1. On values and their measurement Kevin E. Vowles, Ph.D. University of Bath Association for Contextual Behavioral Science 01 July 2009

2. Overview Some thoughts on values measurement:Some thoughts on values measurement: –In practice –Via assessment (i.e., standardized questionnaires)

3. My observations Values are devilishly complex.Values are devilishly complex. –The answer to, “What matters?” is under the influence of multiple complex behavioral processes, some beneficial, some not. –Values work is best begun early and continued throughout the entirety of treatment. –Values work must be done both directly and with subtlely, a contradiction to be sure.

4. Most Important Skill? ListeningListening –Specifically, reflective listening. –Tests a hypotheses: “Is this what you meant?”

5. Ways of Reflecting Repetition – Repeat an elementRepetition – Repeat an element –“You want some help.” Rephrasing – Repeat with synonymsRephrasing – Repeat with synonyms –“Sounds like you think more assessment and more tests will help.” Reflection of feeling – paraphrase emphasizing emotional dimension.Reflection of feeling – paraphrase emphasizing emotional dimension. –“This sounds as if its very important to you.” Paraphrase – best guess at meaning.Paraphrase – best guess at meaning. –“You are hoping that one more test or evaluation will clear all of this up.”

6. Exercise - Part 1 Speaker:Speaker: –Think of something you want to change, but still have some ambivalence about. –Perhaps something related to a health (smoking, diet, exercise), recreation (TV watching, hobby), or work. Listener: Listen reflectively.Listener: Listen reflectively. Speaker: Can respond with elaboration.Speaker: Can respond with elaboration.

7. Listening Tips Guess at what they mean.Guess at what they mean. –(It’s ok to be wrong) Make a statement, not a question.Make a statement, not a question. –“Sounds like... ” –“You are wondering if... ” –“You are feeling (thinking, hoping, etc.)” –Express empathy Can start w/simple reflections and then use advancedCan start w/simple reflections and then use advanced

8. Exercise – Part II Speaker – Don’t explain why; simply state what this change would do for you.Speaker – Don’t explain why; simply state what this change would do for you. Clinician – Listen, Reflect, Ask for clarification.Clinician – Listen, Reflect, Ask for clarification.

9. Possible Ideas Why is this important to you?Why is this important to you? If you did that, what would that allow you to do?If you did that, what would that allow you to do? Please:Please: –Slow down –Recognize that this is likely to be important –Notice that there is a human being across from you –Listen, don’t solve

10. An example of measuring values Chronic Pain Values InventoryChronic Pain Values Inventory –Ratings of importance –Ratings of success –Also allows for discrepancy score to be calculated i.e., (importance) – (success)i.e., (importance) – (success)

13. The impact of less struggling and more maintenance of life direction Better: – emotional and physical functioning –Current emotional and physical functioning McCracken & Yang, 2006, Pain; Vowles et al., 2008, Pain –Future emotional and physical functioning McCracken & Vowles, 2008, Health Psych –Improvements in emotional and physical functioning three months after treatment Vowles et al., 2007, Eur J Pain; Vowles & McCracken, 2008, J Consulting & Clin Psych

14. “You desire to know the art of living, my friend? It is contained in one phrase: make use of suffering.” Henri-Frédéric Amiel (1821-1881)

15. k.vowles@bath.ac.uk www.bath.ac.uk/pain-management/