Relationship science informed clinically relevant behaviors in Functional Analytic Psychotherapy: The Awareness, Courage, and Love Model

Power-Related Emotions, Alcohol Intoxication, and Nonconsensual Sex Intentions: The Role of Fear of Intimacy

The problem of alcohol-involved sexual assault against women highlights the need to identify how the presence of alcohol interacts with risk factors associated with sexual assault perpetration. One risk factor for sexual assault perpetration is fear of intimacy, the inhibited capacity to exchange vulnerable thoughts and emotions with a valued individual. Men who have perpetrated sexual violence report higher fear of intimacy and alcohol use than those who have not. However, little research has investigated how fear of intimacy may contribute to sexual assault perpetration in the context of alcohol intoxication. This study examined alcohol intoxication, fear of intimacy, proximal power-related emotions, and nonconsensual sex intentions. Non-monogamous, male social drinkers (N = 94) completed measures and were randomly assigned to an alcohol condition (alcohol [BrAC = .10%] versus control). Participants then read a sexual assault analogue scenario depicting sexual assault against a hypothetical woman and reported power-related emotions and nonconsensual sex intentions. Self-reported fear of intimacy differed across types of past perpetration. Results found that for intoxicated men only, fear of intimacy was positively associated with power-related emotions, and power-related emotions were positively associated with nonconsensual sex intentions. These associations were not observed for men in the control condition who did not consume alcohol. Future research should examine intimacy-related interventions for sexual assault prevention programming.

The role of family intimacy in playing collaborative e-sports with a Switch device to predict the experience of flow and anxiety during COVID-19 lockdown

During the COVID-19 pandemic, most people have more time to stay at home and play games together. In particular, so as to maintain social distancing, most people play with their family members. To understand how people's family intimacy affects their game experience and perceived value of playing, the present study applied a boating game, River Survival, played collaboratively via Swtich. People with experience of playing the game with family members were targeted in this study. They were notified via Facebook and Line special interest groups and responded to the questionnaire through a website. Data of 301 respondents were validated, and were subjected to structural equation modeling. The results of this study indicated that family intimacy positively predicted flow experience, but there was no significant relation to gameplay anxiety. Flow experience positively predicted perceived value, but gameplay anxiety did not significantly predict perceived value. The implication of this study is that without intimacy among team members, players cannot experience flow state or perceived game values.

Enhancing students' well-being with a unified approach based on contextual behavioural science: A randomised experimental school-based intervention

A new generation of interventions has begun to move towards principles of acceptance that deal with the context and function of psychological events. The aim of this paper is to analyse the effectiveness of a brief contextual behavioural intervention to improve the psychological well-being of secondary school students. This intervention represents a unified model with key processes based on contextual behavioural science, including Acceptance and Commitment Therapy (ACT) and Functional Analytic Psychotherapy (FAP). We conducted an intervention with 94 students (age range 17-19 years), randomly assigned to an experimental group (n = 50) or control group (n = 44). Participants took a pretest and post-test of distress, life satisfaction, psychological flexibility and mindfulness. The intervention consisted of three sessions of 1 h each. The results showed significant differences between the groups in distress and significant differences for the interaction (group × pre-post) in all the other variables. The intervention had greater benefits for girls than for boys. These results may provide a breakthrough, thus leading to a process of evidence-based therapies, which would be responsible for inducing psychological improvements in brief periods, in a population with an increasing risk of distress.

CONSCIÊNCIA, CORAGEM E AMOR: ANÁLISE BEHAVIORISTA DE OBJETIVOS DA PSICOTERAPIA ANALÍTICA FUNCIONAL

A Psicoterapia Analítica Funcional é uma abordagem clínica baseada em uma análise funcional comportamental do ambiente terapêutico típico. Seus objetivos e técnicas terapêuticas podem ser descritos em diferentes termos, privilegiando ou não a linguagem utilizada na análise experimental do comportamento. Na formulação original, é destinada a diminuir a frequência de comportamentos clinicamente relevantes (CCRs) problemáticos e aumentar a dos de progresso e de interpretação pela técnica das cinco regras: observar CCRs, evocar CCRs, reforçar CCRs, observar os efeitos da intervenção e implementar a generalização. Sob a influência da Ciência Contextual Comportamental, estes mesmos elementos passaram a ser descritos com o rótulo de ‘Modelo Consciência, Coragem e Amor’ (ACL, do inglês Awareness, Courage and Love). O objetivo deste trabalho foi identificar se a linguagem da nova proposição era compatível com a usada por B. F. Skinner. O método foi uma revisão destes termos, ou seus sinônimos, em importantes livros da obra de B. F. Skinner, notadamente uma literatura caracterizada por sua derivação dos achados de laboratório em pesquisas sobre o comportamento operante. Os livros consultados foram Ciência e comportamento humano, Sobre o behaviorismo, O comportamento verbal, Walden II e Questões recentes na análise comportamental. A revisão permitiu concluir que os termos consciência, coragem e amor já haviam sido explorados na literatura skinneriana, oferecendo análises funcionais e mostrando que seu uso é compatível com o sistema comportamental.

