接纳与承诺疗法的理论背景、实证研究与未来发展

接纳与承诺疗法(Acceptance and Commitment Therapy, ACT)于上世纪90年代初由美国治疗师Steven C. Hayes提出。作为基于正念技术的第三代行为治疗理论之一, 该疗法以功能情境主义为哲学基础, 立足于人类认知和语言基本性质的实证研究, 旨在通过平衡接纳与改变来提高心理灵活性。临床研究已证明其在相当广泛的临床问题上都取得了良好效果, 并在与CBT等传统疗法的对比中展现优势。ACT的临床效果和技术细节可做进一步研究, 该疗法与CBT的融合及其在临床领域之外的应用也是未来的研究方向。     

接纳与承诺疗法的功能性语境主义解读

接纳与承诺疗法(ACT)是认知行为疗法"第三次浪潮"中最有代表性的疗法之一。依托功能性语境主义,探究ACT中的语境主义和实用主义。在功能性语境主义背景下,分析心理事件时要综合考虑其背景和功能及其相应的交互作用,提升分析的准确性、全面性。同时,以目标为导向,明确心理事件的内涵及其改善措施。基于此,在ACT的两大治疗过程中,充分渗透功能性语境主义,并通过灵活多样的治疗方法,提升个体的心理灵活性。     

抑郁反刍的接纳承诺疗法理论与实践

从关系框架理论出发,通过接纳承诺疗法核心病理过程分析抑郁反刍,探究接纳承诺疗法治疗抑郁反刍理论意义上的可能性,并提出在临床中如何治疗抑郁反刍。首先,分析抑郁反刍的理论意义以及临床症状,通过接纳承诺疗法病理视角发现抑郁反刍可以被病理过程解构,指出接纳承诺疗法治疗抑郁反刍理论上的可能性。其次,根据理论分析提出接纳承诺疗法通过提升个体心理灵活性以及明确人生价值来治疗抑郁反刍的方法。最后,阐述接纳承诺疗法治疗抑郁反刍的未来研究方向和可能存在的问题。

     

非自杀性自伤与接纳承诺疗法的多维解析

接纳承诺疗法干预非自杀性自伤已经被一些临床案例证实疗效显著,与其他传统的心理治疗相比,接纳承诺疗法的干预效果更加持久。首先分析了非自杀性自伤基本含义以及各类特征,从心理动机的角度简要说明了非自杀性自伤发生的原因,再结合接纳承诺疗法的心理病理模型及治疗模型,阐述了接纳承诺疗法是通过提高个体心理灵活性减少非自杀性自伤发生的的理论依据与治疗过程,最后梳理了近年来国外学者通过接纳承诺疗法干预非自杀性自伤的实证研究及效果,为其他研究者实践该疗法治疗非自杀性自伤提供借鉴思路。     

接纳承诺疗法的作用机制——基于元分析结构方程模型

接纳承诺疗法(Acceptance and Commitment Therapy, ACT)被认为是行为治疗“第三浪潮”的重要代表。本研究使用元分析结构方程模型, 考察ACT的作用机制。通过数据库检索与筛选, 最终纳入文献50篇。结果发现: ACT所假设的心理灵活性、接纳、此时此刻、价值的中介作用都达到统计显著, 认知解离这一中介变量并不显著; 中介机制在网络化干预中仍然得到检验; 相较之传统CBT, ACT在所假设的机制上有其区别于CBT的优势。后续临床研究应更全面地测量6大核心机制, 关注对美好生活提升的影响, 采用多点瞬时评价法, 并尽可能使用更高级、更先进的统计方法检验其作用机制。     

语境主义对简单知识问题的解决

为了解决柯亨提到的简单知识问题,知识论者从拒斥闭合论证的单一前提、论证过程的无效性与论证内容的含混性等方面入手来解答,但这又会陷入坚持闭合论证与质疑闭合论证有效性的困境。跳出闭合论证怪圈,从语境主义的语境转换、知识归因的风险效应与凸显效应等角度来解决简单知识问题,或许是更为有效、可行的办法。     

正念对压力的影响-基于监测与接纳理论

压力是对潜在威胁性事件产生的生理与心理反应。正念通过专注当下并保持接纳的态度缓解压力。然而以往关于正念缓解压力的研究并没有明确具体的机制,且忽略了正念影响压力过程中的复杂性与多样性。监控与接纳理论通过解构监控与接纳成分,更加清晰地呈现了正念的作用机制,因此本文依据监控与接纳理论,梳理正念对压力的影响效果及其心理神经机制。未来的研究在探讨正念通过监控与接纳成分影响压力的同时应重点关注监控作用效果与机制;重视压力刺激与压力评估的重要性;设计新的实验范式,直接探究正念监控与接纳对压力影响的心理与神经机制。     

