Acceptance and Commitment Therapy Processes and Mediation: Challenges and How to Address Them
Open accessAbstract
Acceptance and commitment therapy (ACT) emphasizes a focus on theory-driven processes and mediating variables, a laudable approach. The implementation of this approach would be advanced by addressing five challenges, including (a) distinguishing ACT processes in measurement contexts, (b) developing and rigorously validating measures of ACT processes, (c) the wide use of psychometrically weaker ACT process measures and the more limited use of stronger measures in earlier work, (d) the inconsistency of past evidence that ACT processes are sensitive or specific to ACT or mediate ACT outcomes specifically, and (e) improving statistical power and transparency. Drawing on the existing literature, we characterize and provide evidence for each of these challenges. We then offer detailed recommendations for how to address each challenge in ongoing and future work. Given ACT's core focus on theorized processes, improving the measurement and evaluation of these processes would significantly advance the field's understanding of ACT.
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Claims the paper makes
7 of 18 cited sources checked · 4 supported · 0 flagged · accuracy not yet measured
- Background
A recent review of ACT mediators concluded that existing studies have been overly focused on a small number of putative processes.
“a recent review of ACT mediators (Stockton et al., 2019) concluded that the extant studies have been "overly focused on a small number of putative processes" (p.333).”
Quote in the paperNot yet classified1 of 1 sources checked- cites Stockton et al., 2019 source
- Background
Independent research groups have seriously challenged the validity and reliability of the AAQ and AAQ-II, ACT's most widely used process measures.
“independent research groups have seriously challenged the validity and reliability of ACT's most widely used process measures: the AAQ and AAQ-II (Allen, 2021;Ong et al., 2020;Rochefort et al., 2018;Tyndall et al., 2019;Wolgast, 2014).”
Quote in the paperNot yet classified1 of 3 sources checked- cites Allen, 2021 source
The Introduction and Discussion (page numbers unavailable) report challenges to the AAQ-II’s discriminant validity, and the Conclusions urge caution about what it measures. The cited paper does not establish comparable challenges to the original AAQ or to the reliability of either measure; its Instruments section reports AAQ-II internal-consistency values of 0.76–0.87. (LLM, conf=0.87)
Experimental — accuracy not yet measured - cites Ong et al., 2020 source
- cites Rochefort et al., 2018 source
- Background
Studies show the AAQ-II loads more strongly with negative affect, distress, and neuroticism than with third-wave constructs like mindfulness and acceptance, and more so than alternative measures of psychological flexibility or experiential avoidance.
“a series of studies showing that the measure loads more strongly with negative affect, distress, and neuroticism measures than with third-wave behavior therapy constructs, such as mindfulness and acceptance, and does so to a greater extent than alternative measures of psychological flexibility or experiential avoidance (Allen, 2021;Rochefort et al., 2018;Tyndall et al., 2019;Wolgast, 2014).”
Quote in the paperNot yet classified2 of 3 sources checked- cites Allen, 2021 source
The Results and Discussion (page unavailable in our copy) report that AAQ-II scores were more strongly related to negative affect and perceived stress than MEAQ scores, supporting the comparison with an alternative experiential-avoidance measure. The paper does not establish that the AAQ-II relates more strongly to those variables than to mindfulness or acceptance, and the cited passages do not assess neuroticism. (LLM, conf=0.86)
Experimental — accuracy not yet measured - cites Rochefort et al., 2018 source
- cites Tyndall et al., 2019 source
The Discussion (page unavailable) reports that the AAQ-II correlates more strongly with depression, anxiety, and stress than the alternative experiential-avoidance measure BEAQ. This supports the distress comparison, but the paper does not establish the claimed comparison with neuroticism or with mindfulness and acceptance measures. (LLM, conf=0.88)
Experimental — accuracy not yet measured
- Background
The replication crisis in psychology has drawn attention to methodological and analytic practices that hinder reliable results across similar studies.
“The replication crisis in psychology (Open Science Collaboration, 2015) has highlighted methodological and analytic practices that prevent researchers from obtaining reliable results across similar studies.”
Quote in the paperNot yet classified1 of 1 sources checked- cites Open Science Collaboration, 2015 source
- Background
Several authors have concluded that the AAQ-II functions more as a measure of distress or neuroticism than of acceptance.
“Several authors have now concluded that the AAQ-II performs more as a measure of distress/neuroticism than acceptance (Rochefort et al., 2018;Tyndall et al., 2019;Wolgast, 2014).”
Quote in the paperNot yet classified2 of 3 sources checked
- Finding
Two shortcomings-many measures lack evaluation of treatment sensitivity, and widely used ACT process measures have not consistently shown treatment sensitivity-pose a major challenge to understanding how ACT works.
“These two shortcomings-the lack of evaluation of treatment sensitivity in many cases, and the failure to consistently demonstrate treatment sensitivity among widely used ACT process measures-pose a major challenge to progress in the study of how ACT works.”
Quote in the paperNot yet classified - Finding
Although ACT sometimes increases AAQ/AAQ-II scores more than inactive or non-gold-standard controls, evidence comparing ACT with gold-standard psychotherapy comparators is more mixed.
“while research has shown that ACT sometimes increases scores on the AAQ/AAQ-II more than inactive or non-gold-standard controls, the evidence comparing ACT to gold-standard psychotherapy comparators is more mixed.”
Quote in the paperNot yet classified - Finding
Evaluations of treatment specificity for the six ACT processes are less common than those for psychological flexibility.
“Compared to evaluations of treatment specificity for psychological flexibility, evaluations of treatment specificity for the six ACT processes are less common.”
Quote in the paperNot yet classified - Finding
Low statistical power combined with pervasive problematic research practices suggests that many results in the ACT mediational literature, and other psychotherapy literatures, may be unreliable and fail to replicate.
“the combination of low statistical power and pervasive problematic research practices in the psychological literature points toward the possibility that many of the results reported in the ACT mediational literature (and other psychotherapy literatures) are unreliable and will not replicate due to meta-scientific”
Quote in the paperNot yet classified - Finding
If the AAQ and its variants are used to measure psychological flexibility, they should exhibit the six-factor structure specified by ACT theory.
“if the AAQ and its variants are used to measure psychological flexibility, they should have a six-factor structure as specified in ACT theory.”
Quote in the paperNot yet classified - Finding
Evidence for treatment specificity of psychological flexibility in ACT randomized trials, usually measured by the AAQ or AAQ-II, appears to depend at least partly on the comparator condition.
“the evidence for the treatment specificity of psychological flexibility in randomized trials of ACT, usually operationalized by the AAQ or AAQ-II, appears to depend at least in part on ACT's comparator condition.”
Quote in the paperNot yet classified - Finding
Inconsistent terminology is problematic because subprocesses such as acceptance or experiential avoidance cannot be equivalent to the higher-order processes under which they are nested.
“Definitionally, this inconsistency in terminology is problematic because subprocesses (e.g., acceptance, experiential avoidance) cannot be equivalent to the processes under which they are nested”
Quote in the paperNot yet classified - Finding
In summary, especially when ACT is compared with CBT, evidence that ACT processes are specific to ACT is mixed, and studies evaluating specificity beyond psychological flexibility are sparse.