Clinical efficacy of a combined acceptance and commitment therapy, dialectical behavioural therapy, and functional analytic psychotherapy intervention in patients with borderline personality disorder

OBJECTIVE

Borderline personality disorder (BPD) consists of a persistent pattern of instability in affective regulation, impulse control, interpersonal relationships, and self-image. Although certain forms of psychotherapy are effective, their effects are small to moderate. One of the strategies that have been proposed to improve interventions involves integrating the therapeutic elements of different psychotherapy modalities from a contextual behavioural perspective (ACT, DBT, and FAP).

METHODS

Patients (n = 65) attending the BPD Clinic of the Instituto Nacional de Psiquiatría Ramón de la Fuente Muñíz in Mexico City who agreed to participate in the study were assigned to an ACT group (n = 22), a DBT group (n = 20), or a combined ACT + DBT + FAP therapy group (n = 23). Patients were assessed at baseline and after therapeutic trial on measures of BPD symptom severity, emotion dysregulation, experiential avoidance, attachment, control over experiences, and awareness of stimuli.

RESULTS

ANOVA analyses showed no differences between the three therapeutic groups in baseline measures. Results of the MANOVA model showed significant differences in most dependent measures over time but not between therapeutic groups.

CONCLUSIONS

Three modalities of brief, contextual behavioural therapy proved to be useful in decreasing BPD symptom severity and emotional dysregulation, as well as negative interpersonal attachment. These changes were related to the reduction of experiential avoidance and the acquisition of mindfulness skills in all treatment groups, which may explain why no differences between the three different intervention modalities were observed.

PRACTITIONER POINTS

Brief adaptations of acceptance and commitment therapy and dialectical behavioural therapy are effective interventions for BPD patients, in combined or isolated modalities, and with or without the inclusion of functional analytic psychotherapy. The reduction of experiential avoidance and the acquisition of mindfulness skills are related with the diminution of BPD symptoms severity, including emotional dysregulation and negative interpersonal attachment.

Addressing microaggressions in racially charged patient-provider interactions: a pilot randomized trial

BACKGROUND

Racial bias in medical care is a significant public health issue, with increased focus on microaggressions and the quality of patient-provider interactions. Innovations in training interventions are needed to decrease microaggressions and improve provider communication and rapport with patients of color during medical encounters.

METHODS

This paper presents a pilot randomized trial of an innovative clinical workshop that employed a theoretical model from social and contextual behavioral sciences. The intervention specifically aimed to decrease providers' likelihood of expressing biases and negative stereotypes when interacting with patients of color in racially charged moments, such as when patients discuss past incidents of discrimination. Workshop exercises were informed by research on the importance of mindfulness and interracial contact involving reciprocal exchanges of vulnerability and responsiveness. Twenty-five medical student and recent graduate participants were randomized to a workshop intervention or no intervention. Outcomes were measured via provider self-report and observed changes in targeted provider behaviors. Specifically, two independent, blind teams of coders assessed provider emotional rapport and responsiveness during simulated interracial patient encounters with standardized Black patients who presented specific racial challenges to participants.

RESULTS

Greater improvements in observed emotional rapport and responsiveness (indexing fewer microaggressions), improved self-reported explicit attitudes toward minoritized groups, and improved self-reported working alliance and closeness with the Black standardized patients were observed and reported by intervention participants.

CONCLUSIONS

Medical providers may be more likely to exhibit bias with patients of color in specific racially charged moments during medical encounters. This small-sample pilot study suggests that interventions that directly intervene to help providers improve responding in these moments by incorporating mindfulness and interracial contact may be beneficial in reducing racial health disparities.