Date of Award:


Document Type:


Degree Name:

Doctor of Philosophy (PhD)



Committee Chair(s)

Michael Levin


Michael Levin


Ginger Lockhart


Rick Cruz


Michael Twohig


Karen Muñoz


Mental and emotional health concerns among college students are prevalent and diverse in their symptom presentations. With increasing demands on counseling centers to provide efficient care and to address students with higher acuity or risk for harm, there has been an increased focus on identifying therapeutic targets that underlie a wide breadth of concerns to broaden the scope and impact of mental health services. Psychological inflexibility is one such target and refers to a combination of excessive avoidance of internal experiences coupled with a lack of actions that align with a person’s values. Interventions for psychological inflexibility aim to support people in reducing actions that are mostly about avoiding unwanted thoughts and feelings and actions that involve moving towards chosen values. Such interventions may produce changes in people’s actions in part through helping people notice and label the different roles their actions play in relation to thoughts, feelings, and personal values. However, the skill of noticing and labeling the purposes of one’s actions has not been studied in interventions for psychological inflexibility despite being discussed in theoretical writings. Training this skill may serve as a direct means of reducing psychological inflexibility and as a foundation for other interventions, thus it may be a relevant target in interventions for psychological inflexibility among college students. Given this, the present study developed and tested an intervention focused on noticing and labeling one’s actions as an intervention for psychological inflexibility in a college student sample, as delivered through web and app-based media. The study recruited 106 students with symptoms of depression and anxiety from a medium sized university in the Mountain West of the United States, and then randomly assigned them to either wait for eight weeks or receive a three-week online and app-based training for noticing and labeling avoidant and values-consistent actions. The results of the study indicated short-term effects on symptoms of depression and anxiety for participants who received the online and app-based training as compared with participants who were asked to wait, although both groups showed reductions in symptoms by the end of the study period. Participants did not report changes in the target skill of noticing and labeling their actions although the study did find larger reductions in psychological inflexibility among participants who received the training as compared with those asked to wait. Further, changes in psychological flexibility were related to changes in behavioral activity and life satisfaction, but not life quality. The results raise questions about the necessity of training the ability to notice and label one’s actions as a direct intervention mechanism for psychological inflexibility. The findings also suggest that changing inflexible patterns of behavior may be more important than the capacity to notice such changes. These results are further interpreted in relation to interventions for college student mental and emotional health.



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