Journal of Contextual Behavioral Science最新文献

{"title":"Mechanisms of change in peer coaching for digital ACT: A serial mediation model on program adherence and psychological flexibility's role in reducing distress","authors":"Korena S. Klimczak,&nbsp;Michael P. Twohig,&nbsp;Gretchen G. Peacock,&nbsp;Michael E. Levin","doi":"10.1016/j.jcbs.2025.100922","DOIUrl":"10.1016/j.jcbs.2025.100922","url":null,"abstract":"<div><h3>Background</h3><div>Coaching is a well-supported intervention for improving adherence to online mental health programs. It is currently unclear whether peer-support coaching improves mental health outcomes solely through improving program adherence, or if it can also have a direct impact on mental health. We investigated this using a randomized controlled trial and applying serial mediation models.</div></div><div><h3>Method</h3><div>A total of 230 college students were instructed to use the 12-session ACT Guide program over 10 weeks. They were randomly assigned to additionally receive either peer-support coaching over weekly phone calls, text message conversations, or a no-coaching control group. Coaching followed a standardized protocol.</div></div><div><h3>Results</h3><div>Phone coaching had a significant total effect, but not a direct effect, on psychological distress. Both the phone coaching → psychological flexibility → distress, and the phone coaching → program adherence → psychological flexibility → distress indirect pathways were significant. Text coaching had a significant total and direct effect on psychological distress. The full serial pathway was the only significant indirect effect (text coaching → program adherence → psychological flexibility → distress).</div></div><div><h3>Conclusions</h3><div>We found that peer coaching in both formats significantly increased program adherence, which in turn improved psychological flexibility, consequently reducing psychological distress. Coaching through phone calls had a significantly greater indirect effect on distress and direct effect on program adherence in comparison to the text message format. It is possible that the skills review and ACT-based strategies used in phone coaching directly improve psychological flexibility regardless of the number of modules completed, with text coaching being too brief to elicit this same effect.</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"37 ","pages":"Article 100922"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144570442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining associations of mindfulness with early-life trauma and risky health behaviors using a network analysis approach in a sample of U.S. college students","authors":"Micah A. Williams ,&nbsp;Hana-May Eadeh ,&nbsp;Kristian Markon ,&nbsp;Jenna L. Adamowicz ,&nbsp;Emily B.K. Thomas","doi":"10.1016/j.jcbs.2025.100917","DOIUrl":"10.1016/j.jcbs.2025.100917","url":null,"abstract":"","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"37 ","pages":"Article 100917"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144596156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating ACT with ERP for OCD treatment: A randomized controlled trial examining symptom reduction and psychological flexibility mechanisms","authors":"Zahra Nejad-Ebrahim Soumee ,&nbsp;Amirhossein Rasouli ,&nbsp;Eric B. Lee ,&nbsp;Seyedeh Elnaz Mousavi","doi":"10.1016/j.jcbs.2025.100924","DOIUrl":"10.1016/j.jcbs.2025.100924","url":null,"abstract":"<div><h3>Background</h3><div>Despite Exposure and Response Prevention's (ERP) established efficacy for Obsessive-Compulsive Disorder (OCD), there is growing interest in exploring complementary therapeutic approaches that may enhance treatment outcomes through different mechanisms of change. This study investigated the efficacy of combined Acceptance and Commitment Therapy plus ERP (ACT + ERP) in treating OCD and its underlying psychological mechanisms in an Iranian sample.</div></div><div><h3>Methods</h3><div>A randomized controlled trial was conducted with 40 OCD-diagnosed participants, randomly allocated to ACT + ERP intervention (n = 20) or wait-list control group (n = 20). The intervention comprised sixteen 120-min sessions delivered twice weekly. Assessments were conducted at baseline, post-treatment, and three-month follow-up using the Obsessive-Compulsive Inventory-Revised (OCI-R), Acceptance and Action Questionnaire-II (AAQ-II), Cognitive Fusion Questionnaire (CFQ), and Interpretation of Intrusions Inventory (III-31).</div></div><div><h3>Results</h3><div>Mixed-model ANOVAs revealed significant time × group interactions across all measures. The ACT + ERP group demonstrated substantial improvements in OCD severity (η² = 0.301), experiential avoidance (η² = 0.139), cognitive fusion (η² = 0.241), and interpretation of intrusions (η² = 0.217). Large effect sizes were maintained at follow-up (Hedges’ g ranging from 0.75 to 1.20). The waitlist group showed no significant changes.</div></div><div><h3>Conclusions</h3><div>The integrated ACT + ERP protocol effectively reduced OCD symptoms and improved psychological flexibility processes, with benefits maintained at follow-up. These findings suggest that combining ACT and ERP may offer a comprehensive treatment approach that enhances therapeutic outcomes through multiple mechanisms of change.