Evaluating Self Help: The Mindfulness & Acceptance Workbook for Anxiety

There’s no shortage of self-help books on the market. There is, however, a paucity of research on whether those self-help books are actually helpful to the people who use them. In an ideal world, every self-help book would be submitted to scientific scrutiny to determine if people actually benefit from using them. Unfortunately, this happens only rarely.

Even a self-help book that is based on well-researched cognitive behavioral principles and written by leaders in the field is not guaranteed to be effective.  For example, one recent study found that college students with greater rumination exhibited more depressive symptoms after using Greenberger & Padesky’s Mind over Mood, a well-respected cognitive behavioral self-help book for depression. These findings suggest that evidence-based psychotherapy interventions don’t always translate into effective self-guided techniques that people can use on their own, and in some instances can actually be harmful.

The Mindfulness & Acceptance Workbook for Anxiety

Over 5 years ago, I wrote a few blogs posts about Forsyth & Eifert’s The Mindfulness & Acceptance Workbook for Anxiety in 2 prior blogs for which I used to contribute. The first, on my blog Scientific Mindfulness, reported on pre-publication research I heard about at a conference. (Unfortunately, it appears the other post has been taken down.) The first author of the workbook, SUNY-Albany professor John Forsyth, PhD, conducted 2 studies on his ACT-based self-help book. He gave copies of the book to people for free, and had them complete online self-report measures at various intervals.

Dr. Forsyth recently posted a summary of this research on his personal blog in anticipation of the upcoming 2nd edition of The Mindfulness & Acceptance Workbook for Anxiety that will be released April 1, 2016. One paragraph in his blog post caught my attention:

Reductions in anxiety and fear did not happen by going after anxiety and fear directly. It was just the opposite. By first focusing on the skills needed to live a more valued life, readers then experienced a decline in their anxiety, fears, and depression, and ultimate improvements in their lives. This is an important message––one that supports the approach we offer in this workbook.

The workbook emphasizes ACT skills to help people engage in meaningful living, and it appears that those skills—rather than interventions aimed at alleviating anxiety and worry—appear the most effective.  Said another way, the findings suggest that people using the workbook improved more from doing things that were important to them than from any particular technique. This is quite profound, if you think about it, and very different from how many people approach anxiety. Attempting to directly suppress or control anxiety-related thoughts and feelings can often backfire.

Because it’s one of the rare self-help books that has been researched specifically as a self-help book, I find myself recommending The Mindfulness & Acceptance Workbook for Anxiety more than any other self-help books, and I was excited to hear there’s an updated edition coming out. I encourage readers to check it out.

Anxiety Treatment at Portland Psychotherapy

Portland Psychotherapy Annual Report – 2015

Hello friends and colleagues. Below is our annual report. The annual reports is part of our mission to be a responsible and transparent business that is an asset to our local and international community. We strive to be responsible stewards of the revenue provided by those clients and customers who purchase our services. We strive to use those limited resources efficiently and effectively to serve the greater good. Transparency comes through out providing updates about what we are doing with that revenue. This report summaries the most important events that occurred over the last year at Portland Psychotherapy.

OUR COMMITMENT

Portland Psychotherapy strives to make quality, evidence-based mental health services

available to all members of our community. Supporting diversity and inclusivity is a core value at Portland Psychotherapy.

OUR MISSION

is to use science to develop and guide compassionate, effective treatment and contribute to the wider community through research and training.

EVIDENCE-BASED THERAPY

is at the heart of our practice. We are dedicated to treating psychological problems with methods based on the best science available.

RESEARCH

drives everything we do. Many of our therapists are also researchers, which means that we stay up-to-date on what the research says about what works. If we can’t provide what we think is the best treatment for what a client is struggling with, we will do our best to refer them to an appropriate treatment.

OUR BUSINESS MODEL

ensures that we are on the cutting edge of what’s happening in evidence-based practice. In 2013 and 2014, about 18% of total revenue went to fund the research our center is conducting. By seeing a therapist at Portland Psychotherapy, you are also helping to support scientific research so that others may benefit.  To read more about our business model, go here.

Highlights from 2015

Clinical services. We continued to expand our clinical services in 2015. The total number of individual therapy sessions provided increased 14% from 4,877 to 5,568 sessions and group therapy sessions increased 64% from 223 to 365 sessions. We continue to provide a substantial amount of low fee services through our postdoctoral fellowship program, about the same number as last year — 509 sessions (when defined as clients paying $60 or less per session). We also started a new skills class based on Radically Open Dialectical Behavior Therapy (RODBT) and solidified our standard DBT program under the leadership of Shadee Hardy, LCSW.

Our building. Two-and-a-half years ago, we moved into our current building, but the renovation work has not stopped until this year. Finally, this year, we were finally able to install the landscaping, which heralded the ending of the renovation process! We are very appreciative that we have a beautiful and comfortable building to work in and hope that our clients feel the same way.  As part our mission to be environmentally sustainable, we also hired a solar contractor, Solterra Systems , this past fall who will be installing solar panels on our roof as soon as we get some more sunny days!

