Behavioral Sciences

Research

26 pages, 2664 KB

Open AccessArticle

Flexible Teachers, Thriving Classrooms: A Unified Flexibility and Mindfulness (UFM) Model of Classroom Dynamics, Teaching Practices, and Teacher Burnout

by Katie Palmer and Ronald D. Rogge

Behav. Sci. 2026, 16(6), 1018; https://doi.org/10.3390/bs16061018 - 17 Jun 2026

Viewed by 1321

Abstract

Within the conceptual framework of the Unified Flexibility & Mindfulness (UFM) model, the current study applied a contextual behavioral science lens to understanding the challenges and dynamics of classroom teaching in the United States. In particular, the study sought to highlight the specific [...] Read more.

Within the conceptual framework of the Unified Flexibility & Mindfulness (UFM) model, the current study applied a contextual behavioral science lens to understanding the challenges and dynamics of classroom teaching in the United States. In particular, the study sought to highlight the specific flexibility processes linked to lower teacher burnout and to greater use of adaptive instructional and behavior management strategies—deepening the conceptualization and operationalization of teachers’ Social and Emotional Competence (SEC). Toward that end, a sample of 308 K-12 teachers (79% female, 85% white, M_age = 42 years old) with an average of 13 years of teaching experience completed a relational task (RT) indirectly assessing relational thinking about students along with teacher-report measures of: (1) their own use of 14 forms of mindful flexibility (and distracted, reactive inflexibility) in the classroom, (2) their conscious perceptions of student engagement and disaffection with learning, (3) their use of adaptive instructional and behavior management strategies, and (4) a measure of work-related and student-related burnout. Exploratory network analyses largely supported the Unified Flexibility and Mindfulness model shaping teachers’ functioning in the classroom. The results further highlighted unique links from categorical thinking on the RT (i.e., viewing all positive or negative adjectives as essentially the same in students) to greater burnout and unique links from more nuanced thinking on the RT (i.e., the ability to see negative and positive traits coexisting in students) to greater perceptions of both student engagement and disaffection. Teachers’ engagement of committed action and self-as-context (maintaining a broader perspective in the face of disruptive behavior) along with perceptions of greater student engagement emerged as some of the most robust predictors of using adaptive classroom strategies. In contrast, teachers’ engagement in fusion and inaction (along with perceptions of greater student disaffection and lower student engagement) emerged as the most robust predictors of teacher burnout. Implications are discussed. Full article

(This article belongs to the Special Issue Psychological Flexibility for Health and Wellbeing)

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13 pages, 275 KB

Open AccessArticle

Does Psychological Flexibility Correlate with Mystical Experiences: A Machine Learning Approach Including State of Surrender, Near-Death Experiences, and Psilocybin Consumption

by Dylan Briggs, Thomas B. Sease, Ruthie Menou and David R. Perkins

Behav. Sci. 2026, 16(5), 686; https://doi.org/10.3390/bs16050686 - 30 Apr 2026

Viewed by 1974

Abstract

Mystical experiences are characterized by a profound sense of interconnectedness and transcendence of ordinary reality. These experiences can facilitate feelings of connectedness with oneself and others and have been documented as leading to significant positive changes in thoughts, emotions, and behavior. The purpose [...] Read more.

Mystical experiences are characterized by a profound sense of interconnectedness and transcendence of ordinary reality. These experiences can facilitate feelings of connectedness with oneself and others and have been documented as leading to significant positive changes in thoughts, emotions, and behavior. The purpose of the present study was to evaluate the extent to which the four mindfulness facets of psychological flexibility (i.e., experiential acceptance, present-moment awareness, cognitive defusion, and self-as-context) were associated with self-reported mystical experiences while controlling for established covariates. Using a sample of 150 individuals recruited online, a regularized regression with an elastic net—a computationally efficient machine learning algorithm—was used to model the relationships among mystical experiences, State of Surrender, frequency of psychedelic use, near-death experiences, and facets of psychological flexibility. State of Surrender, experiential acceptance, cognitive defusion, and present-moment awareness emerged as the most robust predictors of mystical experiences. Collectively, these findings underscore the role of psychological processes, including surrender-related processes and facets of psychological flexibility, in predicting mystical experiences. Full article

(This article belongs to the Special Issue Psychological Flexibility for Health and Wellbeing)

23 pages, 426 KB

Open AccessArticle

Digital Acceptance and Commitment Therapy for Lifestyle Change in Overweight Pregnant Women: A Feasibility Pilot Study

by Anna Elena Nicoletti, Michele Tonelli, Barbara Purin and Silvia Rizzi

Behav. Sci. 2026, 16(4), 585; https://doi.org/10.3390/bs16040585 - 14 Apr 2026

Cited by 1 | Viewed by 604

Abstract

Overweight and obesity during pregnancy are associated with increased maternal and neonatal risks, yet scalable interventions addressing the psychological processes underlying health behaviours remain limited. This study describes the development and formative evaluation of DEMETRA, a chatbot delivering an Acceptance and Commitment Therapy [...] Read more.

