Akihiko Masuda

DBT, FAP, and ACT: How empirically oriented are the new behavior therapy technologies?

Dialectical Behavior Therapy, Acceptance and Commitment Therapy, and Functional Analytic Psychotherapy have recently come under fire for “getting ahead of their data” ( Corrigan, 2001 ). The current article presents a descriptive review of some of the actual evidence available. Dialectical Behavior Therapy and Acceptance and Commitment Therapy have a small but growing body of outcome research supporting these procedures and the theoretical mechanisms thought to be responsible for them. Functional Analytic Psychotherapy has a limited research base, but its central claim is well substantiated. The claims made in the published literature about these technologies, at least by their originators, seem proportionate to the strength of the current evidence. There is no indication that those interested in the new wave of behavior therapy innovations are less committed to empirical evaluation than has always been the case in behavior therapy.

The Impact of Acceptance and Commitment Training and Multicultural Training on the Stigmatizing Attitudes and Professional Burnout of Substance Abuse Counselors.

Empirically validated methods for reducing stigma and prejudice toward recipients of behavioral health-care services are badly needed. In the present study, two packages presented in 1-day workshops were compared to a biologically oriented educational control condition in the alleviation of stigmatizing attitudes in drug abuse counselors. One, Acceptance and Commitment Training (ACT), utilized acceptance, defusion, mindfulness, and values methods. The other, multicultural training, sensitized participants to group prejudices and biases. Measures of stigma and burnout were taken pretraining, posttraining, and after a 3-month follow-up. Results showed that multicultural training had an impact on stigmatizing attitudes and burnout post-intervention but not at follow-up, but showed better gains in a sense of personal accomplishment as compared to the educational control at follow-up. ACT had a positive impact on stigma at follow-up and on burnout at posttreatment and follow-up and follow-up gains in burnout exceeded those of multicultural training. ACT also significantly changed the believability of stigmatizing attitudes. This process mediated the impact of ACT but not multicultural training on follow-up stigma and burnout. This preliminary study opens new avenues for reducing stigma and burnout in behavioral health counselors.

United States and Japanese college students' attitudes toward seeking professional psychological help

The purpose of the study was to find how nationality, sex, and past experience of seeking professional psychological services are related to attitudes toward seeking professional psychological help. Three hundred Japanese college students and 300 US college students responded to the Attitudes Toward Seeking Professional Psychological Help (ATSPPH) questionnaire. The ATSPPH consists of four subscales: Need (recognition of need), Stigma Tolerance (the degree of tolerance against stigma associated with help‐seeking action), Openness (interpersonal openness), and Confidence (confidence in mental health professionals). As predicted, past experience of seeking professional psychological service and sex were important predictor variables of performance on the ATSPPH scales. Those who had past experience of seeking professional psychological help had more favourable attitudes toward seeking professional psychological help than those who never consulted psychological professionals. Similarly, in testing the past e...

The effects of cognitive defusion and thought distraction on emotional discomfort and believability of negative self-referential thoughts.

Previous research has shown that rapid vocal repetition of a one-word version of negative self-referential thought reduces the stimulus functions (e.g., emotional discomfort and believability) associated with that thought. The present study compares the effects of that defusion strategy with thought distraction and distraction-based experimental control tasks on a negative self-referential thought. Non-clinical undergraduates were randomly assigned to one of three protocols. The cognitive defusion condition reduced the emotional discomfort and believability of negative self-referential thoughts significantly greater than comparison conditions. Favorable results were also found for the defusion technique with participants with elevated depressive symptoms.

Help-Seeking Attitudes, Mental Health Stigma, and Self-Concealment Among African American College Students

Stigma has been noted as a major obstacle of mental health service use among African Americans. The present study investigated whether mental health stigma and self-concealment were uniquely associated with attitudes toward seeking professional psychological services in African American college students. Data of 163 African Americans (n Female = 127; 78% female) were used for present analyses. Results revealed that both mental health stigma and self-concealment were uniquely associated with help-seeking attitudes after controlling for gender, age, and previous experience of seeking professional psychological services.

