Laying Groundwork for the use of Acceptance and Commitment Therapy Constructs to Enhance

171 Pages·2017·1.81 MB·English

UUnniivveerrssiittyy ooff TTeennnneesssseeee,, KKnnooxxvviillllee
TTRRAACCEE:: TTeennnneesssseeee RReesseeaarrcchh aanndd CCrreeaattiivvee
EExxcchhaannggee
Doctoral Dissertations Graduate School
8-2017
LLaayyiinngg GGrroouunnddwwoorrkk ffoorr tthhee uussee ooff AAcccceeppttaannccee aanndd CCoommmmiittmmeenntt
TThheerraappyy CCoonnssttrruuccttss ttoo EEnnhhaannccee tthhee IIddeennttiittyy DDeevveellooppmmeenntt ooff
CCoouunnsseelloorrss--iinn--ttrraaiinniinngg:: AAnn EExxpplloorraattoorryy QQuuaannttiittaattiivvee AAnnaallyyssiiss
Emma Christine Burgin
University of Tennessee, Knoxville, [email protected]
Follow this and additional works at: https://trace.tennessee.edu/utk_graddiss
Part of the Counselor Education Commons, and the Educational Psychology Commons
RReeccoommmmeennddeedd CCiittaattiioonn
Burgin, Emma Christine, "Laying Groundwork for the use of Acceptance and Commitment Therapy
Constructs to Enhance the Identity Development of Counselors-in-training: An Exploratory Quantitative
Analysis. " PhD diss., University of Tennessee, 2017.
https://trace.tennessee.edu/utk_graddiss/4610
This Dissertation is brought to you for free and open access by the Graduate School at TRACE: Tennessee
Research and Creative Exchange. It has been accepted for inclusion in Doctoral Dissertations by an authorized
administrator of TRACE: Tennessee Research and Creative Exchange. For more information, please contact
[email protected].
To the Graduate Council:
I am submitting herewith a dissertation written by Emma Christine Burgin entitled "Laying
Groundwork for the use of Acceptance and Commitment Therapy Constructs to Enhance the
Identity Development of Counselors-in-training: An Exploratory Quantitative Analysis." I have
examined the final electronic copy of this dissertation for form and content and recommend
that it be accepted in partial fulfillment of the requirements for the degree of Doctor of
Philosophy, with a major in Counselor Education.
Melinda M. Gibbons, Major Professor
We have read this dissertation and recommend its acceptance:
Shawn L. Spurgeon, Jacob Leavy, Lisa Yamagata-Lynch
Accepted for the Council:
Dixie L. Thompson
Vice Provost and Dean of the Graduate School
(Original signatures are on file with official student records.)
Laying Groundwork for the use of Acceptance and Commitment Therapy Constructs to Enhance
the Identity Development of Counselors-in-training: An Exploratory Quantitative Analysis

A Dissertation Presented for the
Doctor of Philosophy
Degree
The University of Tennessee, Knoxville

Emma Christine Burgin
August 2017
Copyright © 2017 by Emma Burgin
All rights reserved.

ii
Dedication

This document is dedicated to any person who started a journey with something in their hands
only to drop it along the way. To individuals who either found a way to pick it back up or had to
go all the way back to the starting line to retrieve another. To those who, after all that, finished
or didn’t. There are lessons to be cherished on either path.

Let this document be encouragement of that.

In short, this is dedicated to my own damn self.

iii
Acknowledgement

At times our own light goes out and is rekindled by a spark from another person. Each of us has
cause to think with deep gratitude of those who have lighted the flame within us.
-Albert Schweitzer

Thank you first and foremost to my chair, adviser, and trusted mentor, Dr. Melinda Gibbons.
You were exactly the person I needed in my life through this entire program, and I am so
fortunate circumstance had the foresight to place me in your care. I needed exactly the kind of
supportive, knowledgeable, trustworthy, nurturing person you are to guide me through this, the
most difficult yet rewarding time in my life. I will forever be grateful.

To my committee members – Dr. Shawn Spurgeon, Dr. Lisa Yamagata-Lynch, and Dr. Jacob
Levy – who were so supportive and encouraging throughout this process even as I stumbled and
scraped my knees. Especially Dr. Spurgeon who always let me know that his faith in me never
wavered, even as mine did constantly.

I am thankful to my mother, who has been my legs when I couldn’t walk, my voice when I was
speechless, my glue when I was falling apart, my shelter when I felt left out in the cold. Both
when I needed these efforts and when I tried to refuse them, you were there for me. P.S., I am so
glad I finished this the first time through! Aren’t you!?

Thank you to my father, my hero. He is truly my rock in this life.

Ellen, your unbelievably high standards for yourself and others keeps me on my toes. When you
asked me to forgo my master’s graduation to attend your law school one, I realize now that was
your vote of confidence in me. Thank you for believing that I will be okay.

Dareen, thank you for granting me the privilege to be your friend. It is definitely one of the
greatest honors I have ever been bestowed. Your support and encouragement carried me through
some days when I could not carry myself. I cannot wait to do the rest of life with you as my dear
friend.

A bucket of gratitude to my thera-friends from PBH. They were incredibly supportive,
encouraging, and reaffirming that I was right where I needed to be at all times.

