Stephanie L. Nassar , M.A. Kelly G. Wilson, Ph.D. K. Kate Kellum , Ph.D.

1. Defusion as a core ACT process: Conceptual definitions, current empirical literature, and future directions for exploration Stephanie L. Nassar, M.A. Kelly G. Wilson, Ph.D. K. Kate Kellum, Ph.D.

2. Present Moment Awareness Acceptance Values Six Core Processes Psychological Flexibility Committed Action Defusion Self-as-Context

3. Present Moment Awareness Acceptance and Mindfulness Processes Acceptance Values Six Core Processes Psychological Flexibility Committed Action Defusion Self-as-Context

4. Present Moment Awareness Acceptance and Mindfulness Processes Acceptance Values Six Core Processes Psychological Flexibility Committed Action Defusion Self-as-Context

7. I can’t deal with my panic I am having the thought that …

8. VALUED ACTION

11. Language is the Context

13. Avoidance of public speaking “I am crazy”

14. Behavioral tasks Word repetition Mindfulness meditation Metaphor

15. Grant, 2009

16. Self-report measures Cognitive fusion CFQ Automatic thoughts ATQ-F&B Believability of anxiety BAFT PIPS Pain

18. Masuda et al, 2010: Cognitive defusion vs. thought distraction: A clinical rationale, training, and experiential exercise in altering psychological impacts of negative self-referential thoughts

19. Varra et al., 2008: A RCT examining the effect of ACT on clinician willingness to use EBP pharmacotherapy. Journal of Consulting and Clinical Psychology, 76, 449-458.

20. Other studies • Zettle, Rains, & Hayes (2011) • Reexamined a treatment study comparing ACT and CT intervention for depression and found that defusion mediated changes in depressive symptoms in the ACT condition • Gaudiano, Herbert, & Hayes (2010) • Reanalysis of treatment study comparing TAU and TAU+ACT for individuals with psychosis and found ACT group reported less distress post-treatment than TAU, which was mediated by defusion. ACT group more defused, and those defused tended to report lower levels of post-treatment distress.  • Hinton & Gaynor (2010) • Three sessions of cognitive defusion (CD) compared to a waitlist (WL) condition for university students reporting elevated distress, dysphoria, and low self-esteem. Large changes in distress, depressive symptoms, self-esteem, defused awareness of thoughts, psychological flexibility, and automatic thoughts favoring CD over WL. Maintained at 1-month follow-up.

21. Studies cont’d • Hesser et al. (2009) • Levels of acceptance and defusion behavior during ACT therapy sessions can later predict reduction in symptoms at 6 month follow up. • Healy et al. (2008) • Defusion works for coping with negative self-statements • Marcks & Woods (2005, 2007) • “Soldiers on parade” mindfulness exercise reduces subjective distress from an intrusive thought provoking task and willingness to engage in the task again

23. Questions & Comments Contact: stephanie.l.nassar@gmail.com

24. Limoo Betrang Betrang salivation salivation sour sour bumpy bumpy yellow yellow lemonade lemonade citrus citrus Relational Frame Theory Defining Properties of Relational Frames 1. Mutual Entailment 3. Transformation of Functions 2. Combinatorial Entailment Entailment is controlled by the relational context or “Crel” e.g., the phrase “is a” in “a betrang is a limoo” Transformation is controlled by the functional context or “Cfunc” e.g., the word “taste” in “what does a betrang taste like?”