“In summary, particularly when ACT is compared to CBT, the evidence that ACT processes are specific to ACT is mixed, and studies that evaluate the specificity of ACT processes beyond psychology flexibility are sparse.”
Quote in the paperNot yet classified - Background
A review of mediational analyses across five leading psychology journals and diverse behavioral interventions concluded that questionable research practices in mediation tests were highly likely, perhaps even a foregone conclusion.
“broader evidence from a recent review of mediational analyses across five leading psychology journals and diverse behavioral interventions concluded that "the likelihood of [questionable research practices] in tests of mediation was high-perhaps even a foregone conclusion" (Götz et al., 2021, p. 106).”
Quote in the paperNot yet classified0 of 1 sources checked- cites Götz et al., 2021
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Method
The paper's second half provides detailed recommendations for addressing each of the five challenges.
“In the second half of this paper, we offer detailed recommendations for addressing these challenges.”
Quote in the paperNot yet classified - Method
A recommendation is to develop process measures that are distinct from outcome measures.
“Develop process measures that are distinct from outcome measures”
Quote in the paperNot yet classified - Background
The AAQ's authors acknowledged that it was likely insensitive as a process measure for ACT, that some items were too complex, and that low alpha would likely remain an issue requiring a more multidimensional approach.
“the authors noted that it was "likely to be relatively insensitive when used as a process measure to assess the impact of … ACT" (p.573), adding that "some of the items seem too complex" and the low alpha was likely "to remain an issue" and require "a more multidimensional approach" (p.572).”
Quote in the paperNot yet classified0 of 1 sources checked- cites Hayes et al., 2004 source
- Background
The first widely used and validated ACT process measure, the AAQ, was designed to assess experiential avoidance.
“The first widely used, validated, and published measure of ACT processes, the AAQ (Hayes et al., 2004), was designed to measure experiential avoidance.”
Quote in the paperNot yet classified0 of 1 sources checked- cites Hayes et al., 2004 source
- Background
A meta-analysis on psychological inflexibility and anxiety focused exclusively on the AAQ/AAQ-II, calling it the standard measure for psychological flexibility/inflexibility.
“a meta-analysis of the relationship between psychological inflexibility and anxiety (Bluett et al., 2014) focused exclusively on the AAQ/ AAQ-II as "the standard measure used to assess psychological flexibility/inflexibility" (p.613)”
Quote in the paperNot yet classified0 of 1 sources checked- cites Bluett et al., 2014 source
- Background
Statistical mediation typically requires demonstrating a unidirectional effect of treatment condition on a putative mediator (the a path) and a unidirectional effect of the mediator on an outcome (the b path).
“Statistical mediation typically that must demonstrate both a unidirectional effect of the treatment condition on a putative mediational variable (the a path) and a unidirectional effect of the mediational variable on some outcome variable (the b path; Judd & Kenny, 1981).”
Quote in the paperNot yet classified0 of 1 sources checked- cites Judd & Kenny, 1981 source
- Method
Researchers should identify which ACT process or processes are most likely to change after the focal intervention and measure those specifically, rather than defaulting to measuring psychological flexibility as a whole.
“Researchers should consider which ACT process(es) are most likely to change following the focal intervention and measure those processes specifically, rather than measure psychological flexibility as a whole by default.”
Quote in the paperNot yet classified - Background
Compared with alternative ACT process measures, the AAQ-II changes less during ACT, suggesting it is insensitive to intervention.
“compared to alternative ACT process measures, the AAQ-II changes less during ACT (Benoy et al., 2019), suggesting that it is also insensitive to intervention.”
Quote in the paperNot yet classified0 of 1 sources checked- cites Benoy et al., 2019 source
- Background
A meta-analysis of ACT self-help for anxiety, depression, and psychological flexibility found that the AAQ/AAQ-II was the most frequently used measure of psychological flexibility in the focal studies.
“a meta-analysis of the use of ACT self-help for anxiety, depression, and psychological flexibility found that in the focal studies, the AAQ/AAQ-II was the most common measure of psychological flexibility (French et al., 2017).”
Quote in the paperNot yet classified0 of 1 sources checked- cites French et al., 2017 source
- Method
The authors recommend that researchers and journals publish nonsignificant findings, especially from well-constructed and well-powered studies.
“we also recommend that researchers and journals publish nonsignificant findings, particularly for well-constructed and well-powered studies.”
Quote in the paperNot yet classified
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Until now, the AAQ-II remains the most frequently used and best studied measure for psychological flexibility.
“Until now, the AAQ-II remains the most frequently used and best studied measure for psychological flexibility (41).”
From Increasing psychological flexibility is associated with positive therapy outcomes following a transdiagnostic ACT treatment (2024) · cites this paper as [41]
In Challenge 3 (page unavailable), the paper reports that the AAQ and AAQ-II were the most frequently used process measures in ACT intervention studies, particularly older ones. It does not establish that the AAQ-II alone remains the most frequently used measure or is the best studied measure of psychological flexibility. The paper also notes serious concerns about its validity; 'best studied' should not be read as 'best validated.' (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe AAQ-II measures psychological flexibility as a unidimensional construct, while the underlying theory is that psychological flexibility consists of six interrelated core processes.
“Another point of criticism is that the AAQ-II measures psychological flexibility as a unidimensional construct, while the underlying theory is that psychological flexibility consists of six interrelated core processes (40, 41, 43–45).”
From Increasing psychological flexibility is associated with positive therapy outcomes following a transdiagnostic ACT treatment (2024) · cites this paper as [41]
In “Challenge I: Distinguishing ACT Processes” (page not supplied), the paper says that an AAQ-II measure of psychological flexibility should have the six-factor structure specified by ACT theory. The recommendations section describes those six constructs as facets of one higher-order construct. Our copy does not establish that the AAQ-II actually measures psychological flexibility as a unidimensional construct. (LLM, conf=0.83)
Experimental — accuracy not yet measuredThe AAQ-II was designed to measure psychological inflexibility.
“The AAQ-II was designed to measure psychological inflexibility and it remains questionable whether the absence of inflexibility implies more flexibility, or whether non-inflexibility is equivalent to flexibility (40, 41).”
From Increasing psychological flexibility is associated with positive therapy outcomes following a transdiagnostic ACT treatment (2024) · cites this paper as [41]
There is increasing disagreement about what the AAQ-II actually measures.
“In recent years, there has been increasing disagreement about what the AAQ-II actually measures (39–41).”
From Increasing psychological flexibility is associated with positive therapy outcomes following a transdiagnostic ACT treatment (2024) · cites this paper as [41]
Recent research suggestions for improving the measurement and evaluation of theorized processes of central importance for ACT emphasize processes that are sensitive or specific to ACT or mediate ACT outcomes specifically.
“Recent research suggestions for improving the measurement and evaluation of theorized pro cesses of central importance for ACT emphasize pro cesses that are sensitive or specific to ACT or mediate ACT outcomes specifically (Arch et al., 2023).”
