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A Mixed-Method Study Exploring the Effectiveness of Acceptance and Commitment Therapy Based Group Psychoeducation Program on Psychological Flexibility

Year 2020, Volume: 5 Issue: 3, 355 - 375, 15.10.2020

Abstract

This study aims to develop, implement, and test the effectiveness of an Acceptance and Commitment Therapy-based psychoeducation program for fostering psychological flexibility. The study employed a convergent mixed methods design. For the quantitative phase, the pre-test post-test control group experimental design was used, while in the qualitative phase, a thematic analysis was conducted. The study group consisted of 13 first-year students of the Department of Guidance and Counseling, and Psychology, aged between 18-22, 8 of whom are in the experiment group, and 5 in the control group. The students participated in 8 sessions of 90 minutes. Before and after the psychoeducation, the Acceptance and Action Questionnaire-II was administered to the students and they were also asked to answer the formerly specified open-ended questions in writing. Mann Whitney U and Wilcoxon Signed Ranks tests were used for statistical analysis; while thematic analysis was used for the qualitative component of the study. Quantitative findings showed that psychoeducation significantly increased psychological flexibility, but the change was not at a level to differ from the control group; while qualitative findings revealed that participants experienced changes in 10 themes after psychoeducation. These themes are Being Present, Self-Control, Value-Based Actions, Defusion and Coping with Feelings and Thoughts, Knowledge of Self and Others, Acceptance, Non-Avoidance, Conflict and Crisis Management, Authenticity, and Anxiety. The quantitative and qualitative findings are discussed in light of the relevant literature.