Overweight and obesity during pregnancy are associated with increased maternal and neonatal risks, yet scalable interventions addressing the psychological processes underlying health behaviours remain limited. This study describes the development and formative evaluation of DEMETRA, a chatbot delivering an Acceptance and Commitment Therapy (ACT)-informed intervention to promote healthier lifestyles in pregnant women. In line with Phase 1 of the Obesity-Related Behavioral Intervention Trials framework, a multidisciplinary team developed a six-session digital program delivered via a rule-based virtual assistant. A mixed-methods design was employed to assess acceptability, usability, and perceived relevance among a heterogeneous stakeholder sample. Sixteen stakeholders (psychologists, communication experts, nutritionists, clinicians, and non-overweight, expectant women or those who had recently delivered) participated in iterative testing; 15 completed quantitative measures (Semantic Differential scales, uMARS, BUS-11) and 16 completed semi-structured interviews. Non-parametric analyses indicated significantly positive evaluations across most communication and content domains, particularly clarity and language appropriateness, whereas session duration and several engagement-related dimensions did not significantly differ from neutrality. Qualitative findings confirmed strengths in clarity, non-stigmatising tone, and multimedia support, while identifying limited personalisation and message pacing as key areas for refinement. Overall, findings provide formative evidence that ACT-informed principles can be translated into a chatbot-delivered antenatal program and highlight concrete priorities for optimisation (e.g., personalisation and message pacing). Because end-user testing did not include overweight/obese pregnant women and the sample was small and heterogeneous, conclusions regarding acceptability/feasibility in the intended clinical population remain preliminary; the results primarily support iterative refinement and subsequent proof-of-concept testing in the target group. Full article

(This article belongs to the Special Issue Psychological Flexibility for Health and Wellbeing)

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18 pages, 342 KB

Open AccessArticle

Validation of the Italian Multidimensional Psychological Flexibility Inventory Short Form (MPFI-24)

by Giulia Landi, Zhangxuan Bao, Francesco Bruno, Kenneth I. Pakenham, Francesca Chiesi, Eliana Tossani and Silvana Grandi

Behav. Sci. 2026, 16(4), 510; https://doi.org/10.3390/bs16040510 - 29 Mar 2026

Cited by 1 | Viewed by 786

Abstract

This research examines the psychometric properties of the Italian Multidimensional Psychological Flexibility Inventory short form (MPFI-24), a measure of psychological flexibility/inflexibility. Study 1 investigated its factor structure, reliability and invariance (across gender, age, and mental health status) based on a dataset comprising 1542 [...] Read more.

This research examines the psychometric properties of the Italian Multidimensional Psychological Flexibility Inventory short form (MPFI-24), a measure of psychological flexibility/inflexibility. Study 1 investigated its factor structure, reliability and invariance (across gender, age, and mental health status) based on a dataset comprising 1542 participants (71% female, mean_age = 38.6 years, SD = 15.0). Study 2 reexamined the factorial structure in an independent sample (N = 728, 64.88% females, mean_age = 30.94 years, SD = 14.07), and assessed both convergent validity (with psychological flexibility/inflexibility measures) and concurrent validity (with distress and well-being measures). Confirmatory factor analyses demonstrated very good fit indices for a first-order model comprising the twelve psychological flexibility and inflexibility sub-processes. In addition, the model structured with two second-order factors—psychological flexibility and inflexibility—each defined by six core sub-processes, showed a good model fit. The Italian MPFI-24 also exhibited strong internal consistency and good convergent and concurrent validity. Measurement invariance was established for gender, age, and mental health status. The Italian MPFI-24 is a psychometrically sound instrument for evaluating psychological flexibility and inflexibility, along with their underlying sub-processes, in an Italian context. Full article

(This article belongs to the Special Issue Psychological Flexibility for Health and Wellbeing)

