Journal of Contextual Behavioral Science最新文献

Background and objective

Design and setting

Participants

Methods

Results

Conclusion

This article reviews the central theoretical claims found in the various psychotherapeutic approaches broadly referred to as the existential therapies. Despite substantial differences across existential packages, these therapies broadly arise from the theoretical position that the pain and suffering common to our species arises, not from illnesses hypothesized in traditional medical and psychiatric accounts, but rather from a set of existential concerns that all humans must face. These ‘givens’ of existence include death, identity, isolation, meaning, and freedom. From this theoretical perspective, all branches and brands of psychotherapy need to include some procedures to address these issues. Evidence for the importance of these constructs in human experience is presented, followed by evidence for existential therapies themselves. A dearth of quality research trials establishing a strong evidence base for this branch of therapy was noted. Further, process-based research in this area was shown to be weak. That is, few researchers have sought to show that the hypothesized processes are responsible for the changes observed in existential therapy. We describe how viewing existential therapy through a Process-Based Therapy (PBT) framework and the Extended Evolutionary Meta-Model (EEMM) will encourage: (1) a greater examination of the processes of change occurring; (2) an expansion in the way in which existential therapies operate, enabling the inclusion of procedures drawn from other therapeutic modalities; and (3) more nuanced targeting of existential processes in any given case.

Experiential avoidance, a central treatment target of Acceptance and Commitment Therapy (ACT), involves avoiding uncomfortable internal states and trying to control them. While some researchers suggest several components of ACT align with East Asian values, indicating the possibility of lower experiential avoidance among East Asians compared to Westerners, previous cross-cultural studies have challenged this notion. This study aimed to draw conclusions regarding cultural differences in experiential avoidance between East Asian and Western cultures through two studies. Using a meta-analysis in Study 1, we systematically reviewed previous cross-cultural studies that compared experiential avoidance between the two cultures. Six cross-cultural studies were included in the meta-analysis. In Study 2, we sought to replicate the findings using a large sample of college students. Across studies, East Asians reported greater experiential avoidance compared to Westerners, with significant heterogeneity in effect sizes observed (Study 1). Results from Study 2 showed that being an East Asian predicted greater experiential avoidance when accounting for distress and other covariates. Further, the correlation between experiential avoidance and distress was weaker among East Asian students relative to White students. Our results highlight that elevated levels of experiential avoidance in East Asians may need to be interpreted differently in clinical setting, while within-culture individual differences also need to be considered.

Background

Given the high prevalence of depression worldwide, there is a pressing need for increasing treatment accessibility and identifying treatment modalities that can sustainably address depression. The present study aims to test the feasibility, acceptability, outcomes and mechanisms of a brief online self-help program for depressive symptoms in adults (nCompass), based on Contextual Schema Therapy principles.

Method

102 participants scoring above 14 on the Beck Depression Inventory – Second Version were recruited online and randomly allocated to either the 15-day nCompass intervention or a self-administered online psychoeducation group. Participants filled in self-report measures of depression, schema coping and psychological flexibility at baseline, immediately following the intervention and at a two-week follow-up. Additionally, nCompass participants were administered an instrument measuring the acceptability of the program.

Results

The nCompass intervention was overall feasible and acceptable, with most participants completing the intervention and assessing it as easy to use, satisfactory and useful. Furthermore, results indicate higher decreases in depression and schema coping in the nCompass group by follow-up, compared to the control group. Changes in depressive symptoms from pre-test to post-test and follow-up in the nCompass group were explained by changes in surrender coping. There were no significant differences in psychological flexibility between the groups at either post-test or follow-up.

Discussion

Our results highlight the nCompass program as a promising option for treating depressive symptoms in the general population.