مقایسه اثربخشی ماتریکس درمان ‌پذیرش و تعهد با درمان ‌پذیرش و تعهد متمرکز بر‌شفقت بر اختلال اضطراب اجتماعی

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشجوی دکتری روان‌شناسی بالینی، گروه روان‌شناسی، واحد شیراز، دانشگاه آزاد اسلامی، شیراز، ایران

2 دکتری روان‌شناسی بالینی، استادیار گروه روان‌شناسی، واحد شیراز، دانشگاه آزاد اسلامی، شیراز، ایران

3 دکتری روان‌شناسی، استادیار گروه روا‌‌ن‌شناسی، واحد شیراز، دانشگاه آزاد اسلامی، شیراز، ایران

چکیده

مقدمه: اختلال اضطراب اجتماعی بسیار ناتوان کننده است که به مختل شدن بسیاری از جنبه­های زندگی، و در موارد شدید به کاهش کیفیت زندگی فرد منجر می­شود. بنابراین بکارگیری درمان­ تجربی فراتشخیصی یکپارچه­نگر ضروری می­باشد. این پژوهش با هدف ارزیابی و مقایسه اثربخشی ماتریکس درمان پذیرش و تعهد و درمان پذیرش و تعهد متمرکز بر شفقت بر اضطراب اجتماعی، انعطاف­پذیری پذیرش و عمل، زندگی ارزشمند و شفقت به­خود انجام شد.
مواد و روش­ها: پژوهش حاضر از نوع کارآزمایی بالینی با طرح آزمایشی تک آزمودنی با خط پایه چندگانه ناهمزمان بود که به­روش نمونه­گیری هدفمند در طی 12 جلسه 60 دقیقه­ای، با پیگیری2 ماهه بر روی 6 دانشجوی مبتلا به­اختلال اضطراب اجتماعی اجرا شد. برای مقایسه نتایج این دو الگوی درمانی یکپارچه­نگر، از مقیاس اضطراب اجتماعی لیبویتز، هیمبرگ و همکاران، (1999)، پرسشنامۀ انعطاف­پذیری پذیرش و عمل- نسخۀ دوم بوند، و­ همکاران (2011)، پرسشنامۀ زندگی ارزشمند ویلسون و همکاران (2010) و مقیاس خود شفقت­ورزی- فرم کوتاه ریس و همکاران (2011)، استفاده شد. داده­ها با روش ترسیم دیداری، درصد بهبودی، شاخص تغییر پایا و شاخص­های شش­گانه کارایی بالینی تحلیل شدند.
یافته­ها: نتایج نشان داد که هر دو روش ماتریکس درمان پذیرش و تعهد و درمان پذیرش و تعهد متمرکز بر شفقت در کاهش اضطراب اجتماعی (1.96->Z) و افزایش انعطاف­پذیری پذیرش و عمل، خود شفقت­ورزی و زندگی ارشمند در مرحلۀ آخر درمان و مرحلۀ پیگیری موثر و معنادار است (1.96Z>). همچنین نتایج این پژوهش در مرحله پیگیری نیز نشان دهندۀ تداوم اثربخشی و کارایی این دو مداخله یکپارچه­نگر بر اختلال اضطراب اجتماعی بود.
 بحث و نتیجه­گیری: این پژوهش از اثربخشی و کارایی بالینی ماتریکس درمان پذیرش و تعهد و درمان پذیرش و تعهد متمرکز بر شفقت در دانشجویان با اختلال اضطراب اجتماعی حمایت می­کند.

کلیدواژه‌ها


عنوان مقاله [English]

Comparison of the Affectiveness of ACT Matrix with ACT Focused on Compassion on Social Anxiety Disorder

نویسندگان [English]

  • hamid asadi 1
  • Masoud Mohammadi 2
  • Ghasem naziri 2
  • Azam Davoodi 3
1 Ph.D. Student in Clinical Psychology, Department of psychology, Shiraz Branch, Islamic Azad University, Shiraz, Iran
2 Assistant Professor, Department of Psychology, Shiraz Branch, Islamic Azad University, Shiraz, Iran
3 Assistant Professor, Department of Psychology, Shiraz Branch, Islamic Azad University, Shiraz, Iran
چکیده [English]

