1. Christian-based Acceptance and Commitment Therapy
Christian-based Acceptance and Commitment Therapy: Promoting Psychological Flexibility
GOALS
Identify and explore the core concept of Psychological Flexibility using the hexaflex model in Acceptance and Commitment Therapy.
Prepare clients to accept their thoughts and feelings, and modify their need to control or eliminate them.
Explore basic treatment skills and techniques to promote psychological flexibility and emotional well-being.

2. Promoting Psychological Flexibility
Presented by:
Richard Hoffman, Ph.D.
Clinical Director of CCA
Christian-based Acceptance and Commitment Therapy: Promoting Psychological Flexibility
GOALS
Identify and explore the core concept of Psychological Flexibility using the hexaflex model in Acceptance and Commitment Therapy.
Prepare clients to accept their thoughts and feelings, and modify their need to control or eliminate them.
Explore basic treatment skills and techniques to promote psychological flexibility and emotional well-being.

3. Guiding Scripture Psalm 107: 1 - 9
We want the Church to be known, more than any hospital or clinic, as the place for for
Healing
Growth
Life Changing Relationship
First In Jesus Christ
Second in Committed Relationships of Accountability within the Church
Psalm 107: 1 – 9
1 Give thanks to the Lord, for he is good;
his love endures forever.
2 Let the redeemed of the Lord tell their story—
those he redeemed from the hand of the foe,
3 those he gathered from the lands,
from east and west, from north and south.
107:3 Hebrew north and the sea
4 Some wandered in desert wastelands,
finding no way to a city where they could settle.
5 They were hungry and thirsty,
and their lives ebbed away.
6 Then they cried out to the Lord in their trouble,
and he delivered them from their distress.
7 He led them by a straight way
to a city where they could settle.
8 Let them give thanks to the Lord for his unfailing love
and his wonderful deeds for mankind,
9 for he satisfies the thirsty
and fills the hungry with good things.

4. Mental Disorders in the 21st Century
Mental Health Disorders are Prevalent in the United States
For adults aged 18 to 64 in the United States, the lifetime prevalence rate is 21% for mood disorders and 34% for anxiety disorders
Mental Disorders in the 21st Century

5. Contemporary Responses - Biomedical Model
Secular Mental Health tends to view symptoms as rooted, at least in part, in abnormal neurobiological processes (e.g., structural and functional deficits within the brain).
Result - In the past several decades, the use of antidepressant medication has steadily risen.
Contemporary Responses - Biomedical Model
Secular Mental Health tends to view symptoms as rooted, at least in part, in abnormal neurobiological processes
(e.g., structural and functional deficits within the brain).

6. Biomedical Model Issues
Inner distress is commonly labeled as “abnormal,” rather than a normal, ordinary part of the human condition. 01
Goal of therapy is to become symptom free or eliminate symptom. 02
Point 1 - symptoms do not inevitably lead to disordered functioning; rather, clients’ struggle with symptoms (e.g., unpleasant thoughts, feelings, and sensations), by way of avoidance, determines whether disordered functioning ensues.
Clients create more problems, beyond their initial pain, when they fight against symptoms of daily living has been prevalent within the mental health field for some time.

7. Common Forms of Avoidance
Internet: A Virtual-Based Fantasy World
Pornography Use
Social Distancing
Compulsive Media Consumption
Prosperity Gospel
Social Irresponsibility
Focus on separating Church and Reality
Complete avoidance of community – Can I attend online today?
Common Forms of Avoidance

8. Results of Outcome Research
Which forms of psychotherapy work best? To some extent it depends on the mental health problem being treated:
Depression Anxiety Phobias Bedwetting
Cognitive-behavioral Psychodynamic therapy Exposure therapy Behavior conditioning
Click to show the most effective therapy for each problem.

9. Psychological Flexibility Model is Empirically Validated
Over 300 Randomized Clinical Trials
ACT is consistent with a Faith-based framework
Faith-based vs. Secular Framework
ACT allows for an eclectic integration of Counseling Technique
Integrationist Approach
Why Use ACT Model?
EVT – Expand on Importance Here
Severe substance abuse
Depression
Obsessive-compulsive disorder
Panic disorder
Generalized anxiety disorder
Post-traumatic stress disorder
Trichotillomania
Social phobia
Smoking
Chronic pain
Medical problems
Psychosis
Workplace stress
and more...
Test Anxiety
Mathematics Anxiety
Public Speaking Anxiety in College Students
Enhancing Psychological Health of Students Abroad
Eating & Weight Concerns
Substance Abuse
Faith – Based Framework –
The Problem with Christian Counseling is far to often we are enamored with Secular Counseling Approaches
Eclectic Integration – Expand
Object-Relations Theory
Trauma Informed
Cognitive-Behavioral Techniques

