The 5-Minute Guide to ACT: A Visual ACT Elevator Pitch

The 5-Minute Guide to ACT: A Visual ACT Elevator Pitch

The challenge of explaining ACT

As an ACT trainer, one of the most challenging things for me is when someone who isn’t familiar with ACT says “What’s this whole ACT thing about?” Let’s just say my ACT elevator pitch needs some work! It’s tricky to try to describe something that is supposed to be an experiential therapy. And then there is the whole conundrum of trying to use language to explain a theory that holds that language is at the heart of the problem. But I find that “you just have to experience it” is the trainer equivalent to “because I said so” and is equally unsatisfying (and also not very helpful). So this week I was thrilled when I got another tool in my “what is ACT” arsenal thanks to ACBS member Dov Ben-Yaacov and the 5-minute Guide to ACT Pictogram he created.

The 5-Minute Guide to ACT Pictogram (click on picture to download)

This isn’t something I would necessarily share with clients. However, I do think this simple, yet surprisingly comprehensive pictogram could be very helpful in orienting students and those learning ACT to the general gestalt of how ACT, RFT, and Functional Contextualism fit together.

Another example of the generosity in the ACBS community

One of the things I most love about the Contextual Behavioral Science community is how incredibly generous the community is. I can’t imagine how much time it took Dov to create this. And then he just went ahead and posted it for anyone to use it for free. So it’s with much gratitude to Dov Ben-Yaacov that I pass this along to you. Please use it as it is helpful and also continue to credit Dov Ben-Yaacov as you do so. 

Jenna LeJeune, Ph.D

Author: Jenna LeJeune, Ph.D

Jenna is a clinical psychologist who specializes in working with people who struggle with relationship and intimacy difficulties and with those who have a trauma history. Her research focuses on developing compassion-based interventions targeting stigma, shame, and chronic self-criticism.

Portland Psychotherapy’s Clinical-Research Social Business Model Published in APA Journal – Psychology Research and Practice

Portland Psychotherapy’s Clinical-Research Social Business Model Published in APA Journal – Psychology Research and Practice

Many of those reading this blog probably already know that that in addition to providing science-based mental health services, Portland Psychotherapy is also a productive independent research center.

How we fund our research

What many of you may not know is how we go about funding that research. To our knowledge, we are the only organization of its kind to have set up a private mental health clinic and research center based on social business concepts in which the profits from the money-generating activities of the organization go back to serving the greater good (in this case, scientific research) rather than be used as profits for shareholders.

What we discuss in the article

We are very excited that the APA journal Psychology Research and Practice just published our article that outlines our model, which we call the clinical-research social business model. Among some of the things addressed in the article include:

  • An outline of our clinical-research social business model that is based on social enterprise concepts
  • How we overcame the barriers to conducting research outside of academia, including how we created an independent IRB and how to address infrastructure limitations such as assistants and access to journal articles
  • Benefits of conducting research outside of traditional academic settings
  • How we have shifted the contingencies around money in our model and structure our model such that intrinsic rewards such as mastery, autonomy, and purpose can serve as powerful motivators that advance more communal and creative goals.
  • Ideas about how our model might be applicable to other settings.

One thing we are very aware of at our center is that all our work depends upon a supportive community. If you are reading this, it is likely that YOU are a part of that community and we thank you for that. If you are interested in reading more about our model, how it came to be, and what your support of us has helped make happen, you can read the a pre-print of the article here.

Jenna LeJeune, Ph.D

Author: Jenna LeJeune, Ph.D

Jenna is a clinical psychologist who specializes in working with people who struggle with relationship and intimacy difficulties and with those who have a trauma history. Her research focuses on developing compassion-based interventions targeting stigma, shame, and chronic self-criticism.

“Evidence-Based Psychotherapy” versus “Scientifically Oriented Psychotherapy”

“Evidence-Based Psychotherapy” versus “Scientifically Oriented Psychotherapy”

I just stumbled across a new paper by David and Montgomery (2011), who provide a novel system for categorizing psychotherapies in terms of their quality of evidence. One reason we named this blog Science-Based Psychotherapy, is to highlight some of the flaws in the current methods of evaluating evidence-based practice. I hope that some of the recommendations of David and Montgomery (2011) get adopted, because their guidelines would be a huge advance over the current state of affairs. As stated in the article:

…all the current systems of evaluating evidence-based psychotherapies have a signi?cant weakness; they restrict their focus on evidence to data supporting (psycho)therapeutic packages while ignoring whether any evidence exists to support the proposed theoretical underpinnings of these techniques. (i.e., theory about psychological mechanisms of change; p. 90)

Evidence-based therapy lists ignore basic science and theory

One big problem of the current methods of evaluating evidence is the lack of attention to basic science and theory. The result is that therapy packages that are based on theories that have been clearly invalidated can still appear to be scientifically credible:

By ignoring the theory, the evaluative frameworks of various health-related interventions (including psychotherapy), technically (a) allow pseudoscienti?c (i.e., ‘‘junk-science’’) interventions to enter into the classi?cation schemes and ? or (b) bias the scienti?c research in a dangerous direction (p. 90).

