Brian Whitley

The Adaptive Coping with Emotions Model (ACE Model)

In order to develop an intervention to enhance emotion regulation, it was important to develop a model that describes adaptive emotion regulation. In the Adaptive Coping with Emotions Model (ACE Model), effective emotion regulation is conceptualized as the situation-dependent interaction between seven emotion regulation skills: (1) the ability to be consciously aware of emotions, (2) the ability to identify and correctly label emotions, (3) the ability to identify what causes and maintains one’s emotions, (4) the ability to actively modify emotions in an adaptive manner, (5) the ability to accept and tolerate negative emotions when necessary, (6) the ability to approach and confront situations likely to trigger undesired emotions, and (7) the ability to provide effective self-support in distressing situations. Empirical evidence supports the ACE Model.

How Do Emotion Regulation Deficits Result in Mental Health Problems

There are several likely pathways by which emotion regulation deficits lead to mental disorders: (1) emotion regulation deficits result in intense and perpetuated affective states that are defining criteria for mental disorders (such as depression), (2) emotion regulation deficits trigger dysfunctional strategies that are included in the diagnostic criteria of mental disorders (using avoidance to cope with anxiety), and (3) emotion regulation deficits result in unregulated emotions that impede self-help attempts to regulate other emotions that are related to mental disorders (unregulated anxiety that discourage a depressed person from engaging in positive social experiences). The development of emotion regulation skill deficits and subsequent mental health problems is described using the ART Developmental Model of Emotion Regulation Deficits.

Emotion Regulation: Definition and Relevance for Mental Health

In this chapter we define important concepts related to affect regulation including emotion, mood, feelings, stress, and affect. Then, we review the most significant findings on the relationships between emotion regulation and various mental disorders.

Module Seven: Analyzing Emotions

When we are under stress, the amygdala initiates the release of stress hormones into our brain. These stress hormones can weaken areas in the brain including the prefrontal cortex and the hippocampus, which play important roles in the analysis of emotions. If we fail to analyze and understand the reasons for our present emotions, we may feel confused and out of control. This will likely lead to increased activation in the amygdala and the release of additional stress hormones that will make it even more difficult to analyze the emotions. This vicious cycle can be prevented or interrupted with ART Skill #6—Analyzing Emotions.

Module Eight: Modifying Emotions

When we are under stress, the amygdala initiates the release of stress hormones into our brain. These stress hormones can weaken areas in the brain including the prefrontal cortex and the hippocampus, which play important roles in our ability to use problem-solving techniques to modify our emotions. If, however, through weakened prefrontal and hippocampal functioning, we lose our ability to modify our emotions, we likely feel helpless and out of control. Since feelings of helplessness and out of control are crucial cues for the amygdala to sound the danger alarm bell that things are not going well, the release of more stress hormones is initiated, which results in even further loss of emotion modification capacities. This vicious cycle can be interrupted or prevented with ART Skill #7—Modifying Emotions.

ART Module One: Introduction and Psychoeducation

This chapter begins to describe the Affect Regulation Training (ART) program in detail. A suggested narrative is provided along with corresponding images of computer presentation slides that are shown to the participants during the ART classes. The chapter begins welcoming the participants to the training and providing an overview of ART. As people are generally more familiar with the concept of stress than with concepts such as “feelings” or “emotions,” ART is initially presented as a “stress-reduction program.” As the training progresses and participants feel more secure in the group and with the training concepts, the focus gradually shifts from talking about general stress to talking about challenging “feelings” and “emotions.” The participants are taught that emotions communicate information about our needs and goals and encourage us to take specific action to cope effectively with challenging situations.

Guidelines for Effective Delivery of ART

The therapist plays an important role in teaching the Affect Regulation Training (ART) skills. The manner in which the therapist conducts the training sessions and interacts with the participants will, in large part, determine the participants’ ability to engage in the learning process. One of the important ways to engage the participants is to ensure that the participants’ approach system is activated. This can be done by ensuring that the participants have need-fulfilling experiences. Another way to facilitate participant engagement in the training is to help participants develop and pursue personally relevant goals. Finally, there are psychological theories, techniques, and resources that will help therapists better engage participants in the training process.

Development of the “Affect Regulation Training” (ART) Program

The Affect Regulation Training program was developed as a transdiagnostic intervention to specifically enhance a broad range of affect regulation capabilities. Based on the Adaptive Coping with Emotions Model, we identified seven specific, teachable skills which we termed ART Skills: ART Skill #1—Muscle Relaxation, ART Skill #2—Breathing Relaxation, ART Skill #3—Nonjudgmental Awareness, ART Skill #4—Acceptance and Tolerance of Emotions, ART Skill #5—Compassionate Self-Support, ART Skill #6—Analysis of Emotions, and ART Skill #7—Modification of Emotions. These ART Skills are presented to participants during the training as techniques that can be used to interrupt neurological vicious cycles in the brain, which are involved in intensifying and maintaining negative emotions. As participants become familiar with each skill and its application, the individual ART Skills are chained together to create the ART Sequence.

Limitations and Future Directions of the ART Program

The Affect Regulation Training (ART) program has many positive features that make it an attractive intervention for a variety of populations. However, there are also limitations of this training program. The program limitations are discussed, as well as the current efforts underway to improve and enhance ART in order to increase the training’s efficacy.

Program Evaluation, Efficacy Findings, and Future Directions

The Affect Regulation Training (ART) has received feedback from both participants and therapists who have facilitated the training program. Preliminary efficacy research has pointed to the effectiveness of the training program. Future research needs to overcome the significant limitations of previous research on the efficacy of ART.