1. Stress Less, Live More: How Acceptance and Commitment Therapy Can Help You Lead a Busy yet Balanced life Dr. Richard Blonna

2. What is Stress? Stress means different things to different people Stress means different things to different people What stresses some people challenges others What stresses some people challenges others Four classic ways to define stress : stimulus, response, transaction, and holistic phenomenon Four classic ways to define stress : stimulus, response, transaction, and holistic phenomenon

3. Stress is a Stimulus Stress is something in the external environment Stress is something in the external environment Stress is defined by the stimuli that one is exposed to (stress is bills, work, taxes etc.) Stress is defined by the stimuli that one is exposed to (stress is bills, work, taxes etc.) Some stimuli are defined as “life events” (Holmes & Rahe) Some stimuli are defined as “life events” (Holmes & Rahe)

4. Stress is a Response Stress is something in the internal environment Stress is something in the internal environment Stress is defined as “the non-specific response of the body to any demand” (Hans Selye) Stress is defined as “the non-specific response of the body to any demand” (Hans Selye) The non-specific response include symptoms such as increased muscle tension, breathing rate, hormonal release, metabolic rate etc. The non-specific response include symptoms such as increased muscle tension, breathing rate, hormonal release, metabolic rate etc.

5. Stress is a Transaction Stress is a transaction between a stimulus and a response (Lazarus & Folkman, 1987) Stress is a transaction between a stimulus and a response (Lazarus & Folkman, 1987) The transaction revolves around the appraisal of a “potential stressor” based on two questions: The transaction revolves around the appraisal of a “potential stressor” based on two questions: Is it a threat? Can I cope? Stimulus (potential stressor) and Personality (the individual) factors mediate the transaction Stimulus (potential stressor) and Personality (the individual) factors mediate the transaction

6. Stress as a Holistic Phenomenon Stress is a response that that occurs when the dimensions of health (physical, social, spiritual, emotional, intellectual, occupational and environmental) are out of balance. Stress is a response that that occurs when the dimensions of health (physical, social, spiritual, emotional, intellectual, occupational and environmental) are out of balance. Lack of balance causes the body to make adjustments in order to regain and maintain homeostasis Lack of balance causes the body to make adjustments in order to regain and maintain homeostasis

7. All of these Definitions are Partially Correct In actuality, stress is all of these things (stimulus, response, transaction, holistic phenomenon) combined. In actuality, stress is all of these things (stimulus, response, transaction, holistic phenomenon) combined. Each of the classic ways of defining stress accounts for a piece of the puzzle. Each of the classic ways of defining stress accounts for a piece of the puzzle.

8. A New Way of Defining Stress “Stress is a holistic transaction between an individual and a potential stressor resulting in a stress response (Blonna, 2006).” “Stress is a holistic transaction between an individual and a potential stressor resulting in a stress response (Blonna, 2006).” Blonna’s definition combines elements of the four classic definitions to form a more eclectic picture of stress. Blonna’s definition combines elements of the four classic definitions to form a more eclectic picture of stress.

9. What is ACT? Acceptance and commitment therapy (ACT) is a third wave form of cognitive behavior therapy (CBT) grounded in relational frame theory (RFT Acceptance and commitment therapy (ACT) is a third wave form of cognitive behavior therapy (CBT) grounded in relational frame theory (RFT Numerous ACT studies support its efficacy in treating anxiety, schizophrenia, depression, workplace stress, and burnout, pain, drug use, psychological adjustment to cancer, and diabetes self-management (Ciarrochi & Bailey, 2008). Numerous ACT studies support its efficacy in treating anxiety, schizophrenia, depression, workplace stress, and burnout, pain, drug use, psychological adjustment to cancer, and diabetes self-management (Ciarrochi & Bailey, 2008).

