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An Introduction to Acceptance and Commitment Therapy (ACT)

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Kimberly Nylen April 23, 2007 Outline Brief history Third wave therapies Introduction to ACT Research History 1950 s Behavior therapy 1970 s ... – PowerPoint PPT presentation

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Title: An Introduction to Acceptance and Commitment Therapy (ACT)


1
An Introduction to Acceptance and Commitment
Therapy (ACT)
  • Kimberly Nylen
  • April 23, 2007

2
Outline
  • Brief history
  • Third wave therapies
  • Introduction to ACT
  • Research

3
History
  • 1950s Behavior therapy
  • 1970s Cognitive therapy
  • 1980s to present 3rd wave cognitive behavioral
    therapies

4
Behavior Therapy
  • Interventions derived from conditioning
    principles
  • Exposure
  • Behavioral Activation

5
Cognitive Therapy
  • Focus on social learning, language, information
    processing, cognitive styles
  • Irrational thoughts
  • Cognitive distortions

6
Third Wave Therapies
  • Integrate mindfulness and acceptance

7
Examples
  • Acceptance and Commitment Therapy (ACT)
  • Dialectical Behavior Therapy (DBT)
  • Functional Analytic Psychotherapy (FAP)
  • Integrative Behavioral Couples Therapy (IBCT)
  • Mindfulness-Based Cognitive Therapy (MBCT)

8
What is mindfulness?
  • Consciously bringing awareness to your
    here-and-now experience with openness, interest,
    and receptiveness. (Harris, 2006)

9
Mindfulness is
  • Living in the present moment
  • Engaging fully in what you are doing rather than
    getting lost in your thoughts
  • Noticing as your feelings to come and go (without
    attempts to control them).

10
What is acceptance?
  • Making room for unpleasant sensations, feelings,
    urges, thoughts, etc.
  • Allowing them to come and go without trying to
    change them
  • Acceptance is NOT resignation or tolerance
  • You dont have to like something to accept it

11
Acceptance and Commitment Therapy
  • Pronounced ACT, not A.C.T.

12
ACT
  • Developed by Steven Hayes and colleagues in the
    1980s

13
Framework
  • Western psychology is founded on the assumption
    of healthy normality
  • Psychological disorders are viewed as abnormal

14
Framework
  • ACT does not subscribe to this assumption
  • Rather, ACT assumes that psychological processes
    of the normal mind naturally lead to
    suffering/distress
  • Attempting to control/get rid of this distress is
    part of the problem

15
Why not symptom reduction?
  • Humans natural tendency is to avoid problems
  • Problem something we dont want
  • Solution figure out how to get rid of it or
    avoid it
  • Example Bear outside your window get rid of it
    throw rocks, shoot, call authorities
  • Example snow, rain cant get rid of, but can
    avoid.

16
Avoidance can be bad.
  • Problem-solving approaches (avoiding, getting rid
    of) work really well when it comes to certain
    types of problems.
  • They dont work so well when it comes to
    thoughts, feelings, sensations, memories

17
Example
  • Everyone has anxiety, but people are diagnosed
    with anxiety disorders when their lives revolve
    around controlling anxiety.
  • Panic disorder (anxiety about anxiety avoid
    places that could lead to panic attack)
  • OCD (elaborate rituals to get rid of anxiety)

18
Goals
  • The goal of ACT is not symptom reduction, but it
    is a by-product
  • The goal IS to create a rich and meaningful life,
    while accepting the pain that goes with it
  • A specific type of behavior change that leads to
    psychological flexibility

19
Psychological Flexibility
  • the ability to contact the present moment more
    fully as a conscious human being and to change or
    persist in behavior when doing so serves valued
    ends. (Hayes et al., 2005)

20
Example
  • Snake phobia
  • When person is placed in presence of snake, 3
    effects
  • Tension arousal
  • Avoidance
  • Suppression of other responding

21
Psychological Flexibility
22
Psychological Flexibility
  • After exposure, the person who is afraid of
    snakes will display a range of behaviors in its
    presence (depending on the context of course. For
    example, happening upon a rattle snake would
    probably lead to narrow responding again).

23
Psychological Flexibility
24
Values
  • Another important component of ACT
  • The goal is to help the client live a rich and
    meaningful life, which is defined based on the
    persons individual values

25
Values domains
  • Family relationships
  • Friendships/social relationships
  • Couples/romantic relationships
  • Work/career
  • Education
  • Recreation/Leisure
  • Spirituality/Religion
  • Community/Citizenship
  • Health/Physical Well-being

26
Why is this important?
  • Clients often come to therapy because they arent
    living the kind of life they want to be living.
  • Increasing psychological flexibility is important
    so that clients can live according to their values

27
Stages of values work
  • Defining life values
  • Defining life activities
  • Dealing with barriers to valued living

28
Life Compass Worksheet
29
Example
  • A woman diagnosed with Panic Disorder with
    Agoraphobia
  • Important value is parenting
  • Womans daughter will graduate from high school
    soon, and she would very much like to attend
    graduation...but
  • She is afraid of having a panic attack in the
    large auditorium where commencement is held

30
Example
  • If she does not attend the graduation to avoid a
    panic attack, she is not living in accordance
    with her parenting value
  • Instead of making therapy about how to get rid of
    panic attacks, therapy is about how to be at her
    daughters graduation, in spite of panic attacks
    (exposure ? psychological flexibility)

31
Research does it work?
  • ACT shown to be effective for a number of
    conditions
  • Depression
  • OCD
  • Chronic pain other health conditions
  • PTSD
  • Substance abuse
  • Psychosis

32
Schizophrenia
  • Patients with schizophrenia who received 4 hours
    of ACT showed a 50 decrease in hospital
    readmissions in a 6 month follow-up (Bach
    Hayes, 2002)

33
Research
  • Even short interventions lead to significant
    improvements for a wide variety of conditions
  • Not yet an empirically supported treatment, but
    ACT has spurred a great deal of research since
    the publication of the manual in 1999.

34
Summary
  • ACT is a 3rd wave cognitive-behavioral therapy
    that integrates acceptance and mindfulness
  • Goals of ACT include behavior change and living a
    valued, meaningful life
  • The data support the efficacy of ACT
    interventions for a wide variety of disorders.
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