Academic journal article The Psychological Record

The Valued Living Questionnaire: Defining and Measuring Valued Action within a Behavioral Framework

Academic journal article The Psychological Record

The Valued Living Questionnaire: Defining and Measuring Valued Action within a Behavioral Framework

Article excerpt

A number of cognitive-behavior therapies now strongly emphasize particular behavioral processes as mediators of clinical change specific to that therapy. This shift in emphasis calls for the development of measures sensitive to changes in the therapies' processes. Among these is acceptance and commitment therapy (ACT), which posits valued living as one of its primary core processes. This article offers a definition of values from a behavioral perspective and describes the Valued Living Questionnaire (VLQ) as a first attempt at assessment of valued living. The VLQ is a relatively brief and easily administered instrument derived directly from the primary text on ACT. Initial psychometric support for the VLQ suggests that valued living can be measured, even with the most simple of instruments, in such a way as to consider it a possible mechanism of change in ACT and related approaches.

Key words: behavior therapy, cognitive behavior therapy, Values, Assessment, Valued Living Questionnaire, Acceptance-based psychotherapy, Values-based psychotherapy, Behavioral activation

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Emerging "third-wave" behavior therapies concentrate on the "construction of broad, flexible, and effective repertoires over an eliminative approach to narrowly defined problems" (Hayes, 2004. p. 658). Functional analytic psychotherapy (FAP; Kohlenberg & Tsai, 1991), dialectical behavior therapy (DBT; Linehan, 1993), integrative behavioral couple therapy (IBCT; Christensen, Jacobson, & Babcock, 1995; Jacobson & Christensen, 1996; Jacobson, Christensen, Prince, Cordova, & Eldridge, 2000), mindfulness-based cognitive therapy (MBCT; Segal, Williams, & Teasdale, 2002), behavioral activation (Dimidjian et al., 2006; Jacobson et al., 1996), and Borkovec's present-moment-focused approach to the treatment of GAD (e.g., Borkevec & Sharpless, 2004), among others, share this shift in focus.

In addition to changes in the focus of treatment outcome, many of these newer therapies propose differences in putative mechanisms of action. Changes in acceptance, mindfulness, distress tolerance, and metacognition, among others, have been proposed as mediators of clinical change. Because of these differences, third-wave behavioral treatments pose significant empirical challenges. Not only do we need to carry the burden of examining their efficacy, but we have the additional challenge of generating and refining measures sensitive to differences in process and outcome.

Acceptance and commitment therapy (ACT, said as a word, not as individual letters; Hayes, Strosahl, & Wilson, 1999) is one among these emergent cognitive behavioral therapies in which change processes and outcome are being examined. ACT is based on a functional contextualist philosophical framework and a contemporary contextual behavioral theory of human behavior. ACT's underlying theory incorporates well-validated basic operant and respondent conditioning processes from behavior analysis with relational frame theory, a post-Skinnerian theory of relational conditioning processes considered central to understanding human language, cognition, emotion, and motivation (Hayes, Barnes-Holmes, & Roche, 2001).

Examination of the relative clinical efficacy of ACT is in its infancy. However, early randomized trials have shown considerable promise. Compared to waitlist, placebo, or treatment-as-usual, a recent meta-analysis of ACT (n = 404) demonstrated a large mean effect size (Cohen's d = .63; Hayes, Luoma, Bond, Masuda, & Lillis, 2006) in treating a wide variety of psychological syndromes, as well as other problematic experiences (e.g., burnout; see Hayes et al., 2004).

Although the aforementioned studies showed reductions in distress on a variety of well-standardized measures, such reductions in distress are not the primary targets of treatment. Rather than focusing on symptom elimination, the primary purpose of ACT is to teach clients to accept and embrace necessary suffering in order to increase their ability to engage in committed, life-affirming action. …

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