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Acceptance and Commitment: Implications for Prevention Science
Open accessAbstract
Recent research in behavior analysis and clinical psychology points to the importance of language processes having to do with the control of negative cognition and emotion and the commitment to valued action. Efforts to control unwanted thoughts and feelings, also referred to as experiential avoidance (EA), appear to be associated with a diverse array of psychological and behavioral difficulties. Recent research shows that interventions that reduce EA and help people to identify and commit to the pursuit of valued directions are beneficial for ameliorating diverse problems in living. These developments have the potential to improve the efficacy of many preventive interventions. This paper reviews the basic findings in these areas and points to some ways in which these developments could enhance the impact of preventive interventions.
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“and studies of CBT demonstrate improvement in depression, anxiety, and negative affect,65,72”
From Are smoking cessation treatments associated with suicidality risk? An overview (2016) · cites this paper as [65]
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“On the other hand, what is considered as a key factor in social anxiety disorder (Biglan, Hayes, & Pistorello, 2008) and leads to the continuation or persistence and intensification of the disorder is lack of psychological flexibility”
From Effectiveness of Acceptance and Commitment Therapy on Interpersonal Problemsand Psychological Flexibility in Female High School Students With Social Anxiety Disorder (2015) · cites this paper as Biglan, Hayes, & Pistorello, 2008
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In the citing paper
“More so than for its effectiveness, we included ACT in this study as ACT is explicitly aligned with many elements of both mental health dimensions.”
From Both positive mental health and psychopathology should be monitored in psychotherapy: Confirmation for the dual-factor model in acceptance and commitment therapy (2017) · cites this paper as Biglan, Hayes, & Pistorello, 2008
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“A powerful possible target for a transdiagnostic prevention approach is psychological flexibility,17–19”
From Feasibility of a Prototype Web-Based Acceptance and Commitment Therapy Prevention Program for College Students. (2014) · cites this paper as [17]
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In the citing paper
“The unique and ultimate goal of ACT is to promote one’s psychological flexibility as a critical process of human adaptation and well-being [20].”
From Acceptance and Commitment Therapy for Destructive Experiential Avoidance (ACT-DEA): A Feasibility Study (2022) · cites this paper as [20]
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“there is an extensive literature base demonstrating that this adaptive skill set is broadly beneficial to individual health and functioning [50] (including anxiety, depression, physical health outcomes, satisfaction with life, and work performance [47,72,103]).”
From Evaluation of an App-Delivered Psychological Flexibility Skill Training Intervention for Medical Student Burnout and Well-being: Randomized Controlled Trial (2023) · cites this paper as [103]
The cited source says what the claim attributes to it.
In the citing paper
“It was also demonstrated that flexibility ameliorates the negative consequences of stressors on mental health [76,77].”
The cited source says what the claim attributes to it.
In the citing paper
“It can also be considered central to human adaptation, well-being, and life satisfaction [76,77].”
The cited source says what the claim attributes to it.
In the citing paper
“We believe that EA is a negative reinforcement process [49].”
The cited source says what the claim attributes to it.
In the citing paper
“These studies also showed that the improvements in treatment groups were explained (mediated) by a common mechanism of action, reduced emotional and cognitive avoidance.16”
From Acceptance and commitment therapy (ACT) for adult type 1 diabetes management: Study protocol for a randomised controlled trial (2018) · cites this paper as [16]
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In the citing paper
“Correlational and experimental evidence indicates that experiential avoidance, as the converse of acceptance, contributes to the development and maintenance of different psychological and behavioral problems [32].”
The cited source says what the claim attributes to it.
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“A diathesis-stress model of experiential avoidance has been proposed, suggesting that experiential avoidance makes people vulnerable to stressors, in that individuals who typically try to avoid internal distressing experiences may continue this approach when faced with stressful life events (Biglan, Hayes, & Pistorello, 2008).”
From Psychological Flexibility in Caregivers of Children With Congenital Craniofacial Conditions in the United Kingdom. (2026) · cites this paper as Biglan, Hayes, & Pistorello, 2008
The cited source says what the claim attributes to it.
In the citing paper
“In particular, there is increasing interest in the theory and practice of acceptance and commitment therapy (ACT; Hayes, Strosahl, & Wilson, 1999), not only as a treatment for a range of psychological and behavioural problems, but also for promoting workplace mental health (Biglan, Hayes, & Pistorello, 2008; Bond & Bunce, 2000; Hayes, Bissett et al., 2004).”
From A randomised worksite comparison of acceptance and commitment therapy and stress inoculation training (2010) · cites this paper as Biglan, Hayes, & Pistorello, 2008
In the citing paper
“Second, these results are consistent with the view that the processes designed to promote psychological flexibility will apply across a wide range of psychological and behavioural difficulties (Biglan, Hayes, & Pistorello, 2008; Hayes et al., 2006).”
