Acceptance and Commitment Therapy (ACT)

Acceptance and Commitment Therapy (ACT)

This is considered a third wave behavioral therapy that uses mindfulness skills to develop psychological flexibility and helps clarify and direct values-guided behavior. ACT, pronounced “act,” (not by its initials A-C-T) is a directive and experiential form of therapy based on relational frame theory (RFT), its underlying scientific theory of human language and cognition. This theory emerges from the philosophy of functional contextualism, as opposed to mechanistic models, which aim to repair, change, or fix “problems.” ACT does not see clients as damaged or flawed, and does not define unwanted experiences as “symptoms” or “problems,” but resolves to define the function and context of behavior (ACT defines behavior to encompass both private and public activity, ie. actions, thoughts, memories, emotions, sensations) in order to determine its “workability,” for the purposes of creating rich and meaningful lives.

What is the Aim of ACT?

The aim of ACT is to experience the fullness and vitality of life, which includes a wide spectrum of human experience, including the pain that inevitably goes with it. Acceptance (which is not the same as approval) of how things are, without evaluation or attempts to change it, is a skill that is developed through mindfulness exercises in and out of session. ACT does not attempt to directly change or stop unwanted thoughts or feeling, but to develop a new mindful relationship with those experiences that can free a person up to be open to take action that is consistent with their chosen values. Values clarification is a key component to ACT.

Six Core Processes of ACT

Psychological flexibility is the main goal of ACT and is created through six core processes:

1. Contact with the present moment
2. Self-as-context
3. Defusion
4. Acceptance
5. Values
6. Committed action

These six process are not separate, but overlapping and interconnected. All six of these processes are introduced and developed experientially over the course of treatment. Psychological flexibility can be defined simply as “the ability to be present, open up, and do what matters.”

Mindfulness and ACT

Being present means being in direct contact with the present moment, rather than drifting off into automatic pilot, and getting in touch with the observing self, the part that is aware of, but separate from, the thinking self. Mindfulness techniques are taught to experience the observing self-firsthand, whether they bring awareness to each of the five senses, thoughts, or emotions.

Opening up is the ability to detach from thoughts (defusion) and accepting, or making space for and dropping the struggle with painful feelings, urges, sensations, etc. Acceptance is the ability to allow what is to be as it is instead of fighting or avoiding it. If someone is thinking, “I’m a terrible person,” they might be instructed to say, “I am having the thought that I’m a terrible person.” This effectively separates the person from the cognition, thereby stripping it of its negative charge. When someone is experiencing painful emotions, like anxiety for example, they might be instructed to open up, breathe into, or make space for the physical experience of anxiety and allow it to remain there, just as it is, without exacerbating or minimizing it.

Values Clarification and ACT

Doing what matters is all about values clarification, knowing what matters to you personally, and taking effective action guided by those values. Various exercises are employed to help identify chosen values, which act like a compass from which to direct intentional and effective behavior. People who are fused with their thoughts and tend to struggle with or avoid painful emotions, often struggle with choosing purposeful and values-guided action. Through mindful liberation from such struggle they find acting congruently with their values quite natural and fulfilling.

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Adlerian Psychology

"Meanings are not determined by situations. We determine ourselves by the meanings we ascribe to situations."Alfred Adler.

Adlerian Psychology/Psychotherapy

Adlerian psychotherapy was developed by Alfred Adler (1870-1937). He believed that it was imperative to become intimately familiar with a person’s social context by exploring factors such as birth order, lifestyle, and parental education. Adler was under the firm belief that each person strives to belong and feel significant. Adlerian psychology places its emphasis on a person’s ability to adapt to feelings of inadequacy and inferiority relative to others. This method of therapy pays particular attention to behavior patterns and belief systems that were developed in childhood. Clinicians who use this form of therapy strongly believe that these strategies are the precursors for later self-awareness and behaviors and are directly responsible for how a person perceives themselves and others in their life. By examining these early habitual patterns, we can better develop the tools needed to create our own sense of self-worth, meaning and ultimately create change that results in healing. Adler was a pioneer in the area of holistic theory on personality, psychotherapy, and psychopathology. He believed that a person will be more responsive and cooperative when he or she is encouraged and harbors feeling of adequacy and respect. Conversely, when a person is discouraged, he or she will display counter-productive behaviors that present competition, defeat, and withdrawal. When methods of expression are found for the positive influences of encouragement, one’s feelings of fulfillment and optimism increase.