</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"37 ","pages":"Article 100924"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144665823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Struggles and solutions in psychological research with unaccompanied minors: Reflections from the field","authors":"Dafne Morroni ,&nbsp;Eleonora Charalambous ,&nbsp;Maria Karekla","doi":"10.1016/j.jcbs.2025.100919","DOIUrl":"10.1016/j.jcbs.2025.100919","url":null,"abstract":"<div><h3>Background</h3><div>In 2022, 22,182 individuals applied for asylum in Cyprus, of whom 941 were Unaccompanied Minors (UM).</div></div><div><h3>Objectives</h3><div>A cluster randomized controlled trial (RCT) examining Acceptance and Commitment Therapy with UM was carried out in shelters in Cyprus. The purpose of this paper is to present struggles and solutions from the RCT and to provide recommendations to clinicians and researchers working with UM.</div></div><div><h3>Method</h3><div>Obstacles faced in setting up the study and throughout research with UM were recorded systematically and resolved in team meetings. The Consolidated Framework for Implementation Research (CFIR) was applied to present the struggles and solutions.</div></div><div><h3>Results</h3><div>Akin to established literature, the authors faced several challenges including: UM hesitancy regarding written consent, language and cultural barriers, interpreter bias, difficulties engaging social workers, demanding circumstances in shelters and methodological issues concerning collection of quantitative self-report measures. Solutions included: replacing written consent with child assent, cultural and language adaptation required with material provided in booklets, providing psychoeducation to interpreters prior to an intervention, training social workers in the treatment protocol, building rapport with shelter staff, using tablets for data collection and shorter battery of questionnaires.</div></div><div><h3>Conclusions</h3><div>It is evident that carrying out research in refugee settings requires flexibility and adaptability. Findings from this study inform future intervention efforts and provide both researchers and clinicians with a framework to guide and support their work.</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"37 ","pages":"Article 100919"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developmental of a checklist of transdiagnostic therapeutic skills for use in general healthcare appointments","authors":"Wendy Diana Shoesmith ,&nbsp;Assis Kamu ,&nbsp;Nicholas Tze Ping Pang","doi":"10.1016/j.jcbs.2025.100918","DOIUrl":"10.1016/j.jcbs.2025.100918","url":null,"abstract":"<div><h3>Introduction</h3><div>Psychotherapy is not available for most people globally with mental disorders. Training general healthcare staff in transdiagnostic psychological intervention skills is a more feasible approach in settings where the access to therapy is low. Tools are needed to measure the use of these skills in general healthcare settings to enable further research into effectiveness.</div></div><div><h3>Methods</h3><div>We operationalised skills taught in a psychological intervention course for general healthcare staff and created a 26-item observational checklist. This was validated using generalisability theory by asking five experts to rate 26 videos. Two research assistants then used the checklist to observe doctors’ consultations before and after a psychological intervention course. We used Rasch analysis to refine the checklist so that it conformed to the Rasch unidimensional measurement model. We analysed the pre-post difference in skill use, and length of appointment using linear mixed modelling.</div></div><div><h3>Results</h3><div>The research assistants observed 87 interviews of 12 doctors before the course and 75 interviews of 11 doctors after the course. The final 18-item checklist had a generalisability coefficient of 86.8 % and conformed to the Rasch model. There were 4.28 extra skills on the checklist used per consultation after compared to before the course (95 % CI [2.40, 6.16]). The length of appointment did not change.</div></div><div><h3>Conclusion</h3><div>This approach has allowed the development of a flexible checklist, which is valid, reliable and change sensitive, and can be modified and added to by other researchers according to needs. This provides a foundation for further research into effectiveness.</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"37 ","pages":"Article 100918"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accept to change: Translation and validation of the Acceptance/Avoidance-Promoting Experiences Questionnaire (APEQ) in an international survey of Spanish-speaking psychedelic users","authors":"Óscar Soto-Angona ,&nbsp;Amanda Rodríguez-Urrutia ,&nbsp;Josep Antoni Ramos-Quiroga ,&nbsp;Óscar Álvarez-Bobo ,&nbsp;Genís Ona ,&nbsp;Sergio Pérez Rosal ,&nbsp;Juan París-Pérez ,&nbsp;Max Wolff","doi":"10.1016/j.jcbs.2025.100923","DOIUrl":"10.1016/j.jcbs.2025.100923","url":null,"abstract":"<div><h3>Introduction</h3><div>The Acceptance/Avoidance-Promoting Experiences Questionnaire (APEQ) is a theory-based instrument designed to assess acceptance-related (ACE) and avoidance-related experiences (AVE) during psychedelic-induced altered states of consciousness, proposing a model in which these experiences shape psychological flexibility. This study aimed not only to translate and evaluate the psychometric properties of a Spanish version of the APEQ, but also to test its theoretical assumptions and examine contextual and motivational factors modulating therapeutic processes in psychedelic experiences across diverse Spanish-speaking populations.