References

  • A-tjak, J. G., Davis, M. L., Morina, N., Powers, M. B., Smits, J. A., & Emmelkamp, P. M. (2015). A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems. Psychotherapy and psychosomatics, 84(1), 30-36.
  • Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotionregulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30, 217–237. https://doi.org/10.1016/j.cpr.2009.11.004.
  • Aldao, A., Sheppes, G., & Gross, J. J. (2015). Emotion regulation flexibility. Cognitive Therapy and Research, 39(3), 263–278. https://doi.org/10.1007/s10608-014-9662-4.
  • Arch, J. J., Eifert, G. H., Davies, C., Vilardaga, J. C. P., Rose, R. D., & Craske, M. G. (2012). Randomized clinical trial of cognitive behavioral therapy (CBT) versus acceptance and commitment therapy (ACT) for mixed anxiety disorders. Journal of consulting and clinical psychology, 80(5), 750.
  • Arch, J. J., & Craske, M. G. (2008). Acceptance and commitment therapy and cognitive behavioral therapy for anxiety disorders: Different treatments, similar mechanisms?. Clinical psychology: Science and practice, 15(4), 263-279.
  • Arch, J. J., Wolitzky-Taylor, K. B., Eifert, G. H., & Craske, M. G. (2012). Longitudinal treatment mediation of traditional cognitive behavioral therapy and acceptance and commitment therapy for anxiety disorders. Behaviour research and therapy, 50(7-8), 469-478.
  • Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., ... & Zettle, R. D. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire–II: A revised measure of psychological inflexibility and experiential avoidance. Behavior therapy, 42(4), 676-688.
  • Brandon, S., Pallotti, C., & Jog, M. (2020). Exploratory Study of Common Changes in Client Behaviors Following Routine Psychotherapy: Does Psychological Flexibility Typically Change and Predict Outcomes?. Journal of Contemporary Psychotherapy, 1-8.
  • Buchanan, CM, Eccles, JS, & Becker, JB (1992). Are adolescents the victims of raging hormones: Evidence for activational effects of hormones on moods and behavior at adolescence. Psychological Bulletin, 111(1), 62-107.
  • Carlson, L. E. (2012). Mindfulness-based interventions for physical conditions: a narrative review evaluating levels of evidence. International Scholarly Research Notices, 2012.
  • Carson, S.H., & Langer, E.J., (2006). Mindfulness and self-acceptance. Journal of Rational-Emotive and Cognitive-Behavior Therapy, 24, 29–43. https://doi-org.libproxy.unm.edu/10.1007/s10942-006-0022-5
  • Chandler, M. (1994). Self-continuity in suicidal and nonsuicidal adolescents. In G. G. Noam & S. Borst (Eds.), New directions for child development, No. 64. Children, youth, and suicide: Developmental perspectives (p. 55–70). Jossey-Bass.
  • Ciarrochi, J., Kashdan, T. B., Leeson, P., Heaven, P., & Jordan, C. (2011). On being aware and accepting: A one-year longitudinal study into adolescent well-being. Journal of Adolescence, 34(4), 695-703.
  • Cosio, D. (2019). A group-based, acceptance & commitment therapy intervention for chronic pain. Social Work with Groups: A Journal of Community and Clinical Practice. https://doi-org.libproxy.unm.edu/10.1080/01609513.2019.1604290
  • Creswell, J. W. (2002). Educational research: Planning, conducting, and evaluating quantitative (pp. 146-166). Upper Saddle River, NJ: Prentice Hall.
  • Creswell, J. W. (2007). Qualitative inquiry and research design: Choosing among five approaches (2nd ed.). Thousand Oaks, CA: Sage
  • Dindo, L., Zimmerman, M. B., Hadlandsmyth, K., StMarie, B., Embree, J., Marchman, J., ... & Rakel, B. (2018). Acceptance and commitment therapy for prevention of chronic postsurgical pain and opioid use in at-risk veterans: a pilot randomized controlled study. The Journal of Pain, 19(10), 1211-1221.
  • Donahue, J. J., Santanello, A., Marsiglio, M. C., & Van Male, L. M. (2017). Acceptance and commitment therapy for anger dysregulation with military veterans: A pilot study. Journal of Contemporary Psychotherapy, 47(4), 233-241.
  • Ducasse, D., Jaussent, I., Arpon-Brand, V., Vienot, M., Laglaoui, C., Béziat, S., ... & Olié, E. (2018). Acceptance and commitment therapy for the management of suicidal patients: a randomized controlled trial. Psychotherapy and Psychosomatics, 87(4), 211-222.
  • Ernst, M. M., & Mellon, M. W. (2016). Acceptance and commitment therapy (ACT) to foster resilience in pediatric chronic illness. In Child and Adolescent Resilience Within Medical Contexts (pp. 193-207). Springer, Cham.
  • Halliburton, A. E., & Cooper, L. D. (2015). Applications and adaptations of Acceptance and Commitment Therapy (ACT) for adolescents. Journal of Contextual Behavioral Science, 4(1), 1-11.
  • Harris, R. (2017). ACT’i kolay öğrenmek. Litera.
  • Hayes, S. C. (Ed.). 1989. Rule-governed behavior: Cognition, contingencies, and instructional control. New York: Plenum.
  • Hayes, S. C. (2004). Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behavior therapy, 35(4), 639-665.
  • Hayes, S. C., Barnes-Holmes, D., & Roche, B. (Eds.). (2001). Relational frame theory: A post-Skinnerian account of human language and cognition. Springer Science & Business Media.
  • Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behaviour research and therapy, 44(1), 1-25.
  • Hayes, S. C., & Smith, S. (2005). Get out of your mind and into your life: The new acceptance and commitment therapy. New Harbinger Publications.
  • Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and Commitment Therapy: An experiential approach to behavior change. New York: Guilford Press.
  • Hayes, S. C., Villatte, M., Levin, M., & Hildebrandt, M. (2011). Open, aware, and active: Contextual approaches as an emerging trend in the behavioral and cognitive therapies. Annual review of clinical psychology, 7.
  • Hayes, S. C., & Wilson, K. G. (1994). Acceptance and commitment therapy: Altering the verbal support for experiential avoidance. The Behavior Analyst, 17(2), 289-303.
  • Kabat-Zinn, J. (2005). Coming to our senses. New York: Hyperion
  • Kashdan, T. B., Barrios, V., Forsyth, J. P., & Steger, M. F. (2006). Experiential avoidance as a generalized psychological vulnerability: Comparisons with coping and emotion regulation strategies. Behaviour research and therapy, 44(9), 1301-1320.
  • Kashdan, T. B., & Rottenberg, J. (2010). Psychological flexibility as a fundamental aspect of health. Clinical psychology review, 30(7), 865-878.

