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This pilot randomized control trial (RCT) tested “Do More, Feel Better” (DMFB), a lay-delivered Behavioral Activation intervention for depressed senior center clients. The study examined: 1. the feasibility of training older lay volunteers to fidelity; and 2. the acceptability, safety, and impact of the intervention. Twenty-one lay volunteers at four senior centers were trained in DMFB. Fifty-six depressed clients were randomized to receive 9 sessions of DMFB or Behavioral Activation delivered by social workers (MSW BA). Research assessments of overall client activity level (BADS) and depression severity (HAM-D) were conducted at baseline and weeks 3, 6, and 9. Eighty-one percent of lay volunteers who underwent training were formally certified in DMFB. Depressed clients receiving each intervention reported high levels of satisfaction and showed large and clinically significant changes in 9-week activity level (d ≥ 1.35) and depression severity (d ≥ 3.34). Differences between treatment groups were very small for both activity level (dMSW = 0.16; 95% CI, -0.70 to 1.02) and depression (dMSW = 0.14; 95% CI, -0.63 to 0.91). Increases in activity level were associated with decreases in depression (β = -0.42; 95% CI, -0.55 to -0.30). Both interventions appeared to work as intended by increasing activity level and reducing depression severity. “Do More, Feel Better” shows the potential of evidence-based behavioral interventions delivered by supervised lay volunteers, and can help address the insufficient workforce available to meet the mental health needs of community-dwelling older adults.

Intimate relationships matter to health and happiness. However, the vast scope of relationship research and the abundance of precise micro-theories has presented obstacles to the development of integrative theories with contextual-behavioral foundations that are oriented towards application of findings in domains of public health significance. Derived from the well-validated Interpersonal Process Model, which described intimacy as a dyadic exchange in which Person A engages in a vulnerable self-disclosure, Person B enacts a response, and Person A perceives the response as responsive, we present an integrative, analytic-abstractive, contextual-behavioral model of intimate relations. The model describes the intimacy process as a set of functional relations describing behaviors and responses of Persons A and B in context, languaged as middle-level terms to facilitate cross-disciplinary applications. Three primary relations of the model are non-verbal emotional expression (Person A) and safety (Person B), verbal self-disclosure (Person A) and validation (Person B), and asking (Person A) and giving (Person B). The model also emphasizes the importance of self- and other-awareness, expressions of closeness, and reciprocity as additional terms. Future research directions and potential applications are discussed.

Previous research on microaggressions has emphasized the frequency of and distress produced by microaggressions as reported by people of color. The current research supplements the existing literature by developing a self-report measure of White individuals’ microaggressive likelihood against Black people, the Cultural Cognitions and Actions Scale (CCAS). Study 1 developed the CCAS through exploratory and confirmatory factor analyses of responses to CCAS items from a sample of 978 non-Hispanic White undergraduate students. The final scale comprised four factors (Negative Attitudes, Colorblindness, Objectifying, and Avoidance) assessing microaggressive likelihood, and CCAS total and factor scores were significantly related to several other indicators of racism and bias. Study 2 involved 31 of the previous participants in a lab-based discussion of race-related issues with a confederate and provided initial support for the predictive validity of the measure. Overall, this report supports a growing literature that microaggressions are more than innocuous, harmless behaviors, unrelated to racism, and instead represent relevant processes within the science of racism and bias. It also provides a potential means of testing the effectiveness of interventions intended to reduce the commission of microaggressions.

High quality relationships are essential to psychological health and well-being, and relational intimacy is a core feature of these relationships. Decades of research in relationship science have converged on a central model of intimacy wherein individuals develop close, trusting relationships with one another. Functional Analytic Psychotherapy (FAP) is a contextual behavioral intervention approach that is well-equipped to target interpersonal processes through the provision of in-session, therapist mediated reinforcement of skillful intimate relating. Single-subject level analyses of FAP's efficacy and mechanism of action are supportive; however, there is a need for group-level research to evaluate its efficacy and generalizability. This paper presents the development of the Awareness, Courage, and Responsiveness Scale (ACRS), a self-report measure of behaviors essential to intimate relating informed by contextual behavioral science principles and Reis and Shaver's (1988) Intimacy Process Model. In this five-part study, functioning of the ACRS is examined in undergraduate student samples (Studies 1–3), an adult community sample (Study 3), non-clinical dyadic relationships (Study 4), and a transdiagnostic clinical sample (Study 5). Strengths and limitations of the final measure are discussed.