16 pages, 395 KB

Open AccessArticle

Rethinking Recovery: Psychological Flexibility and Growth Across Diverse Recovery Approaches

by Nicole M. Pyke, David R. Perkins and Emily K. Sandoz

Behav. Sci. 2026, 16(3), 366; https://doi.org/10.3390/bs16030366 - 5 Mar 2026

Viewed by 1241

Abstract

Although recovery capital and psychological flexibility have each been associated with substance use recovery, their combined role in fostering posttraumatic growth remains unclear. This study integrates recovery capital theory with psychological flexibility and posttraumatic growth frameworks to test a theory-driven model of adaptive [...] Read more.

Although recovery capital and psychological flexibility have each been associated with substance use recovery, their combined role in fostering posttraumatic growth remains unclear. This study integrates recovery capital theory with psychological flexibility and posttraumatic growth frameworks to test a theory-driven model of adaptive recovery processes. The study sought to (1) examine whether recovery capital or abstinence predicts posttraumatic growth, (2) assess whether recovery capital or abstinence status predicts psychological flexibility, and (3) test whether psychological flexibility statistically mediates the relationship between recovery and posttraumatic growth. A national sample of 244 adults in recovery from substance use disorder completed the Assessment of Recovery Capital, the Personalized Psychological Flexibility Index, and the Posttraumatic Growth Inventory—Expanded. Multiple linear regressions addressed the first two aims. For Aim 3, the mediation model was tested using the SPSS PROCESS macro (version 4.0) with 5000 bootstrap resamples. Recovery capital significantly predicted both posttraumatic growth and psychological flexibility. Abstinence status did not predict posttraumatic or psychological flexibility. Psychological flexibility partially mediated the association between recovery capital and posttraumatic growth. Psychological flexibility may be a key mechanism by which recovery capital fosters posttraumatic growth, supporting interventions that enhance both resources beyond abstinence alone. Full article

(This article belongs to the Special Issue Psychological Flexibility for Health and Wellbeing)

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18 pages, 560 KB

Open AccessArticle

An Intervention Based on Acceptance and Commitment Therapy for Childhood Separation Anxiety: A Case Study

by David Lobato, Juan Miguel Flujas-Contreras, Francisco Montesinos and María M. Montoya-Rodríguez

Behav. Sci. 2026, 16(1), 82; https://doi.org/10.3390/bs16010082 - 7 Jan 2026

Cited by 1 | Viewed by 2471

Abstract

This study illustrates the application of Acceptance and Commitment Therapy (ACT) for a 12-year-old boy with separation anxiety and his mother. Over 23 sessions, ACT strategies promoted psychological flexibility, values-based parenting, and adaptive behaviors. The intervention reduced the child’s experiential avoidance, anxiety, and [...] Read more.

This study illustrates the application of Acceptance and Commitment Therapy (ACT) for a 12-year-old boy with separation anxiety and his mother. Over 23 sessions, ACT strategies promoted psychological flexibility, values-based parenting, and adaptive behaviors. The intervention reduced the child’s experiential avoidance, anxiety, and depressive symptoms, while increasing value-oriented actions, while the mother showed improved psychological flexibility and life satisfaction. The results were sustained at a three-month follow-up. This case study highlights the potential of ACT in treating childhood separation anxiety by simultaneously involving parents, demonstrating its feasibility and efficacy. The findings provide guidance for adapting ACT for families and child populations. Full article

(This article belongs to the Special Issue Psychological Flexibility for Health and Wellbeing)

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19 pages, 902 KB

Open AccessArticle

Prevention of Postpartum Depression via a Digital ACT-Based Intervention: Evaluation of a Prototype Using Multiple Case Studies

by Anna Elena Nicoletti, Silvia Rizzi, Stefano Fait and Oscar Mayora-Ibarra

Behav. Sci. 2025, 15(12), 1723; https://doi.org/10.3390/bs15121723 - 12 Dec 2025

Cited by 2 | Viewed by 1276

Abstract

Postpartum depression (PPD) affects up to 15% of mothers, yet access to preventive psychological interventions during pregnancy remains limited. Acceptance and Commitment Therapy (ACT) has demonstrated efficacy in promoting psychological flexibility and preventing mental distress. Nevertheless, no studies have yet evaluated its use [...] Read more.

