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Hayes SC, Hofmann SG, Ciarrochi J. The Idionomic Future of Cognitive Behavioral Therapy: What Stands Out From Criticisms of ACT Development. Behav Ther 2023; 54:1036-1063. [PMID: 37863584 PMCID: PMC10589451 DOI: 10.1016/j.beth.2023.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/16/2023] [Accepted: 07/20/2023] [Indexed: 10/22/2023]
Abstract
The present special section critical of Acceptance and Commitment Therapy or Training (ACT in either case) and its basis in psychological flexibility, relational frame theory, functional contextualism, and contextual behavioral science (CBS) contains both worthwhile criticisms and fundamental misunderstandings. Noting the important historical role that behavior analysis has played in the cognitive behavioral therapy (CBT) tradition, we argue that CBS as a modern face of behavior analytic thinking has a potentially important positive role to play in CBT going forward. We clarify functional contextualism and its link to ethical behavior, attempting to clear up misunderstandings that could seriously undermine genuine scientific conversations. We then examine the limits of using syndromes and protocols as a basis for further developing models and methods; the role of measurement and processes of change in driving progress toward more personalized interventions; how pragmatically useful concepts can help basic science inform practice; how both small- and large-scale studies can contribute to scientific progress; and how all these strands can be pulled together to benefit humanity. In each area, we argue that further progress will require major modifications in our traditional approaches to such areas as psychometrics, the conduct of randomized trials, the analysis of findings using traditional normative statistics, and the use of data from diverse cultures and marginalized populations. There have been multiple generational shifts in our field's history, and a similar shift appears to be taking place once again.
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Fang S, Ding D. The differences between acceptance and commitment therapy (ACT) and cognitive behavioral therapy: A three-level meta-analysis. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023. [DOI: 10.1016/j.jcbs.2023.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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Mahony SE, Juncos DG, Winter D. Acceptance and Commitment Coaching for Music Performance Anxiety: Piloting a 6-Week Group Course With Undergraduate Dance and Musical Theatre Students. Front Psychol 2022; 13:830230. [PMID: 35369260 PMCID: PMC8972159 DOI: 10.3389/fpsyg.2022.830230] [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] [Received: 12/06/2021] [Accepted: 02/03/2022] [Indexed: 11/13/2022] Open
Abstract
Treatments for students with problematic levels of music performance anxiety (MPA) commonly rely on approaches in which students are referred to psychotherapists or other clinical professionals for individual care that falls outside of their music training experience. However, a more transdisciplinary approach in which MPA treatment is effectively integrated into students' training in music/performing arts colleges by teachers who work in consultation with clinical psychologists may prove more beneficial, given the resistance students often experience toward psychotherapy. Training singing teachers, and perhaps music teachers at large, to use an evidence-based coaching strategy like Acceptance and Commitment Coaching (ACC) to directly manage students' MPA is one such approach. Building on the work of a previous study in which ACC was administered by a singing teacher to a musical theatre student with problematic MPA, we piloted the effectiveness of a six-session, group ACC course for a sample of performing arts students (N = 6) with MPA related to vocal performances, using a mixed-methods design. The coach here was also a singing teacher without a clinical background, and her training in ACC by a clinical psychologist was of a similar duration (8 h) as the previous teacher's (7 h). Similar to the musical theatre student, the students reported being significantly less fused with their MPA-related cognitions, more accepting of their MPA-related physiological symptoms, and more psychologically flexible while performing in general, and these improvements were maintained after 3 months. Furthermore, they appeared to lower their shame over having MPA and change how they thought in relation to one another. Of note, these improvements were similar to those shown by seven vocal students with MPA after they received Acceptance and Commitment Therapy from a clinical psychologist, but with larger reductions in shame and better acceptance of MPA, which suggests a non-clinical, group ACC intervention that includes supportive discussions to normalize MPA and challenges attempts to control it may be more helpful than individual psychotherapy. These results are promising and indicate a brief training in ACC (<10 h) may be sufficient for singing teachers to provide significant benefit for students with problematic MPA.
