Journal of Contextual Behavioral Science最新文献

The emotional exhaustion component of burnout is concerningly prevalent in psychologists providing psychotherapy. Emotional labor is a known contributor to burnout through the pathway of emotional dissonance and is beginning to develop attention in psychologist wellbeing literature. Although the relationship between emotional dissonance and emotional exhaustion in psychologists has been observed previously, constructs within an individual's locus of control that affect this relationship are not known. We attempted to explore possible variables that may affect emotional dissonance's relationship with emotional exhaustion in psychologists to identify possible factors amenable to future interventions aimed at improving psychologist wellbeing. Specifically, we examined how self-compassion, psychological flexibility, and career experience may affect the relationship between emotional dissonance and emotional exhaustion. We conducted a path analysis on data gathered from 454 psychologists recruited internationally. Results indicated that self-compassion may affect burnout indirectly through the mechanism of emotional dissonance. Additionally, results suggest that psychological flexibility may exert a conditional effect on the relationship between emotional dissonance and emotional exhaustion such that higher rates of psychological flexibility may weaken this relationship. We found no evidence to support career experience's hypothesized conditional effects. Our findings provide the first examination of these constructs in this occupational group and support the potential role of self-compassion and psychological flexibility in assisting psychologists to improve their wellbeing.

Background

Type 1 diabetes (T1D) is a demanding condition for both adolescents and their parents. The first aim of this study was to investigate the acceptability of an acceptance and commitment therapy (ACT) group intervention for 12–16-year-old adolescents with T1D. The second aim was to investigate how adolescents whose glycemic control improved during the intervention differed from those who did not improve.

Methods

A total of 28 adolescents and their parents who completed the intervention were interviewed at the end of the intervention. The adolescents filled in questionnaires regarding diabetes-related psychological flexibility (DAAS) and acceptance and mindfulness (CAMM) before and after the intervention. Glycosylated hemoglobin (HbA1c) levels were obtained from the medical records before and after the intervention. The experiences of the intervention were investigated using semi-structured questionnaires and a thematic analysis. Statistical analyses were performed to study the group differences between adolescents who improved in glycemic control and those who showed no improvement.

Results

Of those who completed the intervention, 86% of the adolescents and 89% of the parents reported being very satisfied or satisfied with the intervention. The thematic analysis showed that among the themes arising from the experiences of adolescents were increased motivation for the treatment of diabetes and a better attitude toward diabetes. Among the parents, themes such as positive changes in mood, a better attitude toward diabetes, and increased motivation for treatment emerged. In terms of group differences, those who improved with regard to glycemic control were older, their HbA1c was higher at the start, and they reported greater changes in diabetes-related psychological flexibility.

Conclusions

The ACT-based group intervention was well accepted and complemented the usual treatment. Thus, this intervention is recommended, especially for adolescents who have not met the glycemic targets.

Metaphors are commonly used in psychotherapy, especially in Acceptance and Commitment Therapy (ACT). Moreover, people use metaphors spontaneously in their everyday lives when trying to understand and make sense of complex issues. Relational Frame Theory (RFT) allows an analysis of metaphors as relating relations, where establishing coordination between a more concrete or familiar semantic domain with a more challenging target domain has pragmatic effects. A total of 806 Spanish-speaking participants were asked to provide a metaphor about life and to explain how they understood this metaphor. Their responses were analysed using reflexive Thematic Analysis (TA). The RFT and contributions from the cognitive linguistics approach to metaphors were used to interpret the patterns identified in the discourse on life metaphors. Participants' metaphors were organised into four themes: (1) recognition of variation in life, (2) attempts to make sense of variation in life, (3) problems with variation in life, and (4) evaluation of life as essentially positive or negative. Metaphors to recognise the multiplicity of events within life use “container”-related source-networks. Meaning in life is denoted through using networks connected with “movement toward a destination”, “human/natural development”, “fiction”, and “game and sports”, whereas metaphors involving disruptions in such patterns of change denote meaninglessness. Metaphors may also use particular qualities of entities and objects to signal positive and negative aspects of life. A variety of experiences connected with the source-networks of metaphors may be involved in the transfer of stimulus functions to the target-network “life”. Qualitative analysis of life metaphors from the RFT perspective offers valuable insights on how metaphors function in everyday life and how they can be used in clinical work.

Employees with mental health conditions often struggle to remain in employment. During the COVID-19 pandemic, these employees faced additional stressors, including worsening mental health and work productivity. In 2020, as part of a larger programme of work called the Mental Health and Productivity Pilot (MHPP), we developed a new early intervention (MENTOR) that jointly involved employees, managers, and a new professional (Mental Health Employment Liaison Worker, MHELW). The intervention involved trained MHELWs delivering ten sessions to employees with existing mental health conditions and managers (three individual sessions and four joint sessions) over twelve weeks. These sessions aimed to improve psychological flexibility, interpersonal relationships, and engagement of employees. This feasibility randomised controlled trial aimed to examine the feasibility and acceptability of the intervention from the perspective of employees and managers using a mixed methods approach. The intervention was largely considered feasible and acceptable. Initial findings suggest there may be benefits for employees productivity, mental health, and managers' mental health knowledge. Logistical challenges acted as a barrier to the participation of employees and managers in the trial and their retention throughout its duration. The major strengths of this study were the co-design and inter-disciplinary approach taken. Overall, findings suggest that this novel intervention has potential but needs some adjustments and testing in a larger sample.

