IS PSYCHOLOGICAL FLEXIBILITY A TRANS-THEORETICAL PROCESS OF THERAPEUTIC CHANGE?
Creators: name: Author, Unknown
Publisher: name: University of Lincoln
Year: 2023

description: IntroductionPsychological flexibility has been considered to be an important ingredient of good psychological health for the last five decades or so. It has been suggested that psychological flexibility predominantly refers to a number of dynamic processes which determine a person’s interactions with their environment.For the purpose of this research, the model of psychological flexibility associated with Acceptance and Commitment Therapy (ACT) has been adopted. From an ACT perspective, psychological flexibility consists of six interlinked processes: present moment awareness, acceptance, cognitive defusion, self-as-context, committed action and values. ACT founders argue that psychological flexibility is a change process in ACT.The evidence suggests that psychological flexibility is a trans-diagnostic process, meaning that an increase in psychological flexibility is associated with a decrease of distress across a range of diagnoses. It is less clear, however, whether psychological flexibility is also trans-theoretical, meaning that it is unclear whether other successful therapies also operate through the process of psychological flexibility.AimsThe primary aims of this study were (1) to examine whether psychological flexibility processes can be detected in client talk during therapy that does not overtly target psychological flexibility as a change process and (2) to examine whether changes in detected levels of psychological flexibility are related to clinical outcomes.MethodA secondary data analysis was conducted in this study. The second, fourth and last sessions of Cognitive Behavioural Therapy (CBT) recordings from three participants were analysed in order to examine whether psychological flexibility could be identified in their speech. Additionally, a panel of judges (blinded to the actual clinical outcomes of the participants) made predictions about the therapy outcomes based on the analysed data.ResultsThe results showed that the psychological flexibility process can be reliably identified in the talk of participants who engage in CBT. It is unclear, however, whether accurate outcome predictions can be made based on the identified patterns of psychological flexibility.DiscussionThere is a large body of research supporting the notion that a number of well-established psychological treatments produce similar outcomes across different presentations and populations, which have led some authors to conclude that some therapeutic processes contributing to achieving therapeutic change are common across all psychological treatments. It has been argued that psychological flexibility is an important process of psychotherapeutic change, and the results of this study show that its components can be identified in CBT which does not explicitly target psychological flexibility. This finding provides a platform for future research into the role of psychological flexibility in facilitating psychotherapeutic change. However, whether accurate outcome predictions can be made based on the identified patterns of psychological flexibility remains unclear.Given that there are many similarities between ACT and CBT, it would be valuable to examine whether psychological flexibility can be also detected in therapies which do not have cognitive and behavioural roots, such as psychodynamic therapy. Additionally, further research should analyse the talk of participants whose clinical outcomes are more varied in order to examine the relationship between patterns of psychological flexibility identified in text and participants’ clinical outcomes.