CU psychology grad student aims to prevent and reduce anxiety in youth using mindfulness and value-based behavior

At just 16 years old, the girl had missed nearly a year of school after a series of concussions left her with lingering physical and emotional struggles.

The girl’s psychologist, Rebecca Schneider, knew just how to help. Using a treatment called Acceptance and Commitment Therapy (ACT), Schneider taught her teenage patient techniques that would help her get back her life.

“ACT's focus on acceptance of uncomfortable emotions and sensations allowed us to focus on how to reconnect with her life even in the face of continued discomfort,” says Schneider, who is a PhD candidate, expecting to graduate this year, in the University of Colorado Boulder’s Department of Psychology and Neuroscience. 

Although the girl still has a long way to go, she is now missing significantly less school than she used to. The next step is to get her back to seeing her friends more regularly. 

Schneider is completing her capstone internship at Stanford University in Palo Alto, California, where she provides both inpatient and outpatient therapy, focusing on youth. Getting to this point, she says, is a credit to the connections she made at CU Boulder.

“CU really set me up well, and people are really impressed by my training,” she says. 

After completing her bachelor’s degree in psychology at the University of North Carolina at Chapel Hill, the Atlanta native came to CU Boulder specifically to study interventions for anxiety using ACT under Associate Professor Joanna Arch.

ACT is a variation of traditional Cognitive Behavioral Therapy (CBT), which is a psychological treatment that is widely used in treating mood and anxiety disorders. It identifies problematic thinking and behavioral patterns, then works to change these patterns through development of coping skills and changing feelings through modifying thoughts and behaviors. 

One key difference between the two treatments is that while CBT treatment involves efforts to manage feelings by changing maladaptive thoughts, ACT focuses more on addressing the context and function of these thoughts and feelings. 

“In ACT, there is less of an emphasis on having to challenge your thoughts or question them, but how to relate to them differently, not judging them as right or wrong,” Schneider explains.  

ACT focuses on accepting the presence of difficult emotions and then moving toward valued behaviors. For example, Schneider’s dissertation research examines the effect of incorporating college students’ personal values in deliberately and systematically facing feared situations, termed "exposure therapy."

Dissertation research participants were asked to give a public speech in exchange for either an extrinsic, monetary reward or for an intrinsic motivation based on their values. 

“We helped them identify core values, such as connection, creativity, or family, and linked those to the exposure,” Schneider says. “The question we asked is: What values is your anxiety impacting, and if you didn’t have to avoid the feared situation, what would you be able to do?” 

While she’s still evaluating the results, she reveals that the subjects who identified their core values reported feeling less anxious immediately before and after the speech, although those who spoke for monetary reward spoke for a longer period of time. 

Schneider is drawn to treating anxiety disorders because their presentation is unique in different people, which allows for greater creativity in treatment, she says.

ACT in particular has produced significant positive results in treating anxiety disorders. And Schneider believes the therapy model can address difficulties that young people may have with regulating their emotions and behaviors. Emotion dysregulation includes things such as not being aware of or attending to emotions, having a negative emotional response to negative emotions, and difficulty pursuing meaningful goals due to negative emotions. 

Schneider also led a 2016 research study in collaboration with Ben Hankin, currently at the University of Illinois, and Joanna Arch on the relationship between emotional dysregulation and anxiety, which was published in the Journal of Clinical Child & Adolescent Psychology. Titled “The Longitudinal Effect of Emotion Regulation Strategies on Anxiety Levels in Children and Adolescents,” the study examines whether difficulties with emotional regulation predicted higher levels of anxiety in a population of 312 youth monitored for a period of three years.

“By showing that emotional dysregulation can affect anxiety over time, we can reduce or prevent the development of anxiety by targeting reductions in maladaptive strategies, and trying to add in more emotional regulation skills,” Schneider says.

Learning to accept troublesome emotions, practice self-compassion, and tolerate distress while accomplishing their goals are some of the skills she practices with her clients.

“Through ACT, my patients have learned that it’s okay to feel anxious, and anxiety isn’t dangerous,” she says. “They’ve also learned how to pay less attention to their pain so that they can keep doing the things they love.” 

Schneider has accepted a postdoctoral fellowship with McLean Hospital, the prominent psychiatric affiliate of Harvard Medical School. She will work with children in residential treatment for Obsessive-Compulsive Disorder using ACT-based exposure therapy.