Conclusions on ACT and CBT in Prisoner Population

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Risk-Need-Responsivity principles (RNR, Andrews & Bonta, 2006) have garnered much research, although the effectiveness of such approaches is ______

unclear

Third wave therapies are sensitive to the context and functions of psychological states rather than form and content that would usually be the focus of treatment in more traditional cognitive behavioral approaches. Several concepts key to third wave therapies such as acceptance, defusion, clarification of values and psychological flexibility may be especially useful in working with ______ populations

forensic

Experiential avoidance has been found to be related to interpersonal problems. ACT, founded upon the theory of contextual functionalism (for review see Hayes, 2004), is an evidence-based contextual cognitive-behavioral ______

approach

Interestingly, reduction in aggression was mediated by reduction in emotional avoidance, a key mechanism of change within the ACT ______

model

Individuals who have been involved with the criminal justice system are often high risk for repeat criminal behavior, mental health problems, significant relationship distress, low social support, and severe substance abuse. However, the implementation of effective interventions and rehabilitative programs for these individuals is often challenging due to the punishment and control-oriented culture of ______

corrections

Jim presented as highly guarded due to his history of physical, emotional, and sexual abuse as a ______

child

Jim's immediate family history of alcoholism and his own abuse history as a ______ were important factors addressed by the ACT clinician to model psychological flexibility and address Jim's suppression of emotions, criminogenic thinking, Antisociality, and lack of empathy towards victims and peers in session.

child

Jim was able to notice times when he was angered and gained depth of perspective through the core process of Self-as-Context, which reinforced his ability to bring total awareness of uncontrollable past and present events in his life without getting caught up in these events.

TFPs

Through Defusion interventions, Jim learned to reduce the impact of his judgmental thinking by changing his responses to the thoughts versus the thoughts alone, helping him let go of the struggle he has trying to control his ______.

TFPs

Facilitating prosocial change through purposeful living, Jim emphasized the importance of integrity and being seen as more than just a person with sex offenses, aiming for people to see him as someone who can change, which made him more approachable when he didn't control his ______.

TFPs

ACT stands for Acceptance and Commitment ______

Therapy

Creating a strong therapeutic relationship is key for any ______

Intervention

Values clarification overlaps nicely with the responsivity portion of the Risk-Needs-Responsivity rehabilitation model by matching a forensic client’s learning style, motivation and ______

Skills

Symptom reduction is never the goal of ACT; symptoms typically abate when clients act on valued living in the presence of these public or private symptomatic ______

Experiences

High rate of individuals diagnosed with mental health disorders in prisons – GLOBAL ______

Issue

ACT can range from time-limited sessions to long-term ______

Interventions

ACT focuses on increasing purposeful living through psychological ______

Flexibility

In 2023, more than 10 million people worldwide are estimated to be ______

Affected

The ACT clinician accomplishes this by helping their clients mindfully identify and intervene with their avoidant strategies to TFPs, and assigns S.M.A.R.T. Specific, Measurable, Attainable, Realistic, and ______ – Goals

Timely

Creating a Values Masterpiece This is a powerful way for clinicians to help forensic clients identify their core values. This values clarification exercise is actually an art project involving household magazines, construction paper, safety scissors, and ______ sticks.

Glue

ACT clinicians can assist clients in promoting prosocial behavioral choices by implementing S.M.A.R.T. goals to facilitate risk-mitigating and life-affirming change. One identified method to help clients delineate what is within their power to change is Hands of Control. Here, clients are asked to identify a particular psychosocial stressor. Opening up their left palm, they identify whether the stressor involves futile attempts to control ______.

TFPs

Therapist training is not required for non-mental health professionals who desire to learn ACT. However, for those who work in the mental health profession and use ACT, at minimum a Bachelors degree-level training in psychology is recommended. Beyond this level of education, ACT training through graduate-level coursework teaching the theory behind this mindfulness-based psychotherapy is becoming increasingly popular. ACT has been empirically validated to address a wide range of populations, life difficulties, and psychopathologies. ACT emphasizes the normality of human suffering experienced by humankind, and the lengths individuals go to avoid or eliminate their discomfort associated with intrusive ______.

TFPs

Forensic clients are no strangers to experiential avoidance. The lack of control they may experience when freedom is taken away from them can lead to a host of unpleasant thoughts and feelings masking anxiety, depression, PTSD, substance abuse, and psychotic symptoms, etc. ACT can be tailored to this population by helping clients alter the function – not the existence – of uncomfortable TFPs; become more mindfully aware of internal experiences and physical surroundings; and clarify values and guide values-congruent behavioral change. Values clarification is particularly important for forensic clients because it serves as the guiding force for prosocial living in this restrictive environment. The application of ACT in forensic settings is somewhat altered to accommodate four basic personality types in corrections (Evert, 2011): 1. The Entitled; 2. The Bully; 3. The Self-righteous; 4. The ______.

