Increasing valued behaviors precedes reduction in suffering: Findings from a randomized controlled trial using ACT

Gloster, Andrew T.; Klotsche, Jens; Ciarrochi, Joseph; Eifert, Georg H.; Sonntag, Rainer F.; Wittchen, Hans‐Ulrich; Hoyer, Jürgen

doi:10.1016/j.brat.2017.01.013

Cited by 81 publications

(59 citation statements)

References 27 publications

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“…Thus, future studies of ACT in the workplace would benefit from having additional and repeated measurement occasions in the first few weeks following the workshop (cf. Arch, Wolitsky‐Taylor, Eifert, & Craske, ; Gloster et al ., ; Hayes, Orsillo, & Roemer, ).…”

Section: Discussionmentioning

confidence: 99%

Acceptance and commitment therapy (ACT) for clinically distressed health care workers: Waitlist‐controlled evaluation of an ACT workshop in a routine practice setting

Waters

Frude

Flaxman

et al. 2017

British J Clinic Psychol

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Objectives. To examine the effects of a 1-day acceptance and commitment therapy (ACT) workshop on the mental health of clinically distressed health care employees, and to explore ACT's processes of change in a routine practice setting.Design. A quasi-controlled design, with participants block allocated to an ACT intervention or waiting list control group based on self-referral date.Methods. Participants were 35 health care workers who had self-referred for the ACT workshop via a clinical support service for staff. Measures were completed by ACT and control group participants at pre-intervention and 3 months post-intervention. Participants allocated to the waitlist condition went on to receive the ACT intervention and were also assessed 3 months later.Results. At 3 months post-intervention, participants in the ACT group reported a significantly lower level of psychological distress compared to the control group (d = 1.41). Across the 3-month evaluation period, clinically significant change was exhibited by 50% of ACT participants, compared to 0% in the control group. When the control group received the same ACT intervention, 69% went on to exhibit clinically significant change. The ACT intervention also resulted in significant improvements in psychological flexibility, defusion, and mindfulness skills, but did not significantly reduce the frequency of negative cognitions. Bootstrapped mediation analyses indicated that the reduction in distress in the ACT condition was primarily associated with an increase in mindfulness skills, especially observing and non-reactivity.Conclusions. These findings provide preliminary support for providing brief ACT interventions as part of routine clinical support services for distressed workers. Practitioner pointsA 1-day ACT workshop delivered in the context of a routine staff support service was effective for reducing psychological distress among health care workers.

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Section: Discussionmentioning

confidence: 99%

Acceptance and commitment therapy (ACT) for clinically distressed health care workers: Waitlist‐controlled evaluation of an ACT workshop in a routine practice setting

Waters

Frude

Flaxman

et al. 2017

British J Clinic Psychol

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“…Operant processes are hypothesized to change as a result of Pavlovian fear extinction (Foa, 2011), but operant behaviors often go unmeasured in studies of exposure processes, and they have failed to be included in leading theories of the mechanisms of exposure (Craske et al, 2008;Foa & McNally, 1996). Decreases in Pavlovian fear responses do not consistently lead to decreases in avoidance (Treanor & Barry, 2017) or to more engagement in important areas of life (Gloster et al, 2017). However, this assumption is not supported by the literature.…”

Section: Translational Research In Anxiety Disordersmentioning

confidence: 87%

“…However, this assumption is not supported by the literature. Decreases in Pavlovian fear responses do not consistently lead to decreases in avoidance (Treanor & Barry, 2017) or to more engagement in important areas of life (Gloster et al, 2017). Avoidance may persist even after fear has been extinguished, and the availability of an avoidance response following fear extinction has been shown to increase levels of fear (Vervliet & Indekeu, 2015;Vervliet, Lange, & Milad, 2017;Xia, Eyolfson, Lloyd, Vervliet, & Dymond, 2019).…”

Section: Translational Research In Anxiety Disordersmentioning

confidence: 98%

Relapse of anxiety‐related fear and avoidance: Conceptual analysis of treatment with acceptance and commitment therapy