From A randomised worksite comparison of acceptance and commitment therapy and stress inoculation training (2010) · cites this paper as Biglan, Hayes, & Pistorello, 2008
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Citations
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Sorted by citations
(2009) · Cited by 2,013
The critical role of nurturing environments for promoting human well-being.
Biglan, A., Flay, B. R., Embry, D. D., & Sandler, I. N. (2012) · American Psychologist · doi:10.1037/a0026796 · Cited by 399
Self-citationMaterialism and Diminished Well–Being: Experiential Avoidance as a Mediating Mechanism
Kashdan, T. B., & Breen, W. E. (2007) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.2007.26.5.521 · Cited by 366
Evidence-based Kernels: Fundamental Units of Behavioral Influence
Embry, D. D., & Biglan, A. (2008) · Clinical Child and Family Psychology Review · doi:10.1007/s10567-008-0036-x · Cited by 396
Self-citationBohlmeijer, E. T., Fledderus, M., Rokx, T. A. J. J., & Pieterse, M. E. (2011) · Behaviour Research and Therapy · doi:10.1016/j.brat.2010.10.003 · Cited by 232
Brinkborg, H., Michanek, J., Hesser, H., & Berglund, G. (2011) · Behaviour Research and Therapy · doi:10.1016/j.brat.2011.03.009 · Cited by 235
“Biglan et al. (2008) considers the possibility that experiential avoidance may serve as meditator of the impact of stressful events on pathology.”
BackgroundHulbert-Williams, N. J., Storey, L., & Wilson, K. G. (2015) · European Journal of Cancer Care · doi:10.1111/ecc.12223 · Cited by 228
“Using mindfulness training, ACT encourages an open experience of the environment and psychological phenomena, whether perceived as good or bad (Biglan et al 2008).”
MethodHarris, A. R., Jennings, P. A., Katz, D. A., Abenavoli, R. M., & Greenberg, M. T. (2016) · Mindfulness · doi:10.1007/s12671-015-0451-2 · Cited by 221
“It is also congruent with conceptual models of mindful emotion regulation (e.g., Baer 2003; Biglan et al. 2008; Chambers et al. 2009) which emphasize greater acceptance of emotion and less mental and behavioral reactivity to emotion (e.g., tendencies to become absorbed in or attempt to modify…”
BackgroundFledderus, M., Bohlmeijer, E. T., Pieterse, M. E., & Schreurs, K. M. G. (2012) · Psychological Medicine · doi:10.1017/s0033291711001206 · Cited by 209
“The intervention targets both experiential avoidance (EA) that can be considered a generic risk factor for mental illnesses (Biglan et al. 2008) and positive mental health.”
BackgroundAn Exploration of Formal and Informal Mindfulness Practice and Associations with Wellbeing
Birtwell, K., Williams, K., van Marwijk, H., Armitage, C. J., & Sheffield, D. (2018) · Mindfulness · doi:10.1007/s12671-018-0951-y · Cited by 241
“Psychological flexibility is the ability to be fully present and Bto change, or persist in, behaviour when doing so serves valued ends^ (Biglan et al. 2008, p.142).”
BackgroundAcceptance and Commitment Therapy for Health Behavior Change: A Contextually-Driven Approach
Zhang, C.-Q., Leeming, E., Smith, P., Chung, P.-K., Hagger, M. S., & Hayes, S. C. (2018) · Frontiers in Psychology · doi:10.3389/fpsyg.2017.02350 · Cited by 199
“Perhaps the most studied set of contextual processes of this kind is psychological flexibility, which is “the ability to contact the present moment more fully as a conscious human being and to change, or persist in, behavior when doing so serves valued ends” (Biglan et al., 2008).”
BackgroundSelf-citationFledderus, M., Bohlmeijer, E. T., Smit, F., & Westerhof, G. J. (2010) · American Journal of Public Health · doi:10.2105/ajph.2010.196196 · Cited by 197
Further evaluation of the psychometric properties of the acceptance and action questionnaire-II
Fledderus, M., Oude Voshaar, M. A. H., ten Klooster, P. M., & Bohlmeijer, E. T. (2012) · Psychological Assessment · doi:10.1037/a0028200 · Cited by 195
Flaxman, P. E., & Bond, F. W. (2010) · Behaviour Research and Therapy · doi:10.1016/j.brat.2010.05.004 · Cited by 197
Wynne, B., McHugh, L., Gao, W., Keegan, D., Byrne, K., Rowan, C., Hartery, K., Kirschbaum, C., Doherty, G., Cullen, G., et al. (2019) · Gastroenterology · doi:10.1053/j.gastro.2018.11.030 · Cited by 188
“This can be defined as the ability to contact the present moment more fully as a conscious human being and to change, or persist in, behavior when doing so serves valued ends (20).”
