Valid measures capturing underlying psychological processes post surgery for obesity are needed t... more Valid measures capturing underlying psychological processes post surgery for obesity are needed to help identify important clinical targets and develop psychosocial interventions in conjunction with surgery. The Acceptance and Action Questionnaire for Weight (AAQ-W) measures experiential avoidance and has never been evaluated in a bariatric surgery population. Participants were recruited at a bariatric surgery clinic during follow-up care. The evaluation of psychometric properties of AAQ-W was done by repeated measurements of reliability (n = 62), convergent validity (n = 75 and n = 178), predictive validity (n = 61), factor analysis and calculation of internal consistency (n = 178). The AAQ-W was found to have satisfactory psychometric properties. Internal consistency was high (α = .86). Results showed good stability over time (r = .77) and validity coefficients ranging from r = .36 to .71. AAQ-W scores measured six months post surgery predicted satisfaction with life, negative emo...
The purpose of the studies presented here was to provide controlled data on the usefulness of beh... more The purpose of the studies presented here was to provide controlled data on the usefulness of behavioral interventions in reducing epileptic seizures and to provide a theoretical explanation of the psychological mechanisms at work. In Study 1, a single subject replication series, patient recognition of early cues and application of a contingent relaxation technique was found to be useful in
Benign chronic pain is frequently reported among rehabilitation patients. The present study inves... more Benign chronic pain is frequently reported among rehabilitation patients. The present study investigates a behavioral treatment model used with 3 consecutive groups of 8 chronic pain outpatients. The behavioral strategy used was to identify specific pain behaviors such as verbal expression of pain, consumption of analgesics and inactivity and to teach the patient to modify these patterns. The treatment was
ABSTRACT The major contribution of the behavioural approach to the understanding and treatment of... more ABSTRACT The major contribution of the behavioural approach to the understanding and treatment of epilepsy has been the construction of a self-management model comprising: (i) recognition that external factors influence the occurrence and inhibition of the epileptic seizure and (ii) teaching people with epilepsy to recognize and utilize these factors to influence seizure occurrence. The behavioural medicine model regards the epileptic seizure as any behaviour, amenable to classical and operant conditioning. Part one of this paper presents a literature review of behavioural medicine treatment of people with epilepsy. Part two presents a study illustrating spontaneous means by which people with epilepsy predict, prevent and inhibit seizure occurrence. A total of 160 children and adults with refractory seizures were studied over a 10-year period. This study addresses the issues of which types of seizures or what categories of people with epilepsy might be more amenable to learning factors and thus respond to behavioural treatment. The need for a paradigm shift from the traditional medical concept of epilepsy to a behavioural medicine concept, as has been the case with chronic pain, is discussed.
This case example illustrates how Acceptance and Commitment Therapy (ACT) within a behavior medic... more This case example illustrates how Acceptance and Commitment Therapy (ACT) within a behavior medicine approach was used in the rehabilitation of an adolescent with debilitating chronic pain. For chronic pain with unclear etiology (idiopathic pain), pharmacological therapy alone is often insufficient. Psychological treatment strategies have been developed and evaluated for adults with chronic pain. However, few such studies have been conducted with youths. To date, there is limited empirical evidence regarding the effectiveness of psychological treatment for generalized musculoskeletal pain syndromes in children and adolescents. This patient was a 14-year-old girl severely disabled by idiopathic generalized pain. It was hypothesized that avoidance of pain and pain-related stimuli was central to the subject's disability. ACT, a development of cognitive behavior therapy, was used as the treatment model in this study, focusing on building the behavior repertoire in valued life directions rather than emphasizing reductions in pain and distress. As the subject moved in valued directions, exposure to avoided pain stimuli took place naturally. Following treatment, improvements in valued life activities and functional ability was seen, as evidenced by increased school attendance, lower pain ratings, and individual goal achievement. The outcome of this treatment indicates that ACT and a behavioral medicine approach can be useful in the rehabilitation of young people with chronic disabling pain. Empirical studies are needed to investigate the clinical effectiveness of this approach.