From Which emotion regulation strategies are mediating the outcome of acceptance and commitment therapy compared to cognitive-behaviour therapy in the treatment of anxiety symptoms? (2025) · cites this paper as Arch et al., 2023
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Fishbein citation points to a different type of study
MinorThe text describes Fishbein et al. (2022) as a randomized trial involving anxious cancer survivors, but the listed reference describes the development of a self-transcendence questionnaire.
“a recent, larger RCT of ACT versus minimally enhanced usual care for anxious cancer survivors did not observe treatment specificity for values consistency (Fishbein et al., 2022).”
“Fishbein JN, Baer RA, Correll J, & Arch JJ (2022). The Questionnaire On Self-transcendence (QUEST): A measure of trait self-transcendence informed by contextual cognitive behavioral therapies.”
Cites
Estimating the reproducibility of psychological science
Open Science Collaboration (2015) · Science · doi:10.1126/science.aac4716 · Cited by 8,515 · see citing works
Acceptance and commitment therapy: model, processes and outcomes
Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006) · Behaviour Research and Therapy · doi:10.1016/j.brat.2005.06.006 · Cited by 6,587 · see citing works
Self-citation(1999) · Cited by 5,934 · see citing works
MacKinnon, D. P., Fairchild, A. J., & Fritz, M. S. (2007) · Annual Review of Psychology · doi:10.1146/annurev.psych.58.110405.085542 · Cited by 5,688 · see citing works
Required sample size to detect the mediated effect
Fritz, M. S., & MacKinnon, D. P. (2007) · Psychological Science · doi:10.1111/j.1467-9280.2007.01882.x · Cited by 4,810 · see citing works
Putnick, D. L., & Bornstein, M. H. (2016) · Developmental Review · doi:10.1016/j.dr.2016.06.004 · Cited by 4,369 · see citing works
Mokkink, L. B., Terwee, C. B., Patrick, D. L., Alonso, J., Stratford, P. W., Knol, D. L., Bouter, L. M., & de Vet, H. C. W. (2010) · Quality of Life Research · doi:10.1007/s11136-010-9606-8 · Cited by 4,260 · see citing works
Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., Waltz, T., & Zettle, R. D. (2011) · Behavior Therapy · doi:10.1016/j.beth.2011.03.007 · Cited by 3,950 · see citing works
Cella, D., Yount, S., Rothrock, N., Gershon, R., Cook, K., Reeve, B., Ader, D., Fries, J. F., Bruce, B., & Rose, M. (2007) · Medical Care · doi:10.1097/01.mlr.0000258615.42478.55 · Cited by 3,118 · see citing works
Process Analysis: Estimating Mediation in Treatment Evaluations
Judd, C. M., & Kenny, D. A. (1981) · Evaluation Review · doi:10.1177/0193841x8100500502 · Cited by 2,442 · see citing works
Terwee, C. B., Prinsen, C. A. C., Chiarotto, A., Westerman, M. J., Patrick, D. L., Alonso, J., Bouter, L. M., de Vet, H. C. W., & Mokkink, L. B. (2018) · Quality of Life Research · doi:10.1007/s11136-018-1829-0 · Cited by 2,348 · see citing works
Measuring the Prevalence of Questionable Research Practices With Incentives for Truth Telling
John, L. K., Loewenstein, G., & Prelec, D. (2012) · Psychological Science · doi:10.1177/0956797611430953 · Cited by 2,239 · see citing works
Measuring experiential avoidance: A preliminary test of a working model
Hayes, S. C., Strosahl, K., Wilson, K. G., Bissett, R. T., Pistorello, J., Toarmino, D., Polusny, M. A., Dykstra, T. A., Batten, S. V., Bergan, J., et al. (2004) · The Psychological Record · doi:10.1007/bf03395492 · Cited by 2,140 · see citing works
HARKing: Hypothesizing after the results are known
Kerr, N. L. (1998) · Personality and Social Psychology Review · doi:10.1207/s15327957pspr0203_4 · Cited by 1,989 · see citing works
Determining power and sample size for simple and complex mediation models
Schoemann, A. M., Boulton, A. J., & Short, S. D. (2017) · Social Psychological and Personality Science · doi:10.1177/1948550617715068 · Cited by 1,837 · see citing works
Statistical Approaches to Measurement Invariance
Millsap, R. E. (2012) · doi:10.4324/9780203821961 · Cited by 1,554 · see citing works
Constructing validity: New developments in creating objective measuring instruments.
Clark, L. A., & Watson, D. (2019) · Psychological Assessment · doi:10.1037/pas0000626 · Cited by 1,470 · see citing works
Hayes, S. C., Levin, M. E., Plumb-Vilardaga, J., Villatte, J. L., & Pistorello, J. (2013) · Behavior Therapy · doi:10.1016/j.beth.2009.08.002 · Cited by 1,120 · see citing works
The development and initial validation of the cognitive fusion questionnaire
Gillanders, D. T., Bolderston, H., Bond, F. W., Dempster, M., Flaxman, P. E., Campbell, L., Kerr, S., Tansey, L., Noel, P., Ferenbach, C., et al. (2014) · Behavior Therapy · doi:10.1016/j.beth.2013.09.001 · Cited by 837 · see citing works
Hayes, S. C., Villatte, M., Levin, M., & Hildebrandt, M. (2011) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-032210-104449 · Cited by 800 · see citing works
The Reviewer’s Guide to Quantitative Methods in the Social Sciences
(2018) · Routledge eBooks · doi:10.4324/9781315755649 · Cited by 758 · see citing works
<i>p</i> -Curve and Effect Size: Correcting for Publication Bias Using Only Significant Results
Simonsohn, U., Nelson, L. D., & Simmons, J. P. (2014) · Perspectives on Psychological Science · doi:10.1177/1745691614553988 · Cited by 717 · see citing works
Construct Validation in Social and Personality Research
Flake, J. K., Pek, J. C. X., & Hehman, E. (2017) · Social Psychological and Personality Science · doi:10.1177/1948550617693063 · Cited by 715 · see citing works
The Role of Acceptance and Job Control in Mental Health, Job Satisfaction, and Work Performance
Bond, F. W., & Bunce, D. (2003) · Journal of Applied Psychology · doi:10.1037/0021-9010.88.6.1057 · Cited by 711 · see citing works
Forman, E. M., Herbert, J. D., Moitra, E., Yeomans, P. D., & Geller, P. A. (2007) · Behavior Modification · doi:10.1177/0145445507302202 · Cited by 687 · see citing works
Psychological well-being and ill-Being: do they have distinct or mirrored biological correlates?
Ryff, C. D., Dienberg Love, G., Urry, H. L., Muller, D., Rosenkranz, M. A., Friedman, E. M., Davidson, R. J., & Singer, B. (2006) · Psychotherapy and Psychosomatics · doi:10.1159/000090892 · Cited by 672 · see citing works
(2009) · Cited by 655 · see citing works
The empirical status of acceptance and commitment therapy: A review of meta-analyses
Gloster, A. T., Walder, N., Levin, M. E., Twohig, M. P., & Karekla, M. (2020) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2020.09.009 · Cited by 622 · see citing works
Gámez, W., Chmielewski, M., Kotov, R., Ruggero, C., & Watson, D. (2011) · Psychological Assessment · doi:10.1037/a0023242 · Cited by 524 · see citing works
The valued living questionnaire: defining and measuring valued action within a behavioral framework
Wilson, K. G., Sandoz, E. K., Kitchens, J., & Roberts, M. (2010) · The Psychological Record · doi:10.1007/bf03395706 · Cited by 518 · see citing works
Best (but oft-forgotten) practices: mediation analysis ,
Fairchild, A. J., & McDaniel, H. L. (2017) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.117.152546 · Cited by 512 · see citing works
Do we need to challenge thoughts in cognitive behavior therapy?