BackgroundTrompetter, H. R., ten Klooster, P. M., Schreurs, K. M. G., Fledderus, M., Westerhof, G. J., & Bohlmeijer, E. T. (2013) · Psychological Assessment · doi:10.1037/a0033813 · Cited by 184
“In the present study, the Dutch version of the PIPS (Trompetter, Bohlmeijer, Veehof, & Schreurs, 2013) showed good internal consistency (avoidance, .90; cognitive fusion, .63; total scale .87).”
BackgroundInfluentialLevin, M. E., Pistorello, J., Seeley, J. R., & Hayes, S. C. (2014) · Journal of American College Health · doi:10.1080/07448481.2013.843533 · Cited by 179
“90 These findings raise the question of whether ACT could similarly be applied to prevent mental health problems by targeting psychological flexibility/experiential avoidance in nonclinical samples.(18) A series of studies have found that ACT can improve mental health and positive functioning in the context of worksit…”
Self-citationLivheim, F., Hayes, L., Ghaderi, A., Magnusdottir, T., Högfeldt, A., Rowse, J., Turner, S., Hayes, S. C., & Tengström, A. (2015) · Journal of Child and Family Studies · doi:10.1007/s10826-014-9912-9 · Cited by 169
“The effect of living a more vital life is that selfreported psychological symptoms decline (Biglan et al. 2008).”
Self-citationFledderus, M., Bohlmeijer, E. T., Fox, J.-P., Schreurs, K. M. G., & Spinhoven, P. (2013) · Behaviour Research and Therapy · doi:10.1016/j.brat.2012.11.007 · Cited by 133
A systematic review of the use of acceptance and commitment therapy in supporting parents.
Byrne, G., Ghráda, Á. N., O’Mahony, T., & Brennan, E. (2021) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12282 · Cited by 129
Trompetter, H. R., Lamers, S. M. A., Westerhof, G. J., Fledderus, M., & Bohlmeijer, E. T. (2017) · Behaviour Research and Therapy · doi:10.1016/j.brat.2017.01.008 · Cited by 126
Worksite stress management training: Moderated effects and clinical significance
Flaxman, P. E., & Bond, F. W. (2010) · Journal of Occupational Health Psychology · doi:10.1037/a0020522 · Cited by 126
“…studies (e.g., Kellett et al., 2007; Scott & Stradling, 1990; White, 1998), and support those who advocate the use of SMT for imparting cognitive–behavioral principles and skills in nonclinical contexts (Biglan et al., 2008; Brown, Cochrane, & Hancox, 2000; Schiraldi & Brown, 2001; White, 2000).”
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“The results of this study suggest that acceptance-based interventions may not only increase the efficacy of reducing the incidence of mental disorders (Biglan et al., 2008) but may also help people to live more satisfying lives.”
BackgroundIn search of meaning: Values in modern clinical behavior analysis
Plumb, J. C., Stewart, I., Dahl, J., & Lundgren, T. (2009) · The Behavior Analyst · doi:10.1007/bf03392177 · Cited by 127
Viskovich, S., & Pakenham, K. I. (2020) · Journal of Clinical Psychology · doi:10.1002/jclp.22848 · Cited by 123
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A randomized trial of ACT bibliotherapy on the mental health of K-12 teachers and staff
Jeffcoat, T., & Hayes, S. C. (2012) · Behaviour Research and Therapy · doi:10.1016/j.brat.2012.05.008 · Cited by 115
Self-citationMemory suppression and its deficiency in psychological disorders: A focused meta-analysis.
Stramaccia, D. F., Meyer, A.-K., Rischer, K. M., Fawcett, J. M., & Benoit, R. G. (2020) · Journal of Experimental Psychology General · doi:10.1037/xge0000971 · Cited by 105
Levin, M. E., Hayes, S. C., Pistorello, J., & Seeley, J. R. (2016) · Journal of Clinical Psychology · doi:10.1002/jclp.22254 · Cited by 103
Self-citationRamírez‐Maestre, C., & Esteve, R. (2014) · Journal of Pain · doi:10.1016/j.jpain.2014.02.006 · Cited by 107
The value of workshops on psychological flexibility for early childhood special education staff
Biglan, A., Layton, G. L., Jones, L. B., Hankins, M., & Rusby, J. C. (2013) · Topics in Early Childhood Special Education · doi:10.1177/0271121411425191 · Cited by 98
“…affect a surprising range of problems, including anxiety, depression, schizophrenia, epilepsy, cigarette smoking, stress, job burnout, and diabetes (Biglan et al., 2008; Gifford et al., 2004; Gregg, Callaghan, Hayes, & GlennLawson, 2007; Hayes, Bissett, et al., 1999; Hayes, Masuda, & De Mey, 2003;…”
BackgroundSelf-citationHahs, A. D., Dixon, M. R., & Paliliunas, D. (2019) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2018.03.002 · Cited by 93
Ramaci, T., Bellini, D., Presti, G., & Santisi, G. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.01302 · Cited by 95
“Acceptance and Commitment Therapy (ACT) is a transdiagnostic cognitive-behavioral intervention that aims to foster psychological flexibility as a central means to human adaptation and wellbeing (Biglan et al., 2008).”
