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Leading theories regarding the mechanisms of exposure for OCD focus on Pavlovian fear reduction more than operant processes. Acceptance-based exposure directly targets operant behavior. Integrating these perspectives could lead to a more robust understanding of mechanisms of change in exposure and more effective and enduring treatments. The current study investigated acceptance and regulation of distress during exposure. Participants with intrusive thoughts were randomized into three groups, Acceptance (n = 23), Regulation (n = 20), and Control (n = 21), and completed two behavioral avoidance tests (BATs) 1 week apart. Active conditions completed a 30-min exposure plus 6 days of 10-min exposures at home; Control participants watched videos of the same durations. Self-report measures were collected at both sessions, and behavioral, subjective, and physiological repeated measures data were collected during both BATs. Compared to Control, active conditions decreased OCD symptom severity, rituals, and skin conductance levels, while Acceptance showed lower skin conductance levels than Regulation and Control. Acceptance showed greater willingness and psychological flexibility than Control, while Regulation did not. Results support theorized mechanisms of change in acceptance-based exposure and suggest willingness to experience distress may paradoxically lead to decreased physiological arousal, which has important implications for treatment and future research. • Acceptance and regulation procedures were more effective than a no treatment control condition. • Acceptance reduced skin conductance more than anxiety regulation and control conditions. • Acceptance increased willingness and psychological flexibility over other conditions. • Results suggest increase in willingness can result in lessened emotional reactivity. [ABSTRACT FROM AUTHOR]

Throughout its history the strategy and tactics of contextual behavioral science (CBS) research have had distinctive features as compared to traditional behavioral science approaches. Continued progress in CBS research can be facilitated by greater clarity about how its strategy and tactics can be brought to bear on current challenges. The present white paper is the result of a 2 1/2-year long process designed to foster consensus among representative producers and consumers of CBS research about the best strategic pathway forward. The Task Force agreed that CBS research should be multilevel, process-based, multidimensional, prosocial, and pragmatic, and provided 33 recommendations to the CBS community arranged across these characteristics. In effect, this report provides a detailed research agenda designed to maximize the impact of CBS as a field. Scientists and practitioners are encouraged to mount this ambitious agenda. • The strategies and tactics of contextual behavioral science research are distinctive. • CBS research is multilevel, process-based, multidimensional, prosocial, and pragmatic. • Targeted research is needed in all five of these areas. • Thirty-three recommendations are offered to direct and improve CBS research. • These recommendations can be used as a quality improvement checklist. [ABSTRACT FROM AUTHOR]

Historically speaking, the behavioral tradition advanced functional analysis as a method of applying existing principles to novel situations. In the more than half a century since that idea was advanced, functional analysis has either fallen into disuse, as in most of applied psychology, or has been used but modified to a point that is virtually inapplicable elsewhere, as in applied behavior analysis work with severe developmental disabilities. In this paper we argue that the current challenges with COVID-19 present an ideal time to reinvigorate functional analysis by combining it with the growing body of evidence on processes of change, organized under an extended evolutionary meta-model. This new form of process-based functional analysis takes advantage of the strengths of contextual behavioral science, while opening avenues of fruitful interaction with other wings of intervention and evolutionary science more generally. Using the psychological flexibility model as an example, we show how this approach solves the key problems of classical functional analysis and helps professionals deal with novel challenges such as those posed by COVID-19. Humanity is now facing an extraordinary and unexpected situation. Behavioral science needs to rise to that challenge in a way that provides both immediate practical value and greater assurance of long-term benefits for our understanding of human complexity more generally. Process-based functional analysis can be a vehicle to do just that. • Functional analysis has nearly disappeared in mainstream intervention science. • Change processes and an extended evolutionary meta-model provides an alternative. • Process-based functional analysis is the result. • The psychological flexibility model provides a proof of concept. • This approach suggests how to research the COVID-19 crisis with lasting results. [ABSTRACT FROM AUTHOR]

After two decades of quiescence, clinical psychedelic research re-started in the 1990s and is rapidly accelerating. Early evidence for effectiveness is promising, but understanding of the psychological processes of change underlying observed benefits is limited. This paper outlines contextual behavioral science (CBS) as an ideal framework for understanding psychedelic experiences and the psychological processes of change involved in psychedelic assisted therapy. This paper argues that CBS-based therapies, such as Acceptance and Commitment Therapy (ACT), can contribute to deepening and maintaining the often profound acute effects of psychedelics. The paper begins by briefly outlining the current state of clinical psychedelic research. It then progresses to outlining why CBS may be uniquely positioned to potentially increase the efficacy of psychedelic-assisted therapy, how this scientific model fits with existing data on psychedelic-assisted therapy, as well as with leading neuroscientific theories such as the entropic brain theory. Finally, it concludes by suggesting avenues for future research on how CBS could contribute to psychedelic science, and vice versa. • Clinical psychedelic research re-started in the 1990s and is rapidly accelerating. • Understanding of the psychological processes of change limited. • Contextual behavioral science can be used to understand psychedelic assisted therapy. [ABSTRACT FROM AUTHOR]

Background Health anxiety or hypochondriasis is a disabling and persistent disorder with a high prevalence in primary care, and insufficient treatment opportunities and knowledge of treatment processes. Acceptance and Commitment Therapy (ACT) is a third-wave behavioral therapy, which has shown positive treatment effects in a variety of mental disorders. ACT is proposed to work through the process of ‘psychological flexibility’, but no studies have yet examined possible processes of change in an ACT-based treatment of health anxiety. Aim The pilot study investigated whether changes in ‘psychological flexibility’ and ‘mindfulness’ mediated treatment outcome in health anxiety symptoms. Methods 34 Danish patients with severe health anxiety were allocated to 10 sessions of group-based ACT. The patients completed self-report questionnaires at baseline, at end of treatment and at 6-month follow-up, measuring health anxiety symptoms (Whiteley Index), psychological flexibility (AAQ-II) and mindfulness (FFMQ). Results Paired t -tests showed that psychological flexibility and mindfulness increased significantly during treatment (effect sizes ranged from SRM=.55–.76, p <.05). Regression analysis and Likelihood Ratio Tests showed that in particular psychological flexibility was significantly associated with the previously reported 49% reduction in health anxiety symptoms at 6-month followup. Conclusions Findings from the uncontrolled study indicated that the decrease in health anxiety symptoms at 6-month follow-up was associated with the change in psychological flexibility and mindfulness during treatment. These findings support the processes of change proposed in ACT. [ABSTRACT FROM AUTHOR]