Longmore, R. J., & Worrell, M. (2007) · Clinical Psychology Review · doi:10.1016/j.cpr.2006.08.001 · Cited by 499 · see citing works
The Theory Crisis in Psychology: How to Move Forward
Eronen, M. I., & Bringmann, L. F. (2021) · Perspectives on Psychological Science · doi:10.1177/1745691620970586 · Cited by 459 · see citing works
A unified framework of longitudinal models to examine reciprocal relations.
Usami, S., Murayama, K., & Hamaker, E. L. (2019) · Psychological Methods · doi:10.1037/met0000210 · Cited by 437 · see citing works
What Does the Acceptance and Action Questionnaire (AAQ-II) Really Measure?
Wolgast, M. (2014) · Behavior Therapy · doi:10.1016/j.beth.2014.07.002 · Cited by 421 · see citing works
Factor analysis in psychological assessment research: Common pitfalls and recommendations.
Sellbom, M., & Tellegen, A. (2019) · Psychological Assessment · doi:10.1037/pas0000623 · Cited by 355 · see citing works
Development of the Valuing Questionnaire (VQ)
Smout, M., Davies, M., Burns, N., & Christie, A. (2014) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2014.06.001 · Cited by 350 · see citing works
Sustaining motivational interviewing: A meta-analysis of training studies
Schwalbe, C. S., Oh, H. Y., & Zweben, A. (2014) · Addiction · doi:10.1111/add.12558 · Cited by 343 · see citing works
Constructing validity: Basic issues in objective scale development.
Clark, L. A., & Watson, D. (2015) · American Psychological Association eBooks · doi:10.1037/14805-012 · Cited by 340 · see citing works
Fried, E. I., van Borkulo, C. D., Epskamp, S., Schoevers, R. A., Tuerlinckx, F., & Borsboom, D. (2016) · Psychological Assessment · doi:10.1037/pas0000275 · Cited by 314 · see citing works
Arch, J. J., & Craske, M. G. (2008) · Clinical Psychology: Science and Practice · doi:10.1111/j.1468-2850.2008.00137.x · Cited by 310 · see citing works
Self-citationAcceptance and commitment therapy for anxiety and OCD spectrum disorders: An empirical review
Bluett, E. J., Homan, K. J., Morrison, K. L., Levin, M. E., & Twohig, M. P. (2014) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2014.06.008 · Cited by 306 · see citing works
Flora, D. B., & Flake, J. K. (2017) · Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement · doi:10.1037/cbs0000069 · Cited by 304 · see citing works
Tyndall, I., Waldeck, D., Pancani, L., Whelan, R., Roche, B., & Dawson, D. L. (2019) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2018.09.005 · Cited by 303 · see citing works
The role of the individual in the coming era of process-based therapy
Hayes, S. C., Hofmann, S. G., Stanton, C. E., Carpenter, J. K., Sanford, B. T., Curtiss, J. E., & Ciarrochi, J. (2019) · Behaviour Research and Therapy · doi:10.1016/j.brat.2018.10.005 · Cited by 295 · see citing works
A novel measure of effect size for mediation analysis
Lachowicz, M. J., Preacher, K. J., & Kelley, K. (2018) · Psychological Methods · doi:10.1037/met0000165 · Cited by 271 · see citing works
That’s a Lot to Process! Pitfalls of Popular Path Models
Rohrer, J. M., Hünermund, P., Arslan, R. C., & Elson, M. (2022) · Advances in Methods and Practices in Psychological Science · doi:10.1177/25152459221095827 · Cited by 267 · see citing works
Experiential Avoidance: An Examination of the Construct Validity of the AAQ-II and MEAQ
Rochefort, C., Baldwin, A. S., & Chmielewski, M. (2018) · Behavior Therapy · doi:10.1016/j.beth.2017.08.008 · Cited by 247 · see citing works
Beyond linear mediation: Toward a dynamic network approach to study treatment processes
Hofmann, S. G., Curtiss, J. E., & Hayes, S. C. (2020) · Clinical Psychology Review · doi:10.1016/j.cpr.2020.101824 · Cited by 232 · see citing works
Statistical properties of four effect-size measures for mediation models
Miočević, M., O’Rourke, H. P., MacKinnon, D. P., & Brown, H. C. (2018) · Behavior Research Methods · doi:10.3758/s13428-017-0870-1 · Cited by 200 · see citing works
Lundgren, T., Dahl, J., & Hayes, S. C. (2008) · Journal of Behavioral Medicine · doi:10.1007/s10865-008-9151-x · Cited by 199 · see citing works
Arch, J. J., Wolitzky-Taylor, K. B., Eifert, G. H., & Craske, M. G. (2012) · Behaviour Research and Therapy · doi:10.1016/j.brat.2012.04.007 · Cited by 194 · see citing works
Self-citationStockton, D., Kellett, S., Berrios, R., Sirois, F., Wilkinson, N., & Miles, G. (2019) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465818000553 · Cited by 193 · see citing works
Psychology’s Replication Crisis and the Grant Culture: Righting the Ship
Lilienfeld, S. O. (2017) · Perspectives on Psychological Science · doi:10.1177/1745691616687745 · Cited by 188 · see citing works
Kashdan, T. B., Goodman, F. R., Machell, K. A., Kleiman, E. M., Monfort, S. S., Ciarrochi, J., & Nezlek, J. B. (2014) · Emotion · doi:10.1037/a0035935 · Cited by 187 · see citing works
Trompetter, 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 · see citing works
The Merits of Using Longitudinal Mediation
Jose, P. E. (2016) · Educational Psychologist · doi:10.1080/00461520.2016.1207175 · Cited by 182 · see citing works
Psy-Flex: A contextually sensitive measure of psychological flexibility
Gloster, A. T., Block, V. J., Klotsche, J., Villanueva, J., Rinner, M. T. B., Benoy, C., Walter, M., Karekla, M., & Bader, K. (2021) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2021.09.001 · Cited by 175 · see citing works
The Bull's-Eye Values Survey: A Psychometric Evaluation
Lundgren, T., Luoma, J. B., Dahl, J., Strosahl, K., & Melin, L. (2012) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2012.01.004 · Cited by 172 · see citing works
Self-citationThompson, E. M., Destree, L., Albertella, L., & Fontenelle, L. F. (2021) · Behavior Therapy · doi:10.1016/j.beth.2020.07.002 · Cited by 168 · see citing works
Foundations of idiographic methods in psychology and applications for psychotherapy
Piccirillo, M. L., & Rodebaugh, T. L. (2019) · Clinical Psychology Review · doi:10.1016/j.cpr.2019.01.002 · Cited by 160 · see citing works
A review of AAQ variants and other context-specific measures of psychological flexibility
Ong, C. W., Lee, E. B., Levin, M. E., & Twohig, M. P. (2019) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2019.02.007 · Cited by 142 · see citing works
Acceptance and Commitment Therapy modules: Differential impact on treatment processes and outcomes