Bariatric surgery (BS) is rated as the best evidence based treatment for obesity with regard to w... more Bariatric surgery (BS) is rated as the best evidence based treatment for obesity with regard to weight loss and maintenance of weight loss evaluated to date. Although BS interventions are effective, 20-30% of BS patients start to regain weight within 24 months. Emotional eating is a behavior pattern which has been found to predict poor outcome. The aim of this study is to evaluate the effects of acceptance and commitment therapy (ACT) for patients who underwent BS, with regard to emotional eating, body dissatisfaction and quality of life. This study is a randomized controlled trial (n = 39) with two conditions (1) ACT including two face-to-face sessions and support via an Internet application and (2) treatment as usual (TAU) comprising the standard follow-up used by the BS team. Results show that participants in the ACT condition significantly improve on eating disordered behaviors, body dissatisfaction, quality of life and acceptance for weight related thoughts and feelings, as compared to those in the TAU group. This study shows that it is possible to improve effects of BS by specifically targeting emotional eating behavior.:
Psychological interventions in the treatment of epilepsy have been developed and evaluated for ma... more Psychological interventions in the treatment of epilepsy have been developed and evaluated for many years but the amount of research has hardly made an impact on how epilepsy is treated. The purpose of this study was to develop and evaluate a psychological treatment program consisting of acceptance and commitment therapy (ACT) together with some behavioral seizure control technology shown to be successful in earlier research. The method consisted of a randomized controlled trial group design with repeated measures (n=27). All participants had an EEG verified epilepsy diagnosis with drug refractory seizures. Participants were randomized into one of two conditions, ACT or supportive therapy (ST). Therapeutic effects were measured by examining changes in quality of life (SWLS and WHOQOL) and seizure index (frequency x duration). Both treatment conditions consisted of only nine hours of professional therapy distributed in two individual and two group sessions during a four-week period. The results showed significant effects over all of the dependent variables for the ACT group as compared to the ST group at six- and twelve-month follow-ups. The results from this study suggest that a short-term psychotherapy program combined with anticonvulsant drugs may help to prevent the long-term disability that occurs from drug refractory seizures.
Because of the substantial increase of sick listing, reports of work disabilities and early retir... more Because of the substantial increase of sick listing, reports of work disabilities and early retirement due to the musculoskeletal chronic pain, prevention studies at the work site are greatly needed. The purpose of the present study was to investigate the effects of a cognitive behavioural work site intervention on a group of public health workers judged to be at risk
ObjectiveThere is a need for controlled outcome studies on behavioral treatment of epilepsy. The ... more ObjectiveThere is a need for controlled outcome studies on behavioral treatment of epilepsy. The purpose of this study was to evaluate Acceptance and Commitment Therapy (ACT) and yoga in the treatment of epilepsy.
We present an 8 year follow-up on a group of children with refractory epileptic seizures who part... more We present an 8 year follow-up on a group of children with refractory epileptic seizures who participated in the early 1980s in a controlled group study on the effects of a broad-spectrum behavior modification treatment program on children with refractory epileptic seizures. In the original study, 18 children were divided into three groups: behavior modification group, attention control group, and control group. The purpose was to investigate the effects of a learning-based treatment program superimposed on a regular medical treatment program. Also, the effects of professional attention were evaluated. At the 10 week and 1 year follow-ups, only the group receiving the behavior modification intervention had a significantly reduced rate of seizure index. The present study investigates these same children 8 years later using the same methods of investigation for an additional 10 week period. The results indicate that a significant reduction in seizures was obtained only for the behavior modification group at the 8 year follow-up.