BackgroundApplications and adaptations of acceptance and commitment therapy (ACT) for adolescents
Halliburton, A. E., & Cooper, L. D. (2015) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2015.01.002 · Cited by 95
Fonseca, S., Trindade, I. A., Mendes, A. L., & Ferreira, C. (2020) · Clinical Psychologist · doi:10.1111/cp.12194 · Cited by 89
“Although psychological flexibility has been associated with adaptive coping skills and inversely linked with depression symptoms (Biglan et al, 2008; Kashdan, & Rottenberg, 2010), it was yet to be explored the effect of psychological flexibility on the association between major life events and…”
BackgroundLi, H., Wong, C. L., Jin, X., Chen, J., Chong, Y. Y., & Bai, Y. (2021) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2021.103876 · Cited by 81
Zakiei, A., Khazaie, H., Rostampour, M., Lemola, S., Esmaeili, M., Dürsteler, K., Brühl, A., Sadeghi-Bahmani, D., & Brand, S. (2021) · Life · doi:10.3390/life11020133 · Cited by 84
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Development of a web-based intervention for the indicated prevention of depression
Kelders, S. M., Pots, W. T., Oskam, M. J., Bohlmeijer, E. T., & van Gemert-Pijnen, J. E. (2013) · BMC Medical Informatics and Decision Making · doi:10.1186/1472-6947-13-26 · Cited by 80
“This intervention is based on acceptance and commitment therapy (ACT; [44]) and mindfulness [45,46], and targets experiential avoidance that can be considered as a generic risk factor for mental illnesses [47].”
Pears, S., & Sutton, S. (2021) · Health Psychology Review · doi:10.1080/17437199.2020.1727759 · Cited by 74
“…physical activity) in order to foster the ability to make room for unpleasant internal experiences without trying to change or eliminate them (Biglan et al., 2008; Hayes et al., 1999, 2006); (2) Behavioural commitment to valued life-directions: ACT emphasizes the necessity of identifying…”
BackgroundMethodInfluentialScent, C. L., & Boes, S. R. (2014) · Journal of College Student Psychotherapy · doi:10.1080/87568225.2014.883887 · Cited by 77
Lappalainen, R., Lappalainen, P., Puolakanaho, A., Hirvonen, R., Eklund, K., Ahonen, T., Muotka, J., & Kiuru, N. (2021) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2021.01.007 · Cited by 69
van Aubel, E., Bakker, J. M., Batink, T., Michielse, S., Goossens, L., Lange, I., Schruers, K., Lieverse, R., Marcelis, M., van Amelsvoort, T., et al. (2020) · Behaviour Research and Therapy · doi:10.1016/j.brat.2020.103592 · Cited by 57
Volkaert, B., Wante, L., Beveren, M. V., Vervoort, L., & Braet, C. (2019) · Cognitive Therapy and Research · doi:10.1007/s10608-019-10073-4 · Cited by 77
“This indicates that ACC is probably most effective when combined with adaptive ER strategies and could explain why ACC is an effective core component of broader prevention programs (Biglan et al. 2008; Burckhardt et al. 2016; Raes et al. 2014).”
BackgroundRamírez‐Maestre, C., Esteve, R., & López-Martínez, A. E. (2014) · Annals of Behavioral Medicine · doi:10.1007/s12160-014-9619-6 · Cited by 67
“Several authors have suggested that the concepts of resilience and acceptance are interconnected [14].”