Kabul ve Kararlılık Terapisi Temelli Psikolojik Esneklik Grup Psikoeğitim Programının Etkililiğini Ölçmeye Yönelik Karma Bir Çalışma

Year 2020, Volume: 5 Issue: 3, 355 - 375, 15.10.2020

Abstract

Bu araştırmada psikolojik esnekliği geliştirmek üzere Kabul ve Kararlılık Terapisi temelli bir psikoeğitim programının geliştirilmesi, uygulanması ve etkililiğinin sınanması amaçlanmıştır. Çalışmada yakınsak karma yöntem kullanılmıştır. Nicel kısımda ön test son test kontrol gruplu deneysel desen, nitel kısımda ise tematik analiz kullanılmıştır. Çalışma grubu, yaşları 18-22 arasında değişen, 8’i deney 5’i kontrol grubunda olmak üzere 13 Rehberlik ve Psikolojik Danışmanlık ve Psikoloji Bölümü birinci sınıf öğrencisinden oluşmuştur. Öğrencilerle 90 dakikalık 8 oturum gerçekleştirilmiştir. Öncesi ve sonrasında öğrencilere Kabul ve Eylem Formu II uygulanmış, ayrıca belirlenmiş açık uçlu sorulara yazılı olarak cevap vermeleri istenmiştir. Nicel veriler, Mann Whitney U ve Wilcoxon İşaretli Sıralar testi ile; nitel veriler ise tematik analiz yöntemiyle incelenmiştir. Nicel bulgular, psikoeğitimin psikolojik esnekliği anlamlı şekilde arttırdığını fakat değişimin kontrol grubundan farklılaşacak düzeyde olmadığını göstermiştir. Nitel bulgular ise psikoeğitim sonrası 10 temada katılımcıların değişim yaşadığını ortaya koymuştur. Bu temalar Anda Kalma, Öz-Kontrol, Değer Odaklı Eylemler, Duygu ve Düşüncelerle Ayrışma ve Baş Etme, Kendini ve İnsanları Tanıma, Kabul, Kaçınmama, Çatışma ve Kriz Yönetme, Otantik Olma ve Kaygıdır. Nicel ve nitel bulgular ilgili literatür eşliğinde tartışılmıştır.

