that has more generally been found to be adaptive (Tangney & Dearing, 2002). Thus, improvements related to shame may have also been connected to changes in guilt. The comparability of this sample to others is unclear, as data were not collected on the number of participants who declined to participate or were determined to be ineligible; TLFB data were also not collected pretreatment. Finally, lack of blinding makes it possible that the better outcomes in the ACT condition may have been due to expectations of greater improvement among participants or staff on the treatment unit. While those possibilities cannot be fully eliminated, the fact that improvement was actually slower at first for ACT participants suggests that the effects to do not exclusively reflect demand characteristics.