Three children with very frequent refractory epileptic seizures underwent a behavioral interventi... more Three children with very frequent refractory epileptic seizures underwent a behavioral intervention consisting of symptom discrimination, countermeasures, contingent relaxation, and positive reinforcement for correct responses in a systematic replication series. The studies involved a 6-h nonintervention base rate, a 6-h treatment phase, and a 6-h nonintervention follow-up under laboratory conditions for each child. Neurophysiologic and behavioral measures of the effects of treatment were made using electroencephalogram (EEG)-video equipment. Effects of treatment were assessed by using a random sample of EEG-video sequences in base rate and follow-up. Results showed that no significant reduction of either seizure behavior or paroxysmal EEG activity was found subsequent to training in discrimination of early paroxysmal activity and/or sensations preceding seizures. Both seizure behavior and paroxysmal activity were significantly reduced in all three cases following intervention with an adapted countermeasure technique. No additional effects could be noted subsequent to the application of either contingent relaxation or positive reinforcement for correct responses. Paroxysmal EEG changes and seizure behavior were highly correlated. Reduction of the clinical manifestation or seizure response by behavioral manipulation was accompanied by a reduction of the total amount of paroxysmal activity as measured by the EEG.
A group of 18 children with refractory epileptic seizures was divided into three groups--behavior... more A group of 18 children with refractory epileptic seizures was divided into three groups--behavior modification treatment, attention control, and control groups--with the purpose of investigating the effects of a learning-based broad-spectrum treatment program superimposed on a regular medical treatment program. The design consisted of a 10-week baseline, 6-week intervention, and 10-week and 1-year follow-ups. A combination of number of seizures and seizure duration--termed "seizure index"--was used as a dependent measure. There was a significant reduction in seizure index only for those children receiving the behavior modification treatment, at both follow-ups. The results indicate that this behavioral treatment program may be of substantial help to children with epilepsy who are resistant to conventional drug therapy.
A group of eighteen adults with refractory epileptic seizures were given psychological treatment ... more A group of eighteen adults with refractory epileptic seizures were given psychological treatment in a two-phase experimental group study. In phase one, the experimental phase, the patients were divided into three groups--contingent relaxation (CR), attention control (ATC) treatment, and a no-treatment (NT) control group--with the purpose of investigating the effects of a learning-based contingent relaxation program compared with the effects of professional attention alone when superimposed on a regular medical treatment program. The design of the experimental phase was comprised of a 10-week baseline, 6-week intervention, and 10-week follow-up. Results of this phase at the end of follow-up showed a significant reduction only for those patients receiving the CR treatment. In the nonexperimental phase, the two control groups also received the CR treatment for a 6-week period, and subsequent seizure frequency measures for all three groups were analyzed after 10-week and 30-week follow-up periods. Results of this phase showed a significant reduction in seizure frequency for all three groups after receiving the CR treatment. Effects of the CR treatment were maintained at a 30-week follow-up. The results indicate that the CR treatment program may be of substantial help to adults whose seizures are resistant to conventional drug therapy.
Research highlights • Bariatric surgery is associated with dramatic weight loss. • Follow-up st... more Research highlights • Bariatric surgery is associated with dramatic weight loss. • Follow-up studies show that many surgery patients continue to struggle with self-stigma, body dissatisfaction and emotional eating. • To date we are aware of only three published randomized controlled trials evaluating psychological interventions in combination with bariatric surgery. • Acceptance and Commitment Therapy (ACT) targets psychological flexibility: acceptance to have difficult feelings and thoughts, while at the same time engaging in vital healthy activities. • The present study shows significant improvements in the ACT group as compared with (TAU) after treatment as usual at a 6-month follow-up and shows that the mechanism of change may be psychological flexibility. • Results from this study indicate the possibility of optimizing bariatric surgery outcomes by adding interventions targeting psychological flexibility. The current article presents and evaluates an Acceptance and Commit...
