Acceptance and Commitment Therapy An Experiential Approach to Behavior Change

by Hayes, Steven C.; Strosahl, Kirk D.; Wilson, Kelly G.

• ISBN13: 9781572309555
• ISBN10: 1572309555
• Additional ISBN(s): 9781462528943
• Edition: 1st
• Format: Paperback
• Copyright: 2003-07-29
• Publisher: The Guilford Press
• More Book Details
• Purchase Benefits

Summary

Most therapists and clients believe that a more vital life can be attained by overcoming negative thoughts and feelings. Yet despite efforts to achieve this goal, many individuals continue to suffer with behavior disorders, adjustment difficulties, and low life satisfaction. This volume presents a unique psychotherapeutic approach that addresses the problem of psychological suffering by altering the very ground on which rational change strategies rest. Acceptance and Commitment Therapy (ACT) focuses in particular on the ways clients understand and perpetuate their difficulties through language. Providing a comprehensive overview of the approach and detailed guidelines for practice, this book shows how interventions based on metaphor, paradox, and experiential exercises can enable clients to break free of language traps, overcome common behavioral problems, and enhance general life satisfaction.

Author Biography

Steven C. Hayes, PhD, is Nevada Foundation Professor in the Department of Psychology at the University of Nevada. His career has focused on the analysis of the nature of human language and cognition and the application of this to the understanding and alleviation of human suffering. Among other offices, he has been President of Division 25 of the American Psychological Association, of the American Association of Applied and Preventive Psychology, and of the Association for Advancement of Behavior Therapy (AABT).

Kirk D. Strosahl, PhD, is Research and Training Director for the Mountainview Consulting Group, where he provides consultation and training on integrative primary care medicine, outcomes management in applied delivery systems, clinical management of the suicidal patient, and Acceptance and Commitment Therapy (ACT). Dr. Strosahl began his career as the Director of the Suicidal Behaviors Research Clinic at the University of Washington, where, along with Marsha Linehan, PhD, and John Chiles, MD, he helped elaborate the use of acceptance and mindfulness strategies with suicidal borderline patients. From 1984 through 1998 he worked as a staff psychologist and as the Research Evaluation Manager for the Division of Behavioral Health Services at Group Health Cooperative of Puget Sound, where he became a recognized expert in integration of behavioral health services into primary care medicine, and in the dissemination of empirically supported therapies into managed care settings.

Kelly G. Wilson, PhD, is Associate Director of the Center for Contextual Psychology at the University of Nevada, Reno. He has directed a National Institute on Drug Abuse grant since 1993, examining both Acceptance and Commitment Therapy (ACT) and 12-Step facilitation treatment of substance abuse. An author of over 20 articles and chapters, his interests include the integration of basic and applied behavioral science, behavioral analysis of nontraditional behavioral topics, the interface of ACT and other acceptance-oriented traditions, and the application of acceptance strategies to substance abuse.

