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Perspectives on ACT from a Systems View of Change J. Scott Fraser, Ph.D.

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Presentation on theme: "Perspectives on ACT from a Systems View of Change J. Scott Fraser, Ph.D."— Presentation transcript:

1 Perspectives on ACT from a Systems View of Change J. Scott Fraser, Ph.D.

2 ACT Propositions Will Often Alternate With Those of the Process of Change View

3 Life Difficulties …tend to be unpleasant situations that draw action to either change, assimilate or accommodate them...common solutions can & do work, and often difficulties simply need to be accepted Life Problems …tend to arise from vicious cycles of more of the same solutions applied at a first-order level… The solution has become the problem…2 nd order solutions are needed for resolution

4 Life Difficulties are “Normal” “It is psychologically healthy to have unpleasant thoughts and feelings as well as pleasant ones, and doing so gives us full access to the richness of our unique personal histories.” (p.23) (Life Difficulties are “Normal”) (“Life is one damned thing after another, but it’s the only game in town.” [John Weakland of MR] ) Life Problems as Vicious Cycles The clinical establishment “…views distressing states of mind as signs of disorder and disease.” (p.8) Attempting to solve these “problems” then becomes the problem. (Life Problems as Vicious Cycles)

5 Social Constructivism: Social Constructivism: Reality is relative and dependent upon context Reality is co-created within social context The Process of Change: The Process of Change: First-order change, within First-order change, within perceived reality and rules Second-order changeof Second-order change, or a change of reality and rules

6 Co-created premises guide our viewing and doing…channeling our interactions This applies to ideas on the nature of problems and how to resolve them Applies equally to therapists’ theories and practices in therapy

7 First-Order Change: First-Order Change: A change in intensity, frequency, location, duration, etc. of interactions (solutions) Variations of similar interactions within the accepted premises and patterns of a system Often does resolve problems Only yield problems when failed solutions are re-applied over and again

8 Vicious Cycle Patterns Of first-order change

9 “ The ACT perspective, however, is that the conceptualized outcome, that is, the supposed solution, is often itself the problem.” (p.165 emphasis added.)

10 Second-Order Change: Second-Order Change: A change of a system’s primary premises, rules and patterns Usually yields strikingly different or opposite interactions May appear counter-intuitive or paradoxical from first- order premises It is the key element of most effective treatments

11 The Nine Dot Problem... The Child’s Finger Trap The Bird in The Vestibule

12 Socially Mediated Language Frames Our Realities (Cognitive Fusion fuels problems) Socially Mediated Language Frames Our Realities (Cognitive Fusion fuels problems) “…we formulate a situation symbolically and then organize our behavior to fit the demands of the rules that we are programmed to follow.” (p.245) “These rules are socially inculcated into us and thus appear to be the “normal, rational thing to do.” (p.245) “…the clients’ problem-solving efforts are channeled by culturally sanctioned rules that describe how problems are to be identified, analyzed, and solved.” (p. 245) [Or…Socially Constructed Reality]

13 Experiential Avoidance Fuels Most Problems Experiential Avoidance Fuels Most Problems “…the person is more likely to follow blindly the instructions that are socially transmitted through language.” First-Order Change “In some circumstances, this result can be adaptive;” (p.20) (First-Order Change) Vicious CyclesSecond-Order Change is needed “But in other cases, people may engage repeatedly in ineffective sets of strategies because to them they appear to be “right” or “fair” despite negative real-world consequences.” (p.20) (Vicious Cycles; Second-Order Change is needed)

14 Represent the classic description of problem patterns across most, if not all models of effective psychotherapy They involve a trigger, within a frame describing the situation, repeated failed solutions, and escalation Interdicting vicious cycles is the heart of all effective treatments

15 Escalating Patterns ATTEMPTED SOLUTIONS Positive Feedback

16 “There is an inherent paradox in attempting to avoid, suppress, or eliminate unwanted private experiences in that often such attempts lead to an upsurge in the frequency and intensity of the experiences to be avoided..” (p.20) The Classic Vicious Cycle (The Classic Vicious Cycle)

17 Pattern Re-Direction and second-order change

18 ViewingDoing Changing the Viewing and/or the Doing around the defined problem. ReframeDeframe Reframe and/or Deframe descriptions and rules pattern shifts/reversals Initiate interactional/behavioral pattern shifts/reversals Or Accept Premises and Build New Interactions Or Accept Premises and Build New Interactions small shift Initiate a small shift and then build upon it ValuesGoals Contract Clarify Values, Goals and Contract Positive Feedback Cycles Engage Positive Feedback Cycles Virtuous Cycles Initiate Virtuous Cycles

19 Enhance Psychological Flexibility Initiate Defusion from current language and frames Initiate Acceptance and Present Moment Function Clarify Values and enhance Willingness for Action Support Flexible Response Styles Open…Acceptance—Defusion Centered…Present Moment—Self-As-Context Engaged…Values—Committed Action

20 The elements common to all effective treatments

21 Common Elements of Effective Treatments: An emotionally charged relationship or alliance A rationale, structure, or “myth” explaining problems and implying solutions Related procedures implying direction to solutions and instilling hope Recent meta-analyses of psychotherapy research suggest that these elements are common across all effective therapy (Wampold, 2012)

22 The key element that this model adds to the Contextual Model is that the focus of change in all effective treatments is upon second-order change

23 The creative essence of therapeutic change across all therapies is second-order change

24 The Labyrinth of Crete: A Path of Dilemmas The Labyrinth of Chartres: A Path of Meditation The Golden Thread In Greek mythology, the warrior Theseus was given a golden thread to guide him to the center of the labyrinth of Crete. Once he defeated the fierce Minotaur, he used the thread to find his way back out. “The Golden Thread” has thus come to refer to a guide that helps find the unifying path through disorienting and seemingly disconnected alternatives.

25 Once we can trace the path of this golden thread across the broad tapestry of effective interventions to a wide array of problems, we can see the essential “tie that binds” them all together. Following the process of change helps us integrate approaches while empowering our own creative, flexible, and effective clinical practice.

26 This ancient Celtic design has been used to symbolize the spiral connections among all things. We have used this design to represent the spiral connections among all effective psychotherapies.

27 All effective treatments describe problems as vicious cycles and interdict them through second-order change interventions.

28 Fraser, J.S. & Solovey, A. (2007) Second-order change in psychotherapy: The golden thread that unifies effective treatments. Washington, DC, APA Books

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