In discussing transcultural functional analytic psychotherapy (FAP), the treatment of clients fro... more In discussing transcultural functional analytic psychotherapy (FAP), the treatment of clients from culturally diverse backgrounds, we draw upon not only the experiences of FAP therapists outside the United States (e.g., Carrascoso , 2003; Ferro , Valero, & Vives , 2006; López , Ferro, & Calvillo , 2002; Ferro , Valero , & López Bermúdez , 2009), but also the booming
The aim of the present study was to provide information about factors related to long-duration pa... more The aim of the present study was to provide information about factors related to long-duration pain (LDP) (>3 months), sick leave (SL) and long sick leave (LSL) (>3 months) among staff in the community health services. The specific research question was: To what extent do data on activity, physical function, pain severity, psychological/cognitive factors, expectations of LDP, expectations to be working within 6 months and work satisfaction predict LDP, SL and LSL respectively? Logistic regression analyses were used to test predicted membership in the groups LDP, SL and LSL. In this context prediction refers to statistical prediction only, due to the cross-sectional design. Staff (n = 914) in the public health services in a medium-sized Swedish city completed a questionnaire during the spring of 2000. The results show that musculoskeletal pain and SL for this occupational group are common. Pain severity, expectations of LDP and fear-avoidance increased the odds of being in the LDP group, while kinesiophobia decreased the odds. Pain severity and kinesiophobia increased the odds of being in the SL group, while expectations to be working in 6 months decreased the odds. Only expectations to be working in 6 months predicted membership in the LSL group, decreasing the odds. Although some caution is warranted concerning the representativity of the sample, the results indicate that expectations about pain duration and ability to work are important psychosocial factors in LDP and LSL.
Bariatric surgery (BS) is rated as the best evidence based treatment for obesity with regard to w... more Bariatric surgery (BS) is rated as the best evidence based treatment for obesity with regard to weight loss and maintenance of weight loss evaluated to date. Although BS interventions are effective, 20-30% of BS patients start to regain weight within 24 months. Emotional eating is a behavior pattern which has been found to predict poor outcome. The aim of this study is to evaluate the effects of acceptance and commitment therapy (ACT) for patients who underwent BS, with regard to emotional eating, body dissatisfaction and quality of life. This study is a randomized controlled trial (n = 39) with two conditions (1) ACT including two face-to-face sessions and support via an Internet application and (2) treatment as usual (TAU) comprising the standard follow-up used by the BS team. Results show that participants in the ACT condition significantly improve on eating disordered behaviors, body dissatisfaction, quality of life and acceptance for weight related thoughts and feelings, as compared to those in the TAU group. This study shows that it is possible to improve effects of BS by specifically targeting emotional eating behavior.:
Valid measures capturing underlying psychological processes post surgery for obesity are needed t... more Valid measures capturing underlying psychological processes post surgery for obesity are needed to help identify important clinical targets and develop psychosocial interventions in conjunction with surgery. The Acceptance and Action Questionnaire for Weight (AAQ-W) measures experiential avoidance and has never been evaluated in a bariatric surgery population. Participants were recruited at a bariatric surgery clinic during follow-up care. The evaluation of psychometric properties of AAQ-W was done by repeated measurements of reliability (n = 62), convergent validity (n = 75 and n = 178), predictive validity (n = 61), factor analysis and calculation of internal consistency (n = 178). The AAQ-W was found to have satisfactory psychometric properties. Internal consistency was high (α = .86). Results showed good stability over time (r = .77) and validity coefficients ranging from r = .36 to .71. AAQ-W scores measured six months post surgery predicted satisfaction with life, negative emo...
The purpose of the studies presented here was to provide controlled data on the usefulness of beh... more The purpose of the studies presented here was to provide controlled data on the usefulness of behavioral interventions in reducing epileptic seizures and to provide a theoretical explanation of the psychological mechanisms at work. In Study 1, a single subject replication series, patient recognition of early cues and application of a contingent relaxation technique was found to be useful in
Benign chronic pain is frequently reported among rehabilitation patients. The present study inves... more Benign chronic pain is frequently reported among rehabilitation patients. The present study investigates a behavioral treatment model used with 3 consecutive groups of 8 chronic pain outpatients. The behavioral strategy used was to identify specific pain behaviors such as verbal expression of pain, consumption of analgesics and inactivity and to teach the patient to modify these patterns. The treatment was
ABSTRACT The major contribution of the behavioural approach to the understanding and treatment of... more ABSTRACT The major contribution of the behavioural approach to the understanding and treatment of epilepsy has been the construction of a self-management model comprising: (i) recognition that external factors influence the occurrence and inhibition of the epileptic seizure and (ii) teaching people with epilepsy to recognize and utilize these factors to influence seizure occurrence. The behavioural medicine model regards the epileptic seizure as any behaviour, amenable to classical and operant conditioning. Part one of this paper presents a literature review of behavioural medicine treatment of people with epilepsy. Part two presents a study illustrating spontaneous means by which people with epilepsy predict, prevent and inhibit seizure occurrence. A total of 160 children and adults with refractory seizures were studied over a 10-year period. This study addresses the issues of which types of seizures or what categories of people with epilepsy might be more amenable to learning factors and thus respond to behavioural treatment. The need for a paradigm shift from the traditional medical concept of epilepsy to a behavioural medicine concept, as has been the case with chronic pain, is discussed.
