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Martin S. Using values in cognitive and behavioral therapy: A bridge back to philosophy. J Eval Clin Pract 2023; 29:1189-1195. [PMID: 37226577 DOI: 10.1111/jep.13872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/09/2023] [Accepted: 05/16/2023] [Indexed: 05/26/2023]
Abstract
Ancient therapeutic practices have influenced the development of cognitive behavioral therapy (CBT) theories such as Albert Ellis's rational emotive behavior therapy and Aaron Beck's cognitive therapy. By drawing inspiration from Socratic questioning, the importance of philosophy in evidence-based practices in human mental health can be acknowledged. Stoicism has also informed CBT, notably its emphasis on establishing psychological distance from emotions. Cognition and emotion are two aspects of mental processes, and irrational demands are processed through rational deliberation. Using mental imaging techniques and acceptance strategies (to accept oneself and the world as imperfect), avoiding catastrophic interpretations and acknowledging emotions are also included among such practices. METHODS: We will explore the use of values across CBT, acceptance and commitment therapy (ACT), and radically open dialectical behavioral therapy (RO DBT) to clarify their use of values. RESULTS: In this framework, values are conceptualized as life-orienting principles and are now widely used across CBTs, such as acceptance and commitment therapy and radically open dialectical behavioral therapy. In recent years, the development of CBT has involved a renewed relationship with philosophy through the use of values, interest in dialectics and development of self-questioning practices reminiscent of classical Socratic principles. This movement from applied clinical psychology toward philosophical skills has also encouraged the recent emergence of philosophical health considerations. The opposition between psychological and philosophical health can be questioned, and the fundamental issue of philosophical skills implemented in psychiatric treatment (and not solely as practices of enhancement for the sane) needs to be considered.
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Affiliation(s)
- Sylvia Martin
- Center for Research and Bioethics, Uppsala University, Uppsala, Sweden
- Clinical Psychologist specialized in CBT, Psycho-TCCE Private Practice, Nîmes, France
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Tunç H, Morris PG, Kyranides MN, McArdle A, McConachie D, Williams J. The relationships between valued living and depression and anxiety: A systematic review, meta-analysis, and meta-regression. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023. [DOI: 10.1016/j.jcbs.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
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Pasipanodya E, Khong CM, Dirlikov B, Prutton M, Held M, Shem K. Telepsychology for Individuals With Spinal Cord Injury: Protocol for a Randomized Control Study of Video-Based Cognitive Behavioral Therapy. Top Spinal Cord Inj Rehabil 2022; 28:56-67. [PMID: 36457360 PMCID: PMC9678220 DOI: 10.46292/sci22-00010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background A substantial proportion of individuals with spinal cord injury (SCI) experience depression, which has been negatively associated with recovery and community participation after injury. Despite significant barriers to seeking and receiving in-person mental health care, little research has focused on the efficacy of telepsychology among individuals with SCI. Objectives To describe the design and implementation of an ongoing single-center, randomized controlled, video-based cognitive behavioral therapy (CBT) intervention among individuals with SCI. Methods Participants within 1 year of SCI will be randomized 1:1 to intervention or usual care in a 24-week study. Intervention participants will engage in 10 sessions of CBT over 12 weeks with a licensed clinical psychologist, using iPads via Apple FaceTime. Primary outcomes are depressive symptomatology, anxiety, and life satisfaction (as measured by the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7 and Satisfaction with Life Scale, respectively) measured at three time points (baseline, 12 weeks, and 24 weeks). These and other measures are also assessed during monthly telephone surveys conducted between primary timepoints. Results Recruitment is ongoing. Forty-six participants have been enrolled thus far. Conclusion Telepsychology is a convenient, flexible, and effective alternative to traditional in-person services. We anticipate that intervention participants will experience improvements in depressive and anxiety symptoms and will have greater life satisfaction. Telepsychology interventions among individuals with SCI are tasked to maintain participant privacy, provide assistive technology and/or engage caregivers to minimize mobility limitations, and manage risk remotely. Challenges encountered include recruitment during the COVID-19 pandemic. Early intervention on symptoms of psychological morbidity using telepsychology may facilitate greater adaptation following SCI.
