Psych Vivas · Psychotherapy
Acceptance and commitment therapy — structured clinical viva
Fellowship viva on ACT psychological flexibility, hexaflex, avoidance/fusion, evidence, CBT comparison, and medication integration.
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Target exams
FRANZCPMRCPsychABPNMD-DNB
Prompt
You are the psychiatry registrar. A 36-year-old teacher with recurrent major depression and high experiential avoidance says they will rejoin their sports club and rebuild friendships 'when the emptiness and self-critical thoughts are gone.' They ask whether ACT is 'just mindfulness' and whether they must stop sertraline 100 mg to start therapy. Discuss ACT principles, hexaflex processes, experiential avoidance, evidence landmarks (including metas and key trials), comparison with CBT, and combined care.
Interpretation
Reveal interpretationShowHide
Markers want a consultant-level account of ACT as third-wave contextual therapy aimed at psychological flexibility, coherent formulation of waiting-for-symptom-elimination as avoidance/fusion, hexaflex processes with techniques, fair evidence (metas + quality caveats), CBT comparison without brand warfare, and combined care rather than forced medication stop.[1][2][3][4]
References6ShowHide
- [1]Hayes SC, Luoma JB, Bond FW, Masuda A, Lillis J Acceptance and commitment therapy: model, processes and outcomes Behav Res Ther, 2006.PMID 16300724
- [2]Hayes SC, Wilson KG, Gifford EV, Follette VM, Strosahl K Experiential avoidance and behavioral disorders: a functional dimensional approach to diagnosis and treatment J Consult Clin Psychol, 1996.PMID 8991302
- [3]A-Tjak JG, Davis ML, Morina N, Powers MB, Smits JA, Emmelkamp PM A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems Psychother Psychosom, 2015.PMID 25547522
- [4]Ost LG The efficacy of Acceptance and Commitment Therapy: an updated systematic review and meta-analysis Behav Res Ther, 2014.PMID 25193001
- [5]Powers MB, Zum Vorde Sive Vording MB, Emmelkamp PM Acceptance and commitment therapy: a meta-analytic review Psychother Psychosom, 2009.PMID 19142046
- [6]Bai Z, Luo S, Zhang L, Wu S, Chi I Acceptance and Commitment Therapy (ACT) to reduce depression: A systematic review and meta-analysis J Affect Disord, 2020.PMID 31563072