Postpartum depression (PPD) affects up to 15% of mothers, yet access to preventive psychological interventions during pregnancy remains limited. Acceptance and Commitment Therapy (ACT) has demonstrated efficacy in promoting psychological flexibility and preventing mental distress. Nevertheless, no studies have yet evaluated its use for the prevention of PPD through a chatbot-based digital intervention. The present study describes the development and preliminary evaluation of an ACT-based chatbot intervention (REA) to support women during late pregnancy and the early postpartum period. Nineteen participants interacted with the low-fidelity REA prototype, explored its features, completed two questionnaires, and then participated in semi-structured interviews. Quantitative data were analysed using the Wilcoxon signed-rank test; qualitative data were analysed using thematic analysis. Quantitative analysis revealed significantly elevated scores for the majority of variables, including empathy and listening, fluency, lexicon, clarity, engagement, functionality, aesthetics, information, and perceived impact. The interview findings demonstrated a notable level of appreciation for the intervention. The participants described the chatbot as engaging and supportive, highlighting a smooth interaction flow, content-appropriate language, and messages of suitable length. The REA prototype demonstrated high acceptability, usability, and perceived usefulness among a diverse range of stakeholders, thus supporting its potential as a scalable, stigma-reducing tool for the prevention of PPD. Subsequent research endeavours will focus on refining the chatbot’s personalisation features and conducting comprehensive clinical trials to evaluate its efficacy. Full article

(This article belongs to the Special Issue Psychological Flexibility for Health and Wellbeing)

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21 pages, 767 KB

Open AccessArticle

Lessons Learned in Digital Health Promotion: The Promise and Challenge of Contextual Behavioral Science Methodology in Valuing Intervention Research

by Jessica M. Criddle, Wesley Malvini, Hayley Jasper and Michael J. Bordieri

Behav. Sci. 2025, 15(8), 1095; https://doi.org/10.3390/bs15081095 - 12 Aug 2025

Viewed by 2108

Abstract

Using individualized approaches leads to longer-term pro-health behavior change. Both technological delivery methods and values-centered Acceptance and Commitment Therapy (ACT) are useful frameworks for personalized interventions. This investigation sought to explore the effects that valuing had on health using an internet-delivered audio and [...] Read more.

Using individualized approaches leads to longer-term pro-health behavior change. Both technological delivery methods and values-centered Acceptance and Commitment Therapy (ACT) are useful frameworks for personalized interventions. This investigation sought to explore the effects that valuing had on health using an internet-delivered audio and writing group-level intervention. Specifically, we replicated the use of domain-specific outcomes and idiographic motivational statements sent via text message while additionally employing individualized intervention delivery components, objectives, and statistical methods. While this intervention did not generate significant improvement in health behaviors relative to a control in a sample of 107 college student participants, it has implications for future digital health intervention design and implementation as well as the further development of theoretically consistent valuing research methods. Full article

(This article belongs to the Special Issue Psychological Flexibility for Health and Wellbeing)

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24 pages, 691 KB

Open AccessArticle

Nonconsensual Sexual Experience Acknowledgment: Exploring the Roles of Gender Identity, Sexual Aggression Myths, and Psychological Inflexibility

by Wesley Malvini, Jessica M. Criddle, Mark S. Lacour and Emily K. Sandoz

Behav. Sci. 2025, 15(7), 875; https://doi.org/10.3390/bs15070875 - 27 Jun 2025

Cited by 1 | Viewed by 1506

Abstract

Nonconsensual sexual experiences (NSEs) can take many forms, including rape and sexual assault. NSE acknowledgment has been linked to several positive and negative outcomes. A person’s acknowledgment of their NSEs may be in part due to the extent to which they accept myths [...] Read more.

Nonconsensual sexual experiences (NSEs) can take many forms, including rape and sexual assault. NSE acknowledgment has been linked to several positive and negative outcomes. A person’s acknowledgment of their NSEs may be in part due to the extent to which they accept myths about sexual aggression (AMASA). However, AMASA does not fully account for NSE acknowledgment, which necessitates research on possible moderators. Further, other individual differences, such as gender identity, may play a role in both AMASA and acknowledgment. The primary aim of this study was to examine psychological flexibility (PF) and inflexibility (PI) as potential moderators of the relationship between NSE acknowledgment and AMASA. AMASA and gender identity both had significant, positive associations with acknowledgment. Furthermore, there was a significant negative relationship between acknowledgment and PI. The current study provides data on two psychological constructs that may serve as target areas for developing interventions to support people with NSE histories, as well as furthering our understanding of acknowledgment across gender identities. Full article

