Psychology: Acceptance and Commitment Therapy
natalia.na
ACTSeminar-Part1LectureSlides-Sp2020-1.pptxAcceptance and Commitment Therapy-PSYC 498/598
Spring 2020 quarter
Kevin Criswell, Ph.D.
As Steve Hayes said in his TEDx talk in Nevada, “Life asks us questions…and one of the most important questions it asks us is, ‘What are you going to do about difficult thoughts and feelings?’”
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A look at the past flyer from Summer 2020…
Ironically, even though ACT is not about making people feel “happy”, which is illustrated very well by ACT author and writer, Dr. Russ Harris in his The Happiness Trap, engaging in ACT-based work can help people feel better. It can say a lot about how individuals approach life: Which of the two words do they emphasize?
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feeling better…
Choice
Feel better
Feel better
Seek pleasure
Avoid discomfort
Narrowing
“Bad” emotions are to be “fixed”
Emotional openness
Willingness/acceptance
Commit to personal values
All emotions can be experienced
Grading
Participation-brief, single-paragraph discussion posts for each of the three major sections of this seminar, due by 11:59pm on June 7th(each in their own modules in Canvas):
Module 1: Introduction to ACT & Doing What Matters
Module 2: Be Present
Module 3: Open Up
Reflection Discussion Assignment (Canvas), due by 11:59pm on June 7th
Graduate-level only (PSYC 598): Application Discussion Assignment (Canvas), due by 11:59pm on May 31st
Intended Audience & Purpose
Audience: Undergraduate (498) and graduate-level (598) students interested in learning about the evidence for, structure of, and application of Acceptance and Commitment Therapy (ACT).
Purpose
Describe the background and concepts involved in ACT.
Describe the evidence base for ACT.
Describe an ACT conceptual model.
Describe and experience how the six therapeutic processes can be applied to promote psychological flexibility.
Describe how ACT can be applied to a clinical case study.
Agenda
Part 1 (See lecture video within Module 1)
Introductions and “disclaimers”
What is “ACT”?
Evidence base for the effectiveness of ACT
Conceptual model of ACT (Hexaflex/Triflex)
Do What Matters
Part 2 (See lecture video within Module 2)
Be Present
Part 3 (See lecture video within Module 3)
Open Up
A clinical example of ACT applied to a client
Disclaimers
This seminar is not intended to provide sufficient clinical training for students to deliver ACT interventions in clinical settings and/or to individuals with the intention of treating a diagnosed mental disorder (this is consistent with the APA ethics code 2.01, in the area of “Competence”).
Students interested taking what they learned in this class and applying ACT to treat clients/patients should obtain supervised clinical training under ACT-trained clinicians.
https://contextualscience.org/civicrm/profile?_qf_Search_display=true&qfKey=efaaee08948b8245ef15b09c073b0586_5549
As of July 16, 2019: 100+ ACT therapists located in Washington state
I am a mandated reported of sexual harassment (Title IX), abuse of children/elders/vulnerable populations, and imminent danger to self and others.
Title IX: Confidential counseling and non-confidential resources at Bellevue and Cheney campuses are listed in the course syllabus.
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Introductions
Who is your professor?
PhD in Clinical Psychology, Adult Health concentration (LLU 2016)
Clinical experience since 2011 across many settings.
ACT-related coursework in grad school.
Utilized and trained in ACT-based clinical treatment for 3+ years
Developed an ACT-based treatment protocol for couples adjusting to advanced cancer.
Introductions: What about you?
May follow along in your handout:
What do you already know about ACT or what do you think ACT is?
How would you define “mindfulness”?
How would you describe the purpose of mindfulness?
What is “ACT”?
Let’s watch a TEDx talk by Steve Hayes, Ph.D.: https://www.youtube.com/watch?v=GnSHpBRLJrQ
Did you catch what he said about what ACT is?
What was the “little ditty” that he presented about his 30 years of research and what does it mean?
What were some of the ways that we can “put on the mental breaks”?
Other comments or questions about what you noticed in the video?