Introduction and aim:Social anxiety disorder is one of the most difficult anxiety disorders in resistance to therapy.Therefore, the use of unified transdiagnostic experimental therapy is essential.The present study aimed to evaluate the effectiveness of the ACT Matrix and ACT Focused on Compassion on social anxiety disorder.
Methods: This study was a clinical trial with a single-case experimental study non-concurrent multiple baseline design, who performed on 6 students with social anxiety disorder who were selected based on purposive random sampling. The treatment lasted for 12 sessions (60 minutes) with two-month follow-up. To compare the results of these two treatment models, the Social Anxiety Scale (Liebowitz),Self-Compassion Scale-Short Form (Raes & et ‌‌al) Acceptance and Action Questionnaire (Second Version, Bond & et‌ al) and the Valued Living Questionnaire (Wilson & et ‌al) were used. Data were analyzed by visual drawing, recovery percentage,stable change index and six indicators of clinical efficiency.
Findings:The results indicated that both methods of ACT Matrix and ACT Focused on Compassion reduced social anxiety (Z< -1.96) and increased acceptance and action flexibility, self-compassion, and a valuable life in the last stage of therapy and follow-up is effective and significant (Z>1.96). Furthermore, the results of this study in the follow-up phase indicated the continuity of the effectiveness and efficiency of these two integrated interventions on social anxiety disorder.
Conclusion:This study supports the effectiveness of the Matrix of Acceptance and Commitment Therapy and the treatment of compassion-focused acceptance and commitment in students with social anxiety disorder.

کلیدواژه‌ها [English]

