Measuring authentic living from internal and external perspectives: A novel measure of self-authenticity

Self-authenticity refers to knowing and being oneself despite societal expectations, a concept closely related to values-based therapeutic interventions. Authentic living is currently measured using three validated psycho- metric scales; however these have limitations including issues with length, theoretical instability, and lack of measurement invariance testing. The present study sought to develop a novel measure of self-authenticity to resolve these limitations, and to provide further empirical evidence as to the structure of self-authenticity. Using a large sample, split into two subsamples, the novel Self-Authenticity Measure (SAM) was developed and found to be reliable. We present evidence of convergent and concurrent validity, as well as a degree of incremental validity over one of the previously developed authenticity scales. Furthermore, construct validity and (config- ural) measurement invariance were demonstrated through confirmatory factor analysis. Thus, though the measure was initially developed for use with sexual-minority groups, it appears to function similarly in a het- erosexual sample. Self-authenticity correlated with constructs related to psychological flexibility, suggesting that therapeutic techniques based on valued living could increase self-authenticity in individuals. The SAM affords researchers the opportunity to measure self-authenticity from internal (knowing and being oneself) and external (being oneself around others) perspectives. Further testing of measurement invariance is recommended

Psychosocial experiences of chronic illness in individuals with an intellectual disability: A systematic review of the literature

This is an author-produced version of an article accepted for publication in the Journal of Intellectual Disabilities and appeared online on 7/1/2015© 2015Background: Increased life expectancy has led to an increase in diagnoses of chronic illness in people with an intellectual disability; despite this increase, research about the psychological impact is rare. This review explored the psychosocial experiences of chronic illness in adults with an intellectual disability, revealing potential predictors and moderators of these experiences. Methods: Online databases were systematically searched to identify relevant literature, using predefined inclusion criteria. Of the 25,058 titles initially identified, 4 were included, that is, those collecting data on people with an intellectual disability and diagnosed with cancer (n = 2), chronic pain (n = 1) and diabetes (n = 1). Results: Narrative synthesis of the data identified six themes, namely, delayed diagnosis, information, communication and understanding, negative psychological consequences, negative physical consequences, social perception and social support. Conclusions: There are unmet needs within this population, including a lack of assistance in understanding their illness. A substantial gap in the literature should be addressed through further empirical work

Appetitive augmental functions and common physical properties in a pain-tolerance metaphor: An extended replication

Relational frame theory claims that the tacit understanding of metaphorical language rests upon our ability to derive relations based on relevant contextual cues; with metaphor aptness being a function of learning history and the number and nature of contextual cues presented. Recent experimental research has explored whether metaphor aptness plays a role in changing behaviour. Sierra, Ruiz, Flórez, Riaño Hernández, and Luciano (2016) demonstrated that the presence of common physical properties (herein common properties; “cold”) within a perseverance metaphor increased pain tolerance to the cold pressor task. When the metaphor also specified appetitive augmental functions (herein augmentals; “something important to you”), pain tolerance also increased. We tested the replicability of these findings under more stringent conditions, using a stratified (by sex) double-blind randomised-controlled experimental design. Eighty-nine participants completed baseline measures of psychological flexibility, cognitive fusion, generalised pliance, and analogical reasoning ability. Participants were then allocated to a pre-recorded audio-delivered metaphor exercise containing either: (i) common properties; (ii) augmentals; (iii) both; or (iv) neither (control condition). Participants completed the cold pressor task before and after intervention. We found no change in pain tolerance following intervention in any condition. Given potential implications for apt metaphor use for changing behaviour, further work is required to establish why the original study's findings were not replicated, to identify boundary conditions for the putative effect, and test metaphor use in ecologically valid settings

In search of scope: A response to Ruiz et al. (2020)

Deliberate and explicit replication attempts are becoming more common across the behavioral sciences. Whilst replicability has been recognized as a core feature of science for decades (if not centuries), the directness of today’s replication work requires us to consider carefully how we communicate our research and how we conceptualize our theories in light of differing findings. This paper uses a concrete example to make a number of suggestions for how we, as a scientific community, ought to engage with replication attempts. Within Relational Frame Theory (RFT) there is a growing body of applied research on the effective use of metaphors to increase tolerance of aversive states. We conducted a replication of an earlier experimental analogue study (2020, this journal) and failed to find the specified effect. Ruiz et al. (2020, also this journal) have recently published a critical response in which they list a number of differences between our two studies which might account for the negative findings. We will use this series of three papers as our exemplum. We also take the opportunity to acknowledge some points of critique provided by Ruiz et al., and to set the record straight with respect to the differences between the original study and our replication attempt. We hope this discussion might help the CBS community to develop a coherent approach to the very current issue of replication