BackgroundA framework for intentional cultural change
Biglan, A., & Embry, D. D. (2013) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2013.06.001 · Cited by 67
Self-citationScanlon, G. M., & Barnes‐Holmes, Y. (2013) · Emotional and Behavioural Difficulties · doi:10.1080/13632752.2013.769710 · Cited by 62
TEACHER DISTRESS AND THE ROLE OF EXPERIENTIAL AVOIDANCE
Hinds, E., Jones, L. B., Gau, J. M., Forrester, K. K., & Biglan, A. (2015) · Psychology in the Schools · doi:10.1002/pits.21821 · Cited by 59
Self-citationAcceptance and Commitment Therapy-Oriented Parent-Training for Parents of Children with Autism
Corti, C., Pergolizzi, F., Vanzin, L., Cargasacchi, G., Villa, L., Pozzi, M., & Molteni, M. (2018) · Journal of Child and Family Studies · doi:10.1007/s10826-018-1123-3 · Cited by 58
“In line with this perspective, Biglan et al. (Biglan et al. 2008) reported that interventions that teach parents to suppress and control their negative feelings toward the child may generate negative consequences, as they may paradoxically “intensify negative thoughts and distract parents from using newly acquired par…”
MethodKent, W., Hochard, K. D., & Hulbert-Williams, N. J. (2019) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2019.08.004 · Cited by 56
Chuang, C.-W. I., Chan, C., & Leventhal, A. M. (2016) · Journal of Dual Diagnosis · doi:10.1080/15504263.2016.1146557 · Cited by 57
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A Meaning-Centered Approach to Building Youth Resilience
Wong, P. T. P. (2013) · Routledge eBooks · doi:10.4324/9780203146286-38 · Cited by 54
Biglan, A., Gau, J. M., Jones, L. B., Hinds, E., Rusby, J. C., Cody, C., & Sprague, J. (2015) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2014.12.001 · Cited by 52
Self-citationEvolving Prosocial and Sustainable Neighborhoods and Communities
Biglan, A., & Hinds, E. (2009) · Annual Review of Clinical Psychology · doi:10.1146/annurev.clinpsy.032408.153526 · Cited by 54
“Thus, a high priority for community intervention research should be to build social trust and positive interactions through psychological interventions (e.g., Biglan et al. 2008) and modifications of the built environment (e.g., Leyden 2003).”
BackgroundSelf-citationThe Impact of Psychological Flexibility on Psychological Well-Being in Adults With Obesity
Usubini, A. G., Varallo, G., Granese, V., Cattivelli, R., Consoli, S., Bastoni, I., Volpi, C., Castelnuovo, G., & Molinari, E. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.636933 · Cited by 52
“Together, these findings suggest that psychological flexibility is a key factor for the quality of life and psychological well-being (Biglan et al., 2008).”
BackgroundMcKnight, P. E., Afram, A., Kashdan, T. B., Kasle, S., & Zautra, A. (2010) · Journal of Behavioral Medicine · doi:10.1007/s10865-010-9252-1 · Cited by 50
“Psychology embraces this two factor approach with a surging interest in preventative (e.g., acceptance and commitment therapy Biglan et al. 2008 ) and positive psychology (Seligman and Csikszentmihalyi 2000).”
BackgroundStaying hidden: The burden of stigma in PD
McDaniels, B., Pontone, G. M., Mathur, S., & Subramanian, I. (2023) · Parkinsonism & Related Disorders · doi:10.1016/j.parkreldis.2023.105838 · Cited by 44
Accoto, A., Chiarella, S. G., Raffone, A., Montano, A., de Marco, A., Mainiero, F., Rubbino, R., Valzania, A., & Conversi, D. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18115512 · Cited by 46
“It is defined as being aware of the present moment and accepting the emotions, sensations, and thoughts [76,77].”
BackgroundLarsson, A., Hartley, S., & McHugh, L. (2022) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2022.02.005 · Cited by 42
Increasing psychological flexibility to influence cultural evolution
Biglan, A. (2009) · Behavior and Social Issues · doi:10.5210/bsi.v18i1.2280 · Cited by 43
Self-citationThe Body Image Psychological Inflexibility Scale: Development and psychometric properties
Callaghan, G. M., Sandoz, E. K., Darrow, S. M., & Feeney, T. K. (2014) · Psychiatry Research · doi:10.1016/j.psychres.2014.11.039 · Cited by 45
“, worksite stress, employee burnout, and prejudice; for a review see Biglan et al. (2008) and Hayes et al.”
BackgroundMartínez‐Rubio, D., Martínez‐Brotons, C., Monreal‐Bartolomé, A., Barceló‐Soler, A., Campos, D., Pérez‐Aranda, A., Colomer‐Carbonell, A., Cervera‐Torres, S., Solé, S., Moreno, Y., et al. (2021) · Journal of Advanced Nursing · doi:10.1111/jan.14870 · Cited by 42
Sanabria-Mazo, J. P., Colomer-Carbonell, A., Borràs, X., Castaño-Asins, J. R., McCracken, L. M., Montero-Marin, J., Pérez-Aranda, A., Edo, S., Sanz, A., Feliu-Soler, A., et al. (2023) · The Journal of Pain · doi:10.1016/j.jpain.2023.04.008 · Cited by 40
Jiang, X., Sun, J., Song, R., Wang, Y., Li, J., & Shi, R. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1253266 · Cited by 43
“Owing to its adaptability, the ACT has been widely applied in various fields (Biglan et al., 2008; Ost, 2008; Powers et al., 2009; Andersson et al., 2014; Ost, 2014; A-Tjak et al., 2015; Graham et al., 2016; Carlbring et al., 2018; Andersson et al., 2019; Gloster et al., 2020; Thompson et al.,…”
MethodLappalainen, P., Lappalainen, R., Keinonen, K., Kaipainen, K., Puolakanaho, A., Muotka, J., & Kiuru, N. (2023) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2022.12.001 · Cited by 41
“For example, an adolescent may engage in attempts to control painful thoughts and emotions related to the pandemic, which may result in further stress and a range of emotional difficulties (Biglan et al., 2008; Hayes et al., 2006).”