Adlerian Individual Therapy/Couples Therapy/Family Therapy

Adlerian individual psychotherapy, brief therapy, couple therapy, and family therapy all guide clients to release their unproductive feelings and to refocus their attention toward forming corrections in perceived values, feelings, and behaviors that prohibit further positive growth. The paramount goal of this type of therapy is to remove destructive self-directed beliefs and behaviors and to replace them with tools that will allow a client to become confident and socially empowered.

Values Clarification and Adlerian Psychology

Individuals often enter therapy to gain better insight into their own behaviors and responses to circumstances that occur in their lives. Adlerian psychotherapy uses a process of AdlerianValues Clarification. By understanding this organization, and how it has influenced self-worth, acceptance and expectations, a client can begin to accept the emotions they have that are related to the events experienced as a child. This process of perception allows a client to identify, maybe for the first time, with their true inner value, independent of others. Adlerian values clarification allows one to look at prior beliefs in a new way that encourages positive change.

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Art Therapy

Art therapy is a type of therapy in which clients are facilitated by the art therapist - using art media (the creative process) and the resulting artwork to explore their feelings, reconcile emotional conflicts, foster self-awareness, manage behavior and addictions, develop social skills, improve reality orientation, reduce anxiety, and increase self-esteem. A goal in art therapy is to improve or restore a client’s functioning and his or her sense of personal well-being.

Art therapy is an effective treatment for people experiencing developmental, medical, educational, and social or psychological impairment. Individuals who benefit from art therapy include those who have survived trauma resulting from combat, abuse, and natural disaster; persons with adverse physical health conditions such as cancer, traumatic brain injury, and other health disability; and persons with autism, dementia, depression, and other disorders. Art therapy helps people resolve conflicts, improve interpersonal skills, manage problematic behaviors, reduce negative stress, and achieve personal insight. Art therapy also provides an opportunity to enjoy the life-affirming pleasures of art making.

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Biofeedback

Biofeedback is a type of therapy that encourages clients to use their own body’s responses and indicators to facilitate improved health. Many health professionals use this technique with the aid of biofeedback machines or monitors. This method of self-healing and actualization has been used for centuries. Ultimately, the goal of biofeedback is to take the information gathered from your body’s physical responses to stimuli or events, and use it to examine the emotional implications to transform the body itself. This type of therapy was developed by Neal Miller, Leo DiCara, Elmer Green, and Barbara Brown.

Using Biofeedback for Anxiety Related Disorders

When a person is able to gain insight into their own body’s mechanisms, they are better able to control their muscles and other physical reactions. Many people who practice biofeedback are able to regulate their own heart rate and blood pressure, simply by getting in tune with their body. This technique has been used in treating various mental health challenges, and can be especially helpful for treating impulse control and anxiety.

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Cognitive Behavioral Therapy

Cognitive behavior therapy (CBT) is a type of psychotherapeutic treatment that helps patients understand the thoughts and feelings that influence behaviors. It was developed by Dr. Aaron T Beck. CBT is commonly used to treat a wide range of disorders including phobias, addictions, depression, and anxiety.

Cognitive behavior therapy is generally short-term and focused on helping clients deal with a very specific problem. During the course of treatment, people learn how to identify and change destructive or disturbing thought patterns that have a negative influence on behavior.

Cognitive Behavior Therapy Basics

The underlying concept behind CBT is that our thoughts and feelings play a fundamental role in our behavior. The goal of cognitive behavior therapy is to teach patients that while they cannot control every aspect of the world around them, they can take control of how they interpret and deal with things in their environment.

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Control Mastery Therapy

This groundbreaking theory was developed by Joseph Weiss, MD and researched by Dr. Weiss and Harold Sampson, PhD along with the members of the San Francisco Psychotherapy Research Group. The Control Mastery Theory (CMT) is an assimilated technique that explores the progression of psychotherapy and the role it plays in healing. This school of thought believes that psychotherapy is born from a pathogenic perspective developed from difficult and extreme life events, including stressful circumstances that may be still be present.

