Journal of Contextual Behavioral Science最新文献

Although divorce rates are increasing in Japan, studies on the relationships of Japanese couples are lacking. This is the first empirical study on couples therapy in Japan. We developed Contextual Couples Therapy (CCT), a principle-based intervention comprising two sessions for Japanese couples. We evaluated the efficacy and feasibility of the intervention in a randomized controlled trial. A total of 36 individuals (18 couples) were randomly assigned to CCT (n = 16) and waitlist control conditions (n = 20). Couples were assessed at pre- and post-treatment and 1- and 3-month follow-ups using the Couples Satisfaction Index. The results indicated that CCT significantly improved the quality of relationships, and the effects were maintained at 1- and 3-month follow-ups. The findings on the satisfaction and acceptability of CCT are encouraging for conducting full-scale randomized control trials.

Mental health service scalability needs to be improved to meet the growing global demand. The scalability of Focused Acceptance and Commitment Therapy (fACT), a popular evidence-based brief behavioural intervention used in primary care contexts, could be improved through the development and implementation of a digital tool that supports practitioners to overcome service-delivery problems within their practice context.

Through semi-structured in-depth interviews with 12 fACT practitioners, we examined the service-delivery problems that they face within the New Zealand primary care context and identified organisational factors which may be contributing to these problems. From these interviews, six key themes emerged: (1) The brief model works for most clients but is not suitable for every client, (2) practitioners often struggle to access culturally appropriate fACT congruent exercises and psychoeducation material, (3) practitioners feel that they need additional training to maintain good model fidelity, (4) short session times can negatively impact model delivery, (5) public health employed practitioners have high workloads and are often unable to refer clients to secondary or crisis services, and (6) fACT practitioners are unable to effectively follow up with their clients post-session.

This study is part of a broader project aimed at developing an adjunctive digital tool to support the delivery of fACT in New Zealand primary care. These interviews will help us to understand the problems practitioners face in this service-delivery context, identify context-specific factors that may be causing these problems, and offer insights into the necessary features of an engaging digital tool designed to improve model scalability.

The Food Thought Suppression Inventory (FTSI) is a 15-item measure to assess cognitive suppression related to food. The present study aimed to: 1) study the original 15-item FTSI in both women and men through item response theory (IRT), using a graded response model; 2) replicate the factor structure obtained previously in a women sample and test the measurement invariance across body mass index (BMI) groups. In Study 1 (N = 434), the IRT model resulted in an 11-item FTSI shortened version that was equivalent across a community sample of women and men. The original FTSI was highly correlated with the FTSI short version. The short version also presented comparable correlations as the original scale in relation to body image cognitive fusion, psychological flexibility and eating psychopathology. In Study 2 (N = 435), confirmatory factor analyses revealed that the FTSI short version fitted the data well among women with normal weight and those with overweight/obesity, with the measure demonstrating invariance across both groups. These findings indicate that the FTSI short version, comprising the highest quality items, is a reliable and valid measure to assess food thought suppression in both women and men, and maintains the same factorial structure across women's BMI groups. Clinical implications were addressed.

The purpose of this study was to assess the psychometric properties of a Spanish version of the Body Image Acceptance and Action Questionnaire (BI-AAQ) and its recently developed 5-item version, the BI-AAQ-5. The BI-AAQ measures psychological flexibility/inflexibility regarding body image. A sample of Spanish adults (n = 938) completed the BI-AAQ and a battery of measures (including body mass index, psychological flexibility, exposure to and internalization of sociocultural body image expectations, body dissatisfaction, and eating disorder symptoms). Measurement invariance was tested against a U.S. American adult sample (n = 866) that completed the English version of the BI-AAQ. The unidimensional factor structure of the BI-AAQ and BI-AAQ-5 was replicated in both samples using confirmatory factor analysis, with model fit indexes ranging from adequate (e.g., CFI = 0.95) to excellent (e.g., CFI = 0.99). Internal consistency was good for both instruments across samples (α = 0.90 to 0.97). Measurement invariance analyses confirmed full configural and metric invariance and scalar partial invariance. The Spanish BI-AAQ and BI-AAQ-5 showed clear evidence of convergent and incremental construct validity. Both instruments’ scores correlated substantively with theoretically related variables. In addition, the results of a conditional process analysis showed that body-image psychological flexibility measured with either instrument moderated the mediated effect of pressure to conform to cultural ideals of body image on disordered eating through internalization of body image ideals and body dissatisfaction. We concluded both instruments are likely suitable for conducting cross-cultural research with Spanish and English-speaking samples.