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Affiliation(s)
- Sarah E. Mahony
- Performers College, Corringham, United Kingdom
- Voice Study Centre, East Bergholt, United Kingdom
| | - David G. Juncos
- Voice Study Centre, East Bergholt, United Kingdom
- LifeStance Health, Philadelphia, PA, United States
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van Lill X, van Lill R. Developing a brief acceptance and commitment therapy model for industrial psychologists. SA JOURNAL OF INDUSTRIAL PSYCHOLOGY 2022. [DOI: 10.4102/sajip.v48i0.1897] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Heinicke MR, Juanico JF, Valentino AL, Sellers TP. Improving Behavior Analysts’ Public Speaking: Recommendations From Expert Interviews. Behav Anal Pract 2021; 15:203-218. [DOI: 10.1007/s40617-020-00538-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2020] [Indexed: 10/19/2022] Open
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Hoffmeister JD, Kelm-Nelson CA, Ciucci MR. Quantification of brainstem norepinephrine relative to vocal impairment and anxiety in the Pink1-/- rat model of Parkinson disease. Behav Brain Res 2021; 414:113514. [PMID: 34358571 PMCID: PMC8393386 DOI: 10.1016/j.bbr.2021.113514] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/23/2021] [Accepted: 07/30/2021] [Indexed: 12/31/2022]
Abstract
Vocal communication impairment and anxiety are co-occurring and interacting signs of Parkinson Disease (PD) that are common, poorly understood, and under-treated. Both vocal communication and anxiety are influenced by the noradrenergic system. In light of this shared neural substrate and considering that noradrenergic dysfunction is a defining characteristic of PD, tandem investigation of vocal impairment and anxiety in PD relative to noradrenergic mechanisms is likely to yield insights into the underlying disease-specific causes of these impairments. In order to address this gap in knowledge, we assessed vocal impairment and anxiety behavior relative to brainstem noradrenergic markers in a genetic rat model of early-onset PD (Pink1-/-) and wild type controls (WT). We hypothesized that 1) brainstem noradrenergic markers would be disrupted in Pink1-/-, and 2) brainstem noradrenergic markers would be associated with vocal acoustic changes and anxiety level. Rats underwent testing of ultrasonic vocalization and anxiety (elevated plus maze) at 4, 8, and 12 months of age. At 12 months, brainstem norepinephrine markers were quantified with immunohistochemistry. Results demonstrated that vocal impairment and anxiety were increased in Pink1-/- rats, and increased anxiety was associated with greater vocal deficit in this model of PD. Further, brainstem noradrenergic markers including TH and α1 adrenoreceptor immunoreactivity in the locus coeruleus, and β1 adrenoreceptor immunoreactivity in vagal nuclei differed by genotype, and were associated with vocalization and anxiety behavior. These findings demonstrate statistically significant relationships among vocal impairment, anxiety, and brainstem norepinephrine in the Pink1-/- rat model of PD.
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Affiliation(s)
- Jesse D Hoffmeister
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, 1975 Willow Drive, Madison, WI, 53706, USA; Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792-7375, USA.
| | - Cynthia A Kelm-Nelson
- Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792-7375, USA.
| | - Michelle R Ciucci
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, 1975 Willow Drive, Madison, WI, 53706, USA; Department of Surgery, Division of Otolaryngology-Head & Neck Surgery, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI, 53792-7375, USA; Neuroscience Training Program, University of Wisconsin-Madison, 9531 WIMR II, 1111 Highland Avenue, Madison, WI, 53705, USA.
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An Examination of the Relationship Between Perfectionism and Neurological Functioning. J Cogn Psychother 2021; 35:195-211. [PMID: 34362859 DOI: 10.1891/jcpsy-d-20-00037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Clinical perfectionism is the rigid pursuit of high standards, interfering with functioning. Little research has explored neural patterns in clinical perfectionism. The present study explores neural correlates of clinical perfectionism, before and after receiving ten 50-minute, weekly sessions of acceptance and commitment therapy (ACT), as compared to low-perfectionist controls, in specific cortical structures: the dorsolateral prefrontal cortex (DLPFC), medial prefrontal cortex (MPFC), right inferior parietal lobule (IPL). Participants in the perfectionist condition (n = 43) were from a randomized controlled trial evaluating ACT for clinical perfectionism and low-perfectionist controls were undergraduate students (n = 12). Participants completed three tasks (editing a passage, mirror image tracing, circle tracing) using functional near-infrared spectroscopy (fNIRS) to measure neural activation. Results indicate that ḥin the DLPFC and MPFC of the perfectionists whereas activation in the other tasks were relatively similar. There were no differences were observed in the right DLPFC, MPFC, and right IPL between the posttreatment perfectionist and nonperfectionist control groups. Our findings suggest an unclear relationship between neural activation and perfectionism.