  • Social Anxiety
  • Self-Compassion
  • Valuable Living
  • Acceptance and Commitment Therapy Matrix
  • Compassion-focused Acceptance and Commitment Therap
  1. Caouette JD, Guyer AE. Gaining insight into adolescent vulnerability for social anxiety from developmental cognitive neuroscience. Dev Cogn Neurosci. 2014; 8:65-76. https://doi.org/10.1016/j.dcn.2013.10.003
  2. Rapee RM, MacLeod C, Carpenter L, Gaston JE, Frei J, Peters L, et al. Integrating cognitive bias modification into a standard cognitive behavioural treatment package for social phobia: A randomized controlled trial. Behav Res Ther. 2013; 51 (4):207-15. https://doi.org/10.1016/j.brat.2013.01.005
  3. Taylor JH, Landeros-Weisenberger A, Coughlin C, Mulqueen J, Johnson JA, Gabriel D, et al. Ketamine for Social Anxiety Disorder: A Randomized, Placebo-Controlled Crossover Trial. Neuropsychopharmacology. 2018; 43 (2):325-33. https://doi.org/10.1038/npp.2017.194
  4. Edition F. Diagnostic and statistical manual of mental disorders. Am Psychiatric Assoc. 2013; 21. https://www.psychiatry.org/psychiatrists/practice/dsm
  5. Dryman MT, Gardner S, Weeks JW, Heimberg RG. Social anxiety disorder and quality of life: How fears of negative and positive evaluation relate to specific domains of life satisfaction. J Anxiety Disord. 2016; 38:1-8. https://doi.org/10.1016/j.janxdis.2015.12.003
  6. Alvi T, Kouros CD, Lee J, Fulford D, Tabak BA. Social anxiety is negatively associated with theory of mind and empathic accuracy. J Abnorm Psychol. 2020; 129 (1):108. https://doi.org/10.1037/abn0000493
  7. Rapee RM, Schniering CA, Hudson JL. Anxiety Disorders During Childhood and Adolescence: Origins and Treatment. Ann Rev Clin Psych. 2009; 5 (1):311-41. https://doi.org/10.1146/annurev.clinpsy.032408.153628
  8. Spence SH, Donovan CL, March S, Kenardy JA, Hearn CS. Generic versus disorder specific cognitive behavior therapy for social anxiety disorder in youth: A randomized controlled trial using internet delivery. Behav Res Ther. 2017; 90:41-57. https://doi.org/10.1016/j.brat.2016.12.003
  9. Kuckertz JM, Gildebrant E, Liliequist B, Karlström P, Väppling C, Bodlund O, et al. Moderation and mediation of the effect of attention training in social anxiety disorder. Behav Res Ther. 2014; 53:30-40. https://doi.org/10.1016/j.brat.2013.12.003
  10. Demir T, Karacetin G, Eralp Demir D, Uysal O. Prevalence and Some Psychosocial Characteristics of Social Anxiety Disorder in an Urban Population of Turkish Children and Adolescents. Eur Psychiatry. 2012; 28 (1):64-9. https://doi.org/10.1016/j.eurpsy.2011.12.003
  11. Hacker T, Stone P, MacBeth A. Acceptance and commitment therapy – Do we know enough? Cumulative and sequential meta-analyses of randomized controlled trials. J Affect Disord. 2016; 190:551-65. https://doi.org/10.1016/j.jad.2015.10.053
  12. Kennedy AE, Whiting SW, Dixon MR. Improving novel food choices in preschool children using acceptance and commitment therapy. Journal of Contextual Behavioral Science. 2014; 3 (4):228-35. https://doi.org/10.1016/j.jcbs.2014.10.002
  13. Bennett R, Oliver JE. Acceptance and commitment therapy: 100 key points and techniques: Routledge; 2019. https://doi.org/10.4324/9781351056144
  14. Sloshower J, Guss J, Krause R, Wallace RM, Williams MT, Reed S, et al. Psilocybin-assisted therapy of major depressive disorder using Acceptance and Commitment Therapy as a therapeutic frame. Journal of Contextual Behavioral Science. 2020; 15:12-9. https://doi.org/10.1016/j.jcbs.2019.11.002
  15. Werner H, Young C, Hakeberg M, Wide U. A behavioural intervention for young adults with dental caries, using acceptance and commitment therapy (ACT): treatment manual and case illustration. BMC Oral Health. 2020; 20 (1):233. https://doi.org/10.1186/s12903-020-01213-4
  16. Harley J. Bridging the Gap between Cognitive Therapy and Acceptance and Commitment Therapy (ACT). Procedia - Social and Behavioral Sciences. 2015; 193:131-40. https://doi.org/10.1016/j.sbspro.2015.03.252
  17. Kohlenberg RJ, Tsai M, Kuczynski AM, Rae JR, Lagbas E, Lo J, et al. A brief, interpersonally oriented mindfulness intervention incorporating Functional Analytic Psychotherapy׳s model of awareness, courage and love. Journal of Contextual Behavioral Science. 2015; 4 (2):107-11. https://doi.org/10.1016/j.jcbs.2015.03.003