Contextual behavioural coaching: An evidence-based model for supporting behaviour change

As coaching psychology finds its feet, demands for evidence-based approaches are increasing both from inside and outside of the industry. There is an opportunity in the many evidence-based interventions in other areas of applied psychology that are of direct relevance to coaching psychology. However, there may too be risks associated with unprincipled eclecticism. Existing approaches that are gaining popularity in the coaching field such as Dialectic Behavioural Therapy and Mindfulness enjoy close affiliation with Contextual Behavioral Science (CBS). In this article, we provide a brief overview of CBS as a coherent philosophical, scientific, and practice framework for empirically supported coaching work. We review its evidence base, and its direct applicability to coaching by describing CBS’s most explicitly linked intervention – Acceptance and Commitment Therapy/Training (ACT). We highlight key strengths of ACT including: its great flexibility in regard of the kinds of client change it can support; the variety of materials and exercises available; and, the varied modes of delivery through which it has been shown to work. The article lays out guiding principles and provides a brief illustrative case study of Contextual Behavioural Coaching

Web-Based Psychological Interventions for People Living With and Beyond Cancer:Meta-Review of What Works and What Does Not for Maximizing Recruitment, Engagement, and Efficacy

BACKGROUND: Despite high levels of psychological distress experienced by many patients with cancer, previous research has identified several barriers to accessing traditional face-to-face psychological support. Web-based psychosocial interventions have emerged as a promising alternative. OBJECTIVE: This meta-review aimed to synthesize evidence on recruitment challenges and enablers, factors that promote engagement and adherence to web-based intervention content, and factors that promote the efficacy of web-based psychosocial interventions for patients with cancer and cancer survivors. METHODS: We conducted a systematic search of previous reviews that investigated the recruitment, engagement, and efficacy of web-based and app-based psychosocial interventions in adult patients with cancer and cancer survivors. We searched PubMed, CINAHL, PsycINFO, and the Cochrane Library database for relevant literature. The search terms focused on a combination of topics pertaining to neoplasms and telemedicine. Two independent authors conducted abstract screening, full text screening, and data extraction for each identified article. RESULTS: A total of 20 articles met eligibility criteria. There was inconsistency in the reporting of uptake and engagement data; however, anxiety about technology and perceived time burden were identified as 2 key barriers. Web-based psychosocial oncology interventions demonstrated efficacy in reducing depression and stress but reported weak to mixed findings for distress, anxiety, quality of life, and well-being. Although no factors consistently moderated intervention efficacy, preliminary evidence indicated that multicomponent interventions and greater communication with a health care professional were preferred by participants and were associated with superior effects. CONCLUSIONS: Several consistently cited barriers to intervention uptake and recruitment have emerged, which we recommend future intervention studies address. Preliminary evidence also supports the superior efficacy of multicomponent interventions and interventions that facilitate communication with a health care professional. However, a greater number of appropriately powered clinical trials, including randomized trials with head-to-head comparisons, are needed to enable more confident conclusions regarding which web-based psychosocial oncology interventions work best and for whom. TRIAL REGISTRATION: PROSPERO CRD42020202633; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=20263

A review of stress-management interventions for the oncology nursing workforce: what do we know and what should we be doing differently?

Oncology nurses are at risk of chronic stress. In this narrative review we provide an overview of stress-management intervention studies for oncology nurses, and suggest that Acceptance and Commitment Therapy/Training (ACT) provides a better intervention framework due to the relevance of underpinning therapeutic processes (e.g. acceptance, mindfulness, values clarification) to the role and stress-related experiences of this workforce population. Current evidence for stress management intervention effectiveness varies, with few studies describing how theory informs intervention content, or justifying why they should benefit this population specifically. ACT lends itself to data-driven intervention development, thus potentially addressing some methodological limitations in this field. Only one trial has tested ACT in this population, reporting only partial effects. Further empirical research is required given (a) the applicability of ACT for this population and context, and (b) the associated advantages of brief and/or group delivery to address known barriers to participating in stress-management interventions

Recruiting cancer survivors into research studies using online methods: a secondary analysis from an international cancer survivorship cohort study.