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Ozawa S. Application of Near-Infrared Spectroscopy for Evidence-Based Psychotherapy. Front Psychol 2021; 12:527335. [PMID: 34366946 PMCID: PMC8342759 DOI: 10.3389/fpsyg.2021.527335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 06/23/2021] [Indexed: 11/13/2022] Open
Abstract
This perspective article discusses the importance of evidence-based psychotherapy and highlights the usefulness of near-infrared spectroscopy (NIRS) in assessing the effects of psychotherapeutic interventions as a future direction of clinical psychology. NIRS is a safe and non-invasive neuroimaging technique that can be implemented in a clinical setting to measure brain activity via a simple procedure. This article discusses the possible benefits and challenges of applying NIRS for this purpose, and the available methodology based on previous studies that used NIRS to evaluate psychotherapeutic effects. Furthermore, this perspective article suggests alternative methodologies that may be useful, namely, the single- and multi-session evaluations using immediate pre- and post-intervention measurements. These methods can be used to evaluate state changes in brain activity, which can be derived from a single session of psychotherapeutic interventions. This article provides a conceptual schema important in actualizing NIRS application for evidence-base psychotherapy.
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Affiliation(s)
- Sachiyo Ozawa
- UTokyo Center for Integrative Science of Human Behavior (CiSHuB), Center for Evolutionary Cognitive Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
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Escala de ansiedade ao falar em público (EAFP). PSICO 2020. [DOI: 10.15448/1980-8623.2020.4.33790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Este estudo objetiva adaptar a Escala de Ansiedade ao Falar em Público (EAFP) para o contexto brasileiro, reunindo evidências de sua validade fatorial e consistência interna. Dois estudos foram realizados com amostra de universitários. O Estudo 1 participaram 211 pessoas (Midade = 25 anos; DPidade = 9,18; 58,8% homens), tendo os resultados sugerido uma estrutura unifatorial constituída pelos 14 itens que se mostraram discriminativos. No Estudo 2 participaram 208 pessoas (Midade = 25 anos; DPidade = 7,79; 79% mulheres), confirmando a estrutura unifatorial, que se demonstrou invariante quanto ao sexo, apresentando validade convergente com indicadores de saúde geral e confiança de falar em público. Concluiu-se que a versão brasileira da EAFP reuniu evidências psicométricas adequadas, apoiando seu uso em pesquisas que avaliem ansiedade de falar em público.
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Is Acceptance and Commitment Training or Therapy (ACT) a Method that Applied Behavior Analysts Can and Should Use? PSYCHOLOGICAL RECORD 2020. [DOI: 10.1007/s40732-020-00436-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Kuai SG, Liang Q, He YY, Wu HN. Higher anxiety rating does not mean poor speech performance: dissociation of the neural mechanisms of anticipation and delivery of public speaking. Brain Imaging Behav 2020; 15:1934-1943. [PMID: 33034845 DOI: 10.1007/s11682-020-00387-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/31/2020] [Indexed: 11/25/2022]
Abstract
Public speaking anxiety refers to feelings of nervousness when anticipating or delivering a speech. However, the relationship between anxiety in the anticipation phase and speech delivery phase is unclear. In this study, we used functional near-infrared spectroscopy to record participants' brain activities when they were anticipating or performing public speaking tasks in an immersive virtual reality environment. Neuroimaging results showed that participants' subjective ratings of public anxiety in the anticipation phase but not the delivery phase were correlated with activities in the dorsolateral prefrontal cortex, the inferior frontal gyrus, and the precentral and postcentral gyrus. In contrast, their speaking performance could be predicted by activities in the temporal gyrus and the right postcentral gyrus in the delivery phase. This suggests a dissociation in the neural mechanisms between anxiety in preparation and execution of a speech. The conventional anxiety questionnaire is a good predictor of anticipatory anxiety, but cannot predict speaking performance. Using virtual reality to establish a situational test could be a better approach to assess in vivo public speaking performance.
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Affiliation(s)
- Shu-Guang Kuai
- Faculty of Education, East China Normal University, Shanghai, China.
- The Key Lab of Brain Functional Genomics, MOE & STCSM, Institute of Brain and Education Innovation, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China.
