Document Type

Article

Publication Date

1-24-2017

Abstract

Background: Psychological flexibility theory (PFT) suggests three key processes of change: increases in value-directed behaviors, reduction in struggle with symptoms, and reduction in suffering. We hypothesized that Acceptance and Commitment Therapy (ACT) would change these processes and that increases in valued action and decreases in struggle would precede change in suffering.

Method: Data were derived from a randomized clinical trial testing ACT (vs. waitlist) for treatment-resistant patients with primary panic disorder with/without agoraphobia (n= 41). Valued behavior, struggle, and suffering were assessed at each of eight sessions.

Results: Valued actions, struggle, and suffering all changed over the course of therapy. Overall changes in struggle and suffering were interdependent whereas changes in valued behavior were largely independent. Levels of valued behaviors influenced subsequent suffering, but the other two variables did not influence subsequent levels of valued action.

Discussion: This finding supports a central tenet of PFT that increased (re-)engagement in valued behaviors precedes reductions in suffering. Possible implications for a better understanding of response and non-response to psychotherapy are discussed.

Comments

NOTICE: this is the author’s version of a work that was accepted for publication in Behaviour Research and Therapy. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Behaviour Research and Therapy, volume 91, in 2017. DOI: 10.1016/j.brat.2017.01.013

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Copyright

Elsevier

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This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Available for download on Thursday, January 24, 2019

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