The Research Journey of Acceptance and Commitment Therapy (ACT) The Research Journey of Acceptance and Commitment Therapy (ACT) Nic Hooper LecturerinPsychology,UniversityoftheWestofEngland,UK and Andreas Larsson LicensedPsychologist,KarolinskaInstitutetandStockholmCountyCouncil,Sweden ©NicHooperandAndreasLarsson2015 Foreword©StevenC.Hayes2015 Allrightsreserved.Noreproduction,copyortransmissionofthis publicationmaybemadewithoutwrittenpermission. Noportionofthispublicationmaybereproduced,copiedortransmitted savewithwrittenpermissionorinaccordancewiththeprovisionsofthe Copyright,DesignsandPatentsAct1988,orunderthetermsofanylicence permittinglimitedcopyingissuedbytheCopyrightLicensingAgency, SaffronHouse,6–10KirbyStreet,LondonEC1N8TS. Anypersonwhodoesanyunauthorizedactinrelationtothispublication maybeliabletocriminalprosecutionandcivilclaimsfordamages. Theauthorshaveassertedtheirrightstobeidentifiedastheauthorsofthis workinaccordancewiththeCopyright,DesignsandPatentsAct1988. Firstpublished2015by PALGRAVEMACMILLAN PalgraveMacmillanintheUKisanimprintofMacmillanPublishersLimited, registeredinEngland,companynumber785998,ofHoundmills,Basingstoke, HampshireRG216XS. PalgraveMacmillanintheUSisadivisionofStMartin’sPressLLC, 175FifthAvenue,NewYork,NY10010. PalgraveMacmillanistheglobalacademicimprintoftheabovecompanies andhascompaniesandrepresentativesthroughouttheworld. Palgrave®andMacmillan®areregisteredtrademarksintheUnitedStates, theUnitedKingdom,Europeandothercountries. ISBN 978-1-137-44016-7 ISBN 978-1-137-44017-4 (eBook) DOI 10.1057/9781137440174 Thisbookisprintedonpapersuitableforrecyclingandmadefromfully managedandsustainedforestsources.Logging,pulpingandmanufacturing processesareexpectedtoconformtotheenvironmentalregulationsofthe countryoforigin. AcataloguerecordforthisbookisavailablefromtheBritishLibrary. AcatalogrecordforthisbookisavailablefromtheLibraryofCongress. To my parents, thank you for giving everything to me. And to my wife Amy, who has been patient for every step of this journey, I love you very much NH For Therése and our son, Tage, for being the salt of my life. With heartfelt thanks to Lena Seglert, my mother-in-law, who minded Tage while I worked on this during my parental leave AL Contents ListofFiguresandTables ix Foreword x Acknowledgements xviii Prologue xix Part I TheoreticalandHistorical Background 1 TheNeed 3 2 TheThreeWaves 6 3 TheHistoryofACT 17 4 ContextualBehaviouralScience 23 5 TheImportanceofEmpiricalResearch 26 Part II EmpiricalResearch 6 Depression 31 7 AnxietyDisorders 44 8 SeriousMentalIllnesses 66 9 SubstanceAbuse 73 10 SmokingCessation 77 11 EatingBehaviour 86 12 Pain 98 13 OtherHealthConditions 116 14 Work 128 15 TheACTVariety 135 vii viii Contents Part III TheJourneyAhead 16 TheStatistics 157 17 Conclusion 163 References 167 FurtherResources 206 Index 210 Figures and Tables Figures 2.1 TheHexaflexorpsychologicalflexibilitymodel 14 2.2 Thematrix,analternativeACTconceptualizationmodel 15 16.1 Thenumberofoutcomestudiesconductedacrosseach disorder 158 16.2 Thenumberofparticipantsacrosseachdisorder 159 16.3 ThedeliveryformatsofACTresearch 160 16.4 Theaveragenumberoftherapyhoursacrosseach disorder 161 16.5 Thebreakdownofoutcomestudiesacrosscountries 161 16.6 Thebreakdownofoutcomestudiesoverthepast30 years 162 Tables 2.1 Correlationalstudiesofexperientialavoidanceand depressionwithauthor(year),typeofdepression measure,nandr,firstpresentedinRuiz(2010) 12 2.2 Correlationalstudiesofexperientialavoidanceand anxietywithauthor(year),typeofanxietymeasure,n andr,aspresentedinRuiz(2010) 13 ix