1. Weekly Drop-In ACT Group for Transdiagnosed Veterans Iris Taber, PhD, HSP South Texas VA Health Care System, Kerrville Division, Kerrville, TX Care System, Kerrville Division, Kerrville, TX

2. What is a drop-in group? Group meets weekly Veterans come and go as they are able on a weekly basis Because it is a drop in group, general focus on any ACT tenet is about three weeks so that anyone who misses a session or two can still obtain the necessary information Two groups cover same topics, general attendance varies from 13 to 18 veterans on any given week

3. Who Attends? Veterans with a variety of diagnoses –PTSD –Depression –Anxiety, NOS –Veterans with mTBI –Schizoaffective Disorder –Panic Disorder –Obsessive/Compulsive Disorder –Schizophrenia (stable) –Substance Abuse Disorder (generally in remission)

4. Typical Session Check-in with discussion Intro of new members which includes brief intro to ACT, if necessary Mindfulness Exercise Content of week’s topic In-class exercise using week’s topic to further engage group members “Experiment” for veterans to use at home over the next week

5. Rewards System Due to low return rate of homework, have tried rewards system for veterans who return homework at next session— borrowed this from Marsha Linehan who uses “stickers” as rewards. Has not been effective (ideas anyone?)

6. White Bear Suppression Inventory Measures people’s tendency to suppress (i.e., not accept) and struggle with unwanted thoughts and feelings Demonstrates the negative effects of experiential avoidance 15 Item Scale WBSI is sensitive to measuring the effects of treatment

7. WBSI (Cont’d) Survey done anonymously May 2012 Average Score = 48.71 (n=17) July 2012 Average Score = 61.77 (n=13)

8. Mindfulness Attention Awareness Scale Assesses mindfulness across cognitive, emotional, physical, interpersonal, and general domains. Studies show MAAS has good psychometric properties Differentiates people who practice mindfulness and those who don’t Higher scores are associated with enhanced self-awareness

9. MAAS (Cont’d) 15 Item Scale Survey done anonymously Average at Time 1—May 2012 = 46.61 (n=18) Average at Time 2—July 2012 = 70.85 (n=13) Higher scores reflect more mindfulness

10. References Eifert, George H. & Forsyth, John P. (2005.) Acceptance and Commitment Therapy for Anxiety Disorders. Oakland, CA: New Harbinger. Brown, K. W., & Ryan, R. M. (2003). The benefits of being Mindful: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84, 822-848. Hayes, S.C., Strosahl, K. D. (Eds.). (2004). A Practical Guide to Acceptance and commitment Therapy. New York: Springer-Verlag. Wegner, D.M. & Zanakos, S. (1994). Chronic Thought Suppression. Journal of Personality, 62, 615-640.

11. Questions?