Villatte, J. L., Vilardaga, R., Villatte, M., Plumb Vilardaga, J. C., Atkins, D. C., & Hayes, S. C. (2016) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.12.001 · Cited by 136 · see citing works
Hayes, S. C., Merwin, R. M., McHugh, L., Sandoz, E. K., A-Tjak, J. G. L., Ruiz, F. J., Barnes-Holmes, D., Bricker, J. B., Ciarrochi, J., Dixon, M. R., et al. (2021) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2021.03.007 · Cited by 136 · see citing works
P-hacking and publication bias interact to distort meta-analytic effect size estimates
Friese, M., & Frankenbach, J. (2020) · Psychological Methods · doi:10.1037/met0000246 · Cited by 122 · see citing works
Johannsen, M., Nissen, E. R., Lundorff, M., & O'Toole, M. S. (2022) · Clinical Psychology Review · doi:10.1016/j.cpr.2022.102156 · Cited by 116 · see citing works
Niles, A. N., Burklund, L. J., Arch, J. J., Lieberman, M. D., Saxbe, D., & Craske, M. G. (2014) · Behavior Therapy · doi:10.1016/j.beth.2014.04.006 · Cited by 115 · see citing works
Self-citationLongitudinal Research with Latent Variables
(2010) · doi:10.1007/978-3-642-11760-2 · Cited by 110 · see citing works
Five Steps in Latent Curve and Latent Change Score Modeling with Longitudinal Data
McArdle, J. J., & Grimm, K. J. (2010) · Longitudinal Research with Latent Variables · doi:10.1007/978-3-642-11760-2_8 · Cited by 103 · see citing works
French, K., Golijani-Moghaddam, N., & Schröder, T. (2017) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2017.08.002 · Cited by 100 · see citing works
Goldsmith, K. A., MacKinnon, D. P., Chalder, T., White, P. D., Sharpe, M., & Pickles, A. (2018) · Psychological Methods · doi:10.1037/met0000154 · Cited by 99 · see citing works
Abernethy, A. P., Aziz, N. M., Basch, E., Bull, J., Cleeland, C. S., Currow, D. C., Fairclough, D., Hanson, L., Hauser, J., Ko, D., et al. (2010) · Journal of Palliative Medicine · doi:10.1089/jpm.2010.0261 · Cited by 94 · see citing works
O'Neill, L., Latchford, G., McCracken, L. M., & Graham, C. D. (2019) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2019.08.008 · Cited by 87 · see citing works
Ong, C. W., Pierce, B. G., Petersen, J. M., Barney, J. L., Fruge, J. E., Levin, M. E., & Twohig, M. P. (2020) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2020.08.007 · Cited by 87 · see citing works
Acceptance and commitment therapy for family caregivers: A systematic review and meta-analysis.
Han, A., Yuen, H. K., & Jenkins, J. (2021) · Journal of Health Psychology · doi:10.1177/1359105320941217 · Cited by 82 · see citing works
The registration continuum in clinical science: A guide toward transparent practices
Benning, S. D., Bachrach, R. L., Smith, E. A., Freeman, A. J., & Wright, A. G. C. (2019) · Journal of Abnormal Psychology · doi:10.1037/abn0000451 · Cited by 77 · see citing works
Assessing treatment integrity in acceptance and commitment therapy: strategies and suggestions
Plumb, J. C., & Vilardaga, R. (2010) · International Journal of Behavioral Consultation and Therapy · doi:10.1037/h0100912 · Cited by 75 · see citing works
Study preregistration: An evaluation of a method for transparent reporting
Toth, A. A., Banks, G. C., Mellor, D., O’Boyle, E. H., Dickson, A., Davis, D. J., DeHaven, A., Bochantin, J., & Borns, J. (2021) · Journal of Business and Psychology · doi:10.1007/s10869-020-09695-3 · Cited by 73 · see citing works
A systematic review of values measures in acceptance and commitment therapy research
Reilly, E. D., Ritzert, T. R., Scoglio, A. A. J., Mote, J., Fukuda, S. D., Ahern, M. E., & Kelly, M. M. (2019) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2018.10.004 · Cited by 72 · see citing works
Hadash, Y., Plonsker, R., Vago, D. R., & Bernstein, A. (2016) · Psychological Assessment · doi:10.1037/pas0000300 · Cited by 68 · see citing works
Item Response Theory Models for Wording Effects in Mixed-Format Scales
Wang, W., Chen, H.-F., & Jin, K. (2014) · Educational and Psychological Measurement · doi:10.1177/0013164414528209 · Cited by 65 · see citing works
Landis, R. S., James, L. R., Lance, C. E., Pierce, C. A., & Rogelberg, S. G. (2014) · Journal of Business and Psychology · doi:10.1007/s10869-014-9347-8 · Cited by 63 · see citing works
Hadash, Y., & Bernstein, A. (2019) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2019.01.008 · Cited by 63 · see citing works
The “Goldilocks Zone”: (Too) many confidence intervals in tests of mediation just exclude zero.
Götz, M., O’Boyle, E. H., Gonzalez-Mule, E. N., Banks, G. C., & Bollmann, S. (2020) · Psychological Bulletin · doi:10.1037/bul0000315 · Cited by 58 · see citing works
Measuring the Prevalence of Questionable Research Practices with Incentives for Truth-TellingPreprint
John, L. K., Loewenstein, G. F., & Prelec, D. (2012) · SSRN Electronic Journal · doi:10.2139/ssrn.1996631 · Cited by 56 · see citing works
Interrelating Behavioral Measures of Distress Tolerance with Self-Reported Experiential Avoidance
Kapson, H. S., & Haaga, D. A. F. (2011) · Journal of Rational-Emotive & Cognitive-Behavior Therapy · doi:10.1007/s10942-011-0127-3 · Cited by 55 · see citing works
Barrett, K., O’Connor, M., & McHugh, L. (2019) · The Psychological Record · doi:10.1007/s40732-019-00352-7 · Cited by 55 · see citing works
Godbee, M., & Kangas, M. (2020) · Behavior Therapy · doi:10.1016/j.beth.2019.12.010 · Cited by 51 · see citing works
The Acceptance and Action Questionnaire – II: an Item Response Theory Analysis
Ong, C. W., Pierce, B. G., Woods, D. W., Twohig, M. P., & Levin, M. E. (2018) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-018-9694-2 · Cited by 50 · see citing works
Synthesizing Indirect Effects in Mediation Models With Meta-Analytic Methods
Cheung, M. W. ‐. (2021) · Alcohol and Alcoholism · doi:10.1093/alcalc/agab044 · Cited by 50 · see citing works
Reeve, A., Tickle, A., & Moghaddam, N. (2018) · Mental Health Review Journal · doi:10.1108/mhrj-11-2017-0052 · Cited by 49 · see citing works
Ong, C. W., Barney, J. L., Barrett, T. S., Lee, E. B., Levin, M. E., & Twohig, M. P. (2019) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2019.06.005 · Cited by 40 · see citing works
A step-by-step guide on preregistration and effective data sharing for psychopathology research.