The danger of these kinds of incentives is that they push researchers to focus solely on outcome research at the expense of testing and refining the scientific theories that will allow for future advances in therapy.

…a consequence of current classi?cation schemes (which consistently do not address underlying theories about mechanisms of change) is that as long as there are randomized trial data, the validity of the underlying theory is less relevant (p. 90).

The current evaluative systems focus on only one kind of evidence: outcome evidence based on the performance of particular therapy packages. This evidence is typically in the form of randomized controlled trials (RCTs). What David et al. add is a second factor that focuses on evidence for the underlying theory.

They propose that each of these two factors are evaluated on three levels

a) empirically well supported;

(b) equivocal ? no clear data , which includes – not yet evaluated, preliminary data, or mixed data

(c) strong contradictory evidence (SCE; i.e., invalidating evidence).

Here’s their diagram showing how this breaks down:

One of the cool things about this framework is that it allows distinctions between therapies with both types of evidence and therapies that only have one form of evidence. They call those therapies with the highest levels of evidence “Scientifically Oriented Psychotherapies.”

Scienti?cally oriented psychotherapies (SOPs) are those which do not have clear SCE for theory and package; the highest level of validation of a SOP is that in which both the theory about psychological mechanisms of change and the therapeutic package are well validated (i.e., Category I). A SOP seeks to investigate empirically both the therapeutic package in question and the underlying theory guiding the design and implementation of the therapeutic package (i.e., theory about mechanisms of change; p. 91).

A definition of pseudoscience

This allows for a pretty solid definition of a therapy based on pseudoscience.

Pseudoscienti?cally oriented psychotherapies (POPs) are those that claim to be scienti?c, or that are made to appear scienti?c, but that do not adhere to an appropriate scienti?c methodology (e.g., there is an overreliance on anecdotal evidence and testimonial rather than empirical evidence collected in controlled studies; Lilienfeld, Lynn, & Lohr, 2003)…. We de?ne POPs as therapies used and promoted in the clinical ?eld as if they were scienti?cally based, despite strong contrary evidence related to at least one of their two components (i.e., therapeutic package and theory; p. 92).

One consequence of this approach is that it allows for the identification of therapies that have accumulated evidence of effectiveness, but where the theory on which they are based has been invalidated. If these therapies are promulgated based on the invalidated theory, they are classified as pseudoscientifically oriented psychotherapies (POP). Here’s an example from their article of a commonly utilized approach, neurolinguistic programming, that is based on a disproven theory:

An interesting shift from SOPs to POPs is illustrated by neurolinguistic programming. Once an interesting system (e.g., Category IV of SOPs, according to our classi?cation), it is now seen largely as a POP (Category VII) because although its theory was invalidated by a series of studies (for details, see Heap, 1988; Lilienfeld et al., 2003), it continues to be promoted in practice based on the same theory, as if it were valid (p. 95).

Let’s break this down a little bit. While there is a general lack of evidence for the effectiveness of NLP, there is a greater consensus that the underling theory contradicts basic research in neuroscience or psychology. NLP uses many scientific sounding but empty terms such as pragmagraphics, surface structure, non-accessing movement, metamodeling, metaprogramming, and submodalities. While these terms form the theoretical foundation for much of the  NLP techniques and sound scientific, they have not stood up to scientific scrutiny and thus the term pseudoscientific applies to this therapy.

Science cannot be stagnant. It is ever evolving and needs to be modifiable based on what the data suggest. In order for science to progress and produce effective treatments over time, good theory is needed. Theory is what allows scientists to make sense of the findings that are observed and guides new research. Brute force empiricism, without theory, leads to a lot of blind paths and wasted energy. I’m heartened to see a leading journal discussing alternate schemes for evaluating the scientific credibility of therapies that focus on mechanisms of action, theory, and incorporates understanding derived from basic science.

Reference:

David, D., & Montgomery, G. H. (2011). The Scientific Status of Psychotherapies: A New Evaluative Framework for Evidence-Based Psychosocial Interventions. Clinical Psychology: Science and Practice. Volume 18, Issue 2, pages 89–99.

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