| | - Qi Liang
- The Key Lab of Brain Functional Genomics, MOE & STCSM, Institute of Brain and Education Innovation, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Ying-Yao He
- The Key Lab of Brain Functional Genomics, MOE & STCSM, Institute of Brain and Education Innovation, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Hui-Ning Wu
- Faculty of Education, East China Normal University, Shanghai, China
- Center for Information and Neural Networks (CiNet), NICT, Osaka, Japan
- Graduate School of Frontier Biosciences, Osaka University, Osaka, Japan
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Brandrick C, Hooper N, Roche B, Kanter J, Tyndall I. A Comparison of Ultra-Brief Cognitive Defusion and Positive Affirmation Interventions on the Reduction of Public Speaking Anxiety. PSYCHOLOGICAL RECORD 2020. [DOI: 10.1007/s40732-020-00432-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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A preliminary investigation of the effect of acceptance and commitment therapy on neural activation in clinical perfectionism. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2020. [DOI: 10.1016/j.jcbs.2020.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Shaw TA, Juncos DG, Winter D. Piloting a New Model for Treating Music Performance Anxiety: Training a Singing Teacher to Use Acceptance and Commitment Coaching With a Student. Front Psychol 2020; 11:882. [PMID: 32547438 PMCID: PMC7270208 DOI: 10.3389/fpsyg.2020.00882] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 04/09/2020] [Indexed: 12/23/2022] Open
Abstract
Thus far, treatments for music performance anxiety (MPA) have focused primarily on interventions administered by psychologists and mental health clinicians with training and education in psychotherapy. While these interventions are promising or even efficacious, many musicians prefer not to work with a psychotherapist due to stigma and lack of time/access. Student musicians are particularly vulnerable to developing MPA, and while they may prefer consulting with their teachers about MPA over psychotherapists, many teachers feel unqualified to help. Here, we investigated an alternative intervention model, in which a clinical psychologist with MPA expertise trained a singing teacher with no training or education in psychotherapy to use an evidence-based coaching model, Acceptance and Commitment Coaching (ACC), with a student vocalist with problematic MPA, in a single-subject design format. ACC is a version of Acceptance and Commitment Therapy (ACT) that has been used under various names with non-clinical populations to help enhance psychological flexibility, e.g., with athletes, at the workplace, with undergraduates, and others. The teacher received approximately seven hours of ACC training via Skype. In turn, she provided six one-hour ACC sessions to a university student vocalist. Materials for the training and coaching sessions were taken from an ACC book and an ACT-based self-help book for musicians, and the teacher also adhered to a GROW model of coaching. The student made clinically significant improvements in two ACT-based processes believed to correlate with improved psychological flexibility in previous ACT for MPA psychotherapy research, i.e., acceptance of MPA-related discomfort and defusion from MPA-related thoughts. The student also reported a significant shift had occurred in his thinking: he became more willing to have his MPA, and so he volunteered to sing in classes early in the upcoming semester, and he auditioned for & won a lead role in a musical, both of which he previously avoided doing. ACC appears to be a promising MPA intervention that can be administered by a music teacher without training or education in psychotherapy, and it may help schools who do not employ psychologists and are therefore unable to follow best practice guidelines for treating MPA.
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Affiliation(s)
- Teresa A Shaw
- Department of Music, University of Chichester, Chichester, United Kingdom
| | - David G Juncos
- Centre for Voice Studies, East Bergholt, United Kingdom.,Hornstein, Platt & Associates, Counseling and Wellness Centers, Philadelphia, PA, United States
| | - Debbie Winter
- Centre for Voice Studies, East Bergholt, United Kingdom.,Wales Academy for Professional Practice and Applied Research, University of Wales Trinity Saint David, Carmarthen, United Kingdom
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Spencer SD, Buchanan JA, Masuda A. Effects of Brief Acceptance and Cognitive Reappraisal Interventions on Experiential Avoidance in Socially Anxious Individuals: A Preliminary Investigation. Behav Modif 2019; 44:841-864. [PMID: 31167545 DOI: 10.1177/0145445519854321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The current study compared the effects of 15-min acceptance-based and cognitive reappraisal-based interventions on experiential avoidance (EA) in socially anxious college students who participated in an experimental public speaking task. Participants were randomly assigned to receive one of the two interventions designed to aid in preparation for a 5-min laboratory-based public speaking task. Results indicated that participants receiving the acceptance-based intervention reported significantly lower levels of EA at the post-public speaking task measurement time, indicating that this brief acceptance-based intervention yielded the proposed mechanism of action in the sample used for this study. These findings highlight the importance of process-based accounts of cognitive-behavioral psychotherapy and shed light on the importance of developing interventions for alleviating social anxiety.