10. What is ACT? An underlying premise of ACT is that mental suffering occurs when clients become psychologically-inflexible and get stuck An underlying premise of ACT is that mental suffering occurs when clients become psychologically-inflexible and get stuck ACT helps clients become more psychologically flexible, get unstuck, and engage in values- congruent behavior ACT helps clients become more psychologically flexible, get unstuck, and engage in values- congruent behavior

11. Values-Congruent Behavior The primary therapeutic outcome for ACT is getting clients to behave in ways that are congruent with their values The primary therapeutic outcome for ACT is getting clients to behave in ways that are congruent with their values Two key aspects of this are helping clients clarify their values and setting behavioral goals that are congruent with these values Two key aspects of this are helping clients clarify their values and setting behavioral goals that are congruent with these values

12. The Acceptance Component of ACT Acceptance has three aspects : Acceptance has three aspects : 1. Becoming more mindful of thoughts, emotions, and actions 2. Understanding how thoughts, emotions, and actions support or oppose values and goals 2. Understanding how thoughts, emotions, and actions support or oppose values and goals 3. Accepting that trying to control, avoid, or eliminate painful thoughts and feelings is impossible and makes them worse 3. Accepting that trying to control, avoid, or eliminate painful thoughts and feelings is impossible and makes them worse

13. The Commitment Component of ACT Acceptance and Commitment work together Acceptance and Commitment work together acceptance is the cognitive part commitment is the behavioral part Commitment involves sticking to values- congruent behavior while coexisting with troubling thoughts and painful emotions Commitment involves sticking to values- congruent behavior while coexisting with troubling thoughts and painful emotions

14. The Therapeutic Component of ACT ACT does not focus on over-analyzing the past or trying to change thoughts, personal scripts, mental images and emotions ACT does not focus on over-analyzing the past or trying to change thoughts, personal scripts, mental images and emotions ACT is based on RFT research that demonstrates the effectiveness of accepting painful thoughts and troubling emotions and focusing on values- congruent behavior ACT is based on RFT research that demonstrates the effectiveness of accepting painful thoughts and troubling emotions and focusing on values- congruent behavior

15. ACT and RFT ACT is grounded in Relational Frame Theory (RFT), the language theory that underlies it ACT is grounded in Relational Frame Theory (RFT), the language theory that underlies it RFT proposes that current thoughts, personal scripts, mental images and emotions related to stress are linked to their original frames of reference (what RFT refers to as relational frames) from the past in which they were initially learned RFT proposes that current thoughts, personal scripts, mental images and emotions related to stress are linked to their original frames of reference (what RFT refers to as relational frames) from the past in which they were initially learned

16. An RFT View of the Human Mind RFT compares the mind to a 24/7 computer that is running multiple programs simultaneously RFT compares the mind to a 24/7 computer that is running multiple programs simultaneously The “programs” are thoughts, personal scripts, mental images, and emotions The “programs” are thoughts, personal scripts, mental images, and emotions At times, some of the programs get “corrupted” and cause the mind to freeze (get stuck) and crash At times, some of the programs get “corrupted” and cause the mind to freeze (get stuck) and crash

17. Relational Frame Theory The mind uses information from previous relational frames as the basis for assessing the threat posed by current stressors The mind uses information from previous relational frames as the basis for assessing the threat posed by current stressors In addition, the mind can carry this one step further and use the same previous information to jump ahead and project an infinite number of future situations involving this and similar stressors In addition, the mind can carry this one step further and use the same previous information to jump ahead and project an infinite number of future situations involving this and similar stressors

18. Thoughts Thoughts do not occur in a vacuum, they are connected to specific relational frames Thoughts do not occur in a vacuum, they are connected to specific relational frames An underlying principle of ACT is that all thoughts are not equally helpful or important An underlying principle of ACT is that all thoughts are not equally helpful or important ACT evaluates thoughts in terms of whether or not they are helpful in reaching goals and taking valued action. ACT evaluates thoughts in terms of whether or not they are helpful in reaching goals and taking valued action.

19. Thoughts Can organize thoughts in terms of their helpfulness: Can organize thoughts in terms of their helpfulness: helpful thoughts – are consistent with one’s values and goals and facilitate values-congruent behavior unhelpful thoughts - are inconsistent with one’s values and goals and interfere with values-congruent behavior.

20. Personal Scripts Personal scripts are like scenes in a play except the play is one’s life. Personal scripts are like scenes in a play except the play is one’s life. Each script has its own inner dialogue (self-talk) that represents how the scene Each script has its own inner dialogue (self-talk) that represents how the scene played out (old script) is currently running (present script) will ultimately play out (future script).

