Experiential avoidance and psychological acceptance in the psychological recovery from enduring mental illness

Objective The concept of recovery has been generating significant interest in mental health contexts, as has the behavioural change approach of Acceptance and Commitment Therapy (ACT) in psychotherapy contexts. The objective of this study is to observe if psychological acceptance and experiential avoidance, two core concepts of ACT, may be present in the psychological recovery processes of people with enduring mental illness. The reason to study these two psychological constructs is that experiential avoidance has pervasive effects in one’s life and is at the core of several significant clinical problems. As such, ACT suggests the use of psychological acceptance to deal with experiential avoidance, which has been proven successful at improving the quality of life. Method The research involved two studies which sought to pin point the presence of experiential avoidance and psychological acceptance in the psychological recovery process of people with mental illness. The first study was exploratory and qualitative, while the second used a quantitative approach. In Study One, 45 published narratives and 33 life stories from individuals living with long-term mental illness were content-analysed, seeking to locate textual examples of experiential avoidance and psychological acceptance. The objective of this study was to provide a preliminary examination of the role and frequency of psychological acceptance and experiential avoidance in the process of psychological recovery from enduring mental illness. Study Two examined the relationship between psychological acceptance and experiential avoidance in psychological recovery from enduring mental illness, using established measures of recovery and psychological well-being. Forty-one participants with a clinical diagnosis of chronic mental illness (at least 12 months) as reflected in the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) Text Revision (DSM-IV-TR) Axis I were recruited from across New South Wales, Australia. The Acceptance and Action Questionnaire (AAQ-19) was used to examine the presence of psychological acceptance and experiential avoidance; the Recovery Assessment Scale (RAS) and the Stages of Recovery Instrument (STORI) were used to examine the levels of psychological recovery, andthe Psychological Well-Being scales (PWB) were used to measure well-being. Results In Study One, the high prevalence of psychological acceptance in narratives of people self-reporting success in their recovery journey suggests a potential relationship to positive developments in their journey of recovery. Conversely, the role and frequency of experiential avoidance could be associated with less progress in psychological recovery from mental illness. In Study Two, a correlational analysis between level of recovery, as assessed by the RAS instrument, and acceptance, as assessed by the AAQ-19, showed no significant relationship between the two variables. The AAQ-19 nonetheless correlated positively with three of the five subscales of the RAS. In addition, positive correlations were found between the overall score for PWB and the high use of psychological acceptance. Conclusion While Study One indicated the presence of experiential avoidance and psychological acceptance in narratives of people with enduring mental illness, Study Two demonstrated that there was no clear correlation between the use of psychological acceptance and recovery from mental illness. This study, however, demonstrated that there is a relationship between psychological acceptance and positive levels of psychological well-being among individuals with mental illness, indicating that psychological acceptance may play a positive role in improving the psychological well-being of people with mental illness