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Values, Verbal Relations and Compassion: Can We Do a Better Job of Facing Global Challenges

Values, Verbal Relations and Compassion: Can We Do a Better Job of Facing Global Challenges. Steven C. Hayes University of Nevada. The World is Facing a Series of Behavioral Challenges.

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Values, Verbal Relations and Compassion: Can We Do a Better Job of Facing Global Challenges

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  1. Values, Verbal Relations and Compassion: Can We Do a Better Job of Facing Global Challenges Steven C. Hayes University of Nevada

  2. The World is Facing a Series of Behavioral Challenges • “…. knowing is not enough; action is needed. Why should it occur? That is perhaps the most terrifying question in the history of the human species” (Skinner, 1982) 

  3. Terrifying Because(from Paul Chance) • Immediate consequences outweigh delayed consequences. People want to live in a world with clean air, but also want to drive Hummers. • Some chemicals are destructively reinforcing. The reinforcing power of sugar, salt, or drugs threaten our health.

  4. The List • Consequences for the individual outweigh consequences for others. We often fail to make sacrifices for the common good. • In the absence of counter-control, the use of aversives tends to be very reinforcing to those who use them. For example, Abu Ghraib

  5. The List • Coincidental events often strengthen ineffective behavior. Superstition often wins out over rationality. • Simple, familiar wrong ideas are preferred over complex, alien but correct ideas. For example, evolution is rejected by 75% of the US population

  6. The List • Susceptibility to social reinforcement can incline us toward extreme views. For example, 9-11 was perpetrated by mostly well-educated, middle-class people with families but who spent a lot of time interacting with others who shared extreme beliefs

  7. The List • Strong aversives presented abruptly prompt  appropriate action, but strong aversives following a long string of aversives that gradually increase in strength often do not. This suggests that so long as conditions worsen gradually, we will tolerate bad air, foul water, loud noise, psychological and physical abuse, and crime that would once have been considered intolerable.

  8. The Processes • Weak delayed consequences for positive behaviors or powerful short term ones of negative behaviors • Weak social concern or cooperation or using aversives on others • Impulse and superstition rather than scientific data and reason • Entanglement with socially supported deviant beliefs • Lack of attention to gradual aversives

  9. The Problems • Obesity and health • Drugs • Over-population • Lack of self-control • Poverty • Violence • Pollution and global warming

  10. Reformulating the Questions • Not why are we controlled by short term consequences – it is why we ever fail to be. • Not why do we show low concern for others – it is why we ever cooperate or show compassion for others • Not why aren’t we controlled by scientific data – it is how is it that science ever makes a difference • Can a psychological flexibility model help? Is it relevant? • I will share data only from the last three years

  11. Not Why are We Controlled by Short term Consequences Rather, How Do We Ever Fail to Be?

  12. Within a Psychological Flexibility ModelAcceptance and Defusion Increase Willingness to Experience Discomfort of Foregoing Short Term Reinforcers; Use Values or Motivative Augmentals to Increase Psychological Presence of Chosen Long Term ConsequencesSocial Processes that Support Both

  13. Weight MaintenanceLillis et al., 2009 • 87 participants who had completed at least 6 months of organized weight loss intervention (on average their 37th try) • Randomized to 1 day ACT workshop (n = 43) or TAU Control (n = 44)

  14. Acceptance, Defusion from Self-Stigma and Values • Focused on values and patterns of avoidance toward weight-related thoughts, feelings, and bodily sensations • No diet, physical activity, self-monitoring, or weight education components

  15. ACT Control 1.4 Effect Sizes: 1.2 Process Results 1.0 .8 Large .6 Cohen’s d Improvement Medium .4 .2 Small 0 - .2 - .4 AAQ AAQW Breath Holding

  16. Pre to Follow-Up Weight Change 3 month follow-up p < .001 d = 1.21 35 30 25 20 15 Control 10 ACT 5 0 % gaining 5+ lbs % losing 5+ lbs

  17. ACT for Diabetes Management Gregg, Callaghan, Hayes, & Glenn-Lawson, 2007, JCCP • Randomized controlled trial with poor, mostly minority clients • 40 / group: ACT plus diabetes education (one six-hour workshop) or diabetes education (also a six hour workshop) • Only 3 hours were different content

  18. Pre to Follow up Change % in Diabetic Control AAQ (Diabetes) Self- Management 10 50% 50% 5 25% 25% 0 0% 0% Ed’n ACT Ed’n ACT Ed’n ACT AAQD and Self-Management mediated blood glucose outcomes

  19. Pediatric Chronic PainWicksell, Melin, Lekander, & Olsson, Pain, 2010 • 32 children w/ longstanding pediatric pain • Average of 32 mo pain duration • Randomly assigned to ACT or multidiscipinary Rx & medication (MDT). • ACT = 12 session; MDT = 23

  20. 4 6 2 Pain Interference Pain Interference (1-10) Pre Post 3.5 mo 6.5 mo

  21. Effect of Writing About Your ValuesCohen, Garcia, Purdie-Vaughns, Apfel, & Brzustoski (2009), Science, 234, 400-403. • 385 middle school children followed through 7th and 8th grade • Randomly assigned to a series of short (15 minute) writing assignments at the beginning of 7th grade on their values in various specific domains and the importance of these values

  22. Impact on GPA Thru Middle School European Americans or High Achieving African-Americans Both Conditions and Ethnic Groups Are Identical 3.5 3.0 2.5 Low Achieving African-Americans Values 2.0 1.5 Control 1.0 Pre 1 2 3 4 1 2 3 4 Year 1 Year 2