(This article belongs to the Special Issue Psychological Flexibility for Health and Wellbeing)

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11 pages, 238 KB

Open AccessArticle

The Impact of a 3-Month Behavioral Weight Loss Intervention on Psychological Flexibility and Depression

by Samantha J. Schram and Jason Lillis

Behav. Sci. 2025, 15(6), 788; https://doi.org/10.3390/bs15060788 - 7 Jun 2025

Viewed by 1977

Abstract

A significant portion of individuals with overweight or obesity seek behavioral weight loss, which aims to modify behaviors and habits related to diet, physical activity, and lifestyle and has been shown to result in clinically meaningful weight loss and improved cardiometabolic health. While [...] Read more.

A significant portion of individuals with overweight or obesity seek behavioral weight loss, which aims to modify behaviors and habits related to diet, physical activity, and lifestyle and has been shown to result in clinically meaningful weight loss and improved cardiometabolic health. While the physical outcomes of behavioral weight loss are well documented, relevant psychological processes and mental health outcomes are less studied. This secondary analysis examined psychological flexibility in relation to depression change and weight change in adults (N = 508) with a body mass index greater than 25 enrolled in a 3-month automated behavioral weight loss intervention. Psychological flexibility was assessed using the Comprehensive Assessment of Acceptance and Commitment Therapy Processes (CompACT), a tool based on Acceptance and Commitment Therapy (ACT) principles. The Patient-Reported Outcomes Measurement Information System (PROMIS) initiative Depression-Short Form, which collects information directly reported by patients, was used to measure levels of depression. Change in psychological flexibility was found to significantly moderate the positive relationship between weight change and change in depression over the course of a 3-month behavioral weight loss intervention, such that individuals with greater increases in psychological flexibility experienced greater reductions in depression levels when also losing weight. These results suggest that psychological flexibility may enhance the psychological benefits of behavioral weight loss and could be a useful target in a modified version of behavioral weight loss intervention. Full article

(This article belongs to the Special Issue Psychological Flexibility for Health and Wellbeing)

21 pages, 301 KB

Open AccessArticle

The Impact of Parenting Avoidance (IPA): Scale Development and Psychometric Evaluation Among Parents of Transgender Youth

by Haley R. Hedrick, Stephanie V. Caldas and Danielle N. Moyer

Behav. Sci. 2025, 15(5), 625; https://doi.org/10.3390/bs15050625 - 3 May 2025

Viewed by 1519

Abstract

Parental support and acceptance are strong protective factors for better mental health outcomes among transgender and gender diverse youth. Psychological inflexibility, specifically in the role of parenting, or “parenting inflexibility”, refers to an over-reliance on avoidance strategies at the expense of parenting values. [...] Read more.

Parental support and acceptance are strong protective factors for better mental health outcomes among transgender and gender diverse youth. Psychological inflexibility, specifically in the role of parenting, or “parenting inflexibility”, refers to an over-reliance on avoidance strategies at the expense of parenting values. Parenting inflexibility may be related to parental support, making it a useful target of intervention for parents of transgender youth. The aim of the present study was to develop a brief clinically useful measure of parenting inflexibility based on a synthesis of existing measures and to evaluate the psychometric properties across two study populations. Study 1 used exploratory factor analysis to examine this measure among parents in the general population recruited using MTurk. Study 2 used confirmatory factor analysis to examine the measure among parents of transgender youth recruited from a clinic. The final measure, the Impact of Parenting Avoidance (IPA) scale, is a one-factor 7-item measure of parenting inflexibility that is easy to administer and interpret in a pediatric health setting. The resulting measure demonstrated acceptable reliability, and it was significantly correlated with important outcome variables, such as negative parenting practices and lower perceived parental support among transgender and gender diverse youth. Full article

(This article belongs to the Special Issue Psychological Flexibility for Health and Wellbeing)

11 pages, 233 KB

Open AccessArticle

Changes in Psychological Inflexibility and Intimate Partner Violence Among Men in an Acceptance and Commitment Therapy-Based Intervention Program

by Amie Zarling, Meg Berta and Ashlyn Miller

Behav. Sci. 2025, 15(3), 317; https://doi.org/10.3390/bs15030317 - 6 Mar 2025

Cited by 8 | Viewed by 5382

Abstract

Understanding the mechanisms of change in batterer intervention programs (BIPs) is essential for advancing effective interventions for intimate partner violence (IPV). This study evaluates changes in psychological inflexibility and IPV behaviors among men participating in an acceptance and commitment therapy (ACT)-based BIP for [...] Read more.

