What core feature underpins all presentations according to ACT?
Psychological inflexibility
What is the name for the assumption that it is abnormal for humans to experience significant psychological struggle
Assumption of healthy normality
3 primary ways in which ACT achieves psychological flexibility?
- Acceptance (of difficult thoughts and feelings)
- Choosing (what matters)
- Taking Action (in line with what matters)
Name the six aspects of hexaflex?
- Present oriented (rather than focused on the past or future/limited self knowledge)
- Values (as opposed to lack of direction/clarity or contact)
- Committed action (opposed at inaction/stuck/impulsivity/avoidant persistence)
- Self as context (opposed to self as content/conceptualised self)
- Defusion (opposed to cognitive fusion (entanglement with thoughts and beliefs- thoughts capture reality))
- Acceptance (versus experiential avoidance - avoidance of private experiences)
Discuss differences between “waves” of therapy throughout history
First wave - Observable behavior
Second wave - Cognitive therapies
Third wave - Acceptance and mindfulness (function of problematic thinking rather than content)
How is ACT different from CBT?
Goal of ACT is psychological flexibility, rather than symptom reduction.
ACT focuses on the function of problematic thinking, rather than content.
What is cognitive fusion?
Entanglement with thoughts and the belief that thoughts capture reality
What is experiential avoidance?
Avoidance of private experiences
Four aspects of the ACT therapist stance
- Dramatic and powerful change is possible
- Whatever the client is experiencing is not the enemy
- Passionate interest in what the client really wants
- Willingness to self-disclose when it makes a therapeutic point
Barriers to action: FEAR
- Fusion (stuff your mind tells you)
- Excessive goals (too big, insufficient skills and resources)
- Avoidance of discomfort (unwillingness to make room for the discomfort this challenge brings)
- Remoteness from values (losing touch with – or forgetting – what is important or meaningful about this)
What is ACT definition of psychological flexibility?
The ability to contact the present moment more fully as a conscious human being and to change, or persist in behaviour, when doing so serves valued ends
Four types of experiential avoidance? (DOTS)
D – Distraction
O – Opting out
T – Thinking
S – Substances and other strategies
Instead of avoidance, ACT suggests…
Acceptance of thoughts and feelings
What is acceptance in ACT?
Open and curious stance to what comes up. A willingness to feel feelings, sense sensations and remember memories.
What do you do to reduce experiential avoidance? 3 things
- Instil creative hopelessness –sense of unworkability to avoidance
- Highlight futility of avoidance –e.g., orange penguin
- Lean into feelings, makes space for them
Instead of cognitive fusion, ACT suggests…
Cognitive defusion
How do you bring about cognitive defusion?
- Create distance from thinking
- Shift focus from content to process of thinking
- Teach limits of language
- Reframe perceived truths as ‘stories’
Instead of rumination, worry, detachment, ACT suggests…
Contact with the present moment
Instead of viewing oneself as collection of thoughts and memories, ACT suggests…
Self-as-context
How do you encourage self-as-context? 2 ways
- Metaphors – e.g., sky and weather
2. Mindfulness – observe who’s watching
Instead of inactivity, impulsivity and avoidance, ACT recommends…
Committed action - motivated by values
How do you encourage committed action? 3 steps
- Develop goals (short, medium, long)
- Identify barriers
- Take mindful action