This case example illustrates how Acceptance and Commitment Therapy (ACT) within a behavior medic... more This case example illustrates how Acceptance and Commitment Therapy (ACT) within a behavior medicine approach was used in the rehabilitation of an adolescent with debilitating chronic pain. For chronic pain with unclear etiology (idiopathic pain), pharmacological therapy alone is often insufficient. Psychological treatment strategies have been developed and evaluated for adults with chronic pain. However, few such studies have been conducted with youths. To date, there is limited empirical evidence regarding the effectiveness of psychological treatment for generalized musculoskeletal pain syndromes in children and adolescents. This patient was a 14-year-old girl severely disabled by idiopathic generalized pain. It was hypothesized that avoidance of pain and pain-related stimuli was central to the subject's disability. ACT, a development of cognitive behavior therapy, was used as the treatment model in this study, focusing on building the behavior repertoire in valued life directions rather than emphasizing reductions in pain and distress. As the subject moved in valued directions, exposure to avoided pain stimuli took place naturally. Following treatment, improvements in valued life activities and functional ability was seen, as evidenced by increased school attendance, lower pain ratings, and individual goal achievement. The outcome of this treatment indicates that ACT and a behavioral medicine approach can be useful in the rehabilitation of young people with chronic disabling pain. Empirical studies are needed to investigate the clinical effectiveness of this approach.
Bariatric surgery (BS) is rated as the best evidence based treatment for obesity with regard to w... more Bariatric surgery (BS) is rated as the best evidence based treatment for obesity with regard to weight loss and maintenance of weight loss evaluated to date. Although BS interventions are effective, 20-30% of BS patients start to regain weight within 24 months. Emotional eating is a behavior pattern which has been found to predict poor outcome. The aim of this study is to evaluate the effects of acceptance and commitment therapy (ACT) for patients who underwent BS, with regard to emotional eating, body dissatisfaction and quality of life. This study is a randomized controlled trial (n = 39) with two conditions (1) ACT including two face-to-face sessions and support via an Internet application and (2) treatment as usual (TAU) comprising the standard follow-up used by the BS team. Results show that participants in the ACT condition significantly improve on eating disordered behaviors, body dissatisfaction, quality of life and acceptance for weight related thoughts and feelings, as compared to those in the TAU group. This study shows that it is possible to improve effects of BS by specifically targeting emotional eating behavior.:
Psychological interventions in the treatment of epilepsy have been developed and evaluated for ma... more Psychological interventions in the treatment of epilepsy have been developed and evaluated for many years but the amount of research has hardly made an impact on how epilepsy is treated. The purpose of this study was to develop and evaluate a psychological treatment program consisting of acceptance and commitment therapy (ACT) together with some behavioral seizure control technology shown to be successful in earlier research. The method consisted of a randomized controlled trial group design with repeated measures (n=27). All participants had an EEG verified epilepsy diagnosis with drug refractory seizures. Participants were randomized into one of two conditions, ACT or supportive therapy (ST). Therapeutic effects were measured by examining changes in quality of life (SWLS and WHOQOL) and seizure index (frequency x duration). Both treatment conditions consisted of only nine hours of professional therapy distributed in two individual and two group sessions during a four-week period. The results showed significant effects over all of the dependent variables for the ACT group as compared to the ST group at six- and twelve-month follow-ups. The results from this study suggest that a short-term psychotherapy program combined with anticonvulsant drugs may help to prevent the long-term disability that occurs from drug refractory seizures.