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Affiliation(s)
- Samuel D Spencer
- Minnesota State University, Mankato, USA.,University of Hawai'i at Mānoa, Honolulu, USA
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A pilot of acceptance and commitment therapy for public speaking anxiety delivered with group videoconferencing and virtual reality exposure. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2019. [DOI: 10.1016/j.jcbs.2019.01.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Fear of Negative Evaluation and Communication Apprehension: The Moderating Role of Communicative Competence and Extraversion Personality Trait in Pakistani Academia. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2018. [DOI: 10.1007/s10942-018-0301-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Herbert JD, Forman EM, Kaye JL, Gershkovich M, Goetter E, Yuen EK, Glassman L, Goldstein S, Hitchcock P, Tronieri JS, Berkowitz S, Marando-Blanck S. Randomized controlled trial of acceptance and commitment therapy versus traditional cognitive behavior therapy for social anxiety disorder: Symptomatic and behavioral outcomes. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2018. [DOI: 10.1016/j.jcbs.2018.07.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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The codesign of an interdisciplinary team-based intervention regarding initiating palliative care in pediatric oncology. Support Care Cancer 2018; 26:3249-3256. [PMID: 29627863 DOI: 10.1007/s00520-018-4190-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 03/29/2018] [Indexed: 10/17/2022]
Abstract
PURPOSE Children with advanced cancer are often not referred to palliative or hospice care before they die or are only referred close to the child's death. The goals of the current project were to learn about pediatric oncology team members' perspectives on palliative care, to collaborate with team members to modify and tailor three separate interdisciplinary team-based interventions regarding initiating palliative care, and to assess the feasibility of this collaborative approach. METHODS We used a modified version of experience-based codesign (EBCD) involving members of the pediatric palliative care team and three interdisciplinary pediatric oncology teams (Bone Marrow Transplant, Neuro-Oncology, and Solid Tumor) to review and tailor materials for three team-based interventions. Eleven pediatric oncology team members participated in four codesign sessions to discuss their experiences with initiating palliative care and to review the proposed intervention including patient case studies, techniques for managing uncertainty and negative emotions, role ambiguity, system-level barriers, and team communication and collaboration. RESULTS The codesign process showed that the participants were strong supporters of palliative care, members of different teams had preferences for different materials that would be appropriate for their teams, and that while participants reported frustration with timing of palliative care, they had difficulty suggesting how to change current practices. CONCLUSIONS The current project demonstrated the feasibility of collaborating with pediatric oncology clinicians to develop interventions about introducing palliative care. The procedures and results of this project will be posted online so that other institutions can use them as a model for developing similar interventions appropriate for their needs.
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Kumar M, Kalakbandi V, Prashar S, Neelu, Parashar A. Overcoming the effect of low self-esteem on public speaking anxiety with mindfulness-based interventions. DECISION 2017. [DOI: 10.1007/s40622-017-0166-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Juncos DG, Heinrichs GA, Towle P, Duffy K, Grand SM, Morgan MC, Smith JD, Kalkus E. Acceptance and Commitment Therapy for the Treatment of Music Performance Anxiety: A Pilot Study with Student Vocalists. Front Psychol 2017; 8:986. [PMID: 28674509 PMCID: PMC5475388 DOI: 10.3389/fpsyg.2017.00986] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2017] [Accepted: 05/29/2017] [Indexed: 11/13/2022] Open
Abstract
This study investigated the use of Acceptance and Commitment Therapy (ACT) as a treatment for music performance anxiety (MPA) in an uncontrolled pilot design. ACT is a newer, “third-wave” therapy that differs from previous MPA treatments, because its goal is not to reduce symptoms of MPA. Rather, ACT aims to enhance psychological flexibility in the presence of unwanted symptoms through the promotion of six core processes collectively known as the ACT “Hexaflex.” A small group of student vocalists (N = 7) from an elite choral college were recruited using objective criteria for evaluating MPA. Participants received 12 ACT sessions, and their baseline functioning served as a pre-treatment control. Treatment consisted of an orientation to ACT, identifying experientially avoidant behaviors, facilitation of Hexaflex processes, group performances in which valued behaviors were practiced in front of one another, meditations, homework, and completion of self-report measures before, during, and after treatment (at a 1- and 3-month follow-up). Improvements were observed in participants' cognitive defusion, acceptance of MPA symptoms, and psychological flexibility at post-treatment and follow-ups. Students also appeared to improve their performance quality and reduce their shame over having MPA. These results add to existing research suggesting ACT is a promising intervention for MPA, while also highlighting how vocal students may be less impaired by physical MPA symptoms.
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Affiliation(s)
| | | | - Philip Towle
- Performance Enhancement CoachingSan Francisco, CA, United States
| | - Kiera Duffy
- Department of Music, University of Notre DameSouth Bend, IN, United States
| | | | - Matthew C Morgan
- Department of Psychology, La Salle UniversityPhiladelphia, PA, United States
| | | | - Evan Kalkus
- Clinical PsyD Program, Rutgers UniversityNew Brunswick, NJ, United States
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