</div></div><div><h3>Material and methods</h3><div>An international retrospective survey was conducted in a Spanish-speaking cohort (n = 715) reporting a single psychedelic experience in a therapeutic, ritualistic or ceremonial context involving LSD, psilocybin, ayahuasca, mescaline, MDMA, or ketamine. Participants resided in Spain (n = 420), Latin America (n = 274), or other countries (n = 21).</div></div><div><h3>Results</h3><div>The Spanish APEQ demonstrated good construct, criterion and cross-cultural validity, as well as internal consistency across scales and in diverse Spanish-speaking populations. Indicating context-dependency, ACE scores were positively associated with therapeutic and growth-oriented motives and with increased psychological flexibility, whereas AVE scores were associated with hedonic/escapist motives and decreased flexibility. High rates of comorbid mental health conditions and concurrent substance use were observed, reflecting relevant patterns in naturalistic psychedelic users.</div></div><div><h3>Conclusion</h3><div>This study supports the validity and reliability of the Spanish APEQ and provides cross-cultural evidence for the context-dependent nature of psychedelic experiences and their psychological consequences. Beyond validation, these findings confirm core theoretical assumptions of the APEQ and suggest that promoting acceptance during psychedelic states may enhance therapeutic outcomes. The observed comorbidities and substance use patterns point to the need for informed risk-reduction strategies in these populations.</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"37 ","pages":"Article 100923"},"PeriodicalIF":3.4,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144580591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of ACT for parents of children with special health care needs: Preliminary findings from Malaysia","authors":"Re Gal Lim,&nbsp;Fitri Suraya Mohamad,&nbsp;Siok Ping Voon","doi":"10.1016/j.jcbs.2025.100920","DOIUrl":"10.1016/j.jcbs.2025.100920","url":null,"abstract":"<div><div>Parents of children with special health care needs (CSHCN) often experience heightened stress and psychological distress, which not only affects parental well-being but also has cascading effects on their children. Despite the importance of supporting parental psychological health, interventions addressing their well-being remain underexplored, particularly in Malaysia. Culturally adapted interventions for these parents in the Malaysian context are especially scarce. The present study addressed this gap by evaluating the My-CARE protocol, a culturally adapted intervention targeting Chinese Malaysian parents of CSHCN in Kuching, Sarawak, Malaysia. Its preliminary efficacy was evaluated through a quasi-experimental study involving two groups (intervention and control; <em>n</em> = 31 per group) across three time points: baseline, post-intervention, and one-month follow-up. Linear Mixed Model analysis indicated significant time effects on depression, stress, psychological flexibility, and quality of life. Additionally, significant Group × Time interactions were identified for depression, anxiety, stress, psychological inflexibility, parenting stress, and quality of life, demonstrating significant differential changes between groups over time. These findings offer preliminary evidence regarding the potential efficacy of an ACT-based, parent-focused group intervention targeting Chinese Malaysian parents of CSHCN. This study contributes to the emerging literature on the potential value of culturally adapted ACT interventions for this population.</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"37 ","pages":"Article 100920"},"PeriodicalIF":3.4,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144502073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-reported unwanted events and deterioration rates during acceptance and commitment therapy: A brief report of group therapy for fibromyalgia","authors":"Marie-Louise Henning Ottergård ,&nbsp;Linea Pretzmann ,&nbsp;Tobias Lundgren ,&nbsp;Lance McCracken ,&nbsp;Monica Buhrman ,&nbsp;Peter Molander ,&nbsp;Alexander Rozental","doi":"10.1016/j.jcbs.2025.100914","DOIUrl":"10.1016/j.jcbs.2025.100914","url":null,"abstract":"<div><div>Fibromyalgia is a type of generalized chronic pain condition that causes physical tenderness, fatigue, sleep disturbance, cognitive impairment, and comorbid psychiatric symptoms. Medication and psychotherapy can offer some relief. Acceptance and Commitment Therapy (ACT) is a current treatment approach that focuses on fostering acceptance of symptoms and engagement in meaningful, value-driven activities. However, no systematic attempts at investigating unwanted events and deterioration have been made in relation to ACT for fibromyalgia. This brief report presents findings on the occurrence of characteristics of such incidents in a group-based ACT-treatment at a specialized pain clinic. Among the 94 patients included, deterioration rates were generally low across most outcome measures. Unwanted events were monitored