Smith

Dymond

2019

J Exper Analysis Behavior

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Excessive fear and avoidance in relatively safe situations can lead to a narrowing of one's behavioral repertoire and less engagement with valued aspects of living. Ultimately, these processes can reach clinical levels, as seen in anxiety, trauma, and obsessive-compulsive disorders. Research on the basic behavioral processes underlying successful treatment with exposure therapy is growing, yet little is known about the mechanisms contributing to clinical relapse. Until recently, these mechanisms have largely been conceptualized in terms of Pavlovian return of fear, with relatively little research into operant processes. In the current paper, we briefly review translational research in anxiety disorders and the connections between fear and avoidance, focusing on recent work in the acquisition, extinction, and relapse of avoidance behavior and the generalization of this learning through arbitrary symbolic relations. We then introduce one possible treatment approach to mitigating clinical relapse, acceptance and commitment therapy (ACT), and provide a conceptual analysis for why ACT may be especially well-situated to address this issue. Finally, we end with potential directions for future research on treatment and relapse of anxiety disorders.

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“…Data from this study were collected under scientifically stringent conditions so that they are ideally situated to critically test the transfer into clinical care as called for in mobile health developments (Anthes, ; Johnson et al, ; Steinhubl, Muse, & Topol, ). Ultimately, these data may be used to develop a signalling system that will help identify patterns of maladaptive coping in (previously) depressed or socially anxious patients that can (Gloster et al, ) be used in clinical care.…”

Section: Discussionmentioning

confidence: 99%

Daily fluctuation of emotions and memories thereof: Design and methods of an experience sampling study of major depression, social phobia, and controls

Gloster

Miché

Wersebe

et al. 2017

Int J Methods Psych Res

Self Cite

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Symptom fluctuations and the dynamic contexts provoking these are poorly understood. This deficit is compounded by people's limited ability to accurately report about such dimensions in retrospect. Utilizing the advantages of experience sampling methodology (ESM), this study rigorously describes and tests proximal environmental, neurobiological and psychological factors associated with symptoms and mood states. Participants were assigned to three diagnostic groups: Major Depressive Disorder (MDD; n = 118), Social Phobia (SP; n = 47), or a Control Group without SP or MDD (CG; n = 119). Laboratory assessments included cognitive abilities, memory, constructs, and brain derived neurotrophic factor (BDNF). ESM lasted seven days, with six assessments per day covering symptoms, affect, daily events, social interactions, post-event processing, well-being, etc. Morning cortisol and actigraphy were also assessed during ESM. Thereafter, participants provided subjective retrospective recall estimates of the emotions they reported during ESM. The multi-level data of >10,000 observations will allow for thorough examination of fluctuations of psychopathology and well-being in two highly prevalent disorders. Using two clinical groups and a non-affected control group, the clinical specificity versus generalizability of processes can be directly tested, thus providing stimulating information about the overlap and differences between anxiety and affective disorders. This research informs about the development, fluctuation, and maintaining factors of emotions and symptoms and examines the accuracy with which participants recall these dimensions.

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Increasing valued behaviors precedes reduction in suffering: Findings from a randomized controlled trial using ACT

Abstract: This finding supports a central tenet of PFT that increased (re-)engagement in valued behaviors precedes reductions in suffering. Possible implications for a better understanding of response and non-response to psychotherapy are discussed.

Cited by 81 publications

References 27 publications

Acceptance and commitment therapy (ACT) for clinically distressed health care workers: Waitlist‐controlled evaluation of an ACT workshop in a routine practice setting

Acceptance and commitment therapy (ACT) for clinically distressed health care workers: Waitlist‐controlled evaluation of an ACT workshop in a routine practice setting

Relapse of anxiety‐related fear and avoidance: Conceptual analysis of treatment with acceptance and commitment therapy

Daily fluctuation of emotions and memories thereof: Design and methods of an experience sampling study of major depression, social phobia, and controls

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