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。     

接纳承诺疗法和辩证行为疗法的比较分析

通过病理机制、哲学背景、治疗模式和症状应用四个方面的比较分析,对比接纳承诺疗法和辩证行为疗法之间的具体差异,以便帮助来访者实现其目标。尽管这两种心理治疗方法在病理机制解释和哲学背景上的侧重点各不相同:前者用心理僵化来解释心理疾病,侧重接纳的作用;而后者用情绪失调来解释心理疾病,侧重接受和改变之间的综合;但在治疗模式和症状应用上又有许多相似之处:二者都使用正念和隐喻技术,同时都用于治疗抑郁、焦虑、创伤后应激障碍等。     

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。     

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。     

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.     

Creating a strategy for progress: a contextual behavioral science approach

Behavior analysis is a field dedicated to the development and application of behavioral principles to the understanding and modification of the psychological actions of organisms. As such, behavior analysis was committed from the beginning to a comprehensive account of behavior, stretching from animal learning to complex human behavior. Despite that lofty goal, basic behavior analysis is having a generally harder time finding academic support, and applied behavior analysis has narrowed its focus. In the present paper we argue that both of these trends relate to the challenge of human language and cognition, and that developments within clinical behavior analysis and the analysis of derived relational responding are providing a way forward. To take full advantage of these developments, however, we argue that behavior analysts need to articulate their unique approach to theory, to develop more flexible language systems for applied workers, and to expand their methodological flexibility. This approach, which we term contextual behavioral science, is meant as an evolutionary step that will allow behavior analysis to better capture the center of modern psychological concerns in both the basic and applied areas. Clinical behavior analysis is showing a way forward for behavior analysis to regain its vision as a comprehensive approach to behavior.     

The Importance of Theory in Cognitive Behavior Therapy: A Perspective of Contextual Behavioral Science

For the past 30 years, generations of scholars of cognitive behavior therapy (CBT) have expressed concern that clinical practice has abandoned the close links with theory that characterized the earliest days of the field. There is also a widespread assumption that a greater working knowledge of theory will lead to better clinical outcomes, although there is currently very little hard evidence to support this claim. We suggest that the rise of so-called “third generation” models of CBT over the past decade, along with the dissemination of statistical innovations among psychotherapy researchers, have given new life to this old issue. We argue that theory likely does matter to clinical outcomes, and we outline the future research that would be needed to address this conjecture.     

SOME FINAL,GULP, “WORDS” ON REBT,ACT &; RFT

After reviewing the target articles of this issue, Hayes and Ellis respectively see less and more possibilities for integration. This concluding article attempts to better elucidate possibilities for integration between second and third wave CBT’s, as exemplified by Rational-Emotive & Cognitive-Behavior Therapy (REBT) and Acceptance and Commitment Therapy (ACT). We suggest that if ACT is going to err, it will be in the direction of being too afraid of talk. If REBT is going to err, it will be in the direction of not being afraid enough. Address correspondence to Hank Robb, 4550 SW Kruse Way, Suite 225 Lake Oswego, OR 97035, USA.     

Stability and Change in Cognitive Behavior Therapy: Considering the Implications of ACT and RFT

Acceptance and Commitment Therapy (ACT) and Relational Frame Theory (RFT) are part of the new wave of treatments and analyses that seem to be emerging in cognitive behavior therapy. In this article, data in support of these new approaches are provided, and evidence that ACT works through different processes than traditional CBT are presented. The integrative proposals of Ciarrochi and Robb, and Ciarrochi, Robb, and Godsell are then considered. In the long run, whether such integrations are useful is an empirical matter, but concerns are raised about the effects of focusing on the content of beliefs, and the role of logical–empirical challenges to belief. Address correspondence to Steven C. Hayes, Department of Psychology/298, University of Nevada, Reno, NV 89557-0062, USA.     

Acceptance- and mindfulness-based interventions for the treatment of chronic pain: a meta-analytic review

The number of acceptance- and mindfulness-based interventions for chronic pain, such as acceptance and commitment therapy (ACT), mindfulness-based stress reduction (MBSR), and mindfulness-based cognitive therapy (MBCT), increased in recent years. Therefore an update is warranted of our former systematic review and meta-analysis of studies that reported effects on the mental and physical health of chronic pain patients. Pubmed, EMBASE, PsycInfo and Cochrane were searched for eligible studies. Current meta-analysis only included randomized controlled trials (RCTs). Studies were rated for quality. Mean quality did not improve in recent years. Pooled standardized mean differences using the random-effect model were calculated to represent the average intervention effect and, to perform subgroup analyses. Outcome measures were pain intensity, depression, anxiety, pain interference, disability and quality of life. Included were twenty-five RCTs totaling 1285 patients with chronic pain, in which we compared acceptance- and mindfulness-based interventions to the waitlist, (medical) treatment-as-usual, and education or support control groups. Effect sizes ranged from small (on all outcome measures except anxiety and pain interference) to moderate (on anxiety and pain interference) at post-treatment and from small (on pain intensity and disability) to large (on pain interference) at follow-up. ACT showed significantly higher effects on depression and anxiety than MBSR and MBCT. Studies’ quality, attrition rate, type of pain and control group, did not moderate the effects of acceptance- and mindfulness-based interventions. Current acceptance- and mindfulness-based interventions, while not superior to traditional cognitive behavioral treatments, can be good alternatives.