  18. Wilson KG. Mindfulness for two: An acceptance and commitment therapy approach to mindfulness in psychotherapy: New Harbinger Publications; 2009. https://psycnet.apa.org/record/2009-11521-000
  19. Eifert GH, Forsyth JP. Acceptance and commitment therapy for anxiety disorders: A practitioner's treatment guide to using mindfulness, acceptance, and values-based behavior change: New Harbinger Publications; 2005. https://psycnet.apa.org/record/2005-08147-000
  20. Lev A, McKay M. Acceptance and commitment therapy for couples: A clinician's guide to using mindfulness, values, and schema awareness to rebuild relationships. Oakland, CA, US: Context Press/New Harbinger Publications; 2017. 2-10 p. https://psycnet.apa.org/record/2017-15578-000
  21. Callaghan GM, Darrow SM. The role of functional assessment in third wave behavioral interventions: foundations and future directions for a fourth wave. Current Opinion in Psychology. 2015; 2:60-4. https://doi.org/10.1016/j.copsyc.2014.12.005
  22. Gilbert P. An Introduction to Compassion Focused Therapy in Cognitive Behavior Therapy. Int J Cogn Ther. 2010; 3 (2):97-112. https://doi.org/10.1521/ijct.2010.3.2.97
  23. Ozdemir B, Nesrin S. Examining the factors of self-compassion scale with canonical commonality analysis: Syrian sample. Eurasian Journal of Educational Research. 2017; 17 (70):19-36. http://dx.doi.org/10.14689/ejer.2017.70.2
  24. Neff K. Self-Compassion: An Alternative Conceptualization of a Healthy Attitude Toward Oneself. Self and Identity. 2003; 2 (2):85-101. https://doi.org/10.1080/15298860309032
  25. Gilbert P. Introducing compassion-focused therapy. Advances in Psychiatric Treatment. 2018; 15 (3):199-208. https://doi.org/10.1192/apt.bp.107.005264
  26. Irons C, Lad S. Using compassion focused therapy to work with shame and self-criticism in complex trauma. Australian Clinical Psychologist. 2017; 3 (1):1743. https://acp.scholastic.ahq.com/article/1743
  27. Leaviss J, Uttley L. Psychotherapeutic benefits of compassion-focused therapy: An early systematic review. Psychol Med. 2015; 45 (5):927-45. https://doi:10.1017/S0033291714002141
  28. Boersma K, Håkanson A, Salomonsson E, Johansson I. Compassion Focused Therapy to Counteract Shame, Self-Criticism and Isolation. A Replicated Single Case Experimental Study for Individuals With Social Anxiety. Journal of Contemporary Psychotherapy. 2015; 45 (2):89-98. https://doi.org/10.1007/s10879-014-9286-8
  29. Burton M, Schmertz SK, Price M, Masuda A, Anderson PL. The Relation Between Mindfulness and Fear of Negative Evaluation Over the Course of Cognitive Behavioral Therapy for Social Anxiety Disorder. J Clin Psychol. 2013; 69 (3):222-8. https://doi.org/10.1002/jclp.21929
  30. Esmaeili L, Amiri S, Reza Abedi M, Molavi H. The Effect of Acceptance and Commitment Therapy Focused on Self-Compassion on Social Anxiety of Adolescent Girls. Clinical Psychology Studies. 2018; 8 (30):117-37. https://dx.doi.org/10.22054/jcps.2018.8605
  31. Roohi R, Soltani AA, Zinedine Meimand Z, Razavi Nematollahi V. The Effect of Acceptance and Commitment Therapy (ACT) on Increasing the Self-Compassion, Distress Tolerance, and Emotion Regulation in Students with Social Anxiety Disorder. Quarterly Journal of Child Mental Health. 2019; 6 (3):173-87. https://dx.doi.10.29252/jcmh.6.3.16
  32. Poursaleh A, HAMID N, DAVODI I. The effectiveness of Compassion Mind Training (CMT) on social anxiety Symptoms & psychological capitals among female students with social anxiety disorder of Shahid Chamran University of Ahvaz. 2020. https://www.sid.ir/en/journal/ViewPaper.aspx?id=776802
  33. Polk KL, Schoendorff B. The ACT matrix: A new approach to building psychological flexibility across settings and populations. Polk KL, Schoendorff B, editors. Oakland, CA, US: Context Press/New Harbinger Publications; 2014. 1-6 p. https://psycnet.apa.org/record/2014-20372-000
  34. Polk KL, Schoendorff B, Webster M, Olaz FO. The essential guide to the ACT Matrix: A step-by-step approach to using the ACT Matrix model in clinical practice: New Harbinger Publications; 2016. https://contextualscience.org/publications/the_essential_guide_to_the_act_matrix_a_stepbystep
  35. Mirsharifa SM, Mirzaian B, Dousti Y. The Efficacy of Acceptance and Commitment Therapy (ACT) Matrix on Depression and Psychological Capital of the Patients with Irritable Bowel Syndrome. Open Access Maced J Med Sci. 2019; 7 (3):421-7. https://doi.org/10.3889/oamjms.2019.076