Table of Contents

PART I. THE PROBLEM AND THE APPROACH	1	(80)
1. The Dilemma of Human Suffering	3	(10)
The Underlying Assumptions of the Psychological Mainstream	4	(4)
The Assumption of Destructive Normality	8	(5)
2. The Philosophical and Theoretical Foundations of ACT	13	(36)
Why the Level of Technique Is Not Adequate	13	(3)
The Need for Philosophy	16	(2)
Functional Contextualism	18	(8)
Relational Frame Theory and Rule Governance: The View of Language Underlying ACT	26	(19)
Summary: Implications of Functional Contextualism, Rule Governance, and Relational Frame Theory	45	(4)
3. The ACT Model of Psychopathology and Human Suffering	49	(32)
The System That Traps People	51	(7)
The Pervasiveness of Experiential Avoidance	58	(2)
The Destructive Effects of Experiential Avoidance	60	(5)
When Experiential Avoidance Can't Work	65	(4)
How Humans Get Drawn into a Struggle	69	(8)
ACT: Accept, Choose, Take Action	77	(2)
ACT as a Contextual Cognitive-Behavioral Therapy	79	(1)
Concluding Remarks	79	(1)
A Personal Exercise for Therapists	80	(1)
PART II. CLINICAL METHODS	81	(184)
4. Creative Hopelessness: Challenging the Normal Change Agenda	87	(28)
Theoretical Focus	87	(3)
Clinical Focus	90	(1)
Informed Consent	90	(2)
Drawing Out the System	92	(6)
Confronting the System: Creative Hopelessness	98	(10)
Barriers to Giving Up the Unworkable System	108	(1)
Letting Go of the Struggle as an Alternative	109	(1)
Therapeutic Do's and Don'ts	110	(2)
Progress to the Next Phase	112	(1)
Personal Work for the Clinician	112	(1)
Clinical Vignette	113	(1)
Appendix: Client Homework	114	(1)
5. Control Is the Problem, Not the Solution	115	(33)
Theoretical Focus	116	(2)
Clinical Focus	118	(1)
Giving the Struggle a Name: Control Is the Problem	119	(6)
How Emotional Control Is Learned	125	(3)
Examine the Apparent Success of Control	128	(4)
The Alternative to Control: Willingness	132	(4)
The Cost of Unwillingness	136	(2)
Therapeutic Do's and Don'ts	138	(2)
Progress to the Next Stage	140	(1)
Personal Work for the Clinician: Is Control the Problem?	140	(1)
Clinical Vignette	141	(1)
Appendix: Client Homework	142	(6)
6. Building Acceptance by Defusing Language	148	(32)
Theoretical Focus	148	(2)
Clinical Focus	150	(1)
Attacking the Arrogance of Words	151	(3)
Deliteralizing Language	154	(9)
Undermining Reasons as Causes	163	(3)
Disrupting Troublesome Language Practices	166	(2)
Evaluation versus Description	168	(2)
Willingness: The Goal of Deliteralization	170	(4)
Therapeutic Do's and Don'ts	174	(1)
Progress to the Next Stage	175	(1)
Personal Exercise for the Clinician: Your Views of Yourself	176	(1)
Clinical Vignette	177	(1)
Appendix: Client Homework	178	(2)
7. Discovering Self, Defusing Self	180	(24)
The Theoretical Focus: Varieties of Self	181	(6)
Clinical Focus	187	(1)
Undermining Attachment to the Conceptualized Self	188	(1)
Building Awareness of the Observing Self	189	(3)
Experiential Exercises with the Observing Self	192	(6)
Therapeutic Do's and Don'ts	198	(2)
Progress to the Next Phase	200	(1)
Personal Work for the Clinician: Is Your Self Getting in the Way?	201	(1)
Clinical Vignette	202	(2)
8. Valuing	204	(31)
Theoretical Focus	205	(4)
Clinical Focus	209	(1)
Valuing: A Point on the Compass	209	(10)
Outcome Is the Process through Which Process Becomes the Outcome	219	(2)
Values Clarification: Setting the Compass Heading	221	(1)
Assessment of Values, Goals, Actions, and Barriers	222	(7)
Willingness to Have Barriers and Barriers to Willingness	229	(1)
Therapeutic Do's and Don'ts	230	(2)
Progress to the Next Phase	232	(1)
Personal Work for the Clinician: Taking a Direction	232	(1)
Clinical Vignette	233	(2)
9. Willingness and Commitment: Putting ACT into Action	235	(30)
The Client's Quandary and the Way Out	235	(1)
Theoretical Focus	236	(2)
Clinical Focus	238	(1)
Experiential Qualities of Applied Willingness	238	(4)
Reconnecting with Values, Goals, and Actions	242	(1)
Committed Action as a Process	243	(1)
Committed Action Invites Obstacles	244	(1)
A Map for the Journey: FEAR and ACT	245	(4)
Primary Barriers to Committed Action	249	(9)
ACT as a Behavior Therapy	258	(1)
Termination and Relapse Prevention	258	(1)
Therapeutic Do's and Don'ts	259	(2)
Personal Work for the Clinician: Committed Action	261	(1)
Clinical Vignette	261	(2)
Appendix: Client Homework	263	(2)
PART III. USING ACT	265	(24)
10. The Effective ACT Therapeutic Relationship	267	(14)
Positive Leverage Points in ACT	268	(7)
Negative Leverage Points in ACT	275	(4)
The Therapeutic Relationship	279	(1)
Summary	280	(1)
11. ACT in Context	281	(8)
The Relevance of ACT in the 21st Century	283	(6)
References	289	(9)
Index	298