Recruiting participants into cancer survivorship research remains a significant challenge. Few studies have tested and compared the relative use of non-clinical online recruitment methods, especially in samples of adult cancer survivors. This paper reports on the feasibility of recruiting a representative cohort of cancer survivors using online social media. Two-hundred participants with a cancer diagnosis within the past 12 months were recruited via social media (Facebook, Twitter, Reddit) into a longitudinal questionnaire study. Different methods of online recruitment proved to be more effective than others over time. Paid Facebook boosting, Reddit posts, and Twitter adverts placed by existing cancer charities proved most helpful in reaching our recruitment target (contributing 27%, 22% and 32% respectively). Recruiting online achieved a more demographically and clinically representative sample for our study: our sample was younger, less heteronormative, including those with a range of clinical diagnoses, primary and recurrence illness, and patients who had both completed and were still receiving treatment. This was certainly not a quick method of sample recruitment but that could have been optimised by focussing only on the three most effective methods describe earlier. Whilst we found that online recruitment is significantly lower cost than traditional recruitment methods, and can reduce some biases, there still remains the potential for some biases (e.g. excluding much older participants) and ethical/methodological issues (e.g. excluding those without access to the internet). We outline our recruitment strategy, retention rates, and a cost breakdown in order to guide other researchers considering such methods for future research in cancer survivorship

Evaluating process and effectiveness of a low-intensity CBT intervention for women with gynaecological cancer (the EPELIT Trial)

This document is the Accepted Manuscript version of a published work that appeared in final form in AMRC Open Research. To access the final edited and published work see https://doi.org/10.12688/amrcopenres.12971.1Background: Improving survival from gynaecological cancers is creating an increasing clinical challenge for long-term distress management. Psychologist-led interventions for cancer survivors can be beneficial, but are often costly. The rise of the Psychological Wellbeing Practitioner (PWP) workforce in the UK might offer a cheaper, but equally effective, intervention delivery method that is more sustainable and accessible. We aimed to test the effectiveness of a PWP co-facilitated intervention for reducing depression and anxiety, quality of life and unmet needs. Methods: We planned this trial using a pragmatic, non-randomised controlled design, recruiting a comparator sample from a second clinical site. The intervention was delivered over six-weekly sessions; data were collected from participants at baseline, weekly during the intervention, and at one-week and three-month follow-up. Logistical challenges meant that we only recruited 8 participants to the intervention group, and 26 participants to the control group. Results: We did not find significant, between-group differences for depression, quality of life or unmet needs, though some differences at follow-up were found for anxiety (p<.001). Analysis of potential intervention mediator processes indicated the potential importance of self-management self-efficacy. Low uptake into the psychological intervention raises questions about (a) patient- driven needs for group-based support, and (b) the sustainability of this intervention programme. Conclusions: This study failed to recruit to target; the under-powered analysis likely explains the lack of significant effects reported, though some trends in the data are of interest. Retention in the intervention group, and low attrition in the control group indicate acceptability of the intervention content and trial design; however a small baseline population rendered this trial infeasible in its current design. Further work is required to answer our research questions, but also, importantly, to address low uptake for psychological interventions in this group of cancer survivors

Systematic review and empirical investigation of adjustment to cancer diagnosis : predicting clinically relevant psychosocial outcomes and testing Lazarus's Transactional Model of stress

Cancer is one of the leading causes of death in the UK. The Cancer Reform Strategy (2007) highlighted the need for integration of psychological services into routine cancer care. Previous research into psychosocial aspects of adjustment is, however, inconsistent This thesis opens with a background on cancer epidemiology and policy the psychological impact of cancer and, the shortcomings of previous intervention-based research. The Transactional Model is introduced as a potential framework for modelling adjustment. The thesis aimed to test this model for cancer patients in order to provide evidence to better inform the provision of psychological services for cancer patients. A systematic review summarised the literature exploring the extent to which personality, appraisals and emotions were associated with psychosocial outcome. 68 studies were included. A number of small meta-analyses were performed using the Hunter and Schmidt method. Findings demonstrated a lack of consistency, and a number of research questions still unanswered. A methodological critique was provided based on systematic quality assessment. The empirical study had two purposes: prediction of clinical outcome and theory development 160 recently diagnosed colorectal, breast, lung and prostate cancer patients were recruited. Measures of personality, appraisal, emotion, coping and outcome (anxiety, depression and quality of life) were collected at baseline, three- and six-month follow-up. Analyses demonstrated that the data generally fitted the model but adaptations were proposed. Clinically, between 47 and 74% of variance in psychosocial outcome was explained by these predictor variables, with cognitive appraisals most predictive of all Transactional Model components. Statistical theory testing of cognition-emotion processes did not confirm the Transactional Model (Lazarus, 1999). These findings question the prescriptive nature of the theory and further testing is suggested, particularly in response to chronic stressors. Guidelines for methodological improvements are provided. The thesis concludes with proposals for further research, including suggestions for theory- informed interventions.EThOS - Electronic Theses Online ServiceGBUnited Kingdo