Science-Based Psychotherapy

There is a new study out in the Journal Mindfulness entitled Mindfulness and Metta-based Trauma Therapy (MMTT): Initial Development and Proof-of-Concept of an Internet Resource. This pilot study tested the feasibility of an internet-based adjunctive intervention for addressing PTSD and related symptoms. Previous research has shown that a 12-week lovingkindness, or Metta, intervention was effective for reducing PTSD symptoms, with large effect sizes. This current study, in part, addressed whether similar effects could be found using an online intervention....

posted in caring | kindness | love

Excoriation or skin picking has often been in the shadow of its nearest relative, trichotillomania or repetitive hair pulling. One good thing to come out of the DSM-5 was that it finally made skin picking disorder an official diagnosis—excoriation. Prior to the DSM-5, there was no official diagnosis for this condition. I suspect the lack of official diagnosis slowed research into skin picking disorder. As a consequence, there are few published treatment studies for excoriation.


A recent study looked at the use of an acceptance-based protocol that was originally created for trichotillomania. The protocol is Woods & Twohig’s...

Numerous studies have now shown that Exposure and Response (or Ritual) Prevention (ERP) remains  our most effective treatment for obsessive-compulsive disorder (OCD).  In ERP, clients deliberately confront feared stimuli while learning to refrain from engaging in compulsions.


Even with the effectiveness of ERP, the search continues for how to get even better results, as not everyone benefits from ERP and some clients are resistant to it. Recent research on Acceptance and Commitment Therapy (ACT) suggests that other approaches—such as learning to observe obsessions without engaging or “buying into” the content of the obsessions—can supplement ERP. One of the core ideas of ACT is helping clients to mindfully...

In a previous post, I linked to a blog post about therapist reluctance to use exposure therapy. Exposure therapy is one of the most effective interventions for anxiety-related problems but, sadly, remains under-utilized by clinicians. It is an intervention that has been a major focus on my posts on this blog.


A recent study out of Drexel University looks at the role of...

Two recent randomized control trials seem to indicate that acceptance and commitment therapy (ACT) is a good option for people who have no benefitted from prior treatment. A lot of people don’t respond to their first round of treatment, so this is good news for a lot of people. This research adds to a growing list of studies showing that ACT is helpful across a large range of conditions and life difficulties. 


ACT outperforms CBT for people who had not previously responded to therapy

In a study published in July of 2014 the investigators compared group-based ACT to group-based CBT (treatment as usual) for 61 participants.  These participants came to the study with a range of diagnoses and all had participated in...

posted in ACT | RCT

Last week, University of Nevada - Reno professor Steve Hayes, PhD, came through Portland to conduct an intermediate Acceptance and Commitment Therapy (ACT) workshop. In anticipation of the visit, Dr. Hayes reached out to the Oregon chapter of the Association of Contextual Behavioral Science.


Through this outreach, Dr. Hayes agreed to be interviewed for the Oregon chapter. As president-elect of the Oregon chapter, I talked with Dr. Hayes about his thoughts on creating a strong and supportive community.


I think this interview will be of interest to anyone within the ACT community, and particularly those who, like Oregon, have created their own chapter or are thinking about creating a chapter. Dr. Hayes also...

posted in ACT

Eric Morris, PhD, a psychologist in Australia, wrote a really interesting blog post about therapist reluctance to use exposure.  As I’ve written about in previous posts, exposure therapy is one of the most effective interventions we have in treating anxiety-related disorders, such as OCD, phobias, and PTSD. Unfortunately, although exposure has been around for several decades, many therapists don’t use it.


As Dr. Morris writes:


Well, it isn’t just that many therapists use approaches that are not evidence-based. It seems that ...


Last Friday, Portland Psychotherapy research assistants Monica Bahan, Megan Cheslock, and Jackie Potter presented a research poster at the annual Western Psychological Association convention, which took place in Portland. Their poster detailed findings from one of our ongoing studies exploring the relationship between shame, guilt, and drinking behavior. The findings were based on the first 88 participants in the study, all volunteers from the Portland area.


Congratulations to Monica, Megan, and Jackie on their first presentation!

posted in shame

1. Insomnia can cause depression.

A collection of research suggests that untreated insomnia doubles the chance of developing depression, as a causal factor (4 sources – one, two, three, four)


2. Insomnia often does not resolve once the depression is treated or without focused insomnia treatment (...

posted in depression | insomnia

In a special issue of Behavior Therapy on “The Theory-Practice Gap in Cognitive Behavior Therapy,” Jonathan Abramowitz, PhD, authored an interesting paper on the importance of understanding theory when doing exposure therapy. Dr. Abramowitz is a well-respected OCD researcher, and I was attracted to this article as part of my ongoing interest in exposure therapy.


The article is lucid, well-written, and I think would be of value to anyone beginning to work with exposure therapy. He offers anecdotes about where therapists go wrong and makes a good argument for why understanding theory enhances exposure therapy. Dr. Abramowitz writes from a strictly cognitive behavior perspective, so this work does not cover...

posted in exposure | exposure therapy | OCD