  36. Nelson C. University student anxiety and stress–exploring the feasibility, suitability, and benefits of ACT matrix group workshops for university students experiencing anxiety and stress: Laurentian University of Sudbury; 2020. https://zone.biblio.laurentian.ca/handle/10219/3402
  37. Peyamannia B. The Effectiveness of ACT Matrix with compassion on cognitive emotion regulation strategy in Students with Test Anxiety Disorders. The Journal of New Thoughts on Education. 2021; 16 (4):217-36. https://doi:10.22051/jontoe.2020.24026.2494
  38. Fletcher L, Hayes SC. Relational frame theory, acceptance and commitment therapy, and a functional analytic definition of mindfulness. J Ration Emot Cogn Behav Ther. 2005; 23 (4):315-36. https://doi.org/10.1007/s10942-005-0017-7
  39. Hayes SC. The roots of compassion. Chicago: Keynote: the fourth Acceptance and Commitment Therapy Summer Institute; 2008. http://www.globalpres.com/mediasite/Viewer/?peid=017fe6ef4b1544279d8cf27
  40. Gilbert P. Training our minds in, with and for compassion. An introduction to concepts and compassion-focused exercises. Retrieved on. 2010; 21:2016. https://www.getselfhelp.co.uk/docs/GILBERT-COMPASSION-HANDOUT.pdf
  41. First MB, Williams JB, Karg RS, Spitzer RL. User's guide for the SCID-5-CV Structured Clinical Interview for DSM-5® disorders: Clinical version: American Psychiatric Publishing, Inc.; 2016. https://www.appi.org/products/structured-clinical-interview-for-dsm-5-scid-5
  42. Heimberg RG, Horner KJ, Juster HR, Safren SA, Brown EJ, Schneier FR, et al. Psychometric properties of the Liebowitz Social Anxiety Scale. Psychol Med. 1999; 29 (1):199-212. https://doi.org/10.1017/S0033291798007879
  43. Hassani J, Fayyazi M, Akbari A. Reliability, Validity, and Confirmatory Factor Structure of Persian Version of Liebowitz Social Anxiety Scale (LSAS). Social Psychology Research Quarterly. 2016; 6 (24):35-5 (In Persian). https://www.magiran.com/paper/1661657
  44. Baker SL, Heinrichs N, Kim H-J, Hofmann SG. The Liebowitz social anxiety scale as a self-report instrument: a preliminary psychometric analysis. Behav Res Ther. 2002; 40 (6):701-15. https://doi.org/10.1016/S0005-7967(01)00060-2
  45. Liebowitz MR, Heimberg RG, Fresco DM, Travers J, Stein MB. Social Phobia or Social Anxiety Disorder: What's in a Name? Arch Gen Psychiatry. 2000; 57 (2):191-2. https://doi:10.1001/archpsyc.57.2.191-a
  46. Bond FW, Hayes SC, Baer RA, Carpenter KM, Guenole N, Orcutt HK, et al. Preliminary Psychometric Properties of the Acceptance and Action Questionnaire–II: A Revised Measure of Psychological Inflexibility and Experiential Avoidance. Behav Ther. 2011; 42 (4):676-88. https://doi.org/10.1016/j.beth.2011.03.007
  47. Abbasi E, Fti L, Molodi R, Zarabi H. Psychometric properties of Persian version of acceptance and action questionnaire-II. JOURNAL OF PSYCHOLOGICAL MODELS AND METHODS. 2013; 3 (10):65-80. https://www.sid.ir/EN/JOURNAL/VIEWPAPER.ASPX?ID=365235
  48. Raes F, Pommier E, Neff KD, Van Gucht D. Construction and factorial validation of a short form of the Self-Compassion Scale. Clin Psychol Psychother. 2011; 18 (3):250-5. https://doi.org/10.1002/cpp.702
  49. Ghorbani N, Watson PJ, Chen Z, Norballa F. Self-Compassion in Iranian Muslims: Relationships With Integrative Self-Knowledge, Mental Health, and Religious Orientation. The International Journal for the Psychology of Religion. 2012; 22 (2):106-18. https://doi.org/10.1080/10508619.2011.638601
  50. Wilson KG, Sandoz EK, Kitchens J, Roberts M. The Valued Living Questionnaire: Defining and Measuring Valued Action within a Behavioral Framework. The Psychological Record. 2010; 60 (2):249-72. https://doi.org/10.1007/BF03395706
  51. AKBARI M. The Reliability and Validity of Persian version of the Valued Living Questionnaire: based on Acceptance and Commitment approach. CLINICAL PSYCHOLOGY & PERSONALITY (DANESHVAR RAFTAR). 2018; 16 (1):239-49. https://www.sid.ir/en/journal/ViewPaper.aspx?id=741926
  52. Ingram RE, Hayes A, Scott W. Empirically supported treatments: A critical analysis. Handbook of psychological change: Psychotherapy processes & practices for the 21st century. Hoboken, NJ, US: John Wiley & Sons, Inc.; 2000. p. 40-60. https://psycnet.apa.org/record/2001-00353-003
  53. Fisher WW, Kelley ME, Lomas JE. VISUAL AIDS AND STRUCTURED CRITERIA FOR IMPROVING VISUAL INSPECTION AND INTERPRETATION OF SINGLE-CASE DESIGNS. J Appl Behav Anal. 2003; 36 (3):387-406. https://doi.org/10.1901/jaba.2003.36-387