Evidence base for ACT (ACBS, 2019)
300+ RCTs as of May 2019 (e.g., anxiety, pain, depression, stress, substance abuse, weight loss, social anxiety, and more)
45 meta-analytic reviews of ACT-based interventions, as of Jan. 2019 (projected to hit 50 by the end of 2019)
Evidence base for ACT
APA, Div. 12 (Society of Clinical Psychology, 2016) Research supported psychological treatments (“pending re-evaluation”):
Chronic pain: strong research support
Depression: modest research support
Mixed anxiety: modest research support
OCD: modest research support
Psychosis: modest research support
“Strong” and “Modest” research Support? (SCP, 2016)
“Research support for a given treatment is labeled “strong” if criteria are met for what Chambless et al. (1998) termed “well-established” treatments. To meet this standard, well-designed studies conducted by independent investigators must converge to support a treatment’s efficacy. Research support is labeled “modest” if criteria are met for what Chambless et al. (1998) termed “probably efficacious treatments.” To meet this standard, one well-designed study or two or more adequately designed studies must support a treatment’s efficacy. In addition, it is possible for the “strong and “modest” thresholds to be met through a series of carefully controlled single-case studies. For a full description of the Chambless criteria readers are referred to Chambless et al. (1998). In addition, this site labels research support “controversial” if studies of a given treatment yield conflicting results or if a treatment is efficacious but claims about why the treatment works are at odds with the research evidence.”
Conceptual ACT-based Models of PsychoPathology and Wellbeing (Hayes, Pistorello, & Biglan, 2008)
Wellbeing “Hexaflex”
Pathology “Hexaflex”
Psychological flexibility? (Kashdan, 2010)
“…psychological flexibility…is a slippery construct to define. Psychological flexibility actually refers to a number of dynamic processes that unfold over time. This could be reflected by how a person: (1) adapts to fluctuating situational demands, (2) reconfigures mental resources, (3) shifts perspective, and (4) balances competing desires, needs, and life domains. Thus, rather than focusing on specific content (within a person), definitions of psychological flexibility have to incorporate repeated transactions between people and their environmental contexts” (p. 2).
The Vital Cycle vs. The Narrow Cycle (Hayes, 2005)
Creative Hopelessness (Harris, 2009)
Three questions about attempts to get rid of unwanted thoughts and feelings:
What have you tried?
How has it worked?
What was the cost?
The idea: If one continues doing what has been done, then they will continue getting what they have always got.
Consider (handout): What are some messages you have heard about how people should deal with uncomfortable or unwanted thoughts and feelings?
NOTE: This does NOT mean that all attempts at controlling or regulating emotions are unhelpful. It does mean that it may helpful to examine attempts to control thoughts or feelings if individuals are unsatisfied with their situation (emotionally, physically, spiritually, etc.).
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A quick Aside: Metaphors
Why all the metaphors?
How my internship supervisor for trauma-related treatment explained it:
Novel concepts are put into understandable scenarios, and
The concepts are described as separate from an individual’s specific circumstances.
This is especially helpful when presenting new ways of thinking to those who may feel vulnerable, have difficulty trusting others, and/or are vigilant for signs of danger. They get to decide how the concepts apply to them.
Conceptual model of ACT: Simplified (Harris, 2009)
Warning: We are About to go through the Core Processes of ACT
A popular opinion among ACT clinicians: “Practice what you preach”.
I am adopting this approach for teaching you about the core therapeutic processes.
What this means: I may ask you to participate in some ACT-based practices so you can experience what they are like for you, which is intended to enhance your learning experience.
What this does NOT mean: Again, this is not intended to treat any individual student’s diagnosed condition (e.g., OCD, chronic pain). Also, I am NOT requiring you to share details about your personal life (e.g., who are involved in your relationships), disabilities, or diagnosed conditions.
For those of you who find it too difficult or uncomfortable to apply the exercises to yourselves, I have a case study that you may use as a reference for most the exercises.
Case study option: You will be asked to fill out worksheets from the perspective of the case and provide some reasoning for why the individual in the case study would have responded that way.
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Do What Matters
Do What Matters: Values
Consider (handout): How would you define the phrase “personal value”? Give some examples.
(ACBS, n.d.): “Values are chosen qualities of purposive action that can never be obtained as an object but can be instantiated moment by moment…In ACT, acceptance, defusion, being present, and so on are not ends in themselves; rather they clear the path for a more vital, values consistent life.”
My preference: I begin here (as opposed to focusing on opening up and being present) because values can be excellent reminders for why a client (or I) might go through the discomfort of learning new ways of relating to my thoughts and feelings.
metaphors for describing the function of values
Do What Matters: Values Identification
Values are not goals…but specific, measurable, attainable, relevant, and timely (SMART) goals can come from committing to the pursuit of a value.
Example: I value helping others learn (when I was 20-years-old).
Relevant goal: I want to make a career out of helping others learn.
More specific: I want to teach undergraduate-graduate level courses.