10. What a great experience –
Liberia – Country in West Africa
Invited by Jerry Kulah – Methodist University in Grbanga’s Graduate School of Theology
14 Year Civil War – Ended in 2003
Warlord Factions – Seeking Power and Control
Child Soldiers
Unarmed Civilians
CCA after 10 Years -
54 Locations – Mainly in PA, but have expanded recently into Ohio. WV
During our work as a Christian Counselor, I have had wonderful opportunities
When I first came to AACC

11. ACT Model PSYCHOLOGICAL PSYCHOLOGICAL FLEXIBILITY Past – Future Focus
Present
Experiential Avoidance
Disruption of Values
Acceptance
Virtues
Commitment and Accountability Process
Watchfulness and Acceptance Process
PSYCHOLOGICAL
INFLEXIBILITY
PSYCHOLOGICAL
FLEXIBILITY
Self Conceptualized - Avoidance
I’m Feeling Pain – That means there is something wrong with me.
I’m Worthless – I’m Feeling Pain – There is something wrong with me
I’m Ugly, I’m Lonely, I’m in Pain – There is something wrong with me
The ACT therapist works to challenge this belief by asserting that healthy, normal brains churn out negative feelings and thoughts all throughout the day. In other words, it’s just what the brain does. One’s job, then, is not to eliminate these feelings and thoughts—which is impossible—but to establish a more healthy relationship with them so they do not control or govern one’s actions.
Fusion
Avoidance – Trying to Control your Inner World
Relational Learning has Taken Place (Schema or Cognitive Networks have been contructed)
There is no delete key for these experiences – because they are rooted in experience. We can not rid ourselves
of the past.
Past-Future Focus
Relational Learning has Taken Place
Disrupted Values/Becoming Stuck
Psych Flex Model
Self as Context –
Your Thoughts and Feelings don’t define you –
they are something that Happens to you.
Your relationship with these thoughts and feelings can grow and change.
Cognitive Defusion – Stepping Back from Your Thoughts
Life Milestones
Behavior Chain Model
Stimulus Events
Thought Journal
GOAL – Start to Acknowledge your Experience more accurately
Acceptance - Notice when Painful thoughts Occur
Change Relationship to how we deal with that Thought
Acknowledge the Belief
Standing on the Rock
What hurts vs. what matters
“Therefore everyone who hears these words of mine and puts them into practice is like a wise man who built his house on the rock.  Matthew 7:24
Virtues
Committed Action:
Behavior change strategies include:
Applied Behavior Analysis strategies
Contingency management
Level systems
Traditional Behavior Therapy strategies
Flooding
Exposure & ritual prevention
Social skills training
Behavior activation
Self As Context
Cognitive
Defusion
Committed
Action
Cognitive Fusion
Inaction / Stuck
Conceptualized Self
Self as Context