正念承诺接受疗法对提高运动比赛成绩的研究

运动员总希望能在竞技场上争取获得良好绩效。也更希望能够夺得一个又一个更高的目标,与此同时,运动心理学家的往往通过战术方面的干预为运动员获得更高绩效提供保障。因此,两者的进步是相伴相随的。就在我们的研究和运动员愿望不断促进的过程中,正念接受承诺疗法通过一个又一个实践经验证明了运动心理学家通过这一手段完全能够帮助运动员实现他们的目标。和传统的心理行为疗法不同之处在于,正念接受承诺疗法并不是减少那些“问题”想法,也不是减少控制内部加工,它更强调基于正念、接受的方式——活在当下、有意识觉察、不做判断来（为运动员）提供帮助和追求目标价值。     

中西方语境下的“反本质主义”

"反本质主义"是西方后现代的核心理念.是近几年来我国文艺理论界持续讨论的焦点.但是,中西方语境不同,"反本质主义"的目的和任务也不同.本文分别从中西方语境出发,考察"反本质主义"产生的巨大差异:西方后现代语境下的"反本质主义"不能等同于"解构";中国语境下的"反本质主义"所要做的工作是"反权威主义".吴炫先生以"中国式文学性"观念的当代建构来穿越中国语境下"反本质主义"文艺理论课题,可能是当下中国文艺理论界在全球文化语境下迎接"反本质主义"挑战的可行对策.     

关于ACT的接纳在处理失恋情绪中的应用

接受与承诺疗法治疗是“第三代行为治疗”的代表，其对抑郁症疗效得到了不少实证研究的支持。本文对ACT的心理问题形成过程以及治疗的原则进行简述。然后结合一个典型的失恋Z案例，在咨询过程中融合接受与承诺疗法中接纳的思想，协助来访者学会接受失恋的事实，并在处理失恋后悲伤情绪，坚持自己原有价值的生活，即在处理所有这些情绪同时，仍然能够过有意义的生活。     

Safety Planning Within Acceptance and Commitment Therapy

Acceptance and commitment therapy (ACT) is a contextual behavioral psychotherapy that helps clients build meaningful lives in the service of their own chosen values, rather than specifically focusing on symptom reduction or prevention of destructive behaviors. However, empowering ACT clients to navigate suicidal crises effectively is vital to ensuring the opportunity to build a life they will choose to live. Suicide safety planning is a widely used empirically supported approach to prepare clients to survive suicidal crises, and can be effectively incorporated into ACT. In this paper, we offer a contextual behavioral conceptualization of suicide as an extreme attempt to solve the problem of painful thoughts, emotions, and sensations, and provide an example of how this conceptualization and the necessity of safety planning can be introduced to clients. Use of chain analysis of suicidal behavior is introduced as a tool to inform the suicide safety plan. We describe how ACT processes can enhance safety plans and, in turn, create safety plans that will serve as means to develop skills associated with efficacious/effective ACT interventions. Finally, we discuss the ongoing evaluation and revision of the safety plan from an ACT framework.     

Acceptance and Commitment Therapy as a Spiritually Integrated Psychotherapy

This article presents acceptance and commitment therapy (ACT) as a spiritually integrated therapeutic modality. ACT is a value‐driven therapy that involves facilitating transcendence of physical, mental, and emotional experience to alleviate human suffering; as such, ACT shares common ground with the domain of spirituality. Approached as a spiritually integrated therapy, ACT can help clients to access spiritual resources and create life meaning as well as aid in the resolution or transformation of spiritual struggles. Given that spiritual struggles, in particular, can have a significant impact on mental health and well‐being, this article provides guidance in how ACT can address such struggles.     

