Research and Training at Portland Psychotherapy

Portland Psychotherapy is a clinic, research and training center. A central part of our mission is to use science to develop novel methods to help people live better lives and alleviate the suffering that is part of living as a human being, and then share those methods with other clinicians.

Research

Approximately 16 cents of every dollar we take in at Portland Psychotherapy goes to support scientific research. You can read about our projects and publications, as well as ways to get involved in research here.

Our research is made possible by an independent ethics board which reviews our research to ensure it meets the highest ethical standards. We helped establish this board, hosted by the Behavioral Health Research Collaborative in 2011. To learn more about it, click here.

Training

We host training workshops and consultation groups for clinicians seeking to learn about evidence-based approaches, such as Acceptance and Commitment Therapy. To learn more about our training opportunities, click here.

Overall, on our sister site, “Portland Psychotherapy Training,” you can stay up-to-date on our scientific and research endeavors.

Written by Christina Chwyl, B.A.

The Pursuit of Happiness: Understanding the Research

Does valuing happiness help us live a joyful life, or does it backfire?

Happiness seems to have a high currency in America. Over the past few years, the number of popular books written on how to increase it has skyrocketed. To name a few: 10% Happier, The Art of Happiness, Authentic Happiness, The Happiness Advantage, The Happiness Project, 52 Lists for Happiness, Choosing Happier, Flourish. Even the US Declaration of Independence declares the pursuit of happiness as an “inalienable right.”

But what is the consequence of valuing happiness? On the one hand, valuing happiness could lead a person to work harder to attain it. On the other hand, valuing happiness could lead a person to feel unhappy if they don’t reach their standards.

In 2011, a group of researchers decided to put this question to the test. They asked adult females who had recently experienced a stressful life event, such as a divorce or accident, to indicate how much life stress had impacted them and how much they highly valued feeling positively (e.g. “feeling happy is extremely important to me”).

As expected, the participants who highly valued happiness tended to have worse overall wellbeing, including more symptoms of depression, and a lower ratio of positive to negative emotions. Interestingly, the researchers only observed this relationship when participants had lower, but not higher, levels of life stress.

Why did life stress affect this relationship between valuing happiness and wellbeing?

Imagine you just went through a tough breakup. You probably wouldn’t expect to feel happy, let alone feel disappointed by negative feelings. Yet, imagine celebrating a best friend’s birthday party. If you didn’t feel happy in this context, you might feel bummed, especially if you highly valued feeling happy.

In the next study, the researchers had female participants either read an article on the benefits of happiness (“valuing happiness condition”) or making accurate judgments (“control condition”). Then, the participants watched either a sad or happy film clip. Compared to those in the control condition, those in the valuing happiness condition felt worse after watching the sad, but not positive, film clip. Feeling disappointed seemed to play a role in this result: valuing happiness led people to feel disappointed during the sad clip, which, in turn, led them to feel unhappy afterwards.

Does this mean that people should stop valuing happiness?

Not exactly. For one, while the researchers did find paradoxical costs of valuing happiness, they studied people who valued it to a high degree. Other researchers have similarly found that highly valuing happiness is linked to depressive symptoms amongst people who previously struggled with major depression. Yet, valuing happiness to a more moderate degree could help people be happier by motivating them to practice different techniques aimed at increasing happiness. In other words, if people have the right ‘happiness building tools,’ some researchers think that valuing happiness to a certain degree could promote it. More research is needed in order to better understand whether there are conditions under which people could benefit from valuing happiness.

Overall, this research does suggest that a cultural fixation on happiness could have costs, especially if it leads people to feel disappointed with experiencing negative emotions. Research increasingly suggests that accepting negative emotions has benefits, and therapies that encourage acceptance of emotions (e.g. Acceptance and Commitment Therapy) appear effective.

happiness

Self-Help for Anxiety in an International Sample

Since I saw him present on some preliminary results at a conference 6 years ago, I’ve been following with interest University of Albany – SUNY professor John Forsyth’s, PhD, research on his self-help book, The Mindfulness and Acceptance Workbook for Anxiety. (The Workbook was recently published in a 2nd edition but the research is on the 1st edition.)

