9/14/2014. Acceptance and Commitment Training (ACT) Acceptance and Commitment Training (ACT): Towards Building Skills for

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1 cceptance and Commitment Training (CT) cceptance and Commitment Training (CT): Towards Building Skills for Functioning with Increasing Psychological Flexibility Stuart Libman, MD October 7, 2014 CT is an empirically supported behavioral approach to developing skills for living with greater psychological flexibility. cceptance entails becoming more aware of our inner and outer world, and more open to exploring our reactions, our experiences, and the stories we tell about ourselves. Commitment engenders pursuing a valued course of action even as we encounter inevitable adversities along our life paths. Psychological flexibility increases as we become more skilled in living with greater awareness, openness, and engagement. The value of workshops on psychological flexibility for early childhood special education staff Biglan,., Layton, G. L., Backen Jones, L., Hankins, M. & Rusby, J. C. Topics in Early Childhood Special Education, December, 2011 Randomized wait list control study of CT workshops for teacher stress, depression, burnout and collegial support Intervention reduced staff members Experiential voidance, increased teachers Mindful cceptance and Valued Living, and improved teachers sense of efficacy. 1

2 randomized trial of CT bibliotherapy on the mental health of K-12 teachers and staff Jeffcoat, T. & Hayes, S.C. Behaviour Research and Therapy, September, 2012 K-12 school personnel (N = 236; 91% female; years old, 75% above clinical cutoffs in general mental health, depression, anxiety, or stress) responding to a wellness-oriented program announcement were randomized to receive an (CT) self-help volume or to a waitlist. Participants showed significant improvement in psychological health related to the manner in which participants used the workbook and to post levels of psychological flexibility. cceptance and Commitment Therapy for the Treatment of Stress among Social orkers: Randomized Controlled Trial Identifying psychological mechanisms underpinning a Cognitive Behavioural Therapy intervention for emotional burnout Lloyd, J., Bond, F.., & Flaxman, P.E. ork & Stress, employees of a UK government department were randomly assigned to 1of 2 conditions: (1) a worksite CT, group-based series of 3 half-day sessions of training spread across 2 ½ months, & (2) a waitlist control group. Findings were significant for measures of increased psychological flexibility and decreased emotional exhaustion in the CT vs. the control group. Brinkborga, H., Michaneka, J., Hesserb, H., Berglund, G. Behaviour, Research & Therapy, 2011 The aim of the present study was to examine the effect of a brief stress management intervention based on the principles of cceptance and Commitment Therapy (CT) on the stress and general mental health for Swedish social workers (n =106) in a randomized, controlled trial. Two thirds of the participants had high stress levels at baseline. The results showed that the intervention significantly decreased levels of stress and burnout, and increased general mental health compared to a waiting list control. No statistically significant effects were, however, found for those with low levels of stress at baseline. mong participants with high stress, a substantial proportion (42%) reached criteria for clinically significant change. e concluded that the intervention successfully decreased stress and symptoms of burnout, and increased general mental health. Evidence is thus provided supporting CT as brief, stress management intervention for social workers. 2

3 cceptance and Commitment Therapy: Pathways for general practitioners Smout, M. ustralian Family Physician, September, 2012 Background: CT focuses on helping patients to behave more consistently with their own values and apply mindfulness and acceptance skills to their responses to uncontrollable experiences. Objective: This article presents an overview of CT, its evidence base and how general practitioners can apply CT consistent practice in the primary care setting. It describes pathways for general practitioners to develop further expertise in the approach. Using cceptance and Commitment Training in the Support of Parents of Children Diagnosed with utism Blackledge, J. T., & Hayes, S. C. Child & Family Behavior Therapy, 2006 The authors conducted a two day (fourteen hour) workshop with 20 parents of children diagnosed with autism. Participants were found to have pre/post (one week & three month) improvements in Beck Depression Inventory, Global Severity Index of the Brief Symptom Inventory and General Health Questionnaire, as well as on process measures of experiential avoidance (Q) and cognitive fusion (utomatic Thoughts Questionnaire). Evaluating the effectiveness of exposure and acceptance strategies to improve functioning and quality of life in longstanding pediatric pain: randomized controlled trial icksell, R.K., Melin, L., Lekander, M., & Olsson, G.L. PIN, February, 2009 CT compared with Multidisciplinary Team including mitriptyline (N= 32) 10 weekly CT sessions with assessments pre/post/3.5 & 6.5 months CT group performed significantly better than MDT on perceived functional ability in relation to pain intensity and pain-related discomfort, with less interference of pain in quality of life. This form of work has been and continues to be investigated by Dr. Lisa Coyne, recently named Program Director of the Pediatric Institute for OCD & Related Disorder at Harvard s McLean Hospital 3

4 Dilemma for this presentation: Using words and concepts for teaching a model that views our ability to communicate with symbols as not only one of our species finer features, but also as a major contributor to human suffering! So consider our all too human proclivities for: One symbol or event to remind us of another event and another Then getting lost ( imprisoned ) in the stories we tell Sometimes to the exclusion of our actual circumstances Resulting in psychological INflexibility Three Component Processes of Psychological Flexibility: R ING wareness (awar ing) OPENING ENGGING Openness (opening) Engagement (engaging) PSYCHOLOGICL FLEIBILITY 4

5 9/14/2014 OUTER (5 SENSES) BEHVIOR OUTER BEHVIOR hat do you do to move away from your distress? aaaaa Y T O R D S NOTICING Y hat shows up that gets in the way of caring? hat can you do to move towards who/what matters to you (even if with your distress?) NOTICING TORDS ho or what matters to you? INNER BEHVIOR INNER (MENTL) BEHVIOR OUTER (5 SENSES) BEHVIOR MOVING Y ENGGING aaaaa Y DISTRESSING NOTICING T O VLUING R D S INNER (MENTL) BEHVIOR 5

6 9/14/2014 So, for this week, you might consider: Building in a few moments for breathing during the day &/or at bedtime &/or Committing to 1 new values-based CTion &/or pplying The Matrix when you notice yourself becoming reactive to &/or Going online 6