  23. Motivating Physical Exercise Jackson et al., in preparation • 46 female students in a spinning class • Identify fitness motivation via IRAP • Prompt during class – compare to form based prompts or IRAP identified low motivators

  24. Bsln Prompts Bsln Prompts 105 105 Percentage of Instructor’s Heart Rate 95 95 85 85 Baseline Positive Goals Forms 1 3 5 7 9 1 3 5 7 9 105 105 95 95 85 85 1 3 5 7 9 1 3 5 7 9 Exercise Sessions

  25. Average Difference from Baseline Green = Positive Implicit Goals Blue = Instruction About Form

  26. Average Difference from Baseline 10 Green = Non-Preferred “Positive” Implicit Goals 8 6 4 2 HEART RATE DIFFERENCE IN % OF INSTRUCTORS AVERAGE 18 0 17 18 -2 -4 -6 -8 Blue = Instruction About Form -10

  27. Randomized Trial: ACT vs. TAUTapper et al., 2009 • 62 overweight women (BMI = 31.6) • All participants already in weight loss programs • 4 two-hour sessions. 26 attended at least one; 31 left in existing diet • Short ACT protocol • Pre / Post / 6 month follow up

  28. BMI .5 Overall - “Never apply” -.5 -1

  29. Change in Weekly Exercise 3 Overall - “Never apply” 2 1 0 -1

  30. Physical FitnessButryn, Forman, Hoffman, Shaw, and Juarascio, under submission • 46 female students assigned to two 2-hour workshops (two weeks apart) on ACT or education about fitness. • “Post” at week four; follow up at week seven • Primary measure: use of exercise facilities at the University Athletic Center (these were automatically recorded from the swipe cards, resulting in a high integrity measure with no drop outs)

  31. Weekly Number of Exercise Sessions 2.2 ACT 1.8 1.4 1.0 Visits to the Athletic Center Fitness Education .6 .2 Pre Post Follow Up

  32. The Question Is Not Why Aren’t We Controlled by Scientific Data Instead of Impulses It Is How Can We Increase the Impact of Scientific Data

  33. Within the PF Model:Link Science Knowledge to Values;Use Acceptance and Defusion to Deal with the Discomfort of Newness and the Interference of Alternative Beliefs

  34. Adopting ESTsVarra, Hayes, Roget, & Fisher, JCCP, 2008 • 59 drug and alcohol counselors randomly assigned to • One day ACT workshop focused on the psychological barriers to learning • Control condition: One day workshop on EAP policies • Both groups then do a one day educational workshop on the science behind the use of agonists and antagonists

  35. ACT plus Education Control plus Education Frequency of Perceived Barriers to Using Empirically Supported Treatments 75 Mean Score 70 65 Pre Post Phase

  36. Control plus Education ACT plus Education Believability of Perceived Barriers to Using Empirically Supported Treatments 70 65 Mean Score 60 Pre Post Phase

  37. ACT plus Education Control plus Education Willingness to Use Pharmacotherapy 3.5 3.25 3 Mean Score on 1-5 Scale 2.75 2.5 2.25 2 Pre Post Phase

  38. Subsequent Use of Pharmacotherapy 3.5 ACT plus Education 3.25 3 2.75 Control plus Education 2.5 2.25 2 Pre 3 month Follow - up Phase

  39. The Question Is Not Why Do We Show Low Concern For OthersIt Is How Can We Promote Cooperation, Compassion and Concern for Others

  40. Within the PF ModelPromote a Social/Perspective Taking Sense of Self Link Self-Acceptance and CompassionLink Values and Compassion

  41. Experiential Avoidance and MH Stigma Masuda et al., 2007 • RCT comparing education focused on prevalence and costs of stigma toward mental health problems, and accurate information about them • ACT focused on defusion from and mindfulness of prejudicial thoughts, acceptance of difficult prejudicial feelings, and values

  42. Education ACT ACT for Mental Health Stigma Hi EA -25 Lo EA -30 Average MH Stigma Score -35 -40 Pre Post F-Up

  43. Racial PrejudiceLillis & Hayes, 2007 • Replicated with ACT versus Education for racial bias in a college student population • Within subject test (16 with A/B/A/C/A and 16 with A/C/A/B/A) • 32 participants in a two racial differences classes • 90 minute class period • “follow up” = next class period

  44. Assessment Items • Bias Awareness • I feel that I am aware of my own biases • Bias Does Not Affect Me • I feel that my prejudicial thoughts are a significant barrier to me being culturally sensitive • My biases and prejudices affect how I interact with people from different racial and ethnic backgrounds.

  45. Assessment Items • Acceptance • It is OK to have prejudiced thoughts or racial stereotypes • I try not to think negative thoughts I have about people from different racial or ethnic backgrounds. • Defusion and Action • When I evaluate someone negatively, I am able to recognize that this is just a reaction, not an objective fact. • It’s ok to have friends that I have prejudicial thoughts about from time to time.

  46. Assessment Items • Positive Action • I would attend a social event where I was the only person of my race/ ethnic background. • I believe that I am able to transcend racial boundaries with my actions. • I plan to actively seek out experiences that could expose me to people who have a different cultural, racial, or ethnic background than me. • I am likely to join a campus organization or participate in a campus event that is focused on cultural diversity.

  47. YOU HERE NOW I THEN THERE RFT Take on the Formation of Self and Perspective Taking

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