Abstracts
Résumé
Cet article présente une vision de la santé mentale fondée sur le modèle de la flexibilité psychologique sur lequel repose la thérapie d’acceptation et d’engagement (ACT), une approche représentative de la troisième vague des thérapies cognitives-comportementales. Il vise à exposer la théorie et la pratique de l’ACT et à rendre compte de données empiriques qui soutiennent son utilisation clinique.Cet article présente une vision de la santé mentale fondée sur le modèle de la flexibilité psychologique sur lequel repose la thérapie d’acceptation et d’engagement (ACT), une approche représentative de la troisième vague des thérapies cognitives-comportementales. Il vise à exposer la théorie et la pratique de l’ACT et à rendre compte de données empiriques qui soutiennent son utilisation clinique.
Mots-clés :
- troisième vague,
- thérapie cognitive et comportementale (TCC),
- thérapie d’acceptation et d’engagement (ACT),
- efficacité thérapeutique,
- approches transdiagnostiques
Abstract
Objective: This paper presents a vision of mental health using the model of psychological flexibility of Acceptance and Commitment Therapy (ACT). ACT is a representative approach of the third wave of cognitive-behavioural therapy (CBT). This article first describes the theoretical and practical aspects of ACT and, in a second part, reviews some of the empirical data supporting its clinical use. Due to the high rate of comorbidity in mental health settings, transdiagnostic approaches in CBT, such as ACT, have recently become popular and particularly appealing to various clinical settings. Method: The theoretical aspects underlying ACT, as well as its clinical components in the treatment of psychopathology were described based on major books in this area, such as Hayes, Strosahl and Wilson (2012). A descriptive literature review was undertaken to explore the data on the efficacy of ACT for the treatment of mental health problems. Psycinfo and Medline, as well as the Association for Contextual Science website were analyzed for relevant articles. The key search terms were: “Acceptance and Commitment therapy” or “ACT” or “acceptance” or “mindfulness” or “defusion.” The reference lists of the articles retrieved were also analyzed. The articles that were not in English or French were excluded. Results: Data suggest that ACT is particularly effective for stress, anxiety disorders, depression, substance abuse and various chronic medical conditions. The six processes of the model of psychological flexibility have been validated based on the results of correlational and meditational studies. More than seventy randomized clinical trials and a meta-analysis including 18 randomized control trials conclude that ACT is more effective than waiting list, placebo and treatment as usual control conditions. Conclusion: ACT is a promising and evidence-based approach in mental health for the treatment of anxiety and depression as well as for complex and chronic conditions. More research is needed to further validate its theoretical model and further refine our understanding of how ACT could be effective for the management of mental health illness and how it could enhance quality of life for people who suffer from these conditions.
Keywords:
- third wave,
- cognitive behavior therapy (CBT),
- Acceptance and Commitment Therapy (ACT),
- therapeutic efficacy,
- transdiagnostic treatment
Appendices
Bibliographie
- Assagiolio, R. (1971). The act of will. New York : Viking.
- Baer, R. A. (dir.) (2010). Assessing mindfulness and acceptance processes in clients : Illuminating the theory and practice of change. Oakland : Context Press/New Harbinger Publications.
- Barlow, D. H., Allen, L. B. et Choate, M. L. (2004). Toward a Unified Treatment for Emotional Disorders. Behavior Therapy, 35(2), 205-230.
- Beck, A. T., Rush, J. A., Shaw, J. A. et Emery, G. (1979). Cognitive therapy of depression. New York : The Guilford Press.
- Bond, F. W., Hayes, S. C., Baer, R.A., Carpenter, K. M., Guenole, N., Orcutt, H. K., … et Zettle,R. D. (2011). Preliminary psychometric properties of the Acceptance andAction Questionnaire–II : A revised measure of psychologicalinflexibility and experiential avoidance. Behavior Therapy, 42(4), 676-688.
- Brown, T. A., Campbell, L. A.,Lehman, C. L., Grisham, J. R. et Mancill, R. B. (2001). Current andlifetime comorbidity of the DSM-IV anxiety and mood disorders in alarge clinical sample. Journal of Abnormal Psychology, 110(4), 585-599.