Because of the substantial increase of sick listing, reports of work disabilities and early retir... more Because of the substantial increase of sick listing, reports of work disabilities and early retirement due to the musculoskeletal chronic pain, prevention studies at the work site are greatly needed. The purpose of the present study was to investigate the effects of a cognitive behavioural work site intervention on a group of public health workers judged to be at risk
ObjectiveThere is a need for controlled outcome studies on behavioral treatment of epilepsy. The ... more ObjectiveThere is a need for controlled outcome studies on behavioral treatment of epilepsy. The purpose of this study was to evaluate Acceptance and Commitment Therapy (ACT) and yoga in the treatment of epilepsy.
We present an 8 year follow-up on a group of children with refractory epileptic seizures who part... more We present an 8 year follow-up on a group of children with refractory epileptic seizures who participated in the early 1980s in a controlled group study on the effects of a broad-spectrum behavior modification treatment program on children with refractory epileptic seizures. In the original study, 18 children were divided into three groups: behavior modification group, attention control group, and control group. The purpose was to investigate the effects of a learning-based treatment program superimposed on a regular medical treatment program. Also, the effects of professional attention were evaluated. At the 10 week and 1 year follow-ups, only the group receiving the behavior modification intervention had a significantly reduced rate of seizure index. The present study investigates these same children 8 years later using the same methods of investigation for an additional 10 week period. The results indicate that a significant reduction in seizures was obtained only for the behavior modification group at the 8 year follow-up.
Three children with very frequent refractory epileptic seizures underwent a behavioral interventi... more Three children with very frequent refractory epileptic seizures underwent a behavioral intervention consisting of symptom discrimination, countermeasures, contingent relaxation, and positive reinforcement for correct responses in a systematic replication series. The studies involved a 6-h nonintervention base rate, a 6-h treatment phase, and a 6-h nonintervention follow-up under laboratory conditions for each child. Neurophysiologic and behavioral measures of the effects of treatment were made using electroencephalogram (EEG)-video equipment. Effects of treatment were assessed by using a random sample of EEG-video sequences in base rate and follow-up. Results showed that no significant reduction of either seizure behavior or paroxysmal EEG activity was found subsequent to training in discrimination of early paroxysmal activity and/or sensations preceding seizures. Both seizure behavior and paroxysmal activity were significantly reduced in all three cases following intervention with an adapted countermeasure technique. No additional effects could be noted subsequent to the application of either contingent relaxation or positive reinforcement for correct responses. Paroxysmal EEG changes and seizure behavior were highly correlated. Reduction of the clinical manifestation or seizure response by behavioral manipulation was accompanied by a reduction of the total amount of paroxysmal activity as measured by the EEG.
A group of 18 children with refractory epileptic seizures was divided into three groups--behavior... more A group of 18 children with refractory epileptic seizures was divided into three groups--behavior modification treatment, attention control, and control groups--with the purpose of investigating the effects of a learning-based broad-spectrum treatment program superimposed on a regular medical treatment program. The design consisted of a 10-week baseline, 6-week intervention, and 10-week and 1-year follow-ups. A combination of number of seizures and seizure duration--termed "seizure index"--was used as a dependent measure. There was a significant reduction in seizure index only for those children receiving the behavior modification treatment, at both follow-ups. The results indicate that this behavioral treatment program may be of substantial help to children with epilepsy who are resistant to conventional drug therapy.
A group of eighteen adults with refractory epileptic seizures were given psychological treatment ... more A group of eighteen adults with refractory epileptic seizures were given psychological treatment in a two-phase experimental group study. In phase one, the experimental phase, the patients were divided into three groups--contingent relaxation (CR), attention control (ATC) treatment, and a no-treatment (NT) control group--with the purpose of investigating the effects of a learning-based contingent relaxation program compared with the effects of professional attention alone when superimposed on a regular medical treatment program. The design of the experimental phase was comprised of a 10-week baseline, 6-week intervention, and 10-week follow-up. Results of this phase at the end of follow-up showed a significant reduction only for those patients receiving the CR treatment. In the nonexperimental phase, the two control groups also received the CR treatment for a 6-week period, and subsequent seizure frequency measures for all three groups were analyzed after 10-week and 30-week follow-up periods. Results of this phase showed a significant reduction in seizure frequency for all three groups after receiving the CR treatment. Effects of the CR treatment were maintained at a 30-week follow-up. The results indicate that the CR treatment program may be of substantial help to adults whose seizures are resistant to conventional drug therapy.
