Andrew T Gloster1, Jens Klotsche2, Joseph Ciarrochi3, Georg Eifert4, Rainer Sonntag5, Hans-Ulrich Wittchen6, Jürgen Hoyer6. 1. University of Basel, Department of Psychology, Division of Clinical Psychology and Intervention Science, Missionsstrasse 62A, CH-4055 Basel, Switzerland; Technische Universität Dresden, Department of Psychology, Institute for Clinical Psychology and Psychotherapy, Chemnitzer Straße 46, 01187 Dresden, Germany. Electronic address: andrew.gloster@unibas.ch. 2. German Rheumatism Research Centre Berlin, Leibniz Institute, Epidemiology Unit, Charitéplatz 1, 10117 Berlin, Germany; Charité Universitätsmedizin Berlin; Institute for Social Medicine, Epidemiology and Health Economics, Luisenstraße 57, 10117 Berlin, Germany. 3. Institute of Positive Psychology and Education, Australian Catholic University, 25A Barker Road, Strathfield NSW 2135, Australia. 4. Chapman University, 1 University Dr, Orange, CA 92866, USA. 5. Private Practice, In der Wüste 18, 7462 Olpe, Germany. 6. Technische Universität Dresden, Department of Psychology, Institute for Clinical Psychology and Psychotherapy, Chemnitzer Straße 46, 01187 Dresden, Germany.
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.
RCT Entities:
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.
Authors: Andrew T Gloster; Marcel Miché; Hanna Wersebe; Thorsten Mikoteit; Jürgen Hoyer; Christian Imboden; Klaus Bader; Andrea H Meyer; Martin Hatzinger; Roselind Lieb Journal: Int J Methods Psychiatr Res Date: 2017-09 Impact factor: 4.035
Authors: Albert Feliu-Soler; Francisco Montesinos; Olga Gutiérrez-Martínez; Whitney Scott; Lance M McCracken; Juan V Luciano Journal: J Pain Res Date: 2018-10-02 Impact factor: 3.133
Authors: Jeanette Villanueva; Andrea H Meyer; Marcia T B Rinner; Victoria J Block; Charles Benoy; Sandra Brogli; Maria Karekla; Marc Walter; Andrew T Gloster Journal: Int J Clin Health Psychol Date: 2020-02-24
Authors: Jeanette Villanueva; Andrea H Meyer; Thorsten Mikoteit; Jürgen Hoyer; Christian Imboden; Klaus Bader; Martin Hatzinger; Roselind Lieb; Andrew T Gloster Journal: PLoS One Date: 2021-04-14 Impact factor: 3.240
Authors: Andrew T Gloster; Andrea H Meyer; Jens Klotsche; Jeanette Villanueva; Victoria J Block; Charles Benoy; Marcia T B Rinner; Marc Walter; Undine E Lang; Maria Karekla Journal: BMC Psychiatry Date: 2021-03-24 Impact factor: 3.630
Authors: Hanna Wersebe; Roselind Lieb; Andrea H Meyer; Marcel Miche; Thorsten Mikoteit; Christian Imboden; Jürgen Hoyer; Klaus Bader; Martin Hatzinger; Andrew T Gloster Journal: Int J Clin Health Psychol Date: 2018-08-06