- Dahl, J. C., Plumb, J. C., Stewart, I. et Lundgren, T. (2009). Theart and science of valuing in psychotherapy : Helping clientsdiscover, explore, and commit to valued action using acceptance andcommitment therapy. Oakland : New Harbinger Publications.
- David, D. et Montgomery, G. H.(2010). The scientific status of psychotherapies : A newevaluative framework for evidence-based psychosocial interventions. Clinical Psychology : Science and Practice, 18, 89-98.
- Dionne, F. (2011). L’alliance thérapeutique dans les thérapies cognitivo-comportementales contemporaines. Psychologie Québec, 28(2), 24-28.
- Dymond, S., May, R. J., Munnelly, A.et Hoon, A. E. (2010). Evaluating the evidence based for relationalframe theory : A citation analysis. The Behavior Analyst, 33, 97-117.
- Eifert, G. H. et Forsyth, J. P. (2005). Acceptanceand commitment therapy for anxiety disorders : Apactitioner’s treatment guide to using mindfulness, acceptance,and values-based behavior change strategies. Oakland : New Harbinger Publications.
- Gaudiano, B. A., Herbert, J. D. etHayes, S. C. (2010). Is it the symptom or the relation to it ?Investigating potential mediators of change in acceptance andcommitment therapy for psychosis. Behavior Therapy, 41(4), 543-554.
- Harris, R. (2009). Le piège du bonheur. Montréal : Les Éditions de l’Homme.
- Harris, R. (2012). Passez à l’ACT : Pratique de la thérapie d’acceptation et d’engagement. Bruxelles : De Boeck.
- Hayes, S. C. (1984). Making sense of spirituality. Behaviorism, 12(2), 99-110.
- Hayes, S. C. (dir.). (1993). Analytic goals and the varieties of scientific contextualism. Reno : Context Press.
- Hayes, S. C., Barnes-Holmes, D. et Roche, B. (dir.) (2001). Relational frame theory : A post-Skinnerian account of human language and cognition. New York : Kluwer Academic/Plenum Publishers.
- Hayes, S. C. et Duckworth, M. P.(2006). Acceptance and Commitment Therapy and Traditional CognitiveBehavior Therapy Approaches to Pain. Cognitive and Behavioral Practice, 13(3), 185-187.
- Hayes, S. C., Luoma, J. B., Bond,F. W., Masuda, A. et Lillis, J. (2006). Acceptance and commitmenttherapy : Model, processes and outcomes. Behaviour Research and Therapy, 44(1), 1-25.
- Hayes, S. C., Strosahl, K. D. et Wilson, K. G. (1999). Acceptance and commitment therapy : An experiential approach to behavior change. New York : Guilford Press.
- Hayes, S. C., Strosahl, K. D. et Wilson, K. G. (2012). Acceptance and commitment therapy : The process and practice of mindful change (2e éd.). New York : Guilford Press.
- Hayes, S. C., Villatte, M., Levin,M. et Hildebrandt, M. (2011). Open, aware, and active : Contextualapproaches as an emerging trend in the behavioral and cognitivetherapies. Annual Review of Clinical Psychology, 7, 141-168.
- Hinton, M. G. et Gaynor, S. T.(2011). Cognitive defusion for psychological distress, dysphoria, andlow self-esteem : A randomized technique evaluation trial ofvocalizing strategies. International Journal of Behavioral Consultation and Therapy, 6(3), 164-185.
- Jacobson, N. S. (1997). Can contextualism help ? Behavior Therapy, 28, 235-243.
- Kohl, A., Rief, W. et Glombiewski,J. A. (2012). How effective are acceptance strategies ? Ameta-analytic review of experimental results. Journal of Behavior Therapy and Experimental Psychiatry, 43(4), 988-1001.
- Levin, M. E., Hildebrandt, M. J.,Lillis, J. et Hayes, S. C. (2012). The impact of treatment componentssuggested by the psychological flexibility model : A meta-analysisof laboratory-based component studies. Behavior Therapy, 43, 741-756.
- Lundgren, T., Luoma, J. B., Dahl, J.,Strosahl, K. et Melin, L. (2012). The Bull’s-Eye ValuesSurvey : A psychometric evaluation. Cognitive and Behavioral Practice, 19(4), 518-526.