To everyone else who joined me at some point in this journey, thank you for your part. I noticed
each and every one of you and appreciate all of the lessons I learned along the way – the good
and the bad.

iv
Abstract

Counselor educators aid counselors-in-training (CITs) in the process of professional
identity development, which has its own challenges, such as managing anxiety and increasing
self-awareness. One way proposed to enhance these therapeutic challenges is mindfulness.
However, most research examining mindfulness in counselor education to-date lacks a standard
theoretical framework, which may cause counselors to diminish the value of mindfulness in
counselor training. One theory-driven concept of mindfulness comes from ACT, an empirically
validated approach to counseling. It is possible that ACT could serve as a common language for
educators to use when implementing mindfulness into counselor training, and thus, there is need
for more support for the use of ACT tenets within counselor education. Being present, defusion,
and emotional acceptance are constructs that feed into the ACT overall goal of psychological
flexibility. Explicitly, these elements of ACT – which focus on opening up the individual – could
be helpful in progressing CIT development. A needed first step is to determine whether or not
the enactment of ACT principles differ in CITs who have a mindfulness practice versus those
who do not. Additionally, this quantitative study assessed how the ACT principles of present
moment awareness, cognitive defusion, and acceptance contribute to psychological flexibility.
First, it was determined there is no difference between mindfulness practitioners and non-
practitioners on ACT constructs except for mindfulness. Overall, CITs demonstrated high levels
of mindfulness. Second, a correlational analysis identified that there was a significant
relationship between mindfulness, cognitive fusion, emotion regulation, and psychological
flexibility, all in the predicted directions. Third, a standard multiple regression identified
mindfulness, cognitive fusion, and emotion regulation as predictor variables of psychological
v
flexibility. Discussion includes findings, implications for education, clinical practice and future
research.
Keywords: mindfulness, Acceptance and Commitment Therapy, professional development,
counselor education

vi
Table of Contents

Chapter 1 Introduction .....................................................................................................................1
Counselor Development...............................................................................................................3
Mindfulness..................................................................................................................................4
Mindfulness in Counselor Development .................................................................................5
Acceptance and Commitment Therapy .........................................................................................7
The Triflex ...............................................................................................................................8
ACT in Counselor Development .............................................................................................9
Statement of the Problem ............................................................................................................10
Purpose of the Study ...................................................................................................................12
Research Questions .....................................................................................................................12
Definition of Terms.....................................................................................................................13
Delimitations ...............................................................................................................................14
Limitations ..................................................................................................................................15
Organization of Study .................................................................................................................16
Chapter 2 Review of the Literature ................................................................................................17
Professional Development of Counselors ..................................................................................17
Challenges in Counselor Identity Development ....................................................................22
Anxiety ...............................................................................................................................23
Self-awareness ...................................................................................................................25
Other important considerations ..........................................................................................28
Mindfulness................................................................................................................................30
Mindfulness Defined ..............................................................................................................30
How Mindfulness Works .......................................................................................................32
Mindfulness in Treatment ......................................................................................................34
Self-awareness ...................................................................................................................34
Emotions ............................................................................................................................37
Mindfulness in Counselor Education and Training ................................................................39
Summary ................................................................................................................................45
Acceptance and Commitment Therapy ......................................................................................46
Development of ACT .............................................................................................................48
Functional Contextualism ..................................................................................................49
Relational Frame Theory ...................................................................................................49
Empirical Evidence of ACT...................................................................................................51
Clinical Effectiveness of ACT ...............................................................................................53
Anxiety ...............................................................................................................................54
Other Mental Health Disorders ..........................................................................................56
Summary of Evidence ........................................................................................................61
ACT in Counselor Education .................................................................................................62
Summary of the Literature .........................................................................................................65
Chapter 3 Methodology .................................................................................................................67
Research Questions .....................................................................................................................67
Participants ...................................................................................................................................68
Procedure .....................................................................................................................................70
Instrumentation ............................................................................................................................71
vii
Five Facet Mindfulness Questionnaire ...................................................................................71
Cognitive Fusion Questionnaire .............................................................................................73
Emotional Regulation Questionnaire .....................................................................................74
Acceptance and Action Questionnaire ...................................................................................75
Demographics Questionnaire .................................................................................................76
Data Analysis ..............................................................................................................................76
Chapter 4 Results ...........................................................................................................................78
Participants ..................................................................................................................................78
Descriptive Resutlts ....................................................................................................................80
Mindfulness ............................................................................................................................80
Mindfulness (FFMQ) .............................................................................................................81
CFQ ........................................................................................................................................82
ERQ ........................................................................................................................................82
Psychological Flexibility (AAQ-II) ........................................................................................84
Research Question 1 ...................................................................................................................84
Research Question 2 ...................................................................................................................86
Psychological Flexibility ........................................................................................................86
Research Question 3 ...................................................................................................................88
Summary .....................................................................................................................................90
Chapter 5 Discussion .....................................................................................................................91
Major Findings ............................................................................................................................92
Mindfulness ............................................................................................................................92
Other ACT constructs .............................................................................................................94
Cognitive Fusion ....................................................................................................................95
Emotion Regulation ................................................................................................................97
Psychological Flexibility ........................................................................................................98
Limitations ................................................................................................................................100
Implications...............................................................................................................................102
Future Research ....................................................................................................................102
CIT Professional Development ............................................................................................103
Counselor Educators and Supervisors ..................................................................................107
Conclusion ................................................................................................................................110
References ....................................................................................................................................112
Appendices ...................................................................................................................................134
Appendix A: Participant Recruitment Email ............................................................................135
Appendix B: Five Facet Mindfulness Questionnaire ................................................................136
Appendix C: Cognitive Fusion Questionnaire ..........................................................................139
Appendix D: Acceptance and Action Questionnaire ................................................................140
Appendix E: Emotional Regulation Questionnaire...................................................................141
Appendix F: Permission to use ERQ ........................................................................................142
Appendix G: Demographics Questionnaire .............................................................................143
Appendix H: Figures .................................................................................................................146
Appendix I: Tables ....................................................................................................................149
Vita ..........................................................................................................................................159

viii