21. Personal Scripts Each script is connected to a relational frame, the context that sets the stage for the inner- dialogue Each script is connected to a relational frame, the context that sets the stage for the inner- dialogue Personal scripts often get outdated because the relational frame or the person changes Personal scripts often get outdated because the relational frame or the person changes Outdated personal scripts are seldom helpful in taking valued action. Outdated personal scripts are seldom helpful in taking valued action.

22. Mental Images Mental images are the visual images that accompany the personal scripts Mental images are the visual images that accompany the personal scripts Think of the scripts as the dialogue and the images as the moving pictures Think of the scripts as the dialogue and the images as the moving pictures As with personal scripts, mental images are linked to relational frames that set their context As with personal scripts, mental images are linked to relational frames that set their context

23. Mental Images Mental images, are similar to personal scripts in that they can get outdated and no longer represent who the person is Mental images, are similar to personal scripts in that they can get outdated and no longer represent who the person is Many adults still have images of themselves as helpless or worthless children Many adults still have images of themselves as helpless or worthless children Outdated mental images are seldom helpful in taking valued action. Outdated mental images are seldom helpful in taking valued action.

24. Emotions ACT views emotions as something that cannot be controlled and therefore should be acknowledged and accepted not analyzed or changed ACT views emotions as something that cannot be controlled and therefore should be acknowledged and accepted not analyzed or changed Emotions are also linked to past, present, or future relational frames Emotions are also linked to past, present, or future relational frames Even though emotions cannot be controlled, the behavior associated with them can be Even though emotions cannot be controlled, the behavior associated with them can be

25. RFT and Control The mind’s ability to synthesize past and present relational frames and extrapolate into the future is tremendously useful when planning for things it can control: The mind’s ability to synthesize past and present relational frames and extrapolate into the future is tremendously useful when planning for things it can control:behavior some aspects of the environment These are known as external potential stressors

26. RFT and Control The same ability can also be a source of emotional distress when dealing with things it cannot control : The same ability can also be a source of emotional distress when dealing with things it cannot control :thoughts personal scripts mental images emotions These are known as internal potential stressors These are known as internal potential stressors

27. RFT and Control RFT teaches us that the more people try to control, avoid, or eliminate potential stressors that cannot be controlled, the worse they get RFT teaches us that the more people try to control, avoid, or eliminate potential stressors that cannot be controlled, the worse they get Learning how to manage them is the key Learning how to manage them is the key be mindful of them accept them be willing to act while coexisting with them

28. Acceptance vs Control Most people fail in their stress management attempts because they try to control, avoid, or eliminate internal potential stressors Most people fail in their stress management attempts because they try to control, avoid, or eliminate internal potential stressors This is doomed to fail because more than half of all stress is associated with internal potential stressors that cannot be controlled This is doomed to fail because more than half of all stress is associated with internal potential stressors that cannot be controlled

29. ACT & Stress Often clients who seek the services of therapists and counselors do not have mental disorders that meet the criteria established in the DSM lV Often clients who seek the services of therapists and counselors do not have mental disorders that meet the criteria established in the DSM lV These clients, the “worried well”, are stuck because of their psychological inflexibility, and suffer from stress, anxiety and worry that keeps them from taking values-congruent action These clients, the “worried well”, are stuck because of their psychological inflexibility, and suffer from stress, anxiety and worry that keeps them from taking values-congruent action

30. ACT & Stress The worried well, like clients with more serious mental disorders, also struggle with: The worried well, like clients with more serious mental disorders, also struggle with: unhelpful thoughts, personal scripts, mental images, and emotions that contribute to their psychological inflexibility and keep them stressed and stuck in a rut

31. ACT & Stress ACT can help these clients develop greater psychological flexibility, get unstuck, take values-congruent action, and meet their goals ACT can help these clients develop greater psychological flexibility, get unstuck, take values-congruent action, and meet their goals ACT can also help these clients keep their stress, anxiety, and worry from turning into more serious mental disorders ACT can also help these clients keep their stress, anxiety, and worry from turning into more serious mental disorders

32. An ACT View of Stress An ACT view of stress supports a transactional way of defining stress An ACT view of stress supports a transactional way of defining stress Thoughts, personal scripts, mental images, and emotions all come into play during the stress appraisal process Thoughts, personal scripts, mental images, and emotions all come into play during the stress appraisal process

33. An ACT View of Stress All of the core process that contribute to psychological inflexibility also come into play during stress transactions All of the core process that contribute to psychological inflexibility also come into play during stress transactions All of the six therapeutic processes can be adapted to help clients manage their stress All of the six therapeutic processes can be adapted to help clients manage their stress

34. The Six Core Processes There are six “core processes,” that contribute to psychological inflexibility and stress: There are six “core processes,” that contribute to psychological inflexibility and stress: attachment to the conceptualized self cognitive fusion dominance of outmoded scripts and learning experiential avoidance lack of clarity concerning values inaction, impulsivity, and rigidity.