using the 32-item Negative Effects Questionnaire, a self-report measure covering symptoms, treatment quality, dependency, stigma, hopelessness, and failure. A total of 37.6 % reported having experienced unwanted events during the treatment period, and 43.2 % at post-treatment. Among the most frequently occurring unwanted events reported at post-treatment were “Unpleasant memories resurfaced” (12.7 %), “I experienced more unpleasant feelings” (9.9 %), and “I feel like I am under more stress” (8.3 %). However, unwanted events reported during treatment were not related to treatment outcome. The results point to the importance of monitoring unwanted events during treatment, although these experiences may not interfere with benefits participants obtain, and, presumably, may be part of the theorized change process. Further research is warranted to understand how unwanted events and deterioration might affect adherence and dropout.</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"37 ","pages":"Article 100914"},"PeriodicalIF":3.4,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144270765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of workplace acceptance and commitment therapy (ACT) programs on psychological flexibility's subprocesses: A systematic review","authors":"Yass Rad ,&nbsp;Arianna Prudenzi ,&nbsp;Lucie Zernerova ,&nbsp;Jennifer Gerson ,&nbsp;Paul E. Flaxman","doi":"10.1016/j.jcbs.2025.100915","DOIUrl":"10.1016/j.jcbs.2025.100915","url":null,"abstract":"<div><div>Despite growing interest in applying <em>acceptance and commitment therapy</em> (ACT) in workplace settings, recent reviews raised doubt about the efficacy of staff-focused ACT programs for improving psychological flexibility. However, more specific processes targeted by these programs may have been obscured by aggregating effects across a wide array of psychological flexibility measures for meta-analytic review purposes. To investigate this possibility, the current systematic review examines workplace ACT intervention effects on psychological flexibility's subprocesses (i.e., contact with the present moment, acceptance, defusion, self-as-context, values, and committed action). The review protocol was registered with PROSPERO (reference: CRD42022349446). The literature search identified 30 staff-focused ACT trials (18 controlled trials) that administered measures that could be mapped onto one or more psychological flexibility subprocess. Collectively, this body of research indicates strongest evidence for the effectiveness of workplace ACT programs for targeting defusion (observed across three types of defusion measures), and moderate yet consistent evidence that these programs increase mindful awareness and acceptance. Due to measurement issues, effects on values-based action have been less consistent overall. The next generation of workplace ACT research could be advanced by 1) adopting multidimensional psychological flexibility and inflexibility instruments, 2) subprocess-level multiple mediation testing, and 3) increasing methodological quality.</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"37 ","pages":"Article 100915"},"PeriodicalIF":3.4,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144321564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adolescents’ psychological flexibility and non-suicidal self-injury: Exploring between-person and within-person association","authors":"Dongyan Ding,&nbsp;Shuanghu Fang","doi":"10.1016/j.jcbs.2025.100916","DOIUrl":"10.1016/j.jcbs.2025.100916","url":null,"abstract":"<div><div>Most research on the relationship between psychological flexibility and non-suicidal self-injury (NSSI) has been cross-sectional, focusing primarily on specific sub-dimensions of psychological flexibility (<em>e.g.</em>, experiential avoidance, cognitive fusion) rather than its integrated constructs. To address these gaps, this study employed the Random Intercept Cross-Lagged Panel Model (RI-CLPM) to investigate the within-person dynamic relationships between psychological flexibility (including six sub-dimensions) and NSSI. A total of 1119 adolescents (mean age = 13.15, SD = 1.26; 50.2 % female) participated in the study, with data collected at six-month intervals over a 1.5 year period. The study revealed that higher psychological flexibility and its six sub-dimensions (i.e., present awareness, acceptance, cognitive defusion, self-as-context, values, and committed action) significantly predicted lower future NSSI over time, while NSSI did not significantly influence psychological flexibility or its sub-dimensions. Moreover, at the between-person level, committed action and cognitive defusion were negatively associated with NSSI. This research is the first to use RI-CLPM to differentiate within-person effects from between-person effects, providing a comprehensive analysis of the dynamic relationship between psychological flexibility (including its sub-dimensions) and NSSI. The findings offer a solid theoretical foundation for future interventions aimed at enhancing psychological flexibility to reduce NSSI among adolescents.</div></div>","PeriodicalId":47544,"journal":{"name":"Journal of Contextual Behavioral Science","volume":"37 ","pages":"Article 100916"},"PeriodicalIF":3.4,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144321563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}