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Affiliation(s)
- Elizabeth Pasipanodya
- Rehabilitation Research Center, Santa Clara Valley Medical Center, San Jose, California
| | - Cria-May Khong
- Rehabilitation Research Center, Santa Clara Valley Medical Center, San Jose, California
| | - Benjamin Dirlikov
- Rehabilitation Research Center, Santa Clara Valley Medical Center, San Jose, California
| | - Michael Prutton
- Rehabilitation Research Center, Santa Clara Valley Medical Center, San Jose, California
| | - Mark Held
- Department of Psychiatry, Santa Clara Valley Medical Center, San Jose, California
| | - Kazuko Shem
- Rehabilitation Research Center, Santa Clara Valley Medical Center, San Jose, California
- Department of Physical Medicine and Rehabilitation, Santa Clara Valley Medical Center, San Jose, California
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Fields JS, Browne RK, Wieman ST, Lord KA, Orsillo SM, Liverant GI. Associations between valued living and responsiveness to daily rewards. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022. [DOI: 10.1016/j.jcbs.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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5
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Herzberg PY, Stender T, Dechmann JCG, Čolić J, Hoyer J. Do what matters, no matter what! Factorizing positive activities during COVID-19 lockdown. J Health Psychol 2022; 28:477-490. [PMID: 36124687 PMCID: PMC9490392 DOI: 10.1177/13591053221120967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Behavioral activation (BA) interventions systematically encourage positive and value-based activities. Engaging in them is an effective way to counteract negative affect, but it is unknown whether there are subtypes of activities that may have differential effects on mood. This study investigated the factorial structure of 99 potentially rewarding activities used in an online BA intervention during the COVID-19 lockdown. About 3624 German-speaking participants evaluated a list of 99 activities that were easy to apply. We analyzed the initially 99 activities by means of confirmatory factor analysis. Since activities can either be seen as reflective or formative indicators, a reflective as well as a formative model was analyzed. Although the range of chosen activities differed clearly between respondents, a one-factor model provided the best fit. It seems that a general "activity" factor is more important for explaining whether people choose a certain activity or not, than specific characteristics of the activity itself.
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Schulz-Heik RJ, Lazzeroni LC, Hernandez B, Avery TJ, Mathersul DC, Tang JS, Hugo E, Bayley PJ. Valued living among veterans in breath-based meditation treatment or cognitive processing therapy for posttraumatic stress disorder: Exploratory outcome of a randomized controlled trial. Glob Adv Health Med 2022; 11:2164957X221108376. [PMID: 35770246 PMCID: PMC9234823 DOI: 10.1177/2164957x221108376] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Valued living is the extent to which an individual's behavior is consistent with what they believe is important or good. It is unknown whether many complementary and integrative treatments and psychotherapies for posttraumatic stress disorder enhance valued living, and for whom. Objectives Measure within- and between-group changes in valued living in Veterans who completed cognitive processing therapy (CPT) and sudarshan kriya yoga (SKY) for posttraumatic stress disorder (PTSD); evaluate moderators of improvement. Methods Participants with clinically significant symptoms of PTSD were assigned to CPT, a first line, evidence-based psychotherapy for PTSD or SKY, an emerging breath-based meditation with strong preliminary empirical support in a parallel-groups randomized controlled trial at a single Veterans Affairs healthcare center. The Valuing Questionnaire subscales for progress in valued living (VQ-P) and obstruction in valued living (VQ-O) were exploratory outcome measures. Assessors were blind to treatment assignment. Results 59 participants completed treatment (29 CPT, 30 SKY). Participants in the CPT group improved from baseline to end of treatment in both VQ-Progress (d=0.55, p=0.02) and VQ-Obstruction (d=-0.51, p=0.03), while the SKY group did not improve on either subscale (d=0.08, p=0.69; d=0.00, p=1.00). However, differences between treatments were not statistically significant (p=0.16, 0.11, respectively). Participants reporting less valued living and more depression symptoms at baseline reported greater improvements in valued living following treatment. Conclusion CPT may have a positive effect on valued living. Individuals lower in valued living and with more depression may derive relatively more benefit.