Understanding the mechanisms of change in batterer intervention programs (BIPs) is essential for advancing effective interventions for intimate partner violence (IPV). This study evaluates changes in psychological inflexibility and IPV behaviors among men participating in an acceptance and commitment therapy (ACT)-based BIP for men court-mandated to domestic violence classes. Participants (N = 56) were assessed across three time points using validated measures of psychological inflexibility and IPV behaviors. Findings revealed significant improvements in psychological inflexibility and corresponding reductions in IPV behaviors over the intervention period, with medium to large effect sizes. Psychological inflexibility at the final assessment predicted IPV outcomes, accounting for 15% of the variance, even after controlling for baseline IPV, age, and race. These results highlight psychological inflexibility as a potential mechanism of change in IPV interventions. Despite this study’s strengths, including its longitudinal design and rigorous analyses, limitations such as a small sample size and lack of a control group warrant further investigation. This study underscores the potential of ACT-based interventions to reduce IPV by targeting psychological inflexibility and offers insights for refining BIPs to enhance their impact. Full article

(This article belongs to the Special Issue Psychological Flexibility for Health and Wellbeing)

13 pages, 927 KB

Open AccessArticle

The Roles of Psychological Inflexibility and Mindful Awareness on Distress in a Convenience Sample of Black American Adults in the United States

by Akihiko Masuda, Bradley L. Goodnight, Nicole E. Caporino, Cerila C. Rapadas and Erin C. Tully

Behav. Sci. 2025, 15(2), 112; https://doi.org/10.3390/bs15020112 - 22 Jan 2025

Cited by 2 | Viewed by 2616

Abstract

Background: In recent years, the conceptual framework of psychological flexibility/inflexibility has been of global interest in the field of behavioral health. Nevertheless, studies and evidence of psychological flexibility/inflexibility remain limited for underrepresented groups of individuals, including people of color in the United States [...] Read more.

Background: In recent years, the conceptual framework of psychological flexibility/inflexibility has been of global interest in the field of behavioral health. Nevertheless, studies and evidence of psychological flexibility/inflexibility remain limited for underrepresented groups of individuals, including people of color in the United States (U.S.). Among these groups of individuals are Black Americans in the U.S. In response to this empirical gap, the present cross-sectional study investigated whether psychological inflexibility and mindful awareness were uniquely related to general psychological distress, somatization, depression, and anxiety in Black American adults in the United States. Methods: A convenience sample of 359 Black American college students completed self-report measures of interest online. Results: As predicted, correlational analyses showed that psychological inflexibility was positively associated with general psychological distress, somatization, depression, and anxiety, and that mindful awareness was negatively associated with these four distress variables. A path analysis model revealed that psychological inflexibility, but not mindful awareness, was uniquely associated with these distress variables. Conclusions: The present study extended previous findings with a convenience sample of Black American college students, suggesting that psychological inflexibility may be a useful construct for understanding psychological distress, more so than mindful awareness, among Black American adults in the U.S. Full article

(This article belongs to the Special Issue Psychological Flexibility for Health and Wellbeing)

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15 pages, 575 KB

Open AccessArticle

A Pilot Randomized Controlled Trial of a Single-Session Digital Acceptance and Commitment Therapy Intervention

by Michael E. Levin, Miriam N. Mukasa, Emily M. Bowers, Korena S. Klimczak and Ty B. Aller

Behav. Sci. 2025, 15(1), 75; https://doi.org/10.3390/bs15010075 - 16 Jan 2025

Cited by 6 | Viewed by 8555

Abstract

Adherence challenges are common among digital mental health interventions (DMHIs). Single-session DMHIs may help by providing a low-intensity intervention that takes less time to complete. This pilot randomized controlled trial sought to evaluate the acceptability and preliminary efficacy of a single-session DMHI based [...] Read more.