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Dance/Movement Therapy

Movement therapy is beneficial to both physical and mental health. It is used as a method of reducing stress, and has been used by various groups of people including caregivers and people with chronic illness. In addition, the physical impact it has on participants includes increased muscular strength, coordination, and mobility, and decreased muscular tension. Emotionally, this form of therapy enables people to gain a greater sense of well-being and self-awareness and provides an outlet for the expression of feelings. Some experts believe that dance therapy may also insulate the body from disease by strengthening the immune system. Dance therapy was developed in the middle 20th century by Marian Chace, Mary Whitehouse, and Trudy Schoop, and has grown to become an extremely popular and validated form of therapy.

What It Helps With

Dance therapists work with their clients to help them improve their sense of body-image and self-esteem. The creative expression of dance therapy serves to provide the clients with an increase in communication skills and lays the groundwork for more dynamic relationships. In addition, the therapist will observe and interact with the client in order to help him or her gain a deeper sense of self-awareness through movement, motion, and realization of body. Dance therapy has continued to evolve but adheres to these basic principles at its core.

Because dance uses physical expression of emotions and feelings, it is a powerful and insightful method of treatment. The American Dance Therapy Association defines dance therapy as “the psychotherapeutic use of movement as a process which furthers the emotional, cognitive and physical integration of the individual.” Dance/movement therapy allows a person to realize broad transformations in emotional, physical, and behavioral states.

Principles of Dance Therapy

The main principles of dance therapy are designed around four distinct stages:

1. Preparation
2. Incubation
3. Illumination
4. Evaluation

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Emotional Freedom Technique (EFT)

EFT is a revolutionary treatment method that offers healing from physical and emotional pain and disease. Without the use of needles, this form of acupuncture uses the fingertips to stimulate energy points on the body. Developed by Gary Craig, this is an easily mastered technique that can be performed virtually anywhere. This treatment sprang from the idea that, "The cause of all negative emotions is a disruption in the body's energy system."

What is Emotional Freedom Technique Like?

EFT works by tapping on acupressure meridians to release blockages. When these blockages are released, the problem feeling can be released and move through the body. The process starts with a beginning statement of what the problem feeling is and includes a complete acceptance and acknowledgement of the problem. To start the process of EFT, the person would say something like, “Even though I have this (fear) about (failing my upcoming test), I completely accept myself anyway." Often that will not feel true to a person, so they would modify the statement to say, “I am willing to learn to accept myself” or “I want to accept myself." The client says the statement three times while tapping on the karate chop point. In the second part of this treatment, the client focuses on the feeling (fear) in the body and rates it at an intensity between 1-10. Then the client begins to tap on points around the face while saying “this fear” simultaneously. Several rounds of this can be done until the fear is rated at a zero on a scale from 1-10. Once that fear is gone, the therapist will guide the client to feel into other fears that will then come up from different aspects of the same situation or emotional state.

EFT can be an effective way of clearing out feelings. When an unwanted feeling is gone, the limiting beliefs that the client held are released. New, more positive beliefs about themselves can emerge. Learning EFT also empowers the client to take charge of handling their emotional state because they can tap on a feeling any time they want to move out a painful feeling.

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Dialectical Behavior Therapy

Marsha M. Linehan was the developer of dialectical behavior therapy (DBT). She originally set out to address the needs of women with histories of suicidal ideation, suicide attempts, or tendencies to self-harm through her training as a behaviorist. However, she discovered that in reality she was treating people who were symptomatic of Borderline Personality (BPD). Dialectical behavior therapy (DBT) is founded on the belief that environmental and biological factors that remain undetermined cause some people to respond to emotional states more quickly, and sustain a heightened emotional affect for an extended period of time before they return to baseline. This discovery gives credence to the symptoms of BPD which include lives fraught with crisis and severely shifting emotional peaks and valleys. DBT helps these people learn coping techniques that they did not receive in their invalidated childhoods.