BackgroundRacial bias in medical care is a significant public health issue, with increased focus on microaggressions and the quality of patient-provider interactions. Innovations in training interventions are needed to decrease microaggressions and improve provider communication and rapport with patients of color during medical encounters.MethodsThis paper presents a pilot randomized trial of an innovative clinical workshop that employed a theoretical model from social and contextual behavioral sciences. The intervention specifically aimed to decrease providers’ likelihood of expressing biases and negative stereotypes when interacting with patients of color in racially charged moments, such as when patients discuss past incidents of discrimination. Workshop exercises were informed by research on the importance of mindfulness and interracial contact involving reciprocal exchanges of vulnerability and responsiveness. Twenty-five medical student and recent graduate participants were randomized to a workshop intervention or no intervention. Outcomes were measured via provider self-report and observed changes in targeted provider behaviors. Specifically, two independent, blind teams of coders assessed provideremotional rapportandresponsivenessduring simulated interracial patient encounters with standardized Black patients who presented specific racial challenges to participants.ResultsGreater improvements in observed emotional rapport and responsiveness (indexing fewer microaggressions), improved self-reported explicit attitudes toward minoritized groups, and improved self-reported working alliance and closeness with the Black standardized patients were observed and reported by intervention participants.ConclusionsMedical providers may be more likely to exhibit bias with patients of color in specific racially charged moments during medical encounters. This small-sample pilot study suggests that interventions that directly intervene to help providers improve responding in these moments by incorporating mindfulness and interracial contact may be beneficial in reducing racial health disparities.

The interpersonal process model (IPM) suggests that closeness develops in relationships when two people reciprocally engage in vulnerable self-disclosure, respond to each other, and perceive each other’s responses as validating, understanding, and caring (responsive). Little is known about how fear-of-intimacy relates to this foundational intimacy process. We conducted two studies of fear-of-intimacy and the IPM. In Study 1, 146 high fear-of-intimacy participants were randomly assigned to either interact for 1 hr with a research assistant (RA) demonstrating high responsiveness, to interact for 1 hr with an RA displaying low responsiveness, or to view a nature video for 1 hr. Unlike previous experiments with undergraduates documenting that high responsiveness predicts closeness up to 2 weeks after the interaction, the current study with high fear-of-intimacy individuals found that high responsiveness predicted closeness immediately after the interaction but this was not sustained over time. In Study 2, we conducted structural modeling in a diverse sample of 216 survey respondents with a range of fear-of-intimacy scores. Consistent with previous studies, perceived responsiveness strongly predicted closeness. Fear-of-intimacy had negative direct effects on vulnerable self-disclosure and perceived responsiveness but a positive direct effect on closeness.

The US has never been more divided politically. Polarization is notable on majority-liberal college campuses where conservatives feel outnumbered and marginalized. In this study, we examined the effectiveness of a half-day workshop to decrease polarization and improve closeness between conservatives and liberals at a majority-liberal college campus. Informed by political psychology and relationship science, the intervention employed exercises derived from Acceptance and Commitment Therapy and Functional Analytic Psychotherapy to encourage identification of core beliefs and vulnerable discussions of deeper reasons for core political beliefs aimed at generating closeness and understanding between participants. Participants (N = 20) were assigned to 2 groups: one of mixed conservatives and liberals, and one of all liberals. All participants reported improvements in attitudes and hostility towards outgroup members from pre- to post-workshop, but only differences in relations with specific outgroup workshop participants were maintained at 1-month follow-up. Participants also reported arguing less than expected.