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Treatment - Mindfulness & Acceptance

Acceptance and commitment therapy for experiential avoidance-based mental health concerns: A multiple baseline design study with exploratory process of change analysis

(PS14-63) Acceptance and Commitment Therapy for Experiential Avoidance-based Mental Health Concerns: A Multiple Baseline Design Study with Exploratory Process of Change Analysis

Sunday, November 17, 2024
10:30 AM – 11:30 AM EST
Location: Franklin Hall, Level 4, Marriott Downtown
Abstract Text: Although much research exists concerning outcomes of evidence-based psychosocial interventions, relatively less is known about the processes, or mechanisms, of change underlying these interventions. One evidence-based intervention that is commensurate with a process-based, transdiagnostic approach to treatment development is acceptance and commitment therapy (ACT). ACT targets functionally and contextually defined, systematically manipulable behavioral processes of change that underlie topographically diverse symptomology, and it does so to promote a client’s adaptive behavioral functioning in important life domains. Key exemplars of such processes are engaged living (EL) and experiential avoidance (EA). Using a non-concurrent multiple baseline design across participants, the current study investigated the effects of individually delivered ACT in adults with varied mental health concerns, while simultaneously examining EL and EA as potential processes of change on an ongoing basis throughout the course of ACT. Three university students who endorsed mental health concerns associated with elevated levels of EA participated in the present study and received the proposed 10-week ACT intervention, which was modified to specifically target the processes of EL and EA rather than symptomology of particular psychiatric disorders. Results of daily measured primary outcomes (i.e., clinically relevant behavioral excesses and deficits unique to each participant’s presenting concerns) and process of change variables (i.e., daily self-report measures of EL and EA), along with weekly and pre-, mid-, post-treatment, and 3-month follow-up self-report measures, provided equivocal support for the efficacy of the ACT intervention. Salutary findings were most pronounced for one out of three participants. Similarly, cross-lagged correlation analyses did not reveal evidence of temporal precedence of change in process over outcome variables (or vice versa) throughout the course of the intervention for any of the participants. Several factors related to methodology, measurement, and patient characteristics that may have influenced study findings are discussed. Further research should continue to examine the processes of change (and their temporal sequencing) within ACT for transdiagnostic mental health concerns, as well as the relationship between process of change variables and behavioral outcomes more generally. An increased focus on empirically elucidating the relationship between treatment principles and processes of change as it applies to unique individuals offers potential to improve the reach and scope of interventions for reducing suffering and promoting prosperity in diverse groups of people.