12. Spirit Soul Body Getting to the Heart Heart
The above diagram demonstrates a Biblical model for how we process feelings:
Body - This is our physical body which contains our 5 senses.  Feelings and emotions are “sensed” within our physical body.
Spirit -  This is the life that God has “breathed” into us at our creation. 
“Then the LORD God formed man of dust from the ground, and breathed into his nostrils the breath of life; and man became a living being (Genesis 2:7).” 
God’s word shows us a spiritual reality, that our lives and worth, come from Him. Regardless of physical feelings and what they may signal, God chooses to give us the gift of life, which is sacred and full of His purpose. 
Because feelings are generated in connection to the physical world, sometimes they are consistent with (A SPRITUAL SENSE) of our true worth and purpose, sometimes they are not. Our true life and purpose reside in our spirit, not in our feelings or our physical senses.
 “But the one who joins himself to the Lord is of one spirit with Him.”
1 Corinthians 6:17
Most importantly, after receiving the Lord Jesus as Lord and Savior, the Spirit of God becomes one spirit with our human spirit.  This is often referred to in the church as the “indwelling of the Holy Spirit.”
NOW, we have the ability to “sense” the Holy Spirit, and His leading in our human spirit.  This is a “spiritual sense” that goes beyond or deeper than physical feeling. (But can be confused with the physical sense)
Soul - The soul is the seat of the mind.  Therefore it spiritually brings together the physical body and the human spirit.  This is the place where we get a sense of “self” or where we spiritually experience our conscious identity and personality.  The soul is a product of the combination of spirit and body. Therefore, it is an aspect of ourselves where we need to be “watchful” of feelings and spiritual senses we experience, and then attempt to discern their meaning.  This discernment then informs our choices and life direction, or what is referred to as our human will.
For My thoughts are not your thoughts, 
nor are your ways My ways,” declares the LORD.
Isaiah 55:8
Heart - The heart is the center of our soul.  In the midst of our human experience, we have the opportunity to sense the difference between our will, and God’s will.  The heart is connected to our human spirit, so it is also the place in our soul where we have the opportunity to experience the indwelling and the guidance of the Holy Spirit.  The spiritual heart is where we can align our human will with the will of the Holy Spirit. Unfortunately, the heart is also connected to our physical body, which at times can experience powerful or deceptive emotions.  In this way the heart can be vulnerable to physical desires, that if followed, can point us away from God’s will. 
The writer of Proverbs declares, "Watch over your heart with all diligence, for from it flow the springs of life (Prov. 4:23 NASB).”  Scripture tells us to guard our hearts above all else, and carefully attend to what kind emotions and desires spring forth.
“Trust in the LORD with all your heart, and do not lean on your own understanding (Proverbs 3:5-6).”  God designed our emotions and feelings to be gauges, not guides. Feelings can sometimes help us attend to important aspects of our spirit and soul, however, they are not the ultimate source of truth.
Effective emotional management is learning to be watchful of feelings, from a heart perspective.  The key to emotional management is to learn to observe feelings from a spiritual distance.  Feelings should not define us, or rule our “will” or life direction. Often, feelings gain undue influence when we are too close to them psychologically.  This is what we term as being “fused” to your feelings. In this state of experience, it is difficult to see past an emotion and sense spiritual guidance.
Soul
Body

13. Exploring Virtues Exploring Discipleship Faith, Hope and Love
Moral Virtues
Gifts of the Holy Spirit
Fruit of the Holy Spirt
The Christian is called to a life of discipleship, that is, following Jesus Christ.  This is not meant to be a life free of pain/suffering, but instead, a life in which is made possible the addition of a deeper level of fulfillment, joy and peace despite worldly suffering and affliction.
The things that hurt matter (They're not to be avoided)
Avoidance = Lack of Meaning
Avoidance = Disconnection from the Heart
Moral Virtues
Prudence:  Disposes us to practical reasoning to discern our true good in every circumstance and to choose the right means of achieving it.
Justice:  Consists in the constant and firm will to give our due to God and neighbor.
Fortitude:  Ensures firmness in difficulties and constancy in the pursuit of the good.
Temperance:  Moderates the attraction of pleasures and provides balance in the use of created goods.
There are seven GIFTS of the Holy Spirit: Coming from the Book of Isaiah 11:2 they are Wisdom, Understanding, Knowledge, Good Counsel, Piety, Fortitude and Fear of the Lord.
The FRUIT of the Holy Spirit is taken from Galatians 5:22 from where we get the following list of 9.  
These are: Love, joy, peace, patience (also referred to as longsuffering or forbearance), kindness, goodness, faithfulness, gentleness and self-control.

14. Experiential Techniques and Metaphors
Relational Learning
Assimilation and Accommodation
Cognitive Schemas
Relational Frame Theory (RFT)
Passengers on the Bus
Soldiers on Parade
Biblical Metaphors
Metaphors
Will build inner relational networks through learning symbolized by Language.
Language represents relationship to internal processes
Internal Processes represent deeper held beliefs
Metaphors give the opportunity to re-organize language and shift relationship to internal processes.
IT ALLOWS US TO BUILD BIGGER NETWORKS OF INTERNAL RELATIONAL NETWORKS
Church would call this Spiritual Growth – developing deeper meaning
GOAL of RFT
Seek out Inflexibility and add Frames (to Learning Network) that promote Flexibility

15. Experiential Avoidance
Inflexibility
Past – Future Focus
Experiential Avoidance
Disruption of Values
PSYCHOLOGICAL
INFLEXIBILITY
Cognitive Fusion
Inaction / Stuck
Conceptualized Self

16. Flexibility PSYCHOLOGICAL FLEXIBILITY Present Acceptance Virtues
Commitment and Accountability Process
Watchfulness and Acceptance Process
PSYCHOLOGICAL
FLEXIBILITY
Cognitive
Defusion
Committed
Action
Self as Context

17. Acceptance Based Approaches
Help clients to relate to unpleasant inner experiences
with more flexibility,
openness, and
nonjudgmental compassion,
drawing upon Christian reflection or watchfulness
help recognize that fighting against the inner world commonly leads to both relapse