Stress Management for Kids: The Third Wave of Cognitive Behavior Therapy

Transcription

1 Stress Management for Kids: The Third Wave of Cognitive Behavior Therapy Nineteenth Annual School Health Conference 2010 Licensed Psychologist Board Certified in Cognitive and Behavioral Psychology Behavior Therapy Associates, P.A. 35 Clyde Rd. Somerset, NJ

2 The Story of Ugg and Jugg Once upon a time, a very long time ago there were two caveman named Ugg and Jugg. 2

3 Only Ugg Would Survive 3

4 Our Ancestor 4

5 What if Stress is a Fact of Life? All humans will experience stress Attempts to eliminate stress are doomed to fail The more you try to get rid of stress the more you got it Solutions to eliminate stress now become the problem 5

6 Acceptance and Commitment Therapy: ACT 6

7 Let s Do An Experiment! Take out a pen Use your five senses to experience the pen Put the pen away Use your mind to experience the pen mentally Notice the difference 7

8 iview Created by Dr. Kevin Polk

9 World 9

10 World 10

11 World 11

12 World Mind Body 12

13 World Suffering Mind Values Body 13

14 World Struggle with suffering Suffering Mind Body Values Valued Action 14

15 What is Acceptance and Commitment Therapy? a new Cognitive Behavior Therapy emphasizes such processes as mindfulness, acceptance, and values in helping clients overcome obstacles in their lives (not new) basic assumption is that suffering is a normal and unavoidable part of human experience (not new) it is actually people's attempts to control or avoid their own painful experiences that leads to much long-term suffering (not new) 15

16 What is Acceptance and Commitment Therapy? The goal of therapy is not to eliminate certain parts of one's experience of life, but rather to learn how to experience life more fully, without as much struggle, and with vitality and commitment ACT is based on a behavior analytic account of language and cognition called Relational Frame Theory (RFT). ACT has, as of May 2006, been evaluated in over 24 randomized clinical trials for a variety of client problems. 16

17 Definition of ACT ACT uses acceptance and mindfulness processes, and commitment and behavior change processes, to produce greater psychological flexibility. 17

18 Psychological Flexibility is contacting the present moment fully as a conscious human being, and based on what the situation affords changing or persisting in behavior in the service of chosen values. 18

19 How to Do ACT Accept: What is there to be experienced, fully and without defense, for what it is, not what it says it is Choose: Based upon your closely held values, choose what you would like to be about here Take Action: Engage in committed actions that embody your values, inhaling the distressing personal content as it appears 19

20 You Can Get Started Immediately!

21 Step 1. Identify Values 21

22 Connect to Values Values vs. goals Values give life meaning Values are the big M&M Addresses motivation to take action

23 Step2. Identify Old Solutions What have you tried? How has it worked? What has it cost you? The client recognizes their solutions are HOPELESS! Before you can try something new, you have to stop what doesn t work 23

24 24

25 Man In The Hole Are you digging right now? Refusing to walk in order to avoid holes sounds like a pretty boring life Analyzing how you fell in the hole isn t going to help you get out Blaming life for producing holes won t eliminate the holes 25

26 Struggle Switch When in the On Position: Whenever an unpleasant thought, feeling, image, memory or sensation occurs in your mind you struggle to get rid of whatever is causing you discomfort. The struggle becomes the problem. When in the Off Position: Whenever an unpleasant thought, feeling, image, memory or sensation occurs in your mind you notice the discomfort. You contact the experience and you move your life in a valued direction. 26

27 Insanity Doing the same thing over and over expecting to get different results 27

28 Step 3. Set Goals 28

29 Step 4. Notice What Comes Up Unpleasant thoughts Unpleasant feelings Unpleasant memories 29

30 Step 5. Acceptance 30

31 Willingness and Acceptance Often confused as being one and the same but they are not Willingness is an action of willfully exposing oneself (i.e., purposely putting oneself in front of distressing content) Acceptance is a stance of holding distressing content without evaluation or struggle 31

32 Acceptance as the Alternative to Control When is acceptance called for? Remember the serenity prayer? With natural, conditioned uncontrollable private experiences such as emotions, memories, thoughts, sensations When a situation cannot be changed Presence of chronic disease, pain, terminal state The attitudes, beliefs and behaviors of others When change or control strategies produce paradoxical results (i.e., try not to think about Pink Elephants) 32

33 Step 6. Take Action 33

34 Role of Committed Action ACT is ultimately an old school behavior therapy; this is all about finding more effective ways of behaving in the world All of our prior work is for naught if the client does not engage in ever widening patterns of workability Acceptance for acceptance s sake diminishes the work 34

35 Simplify Your Approach You don t have to go through all six core processes to be doing ACT! In more functional patients, there might be one polarity that you are going to target You want to use your assessment data to answer this question: What is the main issue this client is having and what is the best point of entry to attack that problem? In many cases, ACT might turn out to be a single session therapy or a very brief intervention As patients become more chronically distressed, the number of polarities involved increases and this will lengthen therapy 35

36 What Can You Do Tomorrow When You See an Upset Student? Listen and connect Identify what they really care about (i.e., Values) Identify current solutions which have become the problem Establish Creative Hopelessness Guide them to Accept difficult emotions Help them to Choose moving toward what is in their heart Encourage them to Take Action 36

37 What Path Will You Take? Thank You and Good Luck! 37

38 This Is The Technical Stuff! 38

39 The Six Core Processes of ACT Defusion: Establishing new functions for thoughts, feelings, memories, sensations Acceptance: Non-judgmental awareness Getting in the present moment: Showing up Self as context: Contacting the transcendental sense of self in which all experience is safe Valuing: A process that instantiates goal directed behavior Committed action: Engaging in behaviors that are consistent with personal values 39

40 Contact with the Present Moment Acceptance Values Essential Components of ACT Defusion Committed Action Self as Context 40

41 Acceptance and Mindfulness Processes Contact with the Present Moment You can chunk them into two larger groups Acceptance Values Defusion Committed Action Self as Context 41

42 and Contact with the Present Moment Commitment and Behavior Change Processes Acceptance Values Defusion Thus the name Acceptance and Commitment Therapy Self as Context Committed Action 42

43 The Common Core of All of These Processes is Contact with the Present Moment Acceptance Values Psychological Flexibility Defusion Committed Action Self as Context 43