Our study examines the relationship between self-compassion, other-compassion, and romantic attraction in couples, and questions the psychological homogeneity assumption—the idea that psychological responses are uniform across individuals and couples. We analyzed data from 161 participants in 84 couples, with an average age 32 (SD = 12.02), using smartphones for event sampling six times daily over a week to measure self-compassion, other-compassion, and attraction. Through within-person and network analysis, we discovered significant variability in how self and other-compassion influence attraction, identifying two distinct couple types: “synergistic,” where compassion significantly affects attraction, and “independent,” where it does not. Further analysis revealed that, when other-compassion is accounted for, males with high self-compassion were less attracted to their female partners. The significant diversity in how individuals and couples experience compassion and attraction challenges the assumption that conclusions drawn from group averages can be universally applied to individual couples. Clinically this means that efforts to enhance compassion in couples therapy should be tailored to the couple's unique dynamics. Indeed, for some men, emphasizing self-compassion without considering other-compassion could even be detrimental to the relationship. Our findings highlight the need for nuanced case formulation and personalized treatment planning in couples therapy, underscoring the complexity of relationship dynamics and the importance of rejecting “one size fits all” assumptions.

Compassion Focused Therapy (CFT) targets underlying shame and self-criticism to shift one's style of self-relating and capacity to engage with a soothing-affiliate mode. CFT has a strong evidence-base and has been adapted for diverse presenting problems and populations. CFT can serve as a stand-alone treatment approach, or an effective addition to other evidence-based approaches. This theoretical article proposes that CFT is a complementary and synergetic match with a Process-Based Therapy (PBT). This article outlines the theoretical compatibility of the two approaches before presenting an applied case study to illustrate a CFT case formulation using a PBT framework. An illustrative treatment plan is also proposed using the Extended Evolutionary Meta-Model (EEMM). Directions for further research to understand the exact mechanisms of action of CFT and its potential synergetic effects on other treatment approaches are proposed.

Low intervention engagement is common in mental health and health behavior change interventions, but research on engagement is scattered, and heterogeneity in the definition and measurement of engagement is large. To aid future engagement research, we conducted an integrative review in which we 1) discuss definitions of engagement, 2) highlight four complementary models of engagement, and 3) propose an integrative conceptual model of engagement. We searched for definitions and models of engagement in in-person, digital, and blended mental health or health behavior change interventions. Forty studies provided definitions of engagement, which were discussed and categorized. We found that most models and definitions focused on behavioral dimensions of engagement, even though our synthesis of literature indicates that engagement is a complex multidimensional, and dynamic process that consists of behavioral, cognitive, and affective dimensions. Engagement is influenced by contextual factors, such as person- and intervention characteristics, and dynamic factors, such as a person's relationship with the care provider, and motivation for treatment. Levels of engagement vary throughout the intervention process, with intervention effects reciprocally reinforcing engagement through a positive feedback loop. To guide future research on engagement, we designed an integrative conceptual model of engagement, based on existing definitions and theories that considers the complexity of engagement and is applicable in multidisciplinary contexts. Future research ideally has a multidisciplinary and contextual focus and assesses the relationship between engagement and its related constructs.

Functional Analytic Psychotherapy (FAP) is a type of psychotherapy often described as "process-based" because treatment targets are idiographically defined, and intervention strategies are specified in behavioral principles. Recently, refinements have been made to the idea of process-based therapy (PBT) that incorporates an expanded evolutionary meta-model (EEMM). The present discussion articulates how FAP fits into current conceptualizations of engaging in PBT. I argue that embracing a PBT approach to treatment can enhance therapeutic outcomes by expanding the conceptualization of clinically relevant behaviors to be viewed as a series of interrelated processes. EEMM dimensions are explored as clinically relevant behaviors, and established FAP intervention strategies for some of these dimensions are discussed. This expanded conceptualization of FAP is applied to a case example before future directions for FAP are discussed in the context of a process based approach to treatment.