35. Attachment to the Conceptualized Self The conceptualized self refers to the self- descriptions clients to describe themselves: The conceptualized self refers to the self- descriptions clients to describe themselves: “I’m a mother” “I’m of average height and build” “I’m a happily married man” “I’m an architect” “I’m a teacher” The mind creates stereotypes or shortcuts around these descriptions The mind creates stereotypes or shortcuts around these descriptions

36. Attachment to the Conceptualized Self These statements sum up how people view themselves and measure up to societal standards (IQ, SES, body image etc.) These statements sum up how people view themselves and measure up to societal standards (IQ, SES, body image etc.) ACT refers to this way of describing the self as a self-as-content view (you are the sum total of all of the things contained within you) ACT refers to this way of describing the self as a self-as-content view (you are the sum total of all of the things contained within you) People get attached to their self-statements People get attached to their self-statements

37. Attachment to the Conceptualized Self and Stress Stress clients often take a self-as-content view of themselves Stress clients often take a self-as-content view of themselves They use labels and past diagnoses to describe themselves and their problems (social phobic, asthmatic, dyslexic, etc.) They use labels and past diagnoses to describe themselves and their problems (social phobic, asthmatic, dyslexic, etc.) Often these labels limit their psychological flexibility and coping options resulting in stress Often these labels limit their psychological flexibility and coping options resulting in stress

38. Cognitive Fusion Cognitive Fusion is the process of fusing with an aspect of the conceptualized self Cognitive Fusion is the process of fusing with an aspect of the conceptualized self Can fuse with positive or negative attributes: Can fuse with positive or negative attributes: I am a runner (positive) I am a loser (negative) In a sense, cognitive fusion is over-attachment to one aspect of the conceptualized self In a sense, cognitive fusion is over-attachment to one aspect of the conceptualized self

39. Cognitive Fusion & Stress Stress clients often fuse with elements of their conceptualized self and create stereotypes that limit their potential Stress clients often fuse with elements of their conceptualized self and create stereotypes that limit their potential A common occurrence with cognitive fusion is the person becoming the problem: A common occurrence with cognitive fusion is the person becoming the problem: “I am an asthmatic” vs. “I am someone who has asthma”

40. Dominance of Outmoded Personal Scripts & Stress Stress clients often fuse with personal scripts and prior learning that are outmoded and no longer represent who they are as individuals Stress clients often fuse with personal scripts and prior learning that are outmoded and no longer represent who they are as individuals The relational frames these scripts are based on relate to failed attempts to cope with potential stressors that were similar in nature to the ones being appraised in the present moment The relational frames these scripts are based on relate to failed attempts to cope with potential stressors that were similar in nature to the ones being appraised in the present moment

41. Lack of Clarity of Values & Stress Stress clients often feel unable to cope with potential stressors that threaten their values Stress clients often feel unable to cope with potential stressors that threaten their values Sometimes the threat is due to being unclear about the underlying values Sometimes the threat is due to being unclear about the underlying values Stress clients often adhere to values that are based on outmoded personal scripts that no longer represent who they are Stress clients often adhere to values that are based on outmoded personal scripts that no longer represent who they are

42. Experiential Avoidance & Stress Stress clients often avoid experiences that expose them to potential stressors that they’ve previously found stressful Stress clients often avoid experiences that expose them to potential stressors that they’ve previously found stressful Their 24/7 thinking and feeling machines (their minds) project into the future and extrapolate a limitless number of threatening and failed coping scenarios based on past relational frames Their 24/7 thinking and feeling machines (their minds) project into the future and extrapolate a limitless number of threatening and failed coping scenarios based on past relational frames