The Role of Mindfulness and Psychological Flexibility in Somatization, Depression, Anxiety, and General Psychological Distress in a Nonclinical College Sample

The current study investigated whether mindfulness and psychological flexibility uniquely and separately accounted for variability in psychological distress (somatization, depression, anxiety, and general psychological distress). An ethnically diverse, nonclinical sample of college undergraduates (N = 494, 76% female) completed a Web-based survey that included the self-report measures of interest. Consistent with prior research, psychological flexibility and mindfulness were positively associated with each other, and tested separately, both variables were negatively associated with somatization, depression, anxiety, and general psychological distress. Results also revealed that psychological flexibility and mindfulness accounted for unique variance in all 4 measures of distress. These findings suggest that mindfulness and psychological flexibility are interrelated but not redundant constructs and that both constructs are important for understanding the onset and maintenance of somatization, depression, anxiety, and general distress.

A Parametric Study of Cognitive Defusion and the Believability and Discomfort of Negative Self-Relevant Thoughts

A previous time-series study showed that rapidly repeating a single-word version of a negative self-referential thought reduced the discomfort and the believability associated with that thought. The present parametric study examined whether durations of word repetition were differentially effective in altering the discomfort and believability of negative self-referential thought. In two studies, both discomfort and believability varied systematically with the duration of word repetition. The effects of rapid repetition on emotional discomfort bottomed out after 3 s to 10 s of rapid repetition, whereas the effects on believability did so after 20 s to 30 s of repetition. This study lends support to the cognitive defusion interpretation of the effect of word repetition, suggesting that emotional discomfort and believability may be distinctive functional aspects of cognitive events.

A Stage I Pilot Study of Acceptance and Commitment Therapy for Methadone Detoxification

BACKGROUND While agonist replacement therapies are effective for managing opioid dependence, community treatment programs are increasingly choosing detoxification. Unfortunately, success rates for opioid detoxification are very low, in part, due to physical and psychological symptoms associated with opioid withdrawal. Few behavior therapies specifically address the distressing experiences specific to opioid withdrawal. A novel behavioral treatment, acceptance and commitment therapy (ACT), works from the premise that the avoidance of unpleasant private experiences (thoughts, feelings, bodily sensations) is ubiquitous yet may be pathogenic, resulting in treatment drop-out and further drug use. METHODS This Stage I pilot study developed and tested an ACT-based opioid detoxification behavioral therapy. Opioid dependent patients (N=56) who were attending a licensed methadone clinic were randomized to receive either 24 individual therapy sessions of ACT or drug counseling (DC) in the context of a 6-month methadone dose reduction program. RESULTS While no difference was found on opioid use during treatment, 37% of participants in the ACT condition were successfully detoxified at the end of treatment compared to 19% of those who received DC. Fear of detoxification was also reduced across time in the ACT condition relative to DC. CONCLUSION This first study of ACT to assist opioid detoxification indicates promise. Research is needed to refine specific treatment strategies for this population to further strengthen effects.

The role of body image flexibility in the relationship between disordered eating cognitions and disordered eating symptoms among non-clinical college students.

OBJECTIVE A growing body of evidence suggests that rigid and inflexible regulation and coping are at the core of psychopathology, including disordered eating (DE) problems. Employing two cross-sectional studies, the present paper investigated whether body image flexibility (BIF), a specific type of psychological flexibility, mediates the relations between DE cognitions and overall DE pathology. METHOD Ethnically diverse non-clinical college undergraduates (Study 1 N=208; Study 2 N=178) completed an anonymous online survey. RESULTS BIF was found to partially mediate the relationship between DE cognitions and overall DE pathology after controlling for gender and body mass index (BMI). DISCUSSION Our findings suggest that the link between DE cognitions and overall DE pathology is established in part through an inflexible and avoidant coping style specific to negative body image. Clinical implications include targeting BIF as a mechanism of change and treating DE pathology with acceptance- and mindfulness-based behavioral interventions.

Prejudice, terrorism, and behavior therapy

Behavior therapy is relevant not just to the needs of victims of terrorism, but also to the understanding and modification of psychological processes that lead to the perpetration of terrorist acts. A key process of this kind is prejudice. In this paper, human prejudice is defined as the objectification and dehumanization of people as a result of their participation in evaluative verbal categories. Prejudice is difficult to deal with because (a) the same verbal processes that give rise to prejudice are massively reinforced in dealing with the external environment; (b) virtually all cultures openly amplify this process with stigmatized groups; (c) humans are historical beings and verbal/cognitive networks once formed tend to maintain themselves; and (d) many of the things humans do to change or eliminate undesirable verbal categorical processes are either inert or prone to making these processes more resistant to change. Mindfulness, cognitive defusion, acceptance, and valued action are suggested as alternative methods of fighting the war behavior therapy needs to help human society win: not just a war on terrorism, but a war on prejudice.