Similar patterns, where reports of relatively more negative thinking were linked to positive outcomes, have been seen in other studies of ACT. For example, Varra, Hayes, Roget, and Fisher (2008) found that addictions counselors exposed to ACT before training on the use of agonists and antagonists to treat substance misuse reported more barriers to using these technologies but also more willingness to do so. Similarly, Bach and Hayes (2002) found that inpatients suffering from delusions and hallucinations who were exposed to a short ACT intervention reported less reduction in these symptoms than TAU, while at the same time being better able to function outside of the hospital. Similar findings exist for self-confidence (Lappalainen et al., 2007) and barriers to applying training (Varra et al., 2008). Across these studies, initially higher posttreatment levels of difficult thoughts or feelings became, in effect, indicators of healthy acceptance processes that were part of longer term gains.