43. Inaction, Impulsivity, Rigidity, & Stress Experiential avoidance contributes to stress clients’ inaction and rigidity due to a lack of understanding of the relationship between action and personal values Experiential avoidance contributes to stress clients’ inaction and rigidity due to a lack of understanding of the relationship between action and personal values They often act impulsively because their behavior is not congruent with their values (often due to lack of clarity regarding their values) They often act impulsively because their behavior is not congruent with their values (often due to lack of clarity regarding their values)

44. Psychological Inflexibility and Unhelpful Thinking Traps Psychological inflexibility often results in falling into common thinking traps Psychological inflexibility often results in falling into common thinking traps Blonna (2010), synthesized 10 common thinking traps that contribute to getting stuck Blonna (2010), synthesized 10 common thinking traps that contribute to getting stuck ACT refers to the process of falling into these thinking traps as “getting hooked” ACT refers to the process of falling into these thinking traps as “getting hooked”

45. The “Thoughts Are Reality” Trap This is based on the belief that the thoughts clients have about events represent the objective reality of the events This is based on the belief that the thoughts clients have about events represent the objective reality of the events In fact, unless they are experiencing events first-hand, their thoughts are just that; what they think about the event In fact, unless they are experiencing events first-hand, their thoughts are just that; what they think about the event Clients fall into the trap when they think their thoughts are the actual events instead of just their thoughts about them Clients fall into the trap when they think their thoughts are the actual events instead of just their thoughts about them

46. The “Thoughts are True” Trap The “thoughts are true” trap is based on the belief that just because clients think of something that these thoughts must be true. The “thoughts are true” trap is based on the belief that just because clients think of something that these thoughts must be true. Many of the thoughts clients have are really judgments or evaluations and not really ‘truths” based on evidence Many of the thoughts clients have are really judgments or evaluations and not really ‘truths” based on evidence Clients fall into the “thoughts are true” trap when they fail to realize that these truths are really their personal judgments or evaluations. Clients fall into the “thoughts are true” trap when they fail to realize that these truths are really their personal judgments or evaluations.

47. The “All Thoughts Are Equally Important” Trap The “all thoughts are equally important” trap gives equal weight to all thoughts The “all thoughts are equally important” trap gives equal weight to all thoughts Clients fall into this trap when they take all of their thoughts too seriously (after all, they are only thoughts) and assign them the same high importance. Clients fall into this trap when they take all of their thoughts too seriously (after all, they are only thoughts) and assign them the same high importance.

48. The “Thoughts Are Orders” Trap The “thoughts are orders” trap revolves around the belief that just because clients think about doing something they feel that they have to act on it. The “thoughts are orders” trap revolves around the belief that just because clients think about doing something they feel that they have to act on it. Clients fall into the “thoughts are orders trap” when they mindlessly act in response to unhelpful thoughts because they took them as marching orders. Clients fall into the “thoughts are orders trap” when they mindlessly act in response to unhelpful thoughts because they took them as marching orders.

49. The “Thoughts Are Threats” Trap Thinking that something can harm you is different from actually being in harm’s way. Thinking that something can harm you is different from actually being in harm’s way. Sticks and stones will break your clients bones, but words (or thoughts) will never hurt them, unless they allow them to. Sticks and stones will break your clients bones, but words (or thoughts) will never hurt them, unless they allow them to. Clients fall into this trap when they believe their thoughts can actually cause themselves harm. Clients fall into this trap when they believe their thoughts can actually cause themselves harm.

50. The “Outdated Personal Scripts” Trap Based on the belief that outdated personal scripts are still valid Based on the belief that outdated personal scripts are still valid In reality, outdated scripts are like faded old newspaper clippings from the past In reality, outdated scripts are like faded old newspaper clippings from the past Clients fall into this trap when they think these old scripts are still valid even though they stand in the way of creating newer, more helpful ones Clients fall into this trap when they think these old scripts are still valid even though they stand in the way of creating newer, more helpful ones

51. The “Scary Pictures are Real” Trap Based on the belief that the frightening images the mind can churn out 24/7 are real Based on the belief that the frightening images the mind can churn out 24/7 are real In fact, these images are like faded photos from an old album, pictures of past hurtful events In fact, these images are like faded photos from an old album, pictures of past hurtful events Clients fall into this trap when they believe that the images are real and that they are part of the picture of their lives in real-time Clients fall into this trap when they believe that the images are real and that they are part of the picture of their lives in real-time

