Incorporating Acceptance and Mindfulness into the Treatment of Psychosis: Current Trends and Future Directions

305 Pages·2015·3.33 MB·English

by  Brandon A. Gaudiano

Incorporating Acceptance and Mindfulness
into the Treatment of Psychosis

Incorporating Acceptance and
Mindfulness into the Treatment
of Psychosis
Current Trends and Future Directions
EDITED BY BRANDON A. GAUDIANO
1
1
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Library of Congress Cataloging-in-Publication Data
Incorporating acceptance and mindfulness into the treatment of psychosis : current trends and
future directions / edited by Brandon A. Gaudiano.
pages cm
Includes index.
ISBN 978–0–19–999721–3 (hardcover : alk. paper)
1. Psychoses—Treatment. 2. Acceptance and commitment therapy. I. Gaudiano, Brandon A.
RC512.I43 2015
616.89′1425—dc23
2014024190
9 8 7 6 5 4 3 2 1
Printed in the United States of America
on acid-free paper
To my wife, Kristy, and my parents for their constant support and
encouragement, and to my mentors James Herbert, Ph.D., and Ivan Miller,
Ph.D., for all their guidance throughout the years.
—BG

CONTENTS
Foreword by Kim T. Mueser ix
About the Editor xiii
Contributors xv
SECTION I: Introduction and Background
1. An Introduction to Mindfulness and Acceptance Therapies
for Psychosis 3
Brandon A. Gaudiano
2. The Evolution of Cognitive-Behavioral Therapy for Psychosis: The Path
to Integrating Acceptance, Compassion, and Mindfulness 12
Douglas Turkington, Nicola Wright, and James Courtley
3. Ecological Momentary Assessments in Psychosis: A Contextual
Behavioral Approach to Studying Mindfulness and Acceptance 25
Roger Vilardaga, Michael McDonell, Emily Leickly, and Richard Ries
SECTION II: Specific Treatment Models
4. Acceptance and Commitment Therapy for Psychosis: Applying
Acceptance and Mindfulness in the Context of an Inpatient
Hospitalization 57
Patricia Bach
5. Treating Depression in Psychosis: Self-Compassion as a Valued Life
Direction 81
Ross G. White
6. Acceptance-Based CBT for Command Hallucinations: Rationale,
Implementation, and Outcomes of the TORCH Project 108
Frances Shawyer and John Farhall
7. Person-Based Cognitive Therapy for Distressing Psychosis: Integrating a
Mindfulness-Based Approach with Cognitive Therapy 150
Mark Hayward, Lyn Ellett, and Clara Strauss
viii CONTENTS
8. Mindfulness Meditation in Cognitive-Behavioral Therapy
for Psychosis 170
Katherine Newman Taylor and Nicola Abba
SECTION III: Synthesis and Analysis
9. A Model for the Development of Acceptance- and Mindfulness-Based
Therapies: Preoccupation with Psychotic Experiences as a Treatment
Target 203
Neil Thomas
10. Disseminating and Implementing Acceptance- and Mindfulness-Based
Approaches to Psychosis: Challenges and Opportunities 227
Hamish J. McLeod
11. Charting the Course Ahead: Future Clinical and Research Directions in
Mindfulness and Acceptance Therapies for Psychosis 253
Brandon A. Gaudiano
Index 277
FOREWORD
The mind is a wondrous but terrible thing—capable of giving birth to astound-
ing artistic and scientific achievements, selfless caring, love and joy, but also of
wreaking havoc, unspeakable cruelty and hate, and the depths of despair. But
does this perspective give too much credit to the mind? Steven Hayes, whose
groundbreaking work on relational frame theory led to the development of
acceptance and commitment therapy (ACT), said, “I used to think that the most
important part of my body was my brain, and then I asked ‘who is telling me
this?’” Must not there be something that operates outside or beyond the mind or
the brain as we know it, like a self, that is either capable of outright controlling
the mind or at least influencing it and the feelings and behaviors that flow from
it? In their own unique ways, cognitive-behavioral therapy (CBT) and ACT have
responded to this question with a resounding “Yes!” and have sought to give
people greater control over their mental and physical lives through rather differ-
ent, but not incompatible, approaches to dealing with the troubling mind.
The fundamental premise of CBT, often summarized with the thought–feel-
ing–behavior triad, is that how one responds to a situation (e.g., calling out
“hello” to a friend walking down the other side of the street who does not reply
back) is largely determined by the individual’s interpretation (i.e., thoughts and
beliefs) of that situation (e.g., “My friend doesn’t want to acknowledge me in
public”), which leads to the associated feelings (e.g., hurt) and behaviors (e.g.,
avoidance of friend). For a variety of reasons, people’s interpretations of events
are often inaccurate (e.g., the friend may not have heard the person), but they can
learn how to correct them, and that such correcting will alleviate suffering and
improve adaptable behavior. CBT assumes that the content of one’s thoughts is
primarily responsible for the feelings and behaviors that ensue. Its focus is on
changing the processes by which interpretations of events are made in order to
change the conclusions reached and the resulting content of thought. This may
include teaching people how to recognize “automatic” thoughts and to identify
belief structures or schemas that can be logically examined, and refuted and
changed when inaccurate, resulting in changes in associated feelings and behav-
iors. The importance of the content of thoughts and beliefs in CBT is reflected
not only in its theoretical role in determining feelings and behaviors but also