Xavier, A., Cunha, M. I. V. A., & Pinto‐Gouveia, J. (2017) · Journal of Child and Family Studies · doi:10.1007/s10826-017-0871-9 · Cited by 46
“Various studies conducted with adult populations suggest that EA may serve as a mediator of the impact of stressful events on poor outcomes (e.g., Biglan et al. 2008).”
BackgroundA Dynamic Systems Approach to Understanding Mindfulness in Interpersonal Relationships
Skoranski, A. M., Coatsworth, J. D., & Lunkenheimer, E. S. (2019) · Journal of Child and Family Studies · doi:10.1007/s10826-019-01500-x · Cited by 47
“…to “psychological flexibility,” a concept from Acceptance and Commitment Therapy (Hayes et al. 2012) that refers to an individual’s ability to detach from unpleasant thoughts and feelings and instead focus on thoughts and feelings that are in accordance with his or her values (Biglan et al. 2008).”
BackgroundArcher, R., Lewis, R., Yarker, J., Zernerova, L., & Flaxman, P. E. (2024) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2024.100799 · Cited by 59
“Nonetheless, burnout prevention may also require initiatives that can be expanded in scale, for instance by utilizing ACT to bolster resilience skills in the wider work-force (Ahola et al., 2017; Biglan et al., 2008; Chong et al., 2023; Mar-icut¸oiu et al., 2016).”
BackgroundEsteve, R., & Ramírez‐Maestre, C. (2013) · Annals of Behavioral Medicine · doi:10.1007/s12160-013-9499-1 · Cited by 37
“Several authors have suggested that the concepts of resilience and acceptance are interconnected [16, 17]; it has even been proposed that some measures of psychological resilience contain measures of psychological acceptance [16].”
BackgroundAzadeh, S. M., Kazemi-Zahrani, H., & Besharat, M. A. (2015) · Global journal of health science · doi:10.5539/gjhs.v8n3p131 · Cited by 35
Katz, D. A., Harris, A. R., Abenavoli, R. M., Greenberg, M. T., & Jennings, P. A. (2017) · Stress and Health · doi:10.1002/smi.2782 · Cited by 37
Snyder, J. J., Low, S. K., Schultz, T., Barner, S. L., Moreno, D. A., Garst, M., Leiker, R. A., Swink, N. P., & Schrepferman, L. (2011) · Journal of Applied Developmental Psychology · doi:10.1016/j.appdev.2011.06.001 · Cited by 36
Biglan, A., & Glenn, S. S. (2012) · American Psychological Association eBooks · doi:10.1037/13938-010 · Cited by 35
Self-citationGarcía-Gómez, M., Guerra, J., López-Ramos, V. M., & Mestre, J. M. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16234687 · Cited by 33
“We believe that EA is a negative reinforcement process [49].”
BackgroundPeople Create Health: Effective Health Promotion is a Creative Process.
Cloninger, C. R., & Cloninger, K. M. (2013) · PubMed · doi:10.5750/ijpcm.v3i2.399 · Cited by 35
“Extensive experimental work has shown that people can learn to accept unpleasant facts and commit to action toward goals that they personally value, as is done in Acceptance and Commitment Therapy (ACT) [24, 25].”
BackgroundMindfulness and Burnout in Elite Junior Athletes: The Mediating Role of Experiential Avoidance
Zhang, C., Si, G., Chung, P., & Gucciardi, D. F. (2016) · Journal of Applied Sport Psychology · doi:10.1080/10413200.2016.1162223 · Cited by 35
A Descriptive Analysis of the Effects of Weather Disasters on Community Resilience
Sánchez, J. G. A., Houmanfar, R. A., & Alavosius, M. P. (2019) · Behavior and Social Issues · doi:10.1007/s42822-019-00015-w · Cited by 30
Applicability of acceptance and commitment therapy-based mobile app in depression nursing
Kaipainen, K., Välkkynen, P., & Kilkku, N. (2017) · Translational Behavioral Medicine · doi:10.1007/s13142-016-0451-3 · Cited by 26
“ACT utilizes acceptance and mindfulness methods to increase psychological flexibility, which allows a person to commit valued actions despite psychological distress [21, 22].”