Acceptance and commitment therapy (ACT) is evidence-based, transdiagnostic psychotherapy that seeks to increase values-consistent behavior and advances mental health by promoting psychological flexibility (PF) and diminishing psychological inflexibility (PI). PF implies a person's ability to cope with, accept, and adjust to challenging circumstances, whereas PI denotes the inflexible dominance of psychological responses in steering behavior over selected values and contingencies. The Multidimensional Psychological Flexibility Inventories (MPFI-60-24) have been established to cover all six factors of PF and six factors of PI at once. Still, these measures have yet to be validated in a Persian sample and this study seeks to validate the Persian versions of MPFI. We evaluated long and short versions of the MPFI in a Persian sample of 1270 (83% females, ages 18 through 57), divided into two groups, a healthy community group (n = 886) and a clinical group (n = 391). The MPFIs' psychometric properties, including criterion validity, construct validity, internal consistency, and measurement invariance, were investigated. Confirmatory factor analysis (CFA) revealed that a 12-factor model had a good fit to the data for the long version (CFI = .92) and a very good fit (CFI = .98) for the short version. Regarding higher-order models, two-factor second-order model indices for long-form were adequate (CFI = .92), and for short-form, they were good (CFI = .96). All 12 subscales demonstrated sufficient reliability. Measurement invariance for gender and mental health state was observed, as well as good internal consistency and adequate criterion validity with psychological distress markers (i.e., depression, anxiety, and stress). PI was more strongly related to psychological distress than PF. Persian versions of the MPFI are reliable instruments for indexing PF and PI in both genders as well as in community and clinical samples.

Acceptance and Commitment Therapy has gained preliminary evidence for paediatric chronic pain. Several studies show that psychological flexibility/inflexibility is a process driving treatment change in ACT for chronic pain. The literature supporting psychological flexibility as a change process in ACT is typically based on self-report. The aim of the present study was to investigate psychological flexibility (i.e. acceptance, defusion, values formulation and committed action) as in-treatment behaviour during internet-delivered Acceptance and Commitment Therapy for paediatric chronic pain, by having two independent observers rating patient written statements. The sample was self-recruited and consisted of 28 girls between ages 13 and 17 years. Results showed that psychological flexibility could be operationalised as in-treatment behaviours and reliably assessed using observer ratings. Also, data illustrated a within subject variability in ratings of acceptance and defusion, with a considerable difference in degree of acceptance or defusion evoked by different experiential exercises. Furthermore, analyses showed that a higher average degree of acceptance in patient statements during the early phase of treatment was related to larger treatment effects. Defusion, values formulation and committed action showed no significant influence on outcome. Results should be interpreted with caution due to the small sample size.

Experiential avoidance related to teachers or teaching can be assessed using the Teachers Acceptance and Action Questionnaire (TAAQ); however, no Japanese version of the TAAQ has thus far been presented. This study aimed to develop a Japanese version of the TAAQ and examine its reliability and validity. The participants were 300 elementary or middle school teachers in Japan (201 men, 99 women; mean age = 45.37, SD = 10.42). A one-factor structure was identified using confirmatory factor analysis. Internal consistency was assessed using item-total correlation coefficients and Cronbach’s alpha, while test-retest reliability was measured using intraclass correlation coefficients. The results demonstrated sufficient reliability. Pearson’s product-moment correlation coefficients—with scales that measure burnout, experiential avoidance (EA) in general, teachers’ occupational stressors, work engagement, and worry—were calculated to examine concurrent validity and showed a small-to-large significant correlation. Mediation analyses—with occupational stressors as the independent variable, the three factors of burnout as the dependent variables, and teaching-related EA as the mediation variable—were also conducted to examine construct validity, which showed significant mediation models. Hierarchical multiple regression analysis was conducted to examine incremental validity; it showed that once the Japanese version of the TAAQ was added, the effect on burnout improved. Although our Japanese version of the TAAQ has some limitations, it showed sufficient reliability and validity; therefore, its use as a scale in future research is acceptable.

Pediatric obsessive compulsive disorder (OCD) is a significantly impairing disorder. Given the impact of pediatric OCD, it is important to consider how to best adapt treatments for OCD, particularly for more severe youth that may not respond to traditional outpatient formats. Understanding how to implement such treatments via telehealth can improve access to care and reduce treatment burden on families. The current study therefore evaluates preliminary feasibility, acceptability, and effectiveness of delivering a pilot intensive, group-based telehealth treatment combining acceptance-based skills with exposure and response prevention (ERP) for pediatric OCD. Participants (N = 25) received two to 3 h of individual, family, and/or group treatment per day, four days per week, for a total of 10 h of treatment per week. Following the intensive outpatient program (IOP), adolescents reported large decreases in OCD symptoms, and small to large decreases in anxiety and depression. Parents reported similar outcomes, with small to large improvements in the impact of OCD on their child, anxiety, and familial accommodation. This pilot study thereby presents promising results and adds to the growing evidence base of acceptance-based interventions for adolescents with OCD, anxiety, and other mental health concerns.