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La Trobe University CBS Lab: Psychological Flexibility and Healthcare 

 November 6, 2021

By  Julie Grove, President, ANZ ACBS

Authors: Eric Morris, Darcy Fahroedin & Angelika Radeka

School of Psychology & Public Health, La Trobe University, Melbourne Australia

Thanks for the opportunity to share about current research at the La Trobe University Contextual Behavioural Science Lab.

We are a group of researchers, practitioners and students collaborating on research about psychological (in)flexibility as multidimensional processes. We are conducting projects on how these processes influence challenges like insomnia, paranoia, perfectionism, trauma, obsessive-compulsive behaviours, recovery from psychosis, and caregiving. The La Trobe CBS Lab is led by Dr Eric Morris, Senior Lecturer in the School of Psychology & Public Health.

A current research area is about the wellbeing of therapists, counsellors and health professionals. We would like to share two recent projects.

Perfectionism

People studying to become allied health professionals (physiotherapists, social workers, podiatrists, etc) can experience high levels of stress in training (Kinsella et al., 2016) and risk of entering the workforce with burnout symptoms. This has impacts for early career health professionals and the care they offer (Poghosyan et al., 2010). A factor associated with greater burnout and depressive symptoms is perfectionism, leading health professionals to strive excessively, be unhappy with their work, and be plagued by self-criticism. Perfectionism can be a risk for an early exit from a healthcare career.  

Darcy Fahroedin (Master of Clinical Psychology trainee) investigated the association of perfectionism with burnout and depressive symptoms experienced by Allied Health students, and the role of psychological flexibility, in his Honours research.  Allied Health students in Australia (N = 187) responded to an online survey: we observed that not only were students with high levels of perfectionism experiencing greater burnout and depressive symptoms but that psychological inflexibility was important in explaining these impacts. Specifically, we found cognitive fusion and experiential avoidance accounted for how perfectionism relates to depressive symptoms, whereas lack of committed action and cognitive fusion accounted for how perfectionism leads to burnout.

Could it be useful to teach psychological flexibility skills during training, so early career professionals respond flexibly in situations triggering perfectionism? An implication is the value of supporting healthcare students to strengthen their capabilities to respond to challenges with psychological flexibility. This could be through having psychological flexibility competencies incorporated in professional training models. Our study was conducted before the COVID-19 pandemic: we can only speculate on how the increased healthcare demands of current times require flexible responses from practitioners …

For Darcy’s Masters research we are investigating these processes with qualified Allied Health professionals, seeing how perfectionism & psychological flexibility changes over time. This is a collaboration with Kim Holmes and Janet McConville, clinical educators in the School of Allied Health at La Trobe University. [If you are an Allied Health professional and interested in participating in this study, you can find out more here: https://redcap.latrobe.edu.au/redcap/surveys/?s=D3L3EENMA9 ]

Resilience in trauma therapists

Angelika Radeka (PhD candidate) used her extensive experience in training therapists to conduct a Masters research project on the impact of vicarious trauma on helpers of people who have experienced trauma (trauma therapists, social workers and counsellors). We sought to understand whether psychological flexibility contributed to how vicarious trauma effects the wellbeing and functioning of these helpers. Trauma professionals in Australia (N = 311) completed surveys about their work experiences, wellbeing and tendencies toward responding flexibly to unwanted feelings, thoughts, and bodily sensations. We found that psychological inflexibility predicted the presence and intensity of trauma symptoms and led to reduced wellbeing for trauma workers. Cognitive fusion was the strongest predictor of trauma symptoms and a novel finding was that self-as-context was negatively associated with trauma symptoms.  We believe this is the first study to examine trauma using a self-perspective measure founded in ACT theory (the Self as Context Scale: Zettle et al., 2018). We also found that trauma symptoms were mediated by combined psychological inflexibility processes (fusion, avoidance, inflexible selfing) when helpers were exposed to trauma. The influence of psychological inflexibility on vicarious trauma was evident even when accounting for workplace burnout. However, burnout appears to increase a helper’s vulnerability to vicarious trauma. 

We think that if these findings are replicated there are important implications for how trauma professionals are supported, including how workplaces can promote psychological flexibility. Angelika’s PhD research is extending this further, by exploring ways that flexible selfing (capacity to take multiple self-perspectives, fluidity in observing self-experiences, hierarchical and distinction relational framing) may support skilful responding to traumatic experiences. 

It is exciting to share our work with ANZACBS: one of best things about contextual behavioural science is the community that inspires and supports efforts to “create a science more adequate to the human condition”. We hope to contribute through La Trobe CBS Lab to this worldwide project!  

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The ANZ ACBS Contributing Author Program is designed to highlight the amazing work happening within the Contextual Behavioural Science community. If you would like to submit  stories, blogs or, articles contact us at: comms@anzacbs.com.au 

Julie Grove, President, ANZ ACBS


Julie Grove is currently a psychologist in private practice in inner Sydney, having previously worked in tertiary education and community health. She has been a part of the ANZ ACBS community for 15 years and is passionate about supervising and supporting early career therapists in CBS principles.

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