52. The “Personalization” Trap Based on the belief that responsibility for problems is exclusively linked to the self or others Based on the belief that responsibility for problems is exclusively linked to the self or others In fact, responsibility for problems is rarely one- dimensional or exclusive In fact, responsibility for problems is rarely one- dimensional or exclusive Clients fall into the trap when they assign responsibility for their problems exclusively to themselves or others Clients fall into the trap when they assign responsibility for their problems exclusively to themselves or others

53. The “Pervasiveness” Trap Based on the belief that the extent of influence of a stressor or aspect of the conceptualized self situation spills over into every aspect of life Based on the belief that the extent of influence of a stressor or aspect of the conceptualized self situation spills over into every aspect of life In fact, stressors and aspects of the self usually do not affect every aspect of life In fact, stressors and aspects of the self usually do not affect every aspect of life Clients fall into this trap when they believe that these things are not context-specific and permeate every aspect of their lives Clients fall into this trap when they believe that these things are not context-specific and permeate every aspect of their lives

54. The “Permanence” Trap Based on the belief that current troubling thoughts, feelings, and situations will last forever Based on the belief that current troubling thoughts, feelings, and situations will last forever In fact, very few of these situations last forever In fact, very few of these situations last forever Clients fall into the permanence trap when they believe that temporary conditions and situations will last forever and affect them permanently Clients fall into the permanence trap when they believe that temporary conditions and situations will last forever and affect them permanently

55. Getting Unstuck: The Six Core Therapeutic Processes ACT identifies six core therapeutic processes for developing greater psychological flexibility: ACT identifies six core therapeutic processes for developing greater psychological flexibility: 1. being present (developing mindfulness) 2. acceptance 3. defining valued directions 4. commitment (taking action) 5. cognitive defusion 6. self-as-context

56. Developing Mindfulness Mindfulness can be developed two ways: Mindfulness can be developed two ways: informal training (attention building) formal training (mindful meditation) Informal training involves using short activities to help stress clients become more aware of: Informal training involves using short activities to help stress clients become more aware of: internal (thoughts, scripts etc.) processes internal (thoughts, scripts etc.) processes external (environment) stimuli external (environment) stimuli

57. Developing Mindfulness Formal mindfulness training involves learning and practicing mindfulness meditation Formal mindfulness training involves learning and practicing mindfulness meditation daily practice sessions increasing duration from 5-20 minutes Mindfulness meditation is not the same as focused meditation used for relaxation training Mindfulness meditation is not the same as focused meditation used for relaxation training

58. Developing Acceptance Acceptance training builds on mindfulness training and sets the stage for willingness Acceptance training builds on mindfulness training and sets the stage for willingness Before clients can begin to accept their unhelpful thoughts, personal scripts, mental images, and emotions they need to be more mindful of them Before clients can begin to accept their unhelpful thoughts, personal scripts, mental images, and emotions they need to be more mindful of them Acceptance and willingness activities are typically integrated with each other Acceptance and willingness activities are typically integrated with each other

59. Developing Acceptance Involves teaching stress clients about the futility of trying to change internal potential stressors Involves teaching stress clients about the futility of trying to change internal potential stressors Acceptance training involves information giving and the use of metaphors and exercises Acceptance training involves information giving and the use of metaphors and exercises Can demonstrate using Chinese Finger Traps Can demonstrate using Chinese Finger Traps

60. Defining Valued Directions The four steps to defining valued directions: The four steps to defining valued directions: 1. exploring values 2. choosing and ranking values 3. publicly affirming values 4. acting on values ACT uses a variety of in-session and homework assignments to help stress clients do this ACT uses a variety of in-session and homework assignments to help stress clients do this

61. Values Categories There are ten values categories: There are ten values categories: 1. intimate relationships 2. family relationships 3. friendships and other relationships 4. health 5. spirituality

