1、Acceptance and Commitment Therapy:Advanced WorkshopJulian McNallyProgram OutlineReview Of ACT ModelGetting Stuck Into Getting Stuck7 Frequent Problems And How To RespondSweet Spot And Client DescendingMatrix For Case FormulationDeveloping Mastery In ACT“Hexaflex”ACT Model of Effective LivingValues,P
2、urpose&MeaningDefusionCommitted ActionsContact with the Present MomentAcceptance&WillingnessTranscendent Sense of Self/Self As ContextPsychologicalFlexibility“InFlexaHex”ACT Model of PsychopathologyLack of Values Clarity or ContactFusionInaction or Disorganised ActivityDominance of Conceptualised Pa
3、st or Feared FutureExperiential AvoidanceAttachment to“Storied”or Conceptualised Self“Hexaflex”ACT Model of Effective LivingValues,Purpose&MeaningDefusionCommitted ActionsContact with the Present MomentAcceptance&WillingnessTranscendent Sense of Self/Self As ContextMindfulness&Acceptance ProcessesBe
4、haviour Change ProcessesYour turn!Decide who will be client firstBrief your partner on presenting problem,but not whats tricky about this clientCounsellor:Notice yourself getting stuck.Observe thoughts and feelingsClient:observe and resist urge to be agreeable or make it easy for counsellorIf counse
5、llor is not getting stuck,brief“client”on what the actual client does thats tricky and try again.Switch.Pair up-one is“A”the other is“B”Getting Stuck Into“Getting Stuck”My experience is not authoritative because it is infallible.It is the basis of authority because it can always be checked in new pr
6、imary ways.In this way its frequent error or fallibility is always open to correction.Carl Rogers,On Becoming a Person Bennet and CariNotice your reactions and make peace with themProvide an ACT-consistent responseWhere is the client on the Hexaflex?Where are you on the Hexaflex?7 Frequent Problems1
7、What do I do if I get stuck?2Do I need to cover all 6 processes?3What if they say“it didnt work”?4What if they dont know/cant say what their values are or dont have any?5What do I do with clients who are sceptical/concrete/psychotic?6What if they(or I!)dont“get”Self-As-Context?7What do I do with cli
8、ents who are fused with their beliefs or a sick or victim role?What do I do if I get stuck?General principles:uSlow down!uBe willing and acceptinguHold your formulation and treatment trajectory lightlyuStick closely to principles and loosely to techniquesuListen to clients experience before yoursuLi
9、sten to experience before models and ideasuInvite a change in action rather than in understanding or feelingDo I need to cover all 6 processes?uNo!What if they say“it didnt work”?uIs there a control agenda in place?uTry another part of the modeluTry a different technique from the same partWhat if th
10、ey dont know/cant say what their values are or dont have any?How do they know they dont know?When was the earliest(last)time they remember having values?Make the therapy about discovering/creating values?Check for semantic problems Detect values in the presentWhat do I do with clients who are scepti
11、cal/concrete/psychotic?“Trust your experience,not my words or your thoughts”Workability of scepticismSideline“beliefs”and“being right”for a whileYou dont have to do“mindfulness”just pay attentionPsychosis ACT is not an EST other treatmentsMetaphor-imperviousness?Present-moment defusion and willingne
12、ss with Self-As-ContextWhat if they(or I!)dont“get”Self-As-Context?Lets practise!Indicators Of Increased Capacity For Self-As-Contextq Detecting and defusing from rules and storiesq Increased perspective taking and noticingq Noticing own processes of fusion and unwillingnessq Naming or joking about
13、own scripts and storiesq Able to dispassionately examine value-contradictory behaviours and thoughtsq Recognising current choices and history as separate phenomenaq Relating to multiple conceptualisations of self as determined by context and values-in-the-momentWhat if they are fused with their beli
14、efs or a sick or victim role?uTry Self-As-ContextuBe curious and empathicuAppeal to workabilityTemplate for Experiential Exercises1Recognise your mind will interfere,so slow down and accept2Contact with present moment sounds and touch3Locate the moment of choice or stuckness4Immerse in the moment(fi
15、le cabinet or movie screen)5Open eyes and express it6Hold the moment silently and appreciateThe Grid-Kevin PolkEven Simpler Model of ACT ProcessesSwSValued LivingSensory ExperienceMental Experience“I think that.”“Im having the thought that.”“I notice Im having the thought that.”Recontextualising the Problem