MethodUnderstanding adherence to web-based interventions
Kelders, S. M. (2012) · doi:10.3990/1.9789036534178 · Cited by 29
“This intervention is based on acceptance and commitment therapy (ACT; [41]) and mindfulness [42, 43], and targets experiential avoidance that can be considered as a generic risk factor for mental illnesses [44].”
ResultNeural systems underlying motivated behavior in adolescence: Implications for preventive medicine
Richards, J., Plate, R. C., & Ernst, M. (2011) · Preventive Medicine · doi:10.1016/j.ypmed.2011.11.016 · Cited by 29
“Specifically, Biglan et al. (2008) propose that training adolescents to accept negative thoughts and feelings about peer rejection and to define valued life directions that theywould like to pursue can help them to resist pressures from deviant peers to engage in unhealthy behaviors, such as…”
BackgroundNewsome, W. D., & Alavosius, M. P. (2011) · Behavior and Social Issues · doi:10.5210/bsi.v20i0.3234 · Cited by 32
“For example, Bond and Bunce (2003) found that RFT/ACT processes were predictive of both higher work performance and fewer health problems. Dahl el al. (2004) reported that interventions altering inflexible responding prevented pain-related worker disability and dramatically reduced absenteeism among employees. Similar…”
BackgroundA web-based self-guided program to promote valued-living in college students: A pilot study
Firestone, J., Cardaciotto, L., Levin, M. E., Goldbacher, E. M., Vernig, P. M., & Gambrel, L. E. (2019) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2019.01.004 · Cited by 29
On the contribution of psychological flexibility to predict adjustment to breast cancer
Berrocal Montiel, C., Rivas Moya, T., Venditti, F., & Bernini, O. (2016) · Psicothema · doi:10.7334/psicothema2015.271 · Cited by 28
“Our study extends these fi ndings to patients with BC, hence supporting the conceptualization of PF as a common protective factor for mental health across different contexts and populations (Biglan et al., 2008).”
The impact of acceptance-based versus avoidance-based protocols on discomfort
Luciano, C., Molina, F., Gutiérrez-Martínez, O., Barnes-Holmes, D., Valdivia-Salas, S., Cabello, F., Barnes-Holmes, Y., Rodríguez-Valverde, M., & Wilson, K. G. (2010) · Behavior Modification · doi:10.1177/0145445509357234 · Cited by 26
“As noted before (Biglan et al., 2008; Luciano & Hayes, 2001) and evidenced here, the promotion — by education and health professionals, and the media in general — of practices derived from empirical research on the origin of discomfort in verbal or language-able beings is highly recommended for the…”
BackgroundVolkaert, B., Wante, L., Vervoort, L., & Braet, C. (2018) · BMC Public Health · doi:10.1186/s12889-018-5754-5 · Cited by 28
Psychological Flexibility and Resilience in Parentally Bereaved College Students
Murrell, A. R., Jackson, R., Lester, E. G., & Hulsey, T. (2018) · OMEGA - Journal of Death and Dying · doi:10.1177/0030222817693154 · Cited by 25
Effect of Psychosocial Interventions on Children and Youth Emotion Regulation: A Meta-Analysis
Espenes, K., Tørmoen, A. J., Rognstad, K., Nilsen, W., Waaler, P. M., Wentzel‐Larsen, T., & Kjøbli, J. (2024) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-024-01373-3 · Cited by 34
“…interventions, as mindfulness and acceptance involve the non-judgmental acceptance of emotions, thoughts, and sensations as they are (Segal et al., 2018), and a willingness to experience troublesome thoughts and feelings without striving to alter, avoid, or control them (Biglan et al., 2008).”
Datta, A., Aditya, C., Chakraborty, A., Das, P., & Mukhopadhyay, A. (2016) · Journal of Cancer Education · doi:10.1007/s13187-015-0935-8 · Cited by 24
A Case Study of Overselling Psychotherapy: An ACT Intervention for Diabetes Management
O’Donohue, W., Snipes, C., & Soto, C. G. (2015) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-015-9308-1 · Cited by 23
The longer term experiences of parent training: a qualitative analysis
Furlong, M., & McGilloway, S. (2014) · Child Care Health and Development · doi:10.1111/cch.12195 · Cited by 22
“For instance, parents who maintained positive results demonstrated more self-acceptance and self-efficacy beliefs and did not engage in negative self-evaluations; such practices have been associated with promoting resilience, improving positive parenting, and preventing relapse post intervention (Hess et al. 2002; Big…”
BackgroundNa, E., Lee, K., Jeon, B.-H., Jo, C., Kwak, U.-H., Jeon, Y., Yang, K., Lee, E. J., & Jeong, J. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192416434 · Cited by 21
“The unique and ultimate goal of ACT is to promote one’s psychological flexibility as a critical process of human adaptation and well-being [20].”