62. Values Categories 6. finances 7. learning 8. work 9. the environment 10. civics

63. Commitment Training Since ACT is a values-based form of therapy, goals and objectives must reflect clients’ values Since ACT is a values-based form of therapy, goals and objectives must reflect clients’ values Clear goals and measurable objectives reduce ambiguity and give structure to behavior Clear goals and measurable objectives reduce ambiguity and give structure to behavior Stress clients develop goals and objectives that reflect their values and guide them to where they want to go Stress clients develop goals and objectives that reflect their values and guide them to where they want to go

64. Commitment Training Commitment is the action component of acceptance and a key step in therapy Commitment is the action component of acceptance and a key step in therapy Clients don’t get better by just talking about their problems, they must take action Clients don’t get better by just talking about their problems, they must take action Taking action that is congruent with values is based on setting clear goals and measurable objectives for behavior Taking action that is congruent with values is based on setting clear goals and measurable objectives for behavior

65. Control and Willingness to Act Control and willingness are inversely related: Control and willingness are inversely related: the more stress clients try to control troubling thoughts and painful feelings, the less willing they are to take valued action can demonstrate by using “The Radio” metaphor

66. Willingness and Control A key component of ACT is helping clients shift their focus off of what they cannot control and onto what they can control A key component of ACT is helping clients shift their focus off of what they cannot control and onto what they can control The focus is on engaging in more helpful* behavior and creating more helpful environments The focus is on engaging in more helpful* behavior and creating more helpful environments *in terms of reflecting their values and achieving their goals

67. Willingness to Act The key is getting stress clients to take values- congruent action while coexisting with troubling thoughts, personal scripts etc. The key is getting stress clients to take values- congruent action while coexisting with troubling thoughts, personal scripts etc. behaving in ways that support their values will result in new learning and developing new, more helpful relational frames give homework assignments to build this

68. Willingness and Control Things than can be controlled: Things than can be controlled: personal environment behavior These can be modified and can trigger helpful thoughts, personal scripts, mental images, and emotions and new, more positive relational frames These can be modified and can trigger helpful thoughts, personal scripts, mental images, and emotions and new, more positive relational frames

69. Self-as-Context (the Observer Self) ACT proposes another way of viewing the self, the self as context ACT proposes another way of viewing the self, the self as context In this view, the self is the vessel (the context) that contains a lifetime’s worth of thoughts, personal scripts, etc. In this view, the self is the vessel (the context) that contains a lifetime’s worth of thoughts, personal scripts, etc. This view helps clients see that they are more than their thoughts, personal scripts, etc. This view helps clients see that they are more than their thoughts, personal scripts, etc.

70. Self-as-Context (The Observer Self) ACT teaches clients to view themselves as being more than just the sum total of their thoughts, personal scripts, etc. ACT teaches clients to view themselves as being more than just the sum total of their thoughts, personal scripts, etc. sets the stage for being able to distance themselves from these things when they are unhelpful The observer self allows stress clients to step back and observe their conceptualized selves The observer self allows stress clients to step back and observe their conceptualized selves

71. Self-as Context ACT often uses chess as a metaphor to explain this: ACT often uses chess as a metaphor to explain this: a self-as-content view looks at the pieces and their movement at any given point to describe the game a self-as-context view looks at the existence of the board as the context in which the pieces play out many games over time

72. Self as Context Being able to step back and examine any stressful situation from the perspective of being the board upon which it plays out can help: Being able to step back and examine any stressful situation from the perspective of being the board upon which it plays out can help: put individual moves (thoughts etc) and the game (the entire situation) in a broader perspective evaluated in terms of their helpfulness dismissed as just a bad move or game

73. Self as Context “ What a silly move that was” “ What a silly move that was” “ What a bad choice of moves I made” “ What a bad choice of moves I made” “What a terrible game I played” “What a terrible game I played” Wouldn’t it be nice to be able to dismiss our unhelpful thoughts, scripts, mental images & feelings this way? Wouldn’t it be nice to be able to dismiss our unhelpful thoughts, scripts, mental images & feelings this way?

74. Cognitive Defusion Cognitive defusion techniques teach stress clients how to take an observer self view Cognitive defusion techniques teach stress clients how to take an observer self view ACT uses a variety of metaphors and exercises to help clients identify when they have fused with thoughts etc. and how to defuse from them ACT uses a variety of metaphors and exercises to help clients identify when they have fused with thoughts etc. and how to defuse from them The White Board is one such exercise The White Board is one such exercise