AlyssaStaffing. There were important staffing changes this year. We hired a new office assistant, Alyssa Wong (left), who has stepped into a busy role and is doing a great job. Alyssa joins our already incredible and hard-working administrative team of Debbie Addison (billing manager) and Amy Forrer (office manager) without whom this place would not run. Melissa Platt, Ph.D., transitioned from a postdoc role to a research psychologist role, specializing in research relating to shame and interpersonal trauma. We were also able to hire another postdoctoral fellow, Magda Permut, Ph.D., who is specializing in organizational issues and has been doing important work in helping Portland Psychotherapy to improve our services and maintain a values-based focus for our culture. We also had our first annual overnight employee retreat where we were able to clarify our group values and strengthen our organizational culture. Dr. Paul Guinther and his wife Lindsay Chandler added another baby to our Portland Psychotherapy family – James Martin Guinther. On a sad note, we experienced the death of our unofficial mascot, The Dalai Luoma (right), who in her determined (some might say stubborn) way, was able to come to work every day until the very end.

Research. On the research front, two new research studies were approved by our ethics review board to begin data collection and a third was submitted for approval. Portland Psychotherapy now has two research psychologists on staff with dedicated research time in addition to the two co-owners having time for research.  We have six studies in active data collection. In 2016, we are planning to hire our first full time research coordinator.

A big highlight of 2015 was the initiation of our internal grant program to support advances in contextual behavioral science and evidence-based psychotherapy. The first grant dispersed was for $10,000 and was named the Aaron S. Luoma Portland Psychotherapy Behavioral Science Research Grant, in honor of Dr. Jason Luoma’s brother. Awardees included Drs. Paul Guinther, Brian Thompson, and Scott Rower. The grant has supported their ongoing work on relational frame theory and perspective taking; acceptance and commitment therapy and obsessive-compulsive disorder; and cognitive behavioral therapy for insomnia, respectively.

Portland Psychotherapy staff had seven new peer-reviewed articles accepted for publication or published in 2015:

Guinther, P. M. & Dougher, M. J. (2015). The clinical relevance of stimulus equivalence and relational frame theory in influencing the behavior of verbally competent adults. Current Opinion in Psychology, 2, 21-25.

LeJeune, J.T., & Luoma, J.B. (2015). The Integrated Scientist-Practitioner: A New Model for Combining Research and Clinical Practice in Fee-For-Service Settings. Professional Psychology Research & Practice 46(6), 421-428. Download here. 

Levin, M.E., Luoma, J.B. & Haeger, J. (2015). Decoupling as a mechanism of action in mindfulness and acceptance: A literature review. Behavior Modification, 39(6), 870-911.

Levin, M.E., Luoma, J.B., Vilardaga, R., Lillis, J., Nobles, R. & Hayes, S.C. (In Press). Examining the role of psychological inflexibility, perspective taking and empathic concern in generalized prejudice. Journal of Applied Social Psychology.

Luoma, J.B., & Platt, M. (2015). Stigma, Shame, Self-Criticism, and Compassion in Acceptance and Commitment Therapy. Current Opinion in Psychology, 2, 97-101Download here. 

Platt, M. & Freyd, J. J. (2015). Betray my trust, shame on me: Shame, dissociation, fear, and betrayal trauma. Psychological Trauma: Theory, Research, Practice, and Policy, 7(4) 398-404.

 

Thompson, B. T., Luoma, J. B., Terry, C., LeJeune, J., Guinther, P., & Robb, H. (2015). Creating a Peer-Led Acceptance and Commitment Therapy Consultation Group: The Portland Model. Journal of Contextual Behavioral Science 4(3), 144-150.

Training. In 2015 we hosted or co-hosted five training workshops for professionals. The income from these training events helps support for our research and sliding scale services. In addition to these income-generating training events, we have also hosted twelve meetings of the ACT peer consultation group. Largely due to the work of Dr. Melissa Platt, we’ve greatly increased the training material we’ve been producing on our blog, www.actwithcompassion.com. In addition, most of the clinical staff were able to travel to Berlin, Germany for the Association for Contextual Behavioral Science Annual Conference. At that conference, they were able to see center director, Dr. Jason Luoma, give the presidential plenary signaling the end of his year as president of this association of over 8000 members.

Our business model. Among the publications coming out of our center this year, we are particularly excited about our article  “The Integrated Scientist-Practitioner: A New Model for Combining Research and Clinical Practice in Fee-For-Service Settings,” published this year in Professional Psychology Research & Practice. This article represents the first time that a detailed description of the business model we have created here at Portland Psychotherapy, which we have called the “clinical-research social business model,” has been broadly available for others to read about. In the article, we describe how Portland Psychotherapy is, to our knowledge, the only organization of its kind to utilize social enterprise concepts to support research in a for-profit psychotherapy setting. In our clinical-research social business model, the profits from the income-generating activities of our center do not go to increase shareholder profits. Rather, those profits are used to serve the social good by serving as an internal, stable funding source for in-house research where the products of the research are given away to the public. Our hope is that others might also consider how concepts such as social enterprises, B-corps, and the like might work in their own setting such that making a profit and contributing to the broader social good can be mutually achievable aims.

Summary: 2015 was a good year for Portland Psychotherapy. The organization continues to mature to more fully serve our mission to use science to develop and guide compassionate, effective treatment and contribute to the wider community through research and training. These positive trends look like they will continue in 2016 and we are very optimistic about and excited to see how Portland Psychotherapy can continue to have a positive influence on our community in years to come. Please, keep in touch.

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