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Using Acceptance and Commitment Therapy to Decrease High-Prevalence Psychopathology by Targeting Self-Compassion: A Randomized Controlled Trial
AuthorYadavaia, James E.
AdvisorHayes, Steven C.
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Self-compassion, that is treating oneself with kindness and understanding and without harsh judgment in difficult times, has been presented as an alternative to both self-criticism and self-esteem. It has been conceptualized by Kristin Neff to consist of self-kindness, mindfulness, and common humanity. Although a body of research shows the importance of self-compassion to psychological functioning, Neff's theory is not based on a basic science of behavior change and may therefore be limited in its utility to inform treatment development. Acceptance and Commitment Therapy (ACT) is an acceptance-based behavioral treatment modality that is informed by a basic science of language and cognition called Relational Frame Theory (RFT). This dissertation offers an account of self-compassion based on RFT and seeks to test an ACT intervention for self-compassion based on this account. The intervention tested here was a 6-hour ACT workshop targeting self-compassion using a randomized, waitlist-controlled design. Participants were undergraduates in psychology classes at the University of Nevada, Reno. Among the 532 participants screened for low self-compassion and high general psychological distress, 73 participated in the RCT. Assessments were completed before and after the workshop as well as at 2-month follow-up. Active treatment was significantly superior to control in improvements in the following outcomes: general psychological distress, anxiety, several other psychological symptom dimensions, and positive affect. Active treatment also showed better improvements on the following process variables: self-compassion, psychological flexibility, self-criticism, self-as-context, and nonjudging of experience. Psychological flexibility was shown through mediational and other analyses to be a more powerful process of change than self-compassion.