Acceptance and Commitment Therapy modules: Differential impact on treatment processes and outcomes.

A modular, transdiagnostic approach to treatment design and implementation may increase the public health impact of evidence-based psychosocial interventions. Such an approach relies on algorithms for selecting and implementing treatment components intended to have a specific therapeutic effect, yet there is little evidence for how components function independent of their treatment packages when employed in clinical service settings. This study aimed to demonstrate the specificity of treatment effects for two components of Acceptance and Commitment Therapy (ACT), a promising candidate for modularization. A randomized, nonconcurrent, multiple-baseline across participants design was used to examine component effects on treatment processes and outcomes in 15 adults seeking mental health treatment. The ACT OPEN module targeted acceptance and cognitive defusion; the ACT ENGAGED module targeted values-based activation and persistence. According to Tau-U analyses, both modules produced significant improvements in psychiatric symptoms, quality of life, and targeted therapeutic processes. ACT ENGAGED demonstrated greater improvements in quality of life and values-based activation. ACT OPEN showed greater improvements in symptom severity, acceptance, and defusion. Both modules improved awareness and non-reactivity, which were mutually targeted, though using distinct intervention procedures. Both interventions demonstrated high treatment acceptability, completion, and patient satisfaction. Treatment effects were maintained at 3-month follow up. ACT components should be considered for inclusion in a modular approach to implementing evidence-based psychosocial interventions for adults.

Open, aware, and active: contextual approaches as an emerging trend in the behavioral and cognitive therapies.

A wave of new developments has occurred in the behavioral and cognitive therapies that focuses on processes such as acceptance, mindfulness, attention, or values. In this review, we describe some of these developments and the data regarding them, focusing on information about components, moderators, mediators, and processes of change. These "third wave" methods all emphasize the context and function of psychological events more so than their validity, frequency, or form, and for these reasons we use the term "contextual cognitive behavioral therapy" to describe their characteristics. Both putative processes, and component and process evidence, indicate that they are focused on establishing a more open, aware, and active approach to living, and that their positive effects occur because of changes in these processes.

Adopting the perspective of another in belief attribution: contribution of Relational Frame Theory to the understanding of impairments in schizophrenia.

Impaired ability of identifying mental states is a characteristic of schizophrenia spectrum disorders. In particular, people suffering from this illness tend to fail at attributing a belief to another, which has been linked to difficulties in changing interpersonal perspective. Following the view of Relational Frame Theory on perspective-taking skills, the current study aimed at examining the involvement of social anhedonia, one of the frequent features of schizophrenia, in the development of deficits in reversing the I-YOU relation (i.e., adopting the perspective of another). A task consisting of attributing a belief to another or to the self was employed with 30 non-clinical participants with a high level of social anhedonia and with 15 patients diagnosed with schizophrenia. In comparison to two control groups, both experimental groups showed significant poorer performance when adopting the perspective of another. These results constitute important indications to target specific relational repertoires when attempting to remediate impairments in mental states attribution linked to schizophrenia.