Adherence challenges are common among digital mental health interventions (DMHIs). Single-session DMHIs may help by providing a low-intensity intervention that takes less time to complete. This pilot randomized controlled trial sought to evaluate the acceptability and preliminary efficacy of a single-session DMHI based on acceptance and commitment therapy (ACT) in a non-clinical sample of college students. The trial was pre-registered (NCT06139718). A total of 61 students were recruited, which was below the target of 100 participants. The participants were randomized to the single-session ACT DMHI or to a waitlist condition, with assessments completed at 1-week and 1-month follow-ups. The vast majority of participants (87%) completed the single-session ACT program. The participants provided high program satisfaction ratings. There were no differences between conditions on psychological flexibility, distress, or mental health help seeking. However, the participants assigned to ACT improved significantly more than the waitlist on well-being from baseline to 1-month follow-up (d = 0.29). Overall, the results were mixed, with some support for the acceptability and potential efficacy of a single-session ACT DMHI but also a lack of effect, most notably on psychological flexibility as the process of change in ACT. Full article

(This article belongs to the Special Issue Psychological Flexibility for Health and Wellbeing)

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Review

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32 pages, 793 KB

Open AccessReview

A Scoping Review of the Relationship Between Psychological (In)flexibility and Living with and Managing Type 1 and Type 2 Diabetes

by Max Z. Roberts, Francesca A. Scheiber, Ashley A. Moskovich and Rhonda M. Merwin

Behav. Sci. 2025, 15(6), 792; https://doi.org/10.3390/bs15060792 - 9 Jun 2025

Cited by 5 | Viewed by 3442

Abstract

Diabetes Mellitus (DM) is highly prevalent and carries a significant self-management burden and elevated risk of biopsychosocial sequelae. Psychological flexibility (PF) has been shown to benefit living with and managing chronic health conditions. The present scoping review aimed to synthesize the available evidence [...] Read more.

Diabetes Mellitus (DM) is highly prevalent and carries a significant self-management burden and elevated risk of biopsychosocial sequelae. Psychological flexibility (PF) has been shown to benefit living with and managing chronic health conditions. The present scoping review aimed to synthesize the available evidence on the relationship between PF and factors central to living with and managing DM. A systematic literature search was conducted. Studies were included if they measured psychological (in)flexibility (PI/PF) and/or one of its component processes and sampled individuals with type 1 or type 2 DM. A total of 48 articles were included. Eighteen (37.5%) sampled individuals with T2D, 16 (33.3%) sampled individuals with T1D, and 14 (29.2%) had mixed diagnostic samples. Twenty-nine (60.4%) reported observational studies, and 19 (39.6%) reported 18 intervention studies. Studies were conducted across 17 countries and broadly found that PI/PF were associated with many clinically meaningful DM variables (e.g., HbA1c, diabetes distress, quality of life, and self-management). Intervention studies including individual, group, and digital Acceptance and Commitment Therapy (ACT) interventions showed trends for beneficial change in PI/PF and diabetes outcomes, but some findings were mixed, and many studies were underpowered. Only two studies tested change in PI/PF as a mediator of diabetes-related outcomes, and most studies used the Acceptance and Action Questionnaire, which has been increasingly criticized for poor discriminant validity. Overall, findings show PI/PF are associated with most aspects of living with and managing diabetes and are generally amenable to change through ACT interventions. However, more methodologically rigorous studies are needed to determine whether PI/PF are active change processes in improving diabetes management and outcomes. Six key calls to action are presented to expand and strengthen this important area of research. Full article

(This article belongs to the Special Issue Psychological Flexibility for Health and Wellbeing)

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Other

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11 pages, 200 KB

Open AccessPerspective

Follow, Flex, and Flout: A Relational Frame Theory Account of Flexibility in the Context of Rule-Governed Behavior

by Alison Stapleton, Conor McCloskey and Louise McHugh

Behav. Sci. 2025, 15(6), 795; https://doi.org/10.3390/bs15060795 - 10 Jun 2025

Viewed by 2710

Abstract

Being able to change what we are doing when a behavior no longer serves us is important for our health and wellbeing. In the context of rule-governed behavior, changing one’s behavior in line with shifting contingencies is often described as being “flexible”, with [...] Read more.

Being able to change what we are doing when a behavior no longer serves us is important for our health and wellbeing. In the context of rule-governed behavior, changing one’s behavior in line with shifting contingencies is often described as being “flexible”, with many basic laboratory experiments operationalizing flexibility as deviations from a given rule that no longer results in reinforcement. And yet flexibility is not just about flouting rules; sometimes, being flexible means persisting. This paper unpacks flexibility in the context of rule-governed behavior from a relational frame theory perspective, outlining applied examples relevant to health behaviors. Full article

(This article belongs to the Special Issue Psychological Flexibility for Health and Wellbeing)

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