The Workbook is based on Acceptance and Commitment Therapy (ACT) principles, and it is designed to treat a wide range of anxiety-related problems (it’s “transdiagnostic”).

Self-help books have great potential to help people who don’t have access to or don’t want to pursue psychotherapy. Unfortunately, self-help books are rarely based on well-researched treatments, let alone studied themselves as standalone treatment. Dr. Forsyth and his co-author Dr. Georg Eifert have been working very hard to make their book an exception.

The Most Recent Study

In the most recent published study, Dr. Forsyth’s lab gave out copies of the Workbook to a large (503 people!) international sample—mostly American, with people from the UK, Canada, Australia, New Zealand, and other countries. Participants either received a copy immediately, or they were assigned to a 12-week waiting period before receiving a copy. They completed questionnaires before receiving the book and 12-months later, with follow-up assessment at 6 and 9 months. All waitlist participants received a copy after 12-weeks and completed the same post-treatment and follow-up measures.

Contrary to research studies of self-help books that may include regular phone consultation or other forms of therapist/researcher contact, Dr. Forsyth’s lab deliberately chose to not offer guidance for participants using the Workbook in order to examine how useful it was in the way it would normally be used.

What They Found

The sample included people with generalized anxiety disorder, OCD, major depressive disorder, panic disorder, obsessive-compulsive disorder, social anxiety disorder, and posttraumatic stress disorder, among other conditions.

Participants in both conditions showed improvements in anxiety, depression, worry, quality of life, mindfulness, and self-compassion after using the book, and some continued to show improvement at the 6 and 9-month follow-ups. As a comparison sample, people on the waitlist did not show significant improvement until after receiving and working through the Workbook.

What was really interesting is that some of the improvements in scores on the measures were comparable to studies that involved individual ACT treatment delivered by therapists.

Summary

Dr. Forsyth’s recent publication offers further evidence that The Mindfulness and Acceptance Workbook for Anxiety is a helpful, cost effective treatment option for people struggling with a variety of anxiety-related problems. In my work as an anxiety specialist, I recommend this book more than any other because of the strong research support behind it—and because it offers a number of useful worksheets and recordings.

Here’s a link if you want to check out the 2nd edition of The Mindfulness and Acceptance Workbook for Anxiety.

If you or some you know is struggling with anxiety-related problems, please check out the Portland Psychotherapy Anxiety Clinic.

Portland Psychotherapy Research Grants Awarded

The Research Lab at Portland Psychotherapy is proud to announce they have developed and implemented the first cycle of an internal research grant program to support advances in contextual behavioral science and evidence-based psychotherapy. The first grant was dispersed in 2015 and named the Aaron S. Luoma Portland Psychotherapy Behavioral Science Research Grant/Award, 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 RFT and perspective taking, ACT and OCD, and CBT-I and insomnia, respectively. A new grant cycle is underway in 2016 to continue supporting these researchers and Portland Psychotherapy’s mission of contributing to the wider community through scientific research, compassionate treatment, and effective training.

Research graveyard may come to life

“If enough data is collected, anything may be proven by statistical methods”

Williams and Holland’s Law

It’s an amazing day for scientific research! Hold on, don’t leave me yet. I know I typically try to post things here that are inspiring or at the very least interesting and directly applicable to your everyday life. And the behind-the-scenes politics and procedures of conducting scientific research generally wouldn’t be thought to fall into the “inspiring” category. But trust me, this matters to you!