  54. Eisen SV, Ranganathan G, Seal P, Spiro A. Measuring Clinically Meaningful Change Following Mental Health Treatment. The Journal of Behavioral Health Services & Research. 2007; 34 (3):272-89. https://doi.org/10.1007/s11414-007-9066-2
  55. Hamidpour H. The importance of methodology in cognitive behavioral research. Baztab-e Danesh. 2008; 3 (10):49-56 (In Persian).
  56. Yabandeh MR, Bagholi H, Sarvghad S, Kouroshnia M. Comparing the Effectiveness of Cognitive Behavioral Therapy with Acceptance and Commitment Therapy on Reduction of Social Anxiety Disorder Symptoms. 2019. https://doi.20.1001.1.22285516.1398.10.36.10.7
  57. Khani ZO, Moghadam MF. Effect of Acceptance and Commitment Group Therapy on Social Ad-justment and Social Phobia Among Physically-Disabled Persons. http://rehabilitationj.uswr.ac.ir/article-1-1942-en.html
  58. Craske MG, Niles AN, Burklund LJ, Wolitzky-Taylor KB, Vilardaga JCP, Arch JJ, et al. Randomized controlled trial of cognitive behavioral therapy and acceptance and commitment therapy for social phobia: outcomes and moderators. J Consult Clin Psychol. 2014; 82 (6):1034. https://doi.org/10.1037/a0037212
  59. Werner KH, Jazaieri H, Goldin PR, Ziv M, Heimberg RG, Gross JJ. Self-compassion and social anxiety disorder. Anxiety, Stress, & Coping. 2012; 25 (5):543-58. https://doi.org/10.1080/10615806.2011.608842
  60. Allen AB, Leary MR. Self-Compassion, Stress, and Coping. Soc Personal Psychol Compass. 2010; 4 (2):107-18. https://doi.org/10.1111/j.1751-9004.2009.00246.x
  61. Heimberg RG, Brozovich FA, Rapee RM. Chapter 15 - A Cognitive Behavioral Model of Social Anxiety Disorder: Update and Extension. In: Hofmann SG, DiBartolo PM, editors. Social Anxiety (Second Edition). San Diego: Academic Press; 2010. p. 395-422. https://doi.org/10.1016/B978-0-12-375096-9.00015-8
  62. Baumeister RF, Bratslavsky E, Finkenauer C, Vohs KD. Bad is Stronger than Good. Rev Gen Psychol. 2001; 5 (4):323-70. https://doi.org/10.1037/1089-2680.5.4.323
  63. Fredrickson BL. The role of positive emotions in positive psychology. Am Psychol. 2010; 56:218-26. https://doi.org/10.1037/0003066X.56.3.218
  64. Hazavei F, Robatmeili S. The Effect of "Acceptance and Commitment Therapy" on Psychological Flexibility and Behavioral Inhibition of Adolescents with Social Anxiety Disorder. Journal of Health Promotion Management. 2019; 8 (6):18-29. http://jhpm.ir/article-1-1016-en.html
  65. Zare H. Effectiveness of acceptance and commitment therapy (ACT) on improving the flexibility and cognitive fusion. Social Cognition. 2017; 6 (1):125-34. http://sc.journals.pnu.ac.ir/article_3880_657.html?lang=fa
  66. Azadeh SM, Kazemi-Zahrani H, Besharat MA. Effectiveness of acceptance and commitment therapy on interpersonal problemsand psychological flexibility in female high school students with social anxiety disorder. Global journal of health science. 2016; 8 (3):131-8. https://doi.org/10.5539/gjhs.v8n3p131
  67. Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J. Acceptance and Commitment Therapy: Model, processes and outcomes. Behav Res Ther. 2006; 44 (1):1-25. https://doi.org/10.1016/j.brat.2005.06.006
  68. Besharat MA, Ali Bakhshi Z, Movahedi Nasab AA. Mediation effect of anger rumination on the relationship between dimensions of anger and anger control with physical ill-health. Contemporary Psychology. 2011; 5 (2):3-14 (In Persian). http://ensani.ir/fa/article/343482
  69. Tirch D, Schoendorff B, Silberstein LR. The ACT practitioner's guide to the science of compassion: Tools for fostering psychological flexibility: New Harbinger Publications; 2014. https://contextualscience.org/publications/the_act_practitioners_guide_to_the_science_of_comp
  70. Bagley S. Train your mind: Change your brain. Ballantine Books. New York; 2008. https://www.goodreads.com/book/show/51368.Train_Your_Mind_Change_Your_Brain
  71. Cox BJ, Fleet C, Stein MB. Self-criticism and social phobia in the US national comorbidity survey. J Affect Disord. 2004; 82 (2):227-34. https://doi.org/10.1016/j.jad.2003.12.012
  72. Lutz A, Slagter HA, Dunne JD, Davidson RJ. Attention regulation and monitoring in meditation. Trends Cogn Sci. 2008; 12 (4):163-9. https://doi.org/10.1016/j.tics.2008.01.005
  73. Hofmann SG, Hayes SC. The Future of Intervention Science: Process-Based Therapy. Clinical Psychological Science. 2019; 7 (1):37-50. https://doi.org/10.1177/2167702618772296