Depression is commonly reported by Veterans who have experienced military sexual trauma (MST). An increasing body of literature supports the use of Acceptance and Commitment Therapy (ACT) for the treatment of depression among civilians and military Veterans; however, additional research is needed, particularly among people exposed to trauma. This clinical case study describes the application of ACT with a 21-year-old woman Veteran who sought treatment for depression related to MST. The Veteran’s depression symptoms decreased substantially over the course of therapy. Moreover, she demonstrated increased ability to attend to the present moment, tolerate feelings of uncertainty, and make decisions consistent with her chosen values. Treatment implications of these findings are discussed, with an emphasis on the unique aspects of using ACT in the treatment of MST-related depression among Veterans.
BaerR. (2014). The practicing happiness workbook. Oakland, CA: New Harbinger.
2.
BeckA. T.SteerR. A.BrownG. K. (1996). Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation.
3.
BluettE. J.HomanK. J.MorrisonK. L.LevinM. E.TwohigM. P. (2014). Acceptance and commitment therapy for anxiety and OCD spectrum disorders: An empirical review. Journal of Anxiety Disorders, 28, 612-624. doi:10.1016/j.janxdis.2014.06.008.
4.
BohlmeijerE. T.FledderusM.RokxT. A. J. J.PieterseM. E. (2011). Efficacy of an early intervention based on acceptance and commitment therapy for adults with depressive symptomatology: Evaluation in a randomized controlled trial. Behaviour Research and Therapy, 49, 62-67. doi:10.1016/j.brat.2010.10.003
5.
BondF. W.HayesS. C.BaerR. A.CarpenterK. M.GuenoleN.OrcuttH. K.. . . ZettleR. D. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire–II: A revised measure of psychological inflexibility and experiential avoidance. Behavior Therapy, 42, 676-688.
6.
FormanE. M.HerbertJ. D.MoitraE.YeomansP. D.GellerP. A. (2007). A randomized controlled effectiveness trial of acceptance and commitment therapy and cognitive therapy for anxiety and depression. Behavior Modification, 31, 772-799.
7.
HayesS. C.LuomaJ. B.BondF. W.MasudaA.LillisJ. (2006). Acceptance and Commitment Therapy: Model, processes, and outcomes. Behaviour Research and Therapy, 44, 1-25.
8.
HayesS. C.StrosahlK. D.LuomaJ.SmithA. A.WilsonK. G. (2004). An ACT primer: Core therapy processes, intervention strategies, and therapist competencies. In HayesS. C.StrosahlK. D. (Eds.), A practical guide to acceptance and commitment therapy (pp. 59-73). New York, NY: Springer.
9.
HayesS. C.StrosahlK. D.WilsonK. G. (2011). Acceptance and commitment therapy: The process and practice of mindful change (2nd ed.). New York, NY: Guilford Press.
10.
HayesS. C.VillatteM.LevinM.HildebrandtM. (2011). Open, aware, and active: Contextual approaches as emerging trend in the behavioral and cognitive therapies. Annual Review of Clinical Psychology, 7, 141-168. doi:10.1146/annurev-clinpsy-032210-104449
11.
KarlinB. E.WalserR. D.YesavageJ.AimeeZ.TrockelM.TaylorC. B. (2013). Effectiveness of acceptance and commitment therapy for depression: Comparison among older and younger Veterans. Aging & Mental Health, 17, 555-563. doi:10.1080/1360786 3.2013.789002
12.
KimerlingR.StreetA. E.PavaoJ.SmithM. W.CronkiteR. C.HolmesT. H.FrayneS. M. (2010). Military-related sexual trauma among Veterans Health Administration patients returning from Afghanistan and Iraq. American Journal of Public Health, 100, 1409-1412.
13.
LipariR. N.CookP. J.RockL. M.MatosK. (2008). 2006 Gender Relations Survey of Active Duty Members (DMDC Report No. 2007-2002). Arlington, VA: Department of Defense Manpower Data Center.
14.
MasudaA.TwohigM. P.StormoA. R.FeinsteinA. B.ChouY.WendellJ. W. (2010). The effects of cognitive defusion and thought distraction on emotional discomfort and believability of negative self-referential thoughts. Journal of Behavior Therapy & Experimental Psychiatry, 41, 11-17. doi:10.1016/j.jbtep.2009.08.006
15.
MenninD. S.EllardK. K.FrescoD. M.GrossJ. J. (2013). United we stand: Emphasizing commonalities across cognitive-behavioral therapies. Behavior Therapy, 44, 234-248. doi:10.1016/j.beth.2013.02.004
16.
MottJ. M.MenefeeD. S.LeopoulosW. S. (2012). Treating PTSD and disordered eating in the wake of military sexual trauma: A case study. Clinical Case Studies, 11, 104-118. doi:10.1177/1534650112440499
17.
O’BrienB. S.SherL. (2013). Military sexual trauma as a determinant in the development of mental and physical illness in male and female Veterans. International Journal of Adolescent Mental Health, 25, 269-274.
18.
PowersM. B.Zum VordeSiveVordingM. B.EmmelkampP. M. (2009). Acceptance and commitment therapy: A meta-analytic review. Psychotherapy and Psychosomatics, 78, 73-80. doi:10.1159/000190790
19.
RoweE. L.GradusJ. L.PinelesS. L.BattenS. V.DavisonE. H. (2009). Military sexual trauma in treatment-seeking women Veterans. Military Psychology, 21, 387-395. doi:10.1080/08995600802565768
20.
RuizF. J. (2010). A review of Acceptance and Commitment Therapy (ACT) empirical evidence: Correlational, experimental psychopathology, component and outcome studies. International Journal of Psychology & Psychological Therapy, 10, 125-162.
21.
StoddardJ. A.AfariN.HayesS. C. (2014). The big book of ACT metaphors: A practitioner’s guide to experiential exercises and metaphors in Acceptance and Commitment Therapy. Oakland, CA: New Harbinger.
22.
ThompsonB. L.LuomaJ. B.LeJeuneJ. T. (2013). Using Acceptance and Commitment Therapy to guide exposure-based interventions for posttraumatic stress disorder. Journal of Contemporary Psychotherapy, 43, 133-140. doi:10.1007/s10879-013-9233-0
23.
TurchikJ. A.PavaoJ.HyunJ.MarkH.KimerlingR. (2012). Utilization and intensity of outpatient care related to military sexual trauma for Veterans from Afghanistan and Iraq. Journal of Behavioral Health Services & Research, 39, 220-233.
24.
U.S. Code, Title 38 § 1720D, Counseling and treatment for sexual trauma.
25.
WalserR. D.KarlinB. E.TrockelM.MazinaB.TaylorC. B. (2013). Training in and implementation of Acceptance and Commitment Therapy for depression in the Veterans Health Administration: Therapist and patient outcomes. Behaviour Research and Therapy, 51, 555-563. doi:10.1016/j.brat.2013.05.009
26.
WestrupD. (n.d.). ACT for Military Sexual Trauma. Washington, DC: U.S. Department of Veterans Affairs.
27.
ZinzowH. M.GrubaughA. L.MonnierJ.Suffoletta-MaierleS.FruehB. C. (2007). Trauma among female Veterans: A critical review. Trauma, Violence, & Abuse, 8, 384-400.
