Desfusão cognitva na Terapia de Aceitação e Compromisso (ACT): o processo de mudança clínica
Year: 2020
Type: dissertation
Abstract: Acceptance and Commitment Therapy (ACT) has progressively acquired the interest of researchers and clinicians.However, some difficulties may arise when it is presented through the Psychological Flexibility Model, described through six middle-level terms (acceptance, cognitive defusion, contact with the present moment, self-as-context, values and committed action).Especially relevant is the lack of clarity surrounding the link between each of these concepts and the underlying process of clinical change in basic behavioral processes.Because such link is necessary for the pragmatic utility of middle-level terms, regarding both teaching and clinical practice, the clarification of the link is essential.The present thesis' objective is to increase the pragmatic value of the term "cognitive defusion" by (a) increasing its precision through the clarification of the link between this middle-level term and basic behavioral processes; and (b) to aid the in-session implementation by creating guidelines to idiographic, functional-analytic moment-by-moment decision-making for the therapist during in-session client-therapist interaction.In order to do that, four studies were conducted.The first one consists of an exploratory literature review of the concept "cognitive defusion" in the ACT literature and a critical conceptual analysis of the results based on behavior analytic body of knowledge, which lead to a new conceptualization of the term.From the implications of this conceptualization, an experimental analog was done in which two exercises to promote cognitive defusion were directly compared and their results regarding dependent measures of pain and escape in an approach-escape conflict task (Study II).Another implication of Study I was the use of task analysis methodology to describe how ACT therapists promote cognitive defusion in session.In order to do so, first a rational model on how therapists promote cognitive defusion in session was constructed, as well as a categorization system of the therapist's and the client's in-session speech in order to analyze the model quantitatively (Study III).Afterwards, a clinical study was done, in which therapy sessions to promote cognitive defusion were recorded, transcribed, categorized and analyzed quantitatively and qualitatively, refining the theoretical model based on the gathered data (Study IV).
Author: Daniel Afonso Assaz
Language: Portuguese
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
Funder: Universidade de São Paulo
OpenAlex ID: W4205813612