- Luoma, J. B., Hayes, S. C. et Walser, R. D. (2007). Learning ACT : An acceptance and commitment therapy skills-training manual for therapists. Oakland : New Harbinger Publications.
- Mansell, W., Harvey, A., Watkins, E. et Shafran, R. (2009). Conceptual foundations of the transdiagnostic approach to CBT. Journal of Cognitive Psychotherapy, 23(1), 6-19.
- Masuda, A., Hayes, S. C., Sackett, C.F. et Twohig, M. P. (2004). Cognitive defusion and self-relevantnegative thoughts : Examining the impact of a ninety year oldtechnique. Behaviour Research and Therapy, 42(4), 477-485.
- Masuda, A., Hayes, S. C., Twohig, M.P., Drossel, C., Lillis, J. et Washio, Y. (2009). A parametric study ofcognitive defusion and the believability and discomfort of negativeself-relevant thoughts. Behavior Modification, 33(2), 250-262.
- Monestès, J.-L. et Villatte, M. (2011). La thérapie d’acceptation et d’engagement, ACT. Paris : Masson.
- Monestès, J. L., Villatte, M.,Mouras, H., Loas, G. et Bond, F. W. (2009). Traduction et validationfrançaise du questionnaire d’acceptation et d’action(AAQ-II). [French translation and validation of the Acceptance etAction Questionnaire (AAQ-II).] European Review of Applied Psychology/Revue européenne de psychologie appliquée, 59(4), 301-308. doi : 10.1016/j.erap.2009.09.001
- Neveu, C. et Dionne, F. (2010). Lathérapie d’acceptation et d’engagement. [Acceptanceand commitment therapy.] Revue québécoise de psychologie, 31(3), 63-83.
- Öst. (2008). Efficacy of the third wave of behavioral therapies : A systematic review and meta-analysis. Behaviour Research and Therapy, 46(3), 296-321.
- Pierson, H. et Hayes, S. C. (dir.) (2007). Using acceptance and commitment therapy to empower the therapeutic relationship. New York : Routledge/Taylor et Francis Group.
- Powers, M. B., Vörding, Z. V. S.et Emmelkamp, P. M. G. (2009). Acceptance and Commitment Therapy :A meta-analytic review. Psychotherapy and Psychosomatics, 78, 73-80.
- Ruiz, F. J. (2010). A review ofAcceptance and Commitment Therapy (ACT) empirical evidence :Correlational, experimental psychopathology, component and outcomestudies. International Journal of Psychology and Psychological Therapy, 10, 125-162.
- Schoendorff, B., Grand, J. et Bolduc, M.-F. (2011). La thérapie d’acceptation et d’engagement : guide clinique. Bruxelles : De Boeck.
- Smout, M., Hayes, L., Atkins, P. W.B., Klausen, J. et Duguid, J. E. (2012). The empirically supportedstatus of acceptance and commitment therapy : An update. Clinical Psychologist, 16(3), 97-109.
- Törneke, N. (2010). Learning RFT : an introduction to relational frame theory and its clinical applications. United States of America.
- Tsai, M., Kohlenberg, R. J., Kanter, J. W., Kohlenberg, B., Follette, W. C. et Callaghan, G. M. (dir.) (2009). A guide to functional analytic psychotherapy : Awareness, courage, love, and behaviorism. New York : Springer Science + Business Media.
- Wilson, K. G. et Dufrene, T. (2011). Mindfulness for Two : An Acceptance and Commitment Therapy Approach to Mindfulness in Psychotherapy. United States : New Harbinger Publications.
- Wilson, K. G., Sandoz, E. K.,Kitchens, J. et Roberts, M. E. (2010). The Valued LivingQuestionnaire : Defining and measuring valued action within abehavioral framework. The Psychological Record, 60, 249-272.
- Zettle, R. D., Rains, J. C. et Hayes,S. C. (2011). Processes of change in acceptance and commitment therapyand cognitive therapy for depression : A mediation reanalysis ofZettle and Rains. Behavior Modification, 35(3), 265-283.