BackgroundDitton, E., Knott, B., Hodyl, N., Horton, G., Oldmeadow, C., Walker, F. R., & Nilsson, M. (2023) · JMIR Mental Health · doi:10.2196/42566 · Cited by 22
Integrating the human sciences to evolve effective policies
Biglan, A., & Cody, C. (2012) · Journal of Economic Behavior & Organization · doi:10.1016/j.jebo.2012.12.018 · Cited by 19
“Finally, environments nurture prosocial development when they encourage psychological flexibility, which is the ability to pursue valued directions even when thoughts and feelings discourage taking action (Biglan et al., 2008; 2012).”
BackgroundSelf-citationGhouchani, S., Molavi, N., Massah, O., Sadeghi, M., Mousavi, S. H., Noroozi, M., Sabri, A., & Farhoudian, A. (2018) · Journal of Substance Use · doi:10.1080/14659891.2018.1436602 · Cited by 19
Neuropsychological Consequences of Massive Trauma: Implications and Clinical Interventions
Theodoratou, M., Kougioumtzis, G. Α., Yotsidi, V., Sofologi, M., Katsarou, D. V., & Megari, K. (2023) · Medicina · doi:10.3390/medicina59122128 · Cited by 57
“Research such as that by Neuner and colleagues (2004) has demonstrated the effectiveness of narrative exposure in group settings for reducing symptoms of PTSD, suggesting that such therapeutic interventions can modify the distress associated with traumatic memories [74,111].”
BackgroundAmsberg, S., Wijk, I., Livheim, F., Toft, E., Johansson, U.-B., & Anderbro, T. (2018) · BMJ Open · doi:10.1136/bmjopen-2018-022234 · Cited by 17
“These studies also showed that the improvements in treatment groups were explained (mediated) by a common mechanism of action, reduced emotional and cognitive avoidance.(16) Some support also exists for ACT among individuals with type 2 diabetes, which has indicated changes in acceptance coping, self-management and Hb…”
BackgroundExperiential Avoidance and Meaning in Life as Predictors of Valued Living: A daily diary study
Pavlacic, J. M., Schulenberg, S. E., & Buchanan, E. M. (2021) · Journal of Prevention and Health Promotion · doi:10.1177/2632077021998261 · Cited by 18
“…values Living in accordance with one’s values is critical to preventing mental health problems in individuals experiencing stressful events and engaging in potentially harmful behaviors, and to promoting psychological well-being (Biglan et al., 2008; Ceary et al., 2019; Palfai et al., 2011).”
BackgroundPapa, A., Boland, M., & Sewell, M. T. (2012) · Wiley eBooks · doi:10.1002/9781118470886.ch11 · Cited by 18
Gobin, R. L., Strauss, J. L., Golshan, S., Allard, C. B., Bomyea, J., Schnurr, P. P., & Lang, A. J. (2019) · Women s Health Issues · doi:10.1016/j.whi.2019.03.003 · Cited by 16
Metadata
- Authors
- Biglan, A., Hayes, S. C., & Pistorello, J.
- Affiliations
- Oregon Research Institute (US)
- University of Nevada, Reno (US)
- Corresponding author
- Biglan, Anthony
- Venue
- Prevention Science
- Published
- 2008-08-09
- Volume
- 9
- Issue
- 3
- Pages
- 139-152
- ISSN
- 1389-4986 (ISSN-L)
- 1573-6695
- PMC
- PMC2727477
- OpenAlex
- W2090211322
- Semantic Scholar
- 083b59b6411c8db418bb66ff1bda2cb60f66af6b
- Cited by
- 240
- References
- 143
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 19 · 2023: 23 · 2022: 16 · 2021: 18 · 2020: 18 · 2019: 11 · 2018: 17 · 2017: 6 · 2016: 12 · 2015: 18 · 2014: 15 · 2013: 12 · 2012: 13
- FWCI
- 10.41
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Prevention Science (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Public Health Service (PA018760)
- National Institute of Mental Health (MH074968, R21MH074968)
- National Institute on Drug Abuse (P30DA018760, R01DA017868, DA018760, DA017868)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Developmental and Educational Psychology › Behavioral and Psychological Studies
- Keywords
- acceptance and commitment therapy, experiential avoidance, prevention interventions, valued action, negative thinking, emotion regulation, intrusive thoughts
- MeSH terms
- Adaptation, Psychological, Avoidance Learning, Behavior, Behavior Therapy, Humans, Models, Psychological, Preventive Medicine, Psychology, Social, Behavioral Research
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