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Affiliation(s)
- R Jay Schulz-Heik
- War Related Illness and Injury
Study Center, VA Palo Alto Healthcare
System, Palo Alto, CA, USA
| | - Laura C Lazzeroni
- War Related Illness and Injury
Study Center, VA Palo Alto Healthcare
System, Palo Alto, CA, USA
- Department of Psychiatry and
Behavioral Sciences, Stanford University School of
Medicine, Stanford, CA, USA
| | - Beatriz Hernandez
- Department of Psychiatry and
Behavioral Sciences, Stanford University School of
Medicine, Stanford, CA, USA
| | - Timothy J Avery
- War Related Illness and Injury
Study Center, VA Palo Alto Healthcare
System, Palo Alto, CA, USA
- Department of Psychiatry and
Behavioral Sciences, Stanford University School of
Medicine, Stanford, CA, USA
| | - Danielle C Mathersul
- War Related Illness and Injury
Study Center, VA Palo Alto Healthcare
System, Palo Alto, CA, USA
- Department of Psychiatry and
Behavioral Sciences, Stanford University School of
Medicine, Stanford, CA, USA
- Discipline of Psychology, Murdoch University, Murdoch, WA, UK
| | - Julia S Tang
- War Related Illness and Injury
Study Center, VA Palo Alto Healthcare
System, Palo Alto, CA, USA
- Department of Psychiatry and
Behavioral Sciences, Stanford University School of
Medicine, Stanford, CA, USA
| | - Emily Hugo
- War Related Illness and Injury
Study Center, VA Palo Alto Healthcare
System, Palo Alto, CA, USA
- Department of Psychiatry and
Behavioral Sciences, Stanford University School of
Medicine, Stanford, CA, USA
| | - Peter J Bayley
- War Related Illness and Injury
Study Center, VA Palo Alto Healthcare
System, Palo Alto, CA, USA
- Department of Psychiatry and
Behavioral Sciences, Stanford University School of
Medicine, Stanford, CA, USA
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Hoyer J, Dechmann JCG, Stender T, Čolić J. Selecting and imagining rewarding activities during the
COVID
‐19 lockdown: Effects on mood and what moderates them. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2021; 56:585-593. [PMID: 33942893 PMCID: PMC8239711 DOI: 10.1002/ijop.12759] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 03/05/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Jürgen Hoyer
- Institute of Clinical Psychology and Psychotherapy Technische Universität Dresden Germany
| | | | - Tanja Stender
- Institute of Clinical Psychology and Psychotherapy Technische Universität Dresden Germany
| | - Jasmin Čolić
- Institute of Clinical Psychology and Psychotherapy Technische Universität Dresden Germany
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Exploratory Study of Common Changes in Client Behaviors Following Routine Psychotherapy: Does Psychological Flexibility Typically Change and Predict Outcomes? JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2020. [DOI: 10.1007/s10879-020-09468-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
AbstractPsychological flexibility refers to a modifiable pattern of interacting with one’s experiences with openness and awareness (acceptance-and-mindfulness) and active engagement guided by personal values (commitment-and-behavioral activation). Psychological flexibility has a base of research literature that supports its utility as a model of human behavioral health and pathology. Although the model is central in organizing the therapeutic processes of Acceptance and Commitment Therapy, researchers have argued that psychological flexibility processes might be activated in other effective therapy models included in routine psychotherapy, even if those models do not purport to target those processes. This study explored the degree to which aspects of clients’ psychological flexibility, specifically acceptance-and-mindfulness and commitment-and-behavioral activation, changed after episodes of routine psychotherapy and were predictors of outcome changes for a clinically heterogeneous sample (n = 197) in a naturalistic treatment setting. Results showed statistically significant and small improvements in acceptance-and-mindfulness (d = 0.22) and commitment-and-behavioral activation (d = 0.24) and that changes in psychological flexibility were significant predictors of changes in both flourishing and distress, explaining 42% and 23% of those respective therapy outcomes. Whereas a mix of therapy approaches may slightly improve psychological flexibility, more explicit attention to strengthening it might benefit the work of diverse psychotherapists given its potential relevance to achieving common overarching therapy outcomes.
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