More timely, measurable, and attainable: I want to take part in at least one research assistantship and maintain good grades to increase the likelihood that I will be accepted into a PhD program, which will afford me opportunities to teach undergraduate-graduate students.
Do What Matters: Values Identification & Committed Action
Commonly used exercises include:
Values Card Sort (see on Canvas)-values only
Valued Living Questionnaire-values + committed action
The Life Compass-values + committed action
The Bull’s Eye-values + committed action
Committed Action Questionnaire (CAQ-8)-committed action only
And (many) more…
Do What Matters: The Bull’s Eye (Handout)
This exercise gets at values identification and committed action (i.e., how closely one is living consistently with one’s values).
Go to The Bull’s Eye handout, read the directions carefully and follow those directions.
Underneath each area of life (Work/Education, Relationships, Personal Growth/Health, Leisure), try answering the following two questions:
What sort of person do you want to be?
What personal strengths or qualities do you want to develop?
Reminder: If you would prefer not to apply these exercises to yourself, please let me know and I will provide you with a case study! Your job will be to fill it out from the perspective of the individual in the case study.
Do What matters: Reflection
Please take some notes on the following (this will help you with the reflection assignment on Canvas):
How easy or difficult was it for you to identify what sort of person you (or the individual in the case study) want to be in each of the major areas listed in The Bull’s Eye?
On a scale from (not at all) 1-10 (extremely) , how important is the area of Work/Education to you?
On a scale from 1-10, how important is the area of Leisure to you?
On a scale from 1-10, how important is the area of Relationships to you?
On a scale from 1-10, how important is the area of Personal Growth/Health to you?
Do What Matters: Final Words
Comparing levels of importance (e.g., 1-10 scale) with levels of acting consistently/inconsistently in valued area of life can provide important clues as to where much of the best work can be to move closer towards vital living.
A potential problem: But, everything is important (or too many extremely important values)!
Possible solution: Focusing on improvement in one area.
Possible solution: Recognizing that one has limited capacity, and perfectly living according to all values is impossible (e.g., values of being a present father and being a high-achieving researcher can conflict, at times).
Canvas Discussion Assignment(S)
Participation credit for Module 1: Brief Discussion post
Due by 11:59pm on June 7th
Carefully follow directions on the discussion assignment page!
“How can I feel better?” This is a question that all of us have probably thought at least once in our lives. Another question that life throws at us daily is “What are you going to do about difficult thoughts and feelings?” Acceptance and Commitment Therapy (or “ACT” for short) is a set of answers to those questions (TEDx Talks, 2016). What you can expect from this seminar: We will go over the six core therapeutic processes of ACT, sometimes called the “ACT hexaflex.” We will go over the rationale for each process and participate in experiential exercises to demonstrate each process. We will also discuss how they can lead to “psychological flexibility.” I look forward to seeing you there! –Dr. C Dr. Kevin Criswell, Visiting Assistant Professor of Psychology Email: [email protected] | Reference: TEDx Talks. (2016, February). Psychological flexibility: How love turns pain into purpose | Steven Hayes | TEDxUniversityofNevada [Video file]. Retrieved from https://www.youtube.com/watch?v=o79_gmO5ppgv
Acceptance and Commitment Therapy PSYC 498.54/598.053 – Summer 2019 – July 26, 8am – 6pm
“HowcanIfeelbetter?”Thisisaquestionthatallofushaveprobably
thoughtatleastonceinourlives.Anotherquestionthatlifethrowsat
usdailyis“Whatareyougoingtodoaboutdifficultthoughtsand
feelings?”AcceptanceandCommitmentTherapy(or“ACT”forshort)is
asetofanswerstothosequestions(TEDxTalks,2016).
Whatyoucanexpectfromthisseminar:Wewillgooverthesixcore
therapeuticprocessesofACT,sometimescalledthe“ACThexaflex.”We
willgoovertherationaleforeachprocessandparticipatein
experientialexercisestodemonstrateeachprocess.Wewillalsodiscuss
howtheycanleadto“psychologicalflexibility.”
Ilookforwardtoseeingyouthere!–Dr.C
Dr. Kevin Criswell, Visiting Assistant Professor of Psychology
Email: [email protected]| Reference:TEDx Talks. (2016, February). Psychological flexibility: How love turns pain into
purpose | Steven Hayes | TEDxUniversityofNevada[Video file]. Retrieved from https://www.youtube.com/watch?v=o79_gmO5ppgv
Acceptance and Commitment Therapy
PSYC 498.54/598.053 –Summer 2019 –July 26, 8am –6pm