Sheep

The following case study is used to illustrate ACT in forensic settings: Jim is a never-married 38-year-old Caucasian male who was adjudicated for the Felony charge of Rape I for his sexual assault against a 29-year-old female and sentenced to 20 years. He has a lengthy criminal history including crossover sexual offenses against a prepubescent girl, an adolescent female, and violation of a stalking protective order. During childhood, he was exposed to polysubstance abuse, sex (e.g. sexual abuse and incest) and was sexually promiscuous. Upon intake, Jim was classified as a high-risk sex offender, and diagnosed with Paraphilia Not Otherwise Specified (NOS); Polysubstance Dependence; Anxiety Disorder NOS; Antisocial Personality Disorder; and Borderline Intellectual Functioning. Jim's case illustrates the application of ACT in forensic settings to address complex issues related to his criminal behavior, psychological disorders, and ______ experiences.

traumatic

ACT can be incorporated into the forensic client’s treatment plan once their mental health needs have been assessed and level of treatment identified for either individual or group therapy. Professional training is not required for non-mental health professionals who desire to learn ACT. However, for those who work – or aspire to work – in the mental health profession and use ACT, at minimum a Bachelors degree-level training in psychology is recommended. Beyond this level of education, ACT training through graduate-level coursework teaching the theory behind this mindfulness-based psychotherapy is becoming increasingly popular. ACT has been empirically validated to address a wide range of populations, life difficulties, and psychopathologies. ACT emphasizes the normality of human suffering experienced by humankind, and the lengths individuals go to avoid or eliminate their discomfort associated with intrusive TFPs. Forensic clients are no strangers to experiential avoidance. The lack of control they may experience when freedom is taken away from them can lead to a host of unpleasant thoughts and feelings masking anxiety, depression, PTSD, substance abuse, and psychotic symptoms, etc. ACT can be tailored to this population by helping clients alter the function – not the existence – of uncomfortable TFPs; become more mindfully aware of internal experiences and physical surroundings; and clarify values and guide values-congruent behavioral change. Values clarification is particularly important for forensic clients because it serves as the guiding force for prosocial living in this restrictive environment. The application of ACT in forensic settings is somewhat altered to accommodate four basic personality types in corrections (Evert, 2011): The Entitled; The Bully; The Self-righteous; The ______.

Sheep

ACT is not a powerful treatment alternative for forensic clients.

False

Symptom reduction is the main goal of ACT therapy.

False

ACT therapy is solely based on cognitive-behavioral principles.

False

Forensic clients have high rates of mental health disorders, making ACT implementation challenging.

True

Values clarification is not an important aspect of ACT for forensic clients.

False

ACT therapy primarily focuses on symptom reduction rather than promoting purposeful living.

False

In ACT, the concept of Defusion involves actively engaging with and buying into intrusive thoughts.

False

Values clarification is not considered important for forensic clients undergoing ACT therapy.

False

ACT stands for Acceptance and Commitment, and it is not based on Relational Frame Theory.

False

Mindfulness is not a key component in ACT therapy for forensic clients.

False

Values clarification is not considered an important aspect of ACT for forensic clients.

False

ACT in forensic settings does not involve tailoring interventions to accommodate different personality types.

False

Creating a Values Clarification Certificate is not part of the process involving art projects for forensic clients in ACT.

True

ACT focuses on symptom reduction as the primary goal of therapy.

False

Forensic clients' criminogenic thinking is viewed as a permanent fixture of their personality according to ACT principles.

False

Forensic clients are not familiar with experiential avoidance due to their controlled environment.

False

ACT training is only recommended for mental health professionals with a Master's degree or higher in psychology.

False

Values clarification is not essential for forensic clients as they typically have clear values.

False

ACT emphasizes avoiding human suffering and discomfort associated with intrusive thoughts, feelings, and psychotic symptoms.

False

Jim was diagnosed with Borderline Intellectual Functioning along with Antisocial Personality Disorder.

True

Experiential avoidance is not related to interpersonal problems in ACT.

False

Symptom reduction is the main goal of ACT therapy.

False

ACT therapy solely relies on cognitive-behavioral principles.

False

In forensic settings, ACT does not emphasize values clarification for clients.

False

ACT can only be implemented in forensic settings after a client's mental health needs have been assessed.

False

Jim's immediate family history of alcoholism and his own abuse history as a child were not important factors addressed by the ACT clinician.

False

Values clarification is not considered important in ACT for forensic clients.

False

Symptom reduction is the primary goal of ACT therapy.

False

ACT primarily focuses on reducing negative behaviors such as Antisociality and lack of empathy.

False

High rates of mental health disorders in prisons make the implementation of ACT easy for forensic clients.

False

ACT-based group programs are meant to replace therapy or other psychological services for individuals with severe mental illness or substance use.

False

The adaptation of ACT to correctional settings is a well-established practice.

False

Successful implementation and scale up of ACT interventions can be achieved quickly due to the simplicity of the process.

False

ACT interventions sponsored by the Office on Violence Against Women and Department of Justice are planning to standardize the protocols before completing randomized controlled trials.

False

ACT interventions aim to develop treatment manuals only for their own use, excluding other state and federal correctional agencies.

False

ACT therapy primarily focuses on symptom reduction rather than promoting purposeful living.

False

Mindfulness is not a key component in ACT therapy for forensic clients.

False

Values clarification is not an important aspect of ACT for forensic clients.

False

ACT is not a powerful treatment alternative for forensic clients.

False

Risk-Need-Responsivity principles have not been extensively researched for effectiveness.

False

Explore the potential promise of Acceptance and Commitment Therapy (ACT) as a treatment for prisoners compared to Cognitive Behavioral Therapy (CBT) and Dialectical Behaviour Therapy (DBT). Learn about Risk-Need-Responsivity principles in treating offenders.

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