Brief Demo of Acceptance and Commitment Therapy (ACT)
-By Timothy Lyons
Session three is a continuation from a Brief Demonstration of cognitive behavior therapy. It contains a Brief Demo of Acceptance and Commitment Therapy.
In the next meeting we briefly discuss his homework. I let him know that I am interested in his work but that I am also interested in what he was able to see as he practiced because I am going to introduce him to some simple mental techniques that might help him further without having to write things down. Session Three will involve the use of a Brief Demo of Acceptance and Commitment Therapy (ACT) to show the client that the thoughts that he has will always be there but that he has values and can move toward them even though he has problems with his thoughts. This set of tools is influenced by Buddhist notions of mindfulness. It is based on behaviorisms Relational Frame Theory and is a program t very much like Dialectic Behavior Therapy. It is important that Trent be a willing participant so I get his permission as in all therapy sessions. After I make sure he has been doing the homework to help him see his thoughts in situations, I ask him if he has been able to see other thoughts that were not giving him a problem. He lets me know that he has been thinking about his thinking.
Session 3- A Brief Demo of Acceptance and Commitment Therapy:
H- Ok Trent, thanks so much for doing this work. I know that it can be tough but that it is really going to pay off for you. T-no problem, It didn’t take much time and as I practiced I was able to kind of think it out rather than just put it on the paper. H- that is good. I was hoping for that and it is one of the end results as you practice. What is most important is that you see your thoughts. Many people have problems with this and they are unaware that they have internal dialogue or that they are constantly talking to themselves. So I am going to start with some stories and examples of a Brief Demo of Acceptance and Commitment Therapy to help you today. Are you ready? T- Ok, go ahead. H- You said that one of the things that was important to you was to not fight with your mom. You also told me that you wish you could smoke less pot. Correct? T- Yeah that sounds about right. H- I am going to call these, things that are important to you. I want you to keep in mind the learning that you have done over the last week in regards to how your thoughts pop up and that you have been noticing them as I go through the next steps. I want you to think of a green monkey. Do you see it? T- Ok sure I guess. H- Did you notice that no matter what, you could not stop yourself from seeing the monkey? T- What do you mean? H- Ok here it is again, don’t see in our mind what I am about to tell you. Control it. Can you try? T- Yes. H- I want you to think of a purple kitty cat. Were you able to not think about the cat? T- No it popped in my Head. H- Yes and you could not control it. That is the way that your thoughts pop up. And when I say something you can see it in your mind. You can’t even control that you see it. Or stop it. Your mind is always thinking of something. Just like when you get angry. Ok here is the next step. Stand up and bock like a chicken. T- You want me to really do that? H- I want you to do whatever you feel comfortable with. T- I don’t want to do that, do I have to? H- No you don’t. But can you see that I told you to do something and you chose not to do it? Just sit back and notice this event for a moment. Can you tell me who is noticing this right now? T- I am. H- And you chose not to do something? T- Yeah not to look like an ass. H- Good, I am going to put this together. Can you see what I am getting at? (If the client cannot put this task together depending on the cognitive development I can either spell it all out or I can continue with examples.) In this case he gets it. T- You are showing me that I can’t control my thoughts but that I can control my actions. H- Yes exactly. But how can this help you Trent? T- I think that just because I think something I don’t have to go and do it. H- Excellent. And now I want to take it one step further. What is the reason that you are doing this work here? T- So I can cut down on the pot and not fight with Mom so much. H- Yep, this is your therapy. You decide what is important. And that is what is important to you. I want you to think of this as your compass. The direction that it’s pointing at is what is important to you. You can make choices that point toward less fighting and you can make it point toward less use of Marijuana. You will be bombarded with constant thoughts and decisions. Those thought will not stop. It will be as if you are the driver of a bus. Those thoughts are the passengers. They get on and off and the seats are sometimes full and sometimes empty, but no matter what they are saying or yelling you have to make it to the destination. You have to get what it most important to you to the correct spot in the line. And you do it by pointing your bus in the same direction as your compass. You are correct. No matter what you think and I have helped you see that you have those thoughts, you can move toward those things that are important to you. T- OK I get it. I have to keep driving the bus, me, to not fighting with mom and using. I have to do it even though I keep thinking those things. While I am doing that I can also try to sort out what I am thinking by using that form you gave me. H- That is an excellent observation. I am really proud of you. You got that quickly. I also want to keep working in that way so that you practice this over and over so that it becomes a natural part of your tools. We can work on this together.
By utilizing a Brief Demo of Acceptance and Commitment Therapy (ACT), I can help the client see that they can move toward something that they value even though they are thinking things that are not appropriate. Even further, they can come to recognize their thoughts and feelings in a mindful way and even watch them pass by as they continue to move toward those ideals. There are important tools that go further so that the client can separate from those thoughts so that they don’t remain stuck in their same rut in life. The mindfulness and defusion techniques are some of the more powerful and as such I would choose to build up to them after some initial psycho-educational sessions.
After the last session which included a Brief Demo of Acceptance and Commitment Therapy, Trent was on his way to helping himself. One of the most important parts of this arena is the ability for the client to walk away and use the tools they are using in session out in the real world. They have to generalize the techniques. In further sessions I will reinforce in-session behaviors that are positive and help him move toward those goals of being able to cope better with outside issues. It is easy to see it in session and sometimes more difficult to bring it outside. This reinforcement is another part of the eclecticism that I will bring to bear on the problems of my clients. Trent seems that he can cope better already. Just the fact that he sees some of the things that I pointed out and quickly, gives me great hope for a better outcome for his future. The problems will continue to lessen as he grasps the tools further and uses them more deeply in his own life. It will make a difference in his quality of life as long as he uses the tools that I have been trying to teach him.
I observe that these tool work in my sessions. I can change them up depending upon the clients’ needs and the situation at hand. It is important for me to have a mixed bag of tricks as I might not always help with clients who are western oriented or culturally the same. By keeping abreast of these I can help in many different ways.
References for Brief Demo of Acceptance and Commitment Therapy
The Albert Ellis Institute. (n.d.). Rational Emotive & Cognitive-Behavior Therapy. Retrieved March 10, 2017, from http://albertellis.org/rebt-cbt-therapy/
Hayes, S. C., Strosahl, K. D., & Wilson, K. G. (2012). Acceptance and Commitment Therapy (2nd ed.). New York, NY: Guilford Press.
Rollnick, S., Miller, W. R., & Butler, C. C. (2008). Motivational Interviewing in Health Care (1 ed.). London: The Guilford Press.