Examining the relationship between acceptance and commitment therapy (ACT) processes and stigma

This thesis describes three empirical studies that were designed to examine the relationship between Acceptance and Commitment Therapy (ACT) processes and stigma. The unique contributions of this work to the field involved the investigation of multiple ACT processes and different expressions of stig...

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Bibliographic Details
Main Author: Lloyd, Joda
Published: Goldsmiths College (University of London) 2010
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Online Access:http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.524904
Description
Summary:This thesis describes three empirical studies that were designed to examine the relationship between Acceptance and Commitment Therapy (ACT) processes and stigma. The unique contributions of this work to the field involved the investigation of multiple ACT processes and different expressions of stigma within a new and understudied area of application; namely welfare service users. The first phase of experimentation involved a cross-sectional examination of the relationships between ACT processes and stigma towards unemployed people. Fortyfive undergraduate and postgraduate students responded to a series of self-report questionnaires, and a computer-based task. The questionnaires assessed psychological flexibility, mindfulness, and explicit stigma. The computer-based task utilised the Implicit Relational Assessment Procedure (IRAP) to assess implicit stigma. Correlational analysis indicated that ACT processes did not relate to stigma measured explicitly, and that implicit and explicit stigma converged. The findings suggest that participants were not attempting to regulate their stigma expression and therefore were not demonstrating elaborated and considered responding; for this reason explicit stigma did not correlate with psychological flexibility and mindfulness. The second phase of experimentation involved a longitudinal examination of stigma within customer service advisors. Two intervention studies, with formal mediation analyses, were carried out to investigate the impact of increasing ACT processes on indirect and explicit expressions of stigma, and other outcomes of importance. In the first study, one hundred and ten advisors working with elderly people were randomly assigned to two conditions: (1) an ACT group, or; (2) a waitlist control group. Outcome and process of change measures were administered at four time points over ten months. Results showed that ACT resulted in improvements in stigma measured indirectly, emotional exhaustion, and stress. Whilst psychological flexibility and mindfulness mediated changes in the latter variables, this was not found for stigma outcomes. The second study replicated the methodology of the previous but investigated sixty-six advisors working with unemployed people, and also assessed the ACT process of cognitive defusion. Results showed that ACT training decreased stigma measured indirectly, and increased turnover intention, however, ACT processes did not mediate either of these changes. Overall, the second phase of experimentation indicated that while ACT was effective in alleviating stigma that is articulated indirectly, once again no significant relationships between ACT processes and stigma outcomes were demonstrated. The general discussion focuses on the immediate implications of the findings for research and practice, and broader implications in relation to the ACT/RFT account of stigma.