychotherapy and psychological interventions. (4) Psychotherapy research needs to broaden in terms of adoption of large-scale public health strategies and treatments that can be applied to more patients in a simpler and cost-effective way. Increased research on efficacy and moderators of Internet-based treatments and e-mental health tools (e.g. to support "real time" clinical decision-making to prevent treatment failure or relapse) might be one promising way forward.

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Aspects of Exposure Therapy in Acceptance and Commitment Therapy

Cited by 12 publications

References 46 publications

Acceptance-Based Exposure Therapy for Body Dysmorphic Disorder: A Pilot Study

Acceptance-Based Exposure Therapy for Body Dysmorphic Disorder: A Pilot Study

Treating Treatment-Resistant Patients with Panic Disorder and Agoraphobia Using Psychotherapy: A Randomized Controlled Switching Trial

Advancing psychotherapy and evidence‐based psychological interventions

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