School-Based Acceptance and Commitment Therapy for Adolescents With Anxiety: A Pilot Trial

Anxiety disorders are one of the most prevalent diagnoses in youth, often resulting in impaired social and school functioning. Research on treatments for youth anxiety is primarily based in traditional clinical settings. However, integrating youth psychotherapies into the school environment improves access to evidence-based care. The present study is a pilot, randomized waitlist-controlled trial of a school-based, group Acceptance and Commitment Therapy–based (ACT) intervention for adolescents with anxiety. Students at two separate schools (N = 26) with elevated anxiety were randomized to a 12-week waitlist or to immediate treatment. Participants in the immediate treatment condition reported statistically significant decreases in anxiety and class absences at posttreatment and follow-up compared to the waitlist group. No statistically significant differences were found between groups for depression, psychological flexibility, positive mental health, and student well-being. However, medium within-condition effect sizes were seen in the treatment group for all outcomes. Participants reported the treatment as favorable with good acceptance ratings. Overall, this study supports ACT as a viable intervention for schools and other clinical settings providing services to adolescents with anxiety.     

Cognitive Mediators of Treatment for Social Anxiety Disorder: Comparing Acceptance and Commitment Therapy and Cognitive-Behavioral Therapy

Objective

To assess the relationship between session-by-session mediators and treatment outcomes in traditional cognitive-behavioral therapy (CBT) and acceptance and commitment therapy (ACT) for social anxiety disorder.

Method

Session-by-session changes in negative cognitions (a theorized mediator of CBT) and experiential avoidance (a theorized mediator of ACT) were assessed in 50 adult outpatients randomized to CBT (n = 25) or ACT (n = 25) for DSM-IV social anxiety disorder.

Results

Multilevel modeling analyses revealed significant nonlinear decreases in the proposed mediators in both treatments, with ACT showing steeper decline than CBT at the beginning of treatment and CBT showing steeper decline than ACT at the end of treatment. Curvature (or the nonlinear effect) of experiential avoidance during treatment significantly mediated posttreatment social anxiety symptoms and anhedonic depression in ACT, but not in CBT, with steeper decline of the Acceptance and Action Questionnaire at the beginning of treatment predicting fewer symptoms in ACT only. Curvature of negative cognitions during both treatments predicted outcome, with steeper decline of negative cognitions at the beginning of treatment predicting lower posttreatment social anxiety and depressive symptoms.

Conclusions

Rate of change in negative cognitions at the beginning of treatment is an important predictor of change across both ACT and CBT, whereas rate of change in experiential avoidance at the beginning of treatment is a mechanism specific to ACT.     

A Comprehensive Examination of the Model Underlying Acceptance and Commitment Therapy for Chronic Pain

The therapeutic model underlying Acceptance and Commitment Therapy (ACT) is reasonably well-established as it applies to chronic pain. Several studies have examined measures of single ACT processes, or subsets of processes, and have almost uniformly indicated reliable relations with patient functioning. To date, however, no study has performed a comprehensive examination of the entire ACT model, including all of its component processes, as it relates to functioning. The present study performed this examination in 274 individuals with chronic pain presenting for an assessment appointment. Participants completed a battery of self-report questionnaires, assessing multiple aspects of the ACT model, as well as pain intensity, disability, and emotional distress. Initial exploratory factor analyses examined measures of the ACT model and measures of patient functioning separately with each analysis identifying three factors. Next, the fit of a model including ACT processes on the one hand and patient functioning on the other was examined using Structural Equation Modeling. Overall model fit was acceptable and indicated moderate correlations among the ACT processes themselves, as well as significant relations with pain intensity, emotional distress, and disability. These analyses build on the existing literature by providing, to our knowledge, the most comprehensive evaluation of the ACT theoretical model in chronic pain to date.     

An Open Trial of Acceptance and Commitment Therapy With Exposure and Response Prevention in an Intensive Outpatient Setting for Adults With OCD

Intensive outpatient treatment settings for adults with obsessive-compulsive disorder (OCD) are common, but data on their effectiveness are limited. The effectiveness of IOP treatment for adults with OCD using combined acceptance and commitment therapy (ACT) and exposure and response prevention (ERP) was studied with eight adults. The intervention was 15 hours per week for 3 weeks. Measures were collected at pretreatment, 1-week, 2-weeks, posttreatment, and at 1-month follow-up. At the end of treatment, all participants were in the mild range of OCD symptom severity with a mean symptom decrease of 58%. Psychological inflexibility, depression, anxiety, and stress significantly decreased through treatment and participants ended treatment below clinical range for psychological inflexibility and nonclinical to mild range for depression, anxiety, and stress. The results of this study provide preliminary support for the effectiveness of ACT and ERP in an intensive outpatient setting for adults with OCD. The focus of this paper is on the clinical application of this treatment.