References

  • A-tjak, J. G., Davis, M. L., Morina, N., Powers, M. B., Smits, J. A., & Emmelkamp, P. M. (2015). A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems. Psychotherapy and psychosomatics, 84(1), 30-36.
  • Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotionregulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30, 217–237. https://doi.org/10.1016/j.cpr.2009.11.004.
  • Aldao, A., Sheppes, G., & Gross, J. J. (2015). Emotion regulation flexibility. Cognitive Therapy and Research, 39(3), 263–278. https://doi.org/10.1007/s10608-014-9662-4.
  • Arch, J. J., Eifert, G. H., Davies, C., Vilardaga, J. C. P., Rose, R. D., & Craske, M. G. (2012). Randomized clinical trial of cognitive behavioral therapy (CBT) versus acceptance and commitment therapy (ACT) for mixed anxiety disorders. Journal of consulting and clinical psychology, 80(5), 750.
  • Arch, J. J., & Craske, M. G. (2008). Acceptance and commitment therapy and cognitive behavioral therapy for anxiety disorders: Different treatments, similar mechanisms?. Clinical psychology: Science and practice, 15(4), 263-279.
  • Arch, J. J., Wolitzky-Taylor, K. B., Eifert, G. H., & Craske, M. G. (2012). Longitudinal treatment mediation of traditional cognitive behavioral therapy and acceptance and commitment therapy for anxiety disorders. Behaviour research and therapy, 50(7-8), 469-478.
  • Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., ... & Zettle, R. D. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire–II: A revised measure of psychological inflexibility and experiential avoidance. Behavior therapy, 42(4), 676-688.
  • Brandon, S., Pallotti, C., & Jog, M. (2020). Exploratory Study of Common Changes in Client Behaviors Following Routine Psychotherapy: Does Psychological Flexibility Typically Change and Predict Outcomes?. Journal of Contemporary Psychotherapy, 1-8.
  • Buchanan, CM, Eccles, JS, & Becker, JB (1992). Are adolescents the victims of raging hormones: Evidence for activational effects of hormones on moods and behavior at adolescence. Psychological Bulletin, 111(1), 62-107.
  • Carlson, L. E. (2012). Mindfulness-based interventions for physical conditions: a narrative review evaluating levels of evidence. International Scholarly Research Notices, 2012.
  • Carson, S.H., & Langer, E.J., (2006). Mindfulness and self-acceptance. Journal of Rational-Emotive and Cognitive-Behavior Therapy, 24, 29–43. https://doi-org.libproxy.unm.edu/10.1007/s10942-006-0022-5
  • Chandler, M. (1994). Self-continuity in suicidal and nonsuicidal adolescents. In G. G. Noam & S. Borst (Eds.), New directions for child development, No. 64. Children, youth, and suicide: Developmental perspectives (p. 55–70). Jossey-Bass.
  • Ciarrochi, J., Kashdan, T. B., Leeson, P., Heaven, P., & Jordan, C. (2011). On being aware and accepting: A one-year longitudinal study into adolescent well-being. Journal of Adolescence, 34(4), 695-703.
  • Cosio, D. (2019). A group-based, acceptance & commitment therapy intervention for chronic pain. Social Work with Groups: A Journal of Community and Clinical Practice. https://doi-org.libproxy.unm.edu/10.1080/01609513.2019.1604290
  • Creswell, J. W. (2002). Educational research: Planning, conducting, and evaluating quantitative (pp. 146-166). Upper Saddle River, NJ: Prentice Hall.
  • Creswell, J. W. (2007). Qualitative inquiry and research design: Choosing among five approaches (2nd ed.). Thousand Oaks, CA: Sage
  • Dindo, L., Zimmerman, M. B., Hadlandsmyth, K., StMarie, B., Embree, J., Marchman, J., ... & Rakel, B. (2018). Acceptance and commitment therapy for prevention of chronic postsurgical pain and opioid use in at-risk veterans: a pilot randomized controlled study. The Journal of Pain, 19(10), 1211-1221.
  • Donahue, J. J., Santanello, A., Marsiglio, M. C., & Van Male, L. M. (2017). Acceptance and commitment therapy for anger dysregulation with military veterans: A pilot study. Journal of Contemporary Psychotherapy, 47(4), 233-241.
  • Ducasse, D., Jaussent, I., Arpon-Brand, V., Vienot, M., Laglaoui, C., Béziat, S., ... & Olié, E. (2018). Acceptance and commitment therapy for the management of suicidal patients: a randomized controlled trial. Psychotherapy and Psychosomatics, 87(4), 211-222.
  • Ernst, M. M., & Mellon, M. W. (2016). Acceptance and commitment therapy (ACT) to foster resilience in pediatric chronic illness. In Child and Adolescent Resilience Within Medical Contexts (pp. 193-207). Springer, Cham.
  • Halliburton, A. E., & Cooper, L. D. (2015). Applications and adaptations of Acceptance and Commitment Therapy (ACT) for adolescents. Journal of Contextual Behavioral Science, 4(1), 1-11.
  • Harris, R. (2017). ACT’i kolay öğrenmek. Litera.
  • Hayes, S. C. (Ed.). 1989. Rule-governed behavior: Cognition, contingencies, and instructional control. New York: Plenum.
  • Hayes, S. C. (2004). Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behavior therapy, 35(4), 639-665.
  • Hayes, S. C., Barnes-Holmes, D., & Roche, B. (Eds.). (2001). Relational frame theory: A post-Skinnerian account of human language and cognition. Springer Science & Business Media.
  • Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behaviour research and therapy, 44(1), 1-25.
  • Hayes, S. C., & Smith, S. (2005). Get out of your mind and into your life: The new acceptance and commitment therapy. New Harbinger Publications.
  • Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (1999). Acceptance and Commitment Therapy: An experiential approach to behavior change. New York: Guilford Press.
  • Hayes, S. C., Villatte, M., Levin, M., & Hildebrandt, M. (2011). Open, aware, and active: Contextual approaches as an emerging trend in the behavioral and cognitive therapies. Annual review of clinical psychology, 7.
  • Hayes, S. C., & Wilson, K. G. (1994). Acceptance and commitment therapy: Altering the verbal support for experiential avoidance. The Behavior Analyst, 17(2), 289-303.
  • Kabat-Zinn, J. (2005). Coming to our senses. New York: Hyperion
  • Kashdan, T. B., Barrios, V., Forsyth, J. P., & Steger, M. F. (2006). Experiential avoidance as a generalized psychological vulnerability: Comparisons with coping and emotion regulation strategies. Behaviour research and therapy, 44(9), 1301-1320.
  • Kashdan, T. B., & Rottenberg, J. (2010). Psychological flexibility as a fundamental aspect of health. Clinical psychology review, 30(7), 865-878.
There are 33 citations in total.

Details

Primary Language English
Subjects Psychology
Journal Section Articles
Authors

Beyza Kırca This is me 0000-0002-3709-5846

Halil Ekşi 0000-0001-7520-4559

Publication Date October 15, 2020
Submission Date August 11, 2020
Published in Issue Year 2020 Volume: 5 Issue: 3

Cite

APA Kırca, B., & Ekşi, H. (2020). A Mixed-Method Study Exploring the Effectiveness of Acceptance and Commitment Therapy Based Group Psychoeducation Program on Psychological Flexibility. Spiritual Psychology and Counseling, 5(3), 355-375.