The All Trials Campaign has organized experts from around the world who are demanding that all unpublished data from clinical medication trials be published and all misreported data be formally corrected. Just this month, the British Medical Journal (BMJ) and PLOS Medicine have taken up the call of the “Restoring Invisible and Abandoned Trials” initiative (RIAT), endorsing the proposal that sponsors and researchers begin publishing the results of their previously confidential clinical trial documents within one year. If they fail to take these actions, RIAT would call for independent scientists to publish those previously confidential trial documents.

To understand why this is such a potentially momentous move, it’s helpful to first understand a bit about how the world of scientific publishing works. At the heart of the problem is the fact that, in general, only studies that find “significant” results get published, and here the word “significant” means that the study found that the particular drug/intervention/treatment being tested was effective. On the surface this practice seems to make sense. I mean, would you sit down to read a newspaper that had a bunch of titles like “Nothing at all happened in Portland last night” and “Nobody did anything of significance in Congress yesterday” (ok, well, maybe that one doesn’t seem like a stretch!). Those of us who read journal articles to get our news about the latest developments in our field want to spend what little time we have reading articles about treatments that actually seem to work. We’re generally less interested in studies that fail to find that a particular treatment works. The result is that studies showing that a treatment doesn’t work, or worse, caused harm, are often unpublished.

However, the problem with state of affairs is that it gives health care providers and the public very skewed information. For every study we hear about that shows a particular drug or treatment supposedly works, we never know about the potentially countless other studies that showed that it didn’t work, or even that it caused harm. And the picture gets even more worrisome when you take into account how most research is funded in the first place.

The vast majority of scientific researchers are only able to do their work through grant funding (though we have a different model here at Portland Psychotherapy for funding our research which you can read more about here). One way this happens is that a researcher, who is very interested in a particular treatment, spends months writing and rewriting a grant application to ask some institution, such as the National Institutes of Health (NIH), essentially asking them for money to study their idea. But even more frequently, it isn’t the NIH or some other arguably unbiased institution that is funding research. As funding from places like the NIH have dropped drastically in recent years, “industry funded research” (e.g. research paid for by a company that is highly invested in its outcome) has soared, with industry-funded research in universities increasing 250% from 1985 to 2005. Increasingly, researchers are paid by a particular company, often a big pharmaceutical company, who has a vested interest in showing that their product (e.g., their drug) is effective.

Now let’s return to the problem of only publishing “significant” findings. If only those studies that show a “significant” result (e.g. that the drug “Y” was more effective than placebo) are going to be published, the company has every incentive in the world to just keep funding study after study until they finally get one that shows the result they want, not because it is a real result, but because of the natural variation and error that is part of research.  And these companies have the deep pockets to do that. So theoretically, they could fund 100 clinical trials and even if they only found a “significant” result in 1 out of 100 studies they ran, that one “significant” finding gets published in a journal, health care providers read about it, the press picks up on it, there are ads in magazines touting the positive findings, and now it’s the new wonder drug. However, the 99 other studies showed that drug “Y” was ineffective were never published.

From a consumer standpoint, would you purchase something if the advertisers told you that 99 times out of 100 it was shown to be completely ineffective? No, we’re more likely to buy (or in the case of health care providers, prescribe them to our patients) products when they are backed by claims like “Clinical studies prove that drug “Y” significantly reduced symptoms of X”. What the RIAT initiative will do is give us a more complete picture so that we can know about the studies that showed that a drug or other product was harmful or ineffective, versus only hearing about the studies that happen to work out.

Unfortunately, the RIAT initiative doesn’t have the ability to force drug companies or researchers to publish their negative findings. However, it does shine light on this incredibly important issue and, if the public demands it, will put new pressure on researchers and the industries to commit to making ALL their data available. This will allow researchers do what they are meant to do, be scientists, rather than being PR machines for companies with very deep pockets.

If I’ve convinced you here that this issue really does impact you and you’d like to read more about this problem of only publishing “significant” findings, you can read this great, in-depth article on the topic published in Scientific America.

You can also sign the petition to support the All Trial Registry here.