Acceptance and Commitment Therapy for Anxiety Disorders: Three Case Studies Exemplifying a Unified Treatment Protocol

Acceptance and Commitment Therapy (ACT) is an innovative acceptance-based behavior therapy that has been applied broadly and successfully to treat a variety of clinical problems, including the anxiety disorders. Throughout treatment ACT balances acceptance and mindfulness processes with commitment and behavior change processes. As applied to anxiety disorders, ACT seeks to undermine excessive struggle with anxiety and experiential avoidance––attempts to down-regulate and control unwanted private events (thoughts, images, bodily sensations). The goal is to foster more flexible and mindful ways of relating to anxiety so individuals can pursue life goals important to them. This article describes in some detail a unified ACT protocol that can be adapted for use with persons presenting with any of the major anxiety disorders. To exemplify this approach, we present pre- and posttreatment data from three individuals with different anxiety disorders who underwent treatment over a 12-week period. The results showed positive pre- to posttreatment changes in ACT-relevant process measures (e.g., reductions in experiential avoidance, increases in acceptance and mindfulness skills), increases in quality of life, as well as significant reductions in traditional anxiety and distress measures. All three clients reported maintaining or improving on their posttreatment level of functioning.     

Using Acceptance and Commitment Therapy to Treat Infertility Stress

Women and men diagnosed with infertility experience a variety of infertility-related stressors, including changes to their family and social networks, strain on their sexual relationship, and difficulties and unexpected challenges in their relationship. Infertility stress is linked with depression and psychological distress, and can lead to premature dropout from medical treatments and unresolved feelings of loss and grief. The current study examined the effectiveness of treating infertility stress using Acceptance and Commitment Therapy (ACT), a promising new behavior therapy that targets experiential avoidance through mindfulness, acceptance strategies, and value-directed action. This single-case study followed a couple experiencing infertility-related stress following a failed in vitro fertilization (IVF) procedure. The couple completed 6 self-report measures at 7 time points, including a second failed IVF attempt and a 1-year follow-up. Measures included both distress-focused instruments and therapy process-related questionnaires. The female participant reported higher pretreatment stress and depression scores compared to her partner. She reported significant decreases in global infertility stress, social infertility stress, sexual infertility stress, psychological distress, and depression from pretherapy to 1-year follow-up. She also reported a decrease in infertility stress following her second failed in vitro fertilization (IVF) attempt. The male participant reported significant decreases in sexual infertility stress. The study suggests that acceptance-based therapy shows promise in treating infertility stress in patients experiencing infertility who undergo medical treatments. The data from this preliminary case study also suggest that ACT may be helpful for couples following IVF treatment failure. Treatment gains were maintained 1-year posttherapy, indicating that an ACT approach to treating infertility has the potential to produce lasting change.     

Misalignment Between Research Hypotheses and Statistical Hypotheses: A Threat to Evidence-Based Medicine?

Topoi - Evidence-based medicine frequently uses statistical hypothesis testing. In this paradigm, data can only disconfirm a research hypothesis’ competitors: One tests the negation...     

Getting a Grasp on Children’s Representational Capacities in Pantomime of Object Use

This study examined how 5- and 9-year-old children (N = 40) produce pantomimes of object use on verbal request. The task required participants to enact an action with an imagined object. Results showed that with age, children (a) proceeded from body part as object to imaginary object and (b) incorporated into their pantomimes more distinctive features of the object and its use. While the first result replicated previous findings with more items and a more sophisticated coding procedure, the latter result revealed new insights. Children’s selection of distinctive features in pantomime was related to their performance on a semantic odd-one-out task that requires the abstraction of specific features without situational support. The discussion focuses on the cognitive requirements of the task and the potential of pantomime being a reflection of children’s representational development. We suggest an explanation of the findings within the more general developmental model of Karmiloff-Smith.     

Continuous visual cues trigger automatic spatial target updating in dynamic scenes

Dynamic tasks often require fast adaptations to new viewpoints. It has been shown that automatic spatial updating is triggered by proprioceptive motion cues. Here, we demonstrate that purely visual cues are sufficient to trigger automatic updating. In five experiments, we examined spatial updating in a dynamic attention task in which participants had to track three objects across scene rotations that occurred while the objects were temporarily invisible. The objects moved on a floor plane acting as a reference frame and unpredictably either were relocated when reference frame rotations occurred or remained in place. Although participants were aware of this dissociation they were unable to ignore continuous visual cues about scene rotations (Experiments 1a and 1b). This even held when common rotations of floor plane and objects were less likely than a dissociated rotation (Experiments 2a and 2b). However, identifying only the spatial reference direction was not sufficient to trigger updating (Experiment 3). Thus we conclude that automatic spatial target updating occurs with pure visual information.     

Lesser Evil Reasoning and its Pitfalls

We are often faced with dilemmatic situations in which we must choose between alternative courses of action, both of which will have a bad outcome. It is commonly held that in such cases it is both uncontroversial and unproblematic that we have to choose the lesser evil. However, despite its frequent application in ethical decision-making, lesser evil reasoning is not well understood by most of its advocates and it thus occasions much misunderstanding and it presents a number of pitfalls. In this paper I shall thus, first, analyse the concept of a lesser evil; second, offer a critical assessment of lesser evil reasoning; third, discuss the most common pitfalls writers tend to fall into; and finally, explore the application of lesser evil reasoning to choices under uncertainty.     

Panorama

Panorama

Panorama