Research highlights • Bariatric surgery is associated with dramatic weight loss. • Follow-up st... more Research highlights • Bariatric surgery is associated with dramatic weight loss. • Follow-up studies show that many surgery patients continue to struggle with self-stigma, body dissatisfaction and emotional eating. • To date we are aware of only three published randomized controlled trials evaluating psychological interventions in combination with bariatric surgery. • Acceptance and Commitment Therapy (ACT) targets psychological flexibility: acceptance to have difficult feelings and thoughts, while at the same time engaging in vital healthy activities. • The present study shows significant improvements in the ACT group as compared with (TAU) after treatment as usual at a 6-month follow-up and shows that the mechanism of change may be psychological flexibility. • Results from this study indicate the possibility of optimizing bariatric surgery outcomes by adding interventions targeting psychological flexibility. The current article presents and evaluates an Acceptance and Commit...
In discussing transcultural functional analytic psychotherapy (FAP), the treatment of clients fro... more In discussing transcultural functional analytic psychotherapy (FAP), the treatment of clients from culturally diverse backgrounds, we draw upon not only the experiences of FAP therapists outside the United States (e.g., Carrascoso , 2003; Ferro , Valero, & Vives , 2006; López , Ferro, & Calvillo , 2002; Ferro , Valero , & López Bermúdez , 2009), but also the booming
The aim of the present study was to provide information about factors related to long-duration pa... more The aim of the present study was to provide information about factors related to long-duration pain (LDP) (>3 months), sick leave (SL) and long sick leave (LSL) (>3 months) among staff in the community health services. The specific research question was: To what extent do data on activity, physical function, pain severity, psychological/cognitive factors, expectations of LDP, expectations to be working within 6 months and work satisfaction predict LDP, SL and LSL respectively? Logistic regression analyses were used to test predicted membership in the groups LDP, SL and LSL. In this context prediction refers to statistical prediction only, due to the cross-sectional design. Staff (n = 914) in the public health services in a medium-sized Swedish city completed a questionnaire during the spring of 2000. The results show that musculoskeletal pain and SL for this occupational group are common. Pain severity, expectations of LDP and fear-avoidance increased the odds of being in the LDP group, while kinesiophobia decreased the odds. Pain severity and kinesiophobia increased the odds of being in the SL group, while expectations to be working in 6 months decreased the odds. Only expectations to be working in 6 months predicted membership in the LSL group, decreasing the odds. Although some caution is warranted concerning the representativity of the sample, the results indicate that expectations about pain duration and ability to work are important psychosocial factors in LDP and LSL.
Bariatric surgery (BS) is rated as the best evidence based treatment for obesity with regard to w... more Bariatric surgery (BS) is rated as the best evidence based treatment for obesity with regard to weight loss and maintenance of weight loss evaluated to date. Although BS interventions are effective, 20-30% of BS patients start to regain weight within 24 months. Emotional eating is a behavior pattern which has been found to predict poor outcome. The aim of this study is to evaluate the effects of acceptance and commitment therapy (ACT) for patients who underwent BS, with regard to emotional eating, body dissatisfaction and quality of life. This study is a randomized controlled trial (n = 39) with two conditions (1) ACT including two face-to-face sessions and support via an Internet application and (2) treatment as usual (TAU) comprising the standard follow-up used by the BS team. Results show that participants in the ACT condition significantly improve on eating disordered behaviors, body dissatisfaction, quality of life and acceptance for weight related thoughts and feelings, as compared to those in the TAU group. This study shows that it is possible to improve effects of BS by specifically targeting emotional eating behavior.:
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