Krypotos, A., Klugkist, I. G., Mertens, G., & Engelhard, I. M. (2019) · Journal of Abnormal Psychology · doi:10.1037/abn0000424 · Cited by 40 · see citing works
Han, A., Yuen, H. K., Lee, H. Y., & Zhou, X. (2020) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2020.10.004 · Cited by 39 · see citing works
How contextual behavioral scientists measure and report about behavior: A review of JCBS
Newsome, D., Newsome, K., Fuller, T. C., & Meyer, S. (2019) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2018.11.005 · Cited by 37 · see citing works
Treatment sensitivity: Its importance in the measurement of psychological flexibility
Benoy, C., Knitter, B., Schumann, I., Bader, K., Walter, M., & Gloster, A. T. (2019) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2019.07.005 · Cited by 33 · see citing works
Finkelstein-Fox, L., Pavlacic, J. M., Buchanan, E. M., Schulenberg, S. E., & Park, C. L. (2020) · Cognitive Therapy and Research · doi:10.1007/s10608-019-10062-7 · Cited by 33 · see citing works
Tackett, J. L., & Miller, J. D. (2019) · Journal of Abnormal Psychology · doi:10.1037/abn0000455 · Cited by 32 · see citing works
Barney, J. L., Lillis, J., Haynos, A. F., Forman, E., & Juarascio, A. S. (2019) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2018.08.002 · Cited by 23 · see citing works
(2011) · Cited by 23 · see citing works
P-Curve and Effect Size: Correcting for Publication Bias Using Only Significant ResultsPreprint
Simonsohn, U., Nelson, L. D., & Simmons, J. P. (2014) · SSRN Electronic Journal · doi:10.2139/ssrn.2377290 · Cited by 22 · see citing works
Experiential 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 · see citing works
Serowik, K. L., Khan, A. J., LoCurto, J., & Orsillo, S. M. (2018) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-018-9679-1 · Cited by 15 · see citing works
p-Hacking and Publication Bias Interact to Distort Meta-Analytic Effect Size EstimatesPreprint
Friese, M., & Frankenbach, J. (2020) · doi:10.31234/osf.io/bvm58 · Cited by 15 · see citing works
Fishbein, J. N., Baer, R. A., Correll, J., & Arch, J. J. (2022) · Assessment · doi:10.1177/1073191120980061 · Cited by 14 · see citing works
Self-citationJose, P. E. (2018) · Routledge eBooks · doi:10.4324/9781315755649-18 · Cited by 12 · see citing works
The Registration Continuum in Clinical Science: A Guide toward Transparent PracticesPreprint
Benning, S. D., Bachrach, R. L., Smith, E., et al. (2018) · doi:10.31234/osf.io/an8h3 · Cited by 7 · see citing works
Hadash, Y., & Bernstein, A. (2018) · doi:10.31231/osf.io/z237a · Cited by 6 · see citing works
A Step-By-Step Guide on Preregistration and Effective Data Sharing for Psychopathology ResearchPreprint
Krypotos, A., Klugkist, I. G., Mertens, G., et al. (2018) · doi:10.31234/osf.io/ysgfa · Cited by 1 · see citing works
Assessing the valuing process in in acceptance and commitment therapy
Barney, J. L., & Juarascio, A. S. (2017) · doi:10.17918/etd-7517
Foundations of Idiographic Methods in Psychology and Applications for Psychotherapy
Piccirillo, M., & Rodebaugh, T. (2019) · doi:10.31234/osf.io/efdx4
Tackett, J. L., & Miller, J. (2019) · doi:10.31234/osf.io/5zxbd
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Ong, C. W., Barthel, A. L., & Hofmann, S. G. (2024) · Behavior Therapy · doi:10.1016/j.beth.2023.05.007 · Cited by 61 · see citing works
Ong, C. W., Ciarrochi, J., Hofmann, S. G., Karekla, M., & Hayes, S. C. (2024) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2024.100734 · Cited by 51 · see citing works
“Some researchers have levied criticism of the empirical basis of ACT mediational literature, noting that psychological flexibility and inflexibility have been loosely defined and certain subprocesses have been understudied relative to others (Arch et al., 2022).”
BackgroundAn Overview of Research on Acceptance and Commitment Therapy
Levin, M. E., Krafft, J., & Twohig, M. P. (2024) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2024.02.007 · Cited by 49 · see citing works
Morris, E. M. J., Johns, L., & Gaudiano, B. A. (2023) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12479 · Cited by 42 · see citing works
Fawson, S., Moon, Z., Novogrudsky, K., Moxham, F., Forster, K., Tribe, I., Moss-Morris, R., Johnson, C., & Hughes, L. D. (2024) · Health Psychology Review · doi:10.1080/17437199.2023.2261518 · Cited by 40 · see citing works
“This would allow the model and potential mechanisms of change to be adequately tested to support intervention development and provide evidence of these processes translating into change (Arch et al., 2022).”
BackgroundInfluentialHayes, S. C., Hofmann, S. G., & Ciarrochi, J. (2023) · Behavior Therapy · doi:10.1016/j.beth.2023.07.011 · Cited by 37 · see citing works
Atefi, G. L., de Vugt, M. E., van Knippenberg, R. J. M., Levin, M. E., Verhey, F. R. J., & Bartels, S. L. (2023) · Clinical Psychology Review · doi:10.1016/j.cpr.2023.102341 · Cited by 30 · see citing works
Hsu, T., Adamowicz, J. L., & Thomas, E. B. K. (2023) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2023.10.006 · Cited by 31 · see citing works
Sauer, C., Haussmann, A., & Weissflog, G. (2024) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2024.100810 · Cited by 27 · see citing works
Measuring ACT in context: Challenges and future directions
Ong, C. W., Sheehan, K. G., & Haaga, D. A. F. (2023) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2023.04.005 · Cited by 28 · see citing works
Ruiz, F. J., Bianchi, J. M., Bastidas-Suárez, D. M., Ramírez, E. S., & Peña-Hernández, V. (2024) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2024.100854 · Cited by 23 · see citing works
Rutschmann, R., Romanczuk-Seiferth, N., Gloster, A., & Richter, C. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1403718 · Cited by 21 · see citing works
Hsu, T., Hoffman, L., & Thomas, E. B. K. (2023) · Psychological Assessment · doi:10.1037/pas0001214 · Cited by 21 · see citing works
Eadeh, H.-M., Adamowicz, J. L., Markon, K., & Thomas, E. B. K. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2022.10.004 · Cited by 18 · see citing works
Moghaddam, N. G., Morris, J. L., Bayliss, K., & Dawson, D. L. (2023) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2023.06.003 · Cited by 17 · see citing works
Psychometric properties of the Psy-flex scale: A validation study in a community sample in Korea
Jo, D., Seong, B., & Yang, E. (2023) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2023.09.004 · Cited by 16 · see citing works
Borgogna, N. C., Spencer, S. D., Johnson, D. A., Brasil, K. M., McDermott, R. C., Kraus, S. W., & Buchanan, J. A. (2023) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2023.10.001 · Cited by 14 · see citing works
A call for qualitative research in Contextual Behavioral Science
Jando, C., & Dionne, F. (2024) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2024.100751 · Cited by 14 · see citing works
Acceptance as a possible link between past psychedelic experiences and psychological flexibility
Krabbe, A., Sikka, P., & Jylkkä, J. (2024) · Scientific Reports · doi:10.1038/s41598-024-75595-8 · Cited by 13 · see citing works
Pereira, C., Cunha, M. I. V. A., Massano‐Cardoso, I., & Galhardo, A. B. (2023) · Revista Portuguesa de Investigação Comportamental e Social · doi:10.31211/rpics.2023.9.1.285 · Cited by 11 · see citing works
Cunha, M. I. V. A., Temido, A., Moniz, S., & Galhardo, A. B. (2024) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2024.100730 · Cited by 13 · see citing works
McKay, D., & O’Donohue, W. (2023) · Behavior Therapy · doi:10.1016/j.beth.2023.07.004 · Cited by 8 · see citing works
Apolinário-Hagen, J., Drüge, M., Guthardt, L., & Haller, E. (2024) · Advances in Experimental Medicine and Biology · doi:10.1007/978-981-97-4402-2_12 · Cited by 6 · see citing works
Nicolescu, S., Secară, E.-C., Jiboc, N. M., & Băban, A. (2024) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2024.100729 · Cited by 7 · see citing works
Fang, S., Huang, M., Ding, D., & Zheng, Q. (2024) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2024.100805 · Cited by 7 · see citing works
O’Toole, M. S., Ramsdal, N. B., Nørskov, C. S., Roepstorff, I. G., Buskbjerg, C. R., Mads, B., Christiansen, & Elkjær, E. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.119791 · Cited by 7 · see citing works
A psychometric validation of the Korean CompACT-15
Jo, D., Jin, Y., Lee, J., & Yang, E. (2024) · Current Psychology · doi:10.1007/s12144-024-06830-8 · Cited by 7 · see citing works
“Given the recent interest in therapeutic processes, an accurate measurement of these processes is crucial (Arch et al., 2022 ).”
Tayyebi, G., Alwan, N. H., Hamed, A. F., Shallal, A. A., Abdulrazzaq, T., & Khayayi, R. (2024) · Iranian Journal of Psychiatry · doi:10.18502/ijps.v19i3.15809 · Cited by 7 · see citing works
Morey, A., Samuel, V. M., Lewis, M., & Williams, M. O. (2024) · JCPP Advances · doi:10.1002/jcv2.12271 · Cited by 8 · see citing works
“Y recommendations for ACT research to distinguish process from symptom measures and to compare process measures against behavioural outcomes (Arch et al., 2022).”
Levin, M. E., Aller, T. B., Klimczak, K. S., Donahue, M. L., & Knudsen, F. M. (2025) · Behaviour Research and Therapy · doi:10.1016/j.brat.2025.104729 · Cited by 5 · see citing works
Gentili, C., Rickardsson, J., Holmström, L., Wicksell, R. K., Hesser, H., & Zetterqvist, V. (2024) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2024.100725 · Cited by 5 · see citing works
“This is interesting given the debate whether or not different ACT-processes can be conceptually and methodologically differentiated from one another (Arch et al., 2022).”
BackgroundSpencer, S. D., Zimmerman, M. B., Donis, N., Rodrigues, M. M., Jackson, D. O., & Dindo, L. N. (2023) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2023.09.007 · Cited by 4 · see citing works
Age differences in acceptance and commitment therapy for chronic pain
Fishbein, J. N., Tynan, M., Truong, L., Wetherell, J. L., & Herbert, M. S. (2023) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2023.09.006 · Cited by 5 · see citing works
Self-citationSchachter, J., Ajayi, A. A., & Delgado, J. E. (2024) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2024.100852 · Cited by 3 · see citing works
Accepting the Challenge and Committing to the Future of Acceptance and Commitment Therapy Science
Borgogna, N. C., & Aita, S. L. (2025) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2025.02.014 · Cited by 3 · see citing works
Psychometric Properties of the Self-as-Context Scale with a University Counseling Center Sample
Zettle, R. D., Lyons, G. A., Larson, J. M., & Leonard, C. (2025) · Behavioral Sciences · doi:10.3390/bs15070910 · Cited by 3 · see citing works
“One point on which both parties seem to be in agreement within the debate about the status of mediational research within ACT is that self-as-context has been understudied as a purported separate subprocess of psychological flexibility (Arch et al., 2023; Fishbein et al., 2020).”
Lucas, J. D., Lackner, J., Gudleski, G. D., Rogers, A. H., Becerra, R., & Naragon‐Gainey, K. (2025) · Assessment · doi:10.1177/10731911251399030 · Cited by 4 · see citing works
Introduction to Acceptance and Commitment Therapy
Spencer, S. D., & Levin, M. E. (2025) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2025.02.002 · Cited by 3 · see citing works
Acceptance and Commitment Therapy (ACT) for Anxiety Disorders
Arch, J. J., Finkelstein, L. B., & Nealis, M. S. (2025) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2025.02.003 · Cited by 3 · see citing works
Self-citationTransparency and reproducibility in the journal of contextual behavioral science: An audit study
Lear, M. K., Spata, A., Tittler, M. V., Fishbein, J. N., Arch, J. J., & Luoma, J. B. (2023) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2023.03.017 · Cited by 4 · see citing works
Self-citationSpinhoven, P., Kraaij, V., Garnefski, N., Bohlmeijer, E., & Witlox, M. (2025) · Psychotherapy Research · doi:10.1080/10503307.2025.2556836 · Cited by 2 · see citing works
Acceptance and Commitment Therapy for Depression
Zettle, R. D. (2025) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2025.02.005 · Cited by 2 · see citing works
Examining Item Content Across Nine Psychological (In)flexibility Scales: What Do They Measure?Preprint
Ong, C. W., Skolnik, A., Johnson, H. M., et al. (2023) · doi:10.31234/osf.io/wur26 · Cited by 2 · see citing works
Ferreira, M. G., Caetano Vieira de Faria, R., Kishita, N., & Caramelli, P. (2026) · Clinical Gerontologist · doi:10.1080/07317115.2026.2615707 · Cited by 2 · see citing works
“Arch et al. (2023) highlighted that limited empirical work has been conducted to evaluate the structural validity of the Hexaflex model.”
Examining item content across nine psychological (in)flexibility scales: What do they measure?
Ong, C. W., Skolnik, A. M., Johnson, H. M., & Lee, E. B. (2025) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2025.100872 · Cited by 5 · see citing works
Hontoy, L.-M., Joussemet, M., Robichaud, J., Mageau, G. A., & Grégoire, S. (2025) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2025.100927 · Cited by 1 · see citing works
Hontoy, L.-M., Joussemet, M., Robichaud, J., Mageau, G. A., & Grégoire, S. (2025) · Motivation and Emotion · doi:10.1007/s11031-025-10150-0 · Cited by 1 · see citing works
Embracing the bodily felt affective experience: Experiential emotion regulation, a systematic review
Ionescu, A., Pascual‐Leone, A., & Vandekerckhove, M. M. P. (2025) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2025.106456 · Cited by 1 · see citing works
Loureiro, C. P., dos Santos‐Ribeiro, S., Moreira‐de‐Oliveira, M. E., Laurito, L. D., Hühne, V., Torres, B., Twohig, M. P., de Menezes, G. B., & Fontenelle, L. F. (2026) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2026.01.035 · Cited by 2 · see citing works
Imany, M., Mohammadkhani, S., Atashipour, H. S., & Pourhosseini, P. (2025) · BMC Psychology · doi:10.1186/s40359-025-03364-x · Cited by 1 · see citing works
“Furthermore, the overlap between experiential avoidance and other variables—particularly those under the scope of psychological flexibility—can lead to inaccurate assessments [24].”
Transparency and Reproducibility in the Journal of Contextual Behavioral Science (preprint)Preprint
Lear, M. K., Spata, A., Tittler, M. V., Fishbein, J. N., Arch, J. J., & Luoma, J. B. (2023) · doi:10.31219/osf.io/ugcwd
Self-citationSheykhangafshe, F. B., Esrfilian, F., Niri, V. S., et al. (2024) · فصلنامه علمی و پژوهشی اعتیادپژوهی · doi:10.61186/etiadpajohi.17.70.195
Acceptance and Action Questionnaire-II (AAQ-II)
Knudsen, F. M., & Levin, M. E. (2024) · Springer eBooks · doi:10.1007/978-3-030-77644-2_134-1 · Cited by 1 · see citing works
Abasi, M. H., Ghadampour, E., Bahrami, E., & Musaei, M. A. (2024) · فصلنامه علمی و پژوهشی اعتیادپژوهی · doi:10.61186/etiadpajohi.18.73.181
Imany, M., Mohammadkhani, S., Atashipour, H. S., et al. (2025) · SSRN Electronic Journal · doi:10.2139/ssrn.5154593
Spencer, S. D., Jo, D., Hill, M. L., Meyer, M. S., Firoozan, A., & Masuda, A. (2025) · Behavior Modification · doi:10.1177/01454455251343301
“Finally, as discussed elsewhere (Wolgast, 2014), the use of items from the AAQ-II for the daily rating of EA may be particularly problematic due to its questionable discriminant validity vis a vis neuroticism/general psychological distress (Arch et al., 2023; Tyndall et al., 2019).”
Thomson, K. M., Davis, S., Bernier, S. L., Magnacca, C., Noone, S., & Lunsky, Y. (2025) · Journal of Applied Research in Intellectual Disabilities · doi:10.1111/jar.70058
“For example, although the AAQ-II is a widely used process measure, it has limitations related to conceptual ambiguity, weak psychometric properties and insensitivity to treatment outcomes (Arch et al. 2023).”
Acceptance and Action Questionnaire-II (AAQ-II)
Knudsen, F. M., & Levin, M. E. (2025) · Springer eBooks · doi:10.1007/978-3-031-47219-0_134
Heydarabadi, M. B., Shafi, N., Hanafi, A., shirzad, Z., & daneshkhah, S. (2025) · Journal of Health and Care · doi:10.61186/jhc.27.1.7
Yau, P. T., Gloster, A. T., Chien, W. T., & Chong, Y. Y. (2025) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2025.100970
Verkoeyen, N. V. (2026) · Педагогика и просвещение · doi:10.7256/2454-0676.2026.1.78600
Self-as-Context as an Autonomous Mechanism for Anxiety Reduction
Verkoeyen, N. V. (2026) · Психология и Психотехника · doi:10.7256/2454-0722.2026.1.78606
Güngör, A., & Güngör, B. Ş. (2026) · The Family Journal · doi:10.1177/10664807261421566
Shi, J., Na, L., Du, Y., Wang, J., Zhang, R., Guo, C., Hu, M., Fan, S., & Wang, Z. (2026) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.70061
“First, ACT operates primarily through an indirect mechanistic pathway (Arch et al., 2023), and the current study did not include formal mediating variables.”
Jo, D., Im, S., Lee, E., & Yang, E. (2026) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2026.2680603
An item response theory analysis of the Self-as-Context Scale
Zettle, R. D., & Kwon, Y. (2026) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2026.101004
Simerly, G., Broman‐Fulks, J. J., Webb, R. M., & Emery, L. (2026) · Journal of American College Health · doi:10.1080/07448481.2026.2673432
“21,38 As noted above, construct overlap between the AAQ-II and distress measures is an additional limitation that warrants caution in interpreting AAQ-II-based models, though the convergent pattern across both EA measures mitigates this concern.”
Romero‐Moreno, R., Pedroso‐Chaparro, M. D. S., Castelo, A. M. D. L. V., Nogales‐González, C., Leocadio-Baño, J., Zettle, R. D., & Vara‐García, C. (2026) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2026.101019
Gower, T., Styler, Z. R., & Litz, B. T. (2026) · Clinical Psychology Review · doi:10.1016/j.cpr.2026.102786
Mousavi, D., Rief, W., & Wilhelm, M. (2026) · Psychotherapy and Psychosomatics · doi:10.1159/pps/aemag001
Silva, H. S. (2026) · Revista de Geopolítica · doi:10.56238/revgeov17n9-019
Carvalho, S. A., Veloso, B., Pereira, A. S., Soares, A. M., Carreiras, D., Marta‐Simões, J., Moreira, H., & Trindade, I. A. (2026) · Journal of Psychosocial Oncology · doi:10.1080/07347332.2026.2729877
Jo, D., Im, S., Spencer, S. D., & Masuda, A. (2026) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-026-10314-3
“…inflexibility in their theoretical models (e.g., Hexaflex models; Hayes et al., 2012b), and the problematic assumption that the presence of one (i.e., psychological flexibility) necessarily implies the absence of the other (i.e., psychological inflexibility), and vice versa (Arch et al. 2022 ).”
- Authors
- Arch, J. J., Fishbein, J. N., Finkelstein, L. B., & Luoma, J. B.
- Affiliations
- University of Colorado Boulder (US)
- Corresponding author
- Arch, Joanna J.
- Venue
- Behavior Therapy
- Publisher
- Elsevier BV
- Published
- 2023-11
- Volume
- 54
- Issue
- 6
- Pages
- 971-988
- ISSN
- 0005-7894 (ISSN-L)
- PMC
- PMC10665126
- OpenAlex
- W4285600186
- Cited by
- 72
- References
- 107
- Citations by year
- 2026: 16 · 2025: 19 · 2024: 19 · 2023: 17 · 2022: 1
- FWCI
- 12.78
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Behavior Therapy (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (R01NR018479)
- 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 › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- acceptance and commitment therapy, therapeutic process, mediation, process indicators, psychometric validation, statistical power, treatment outcome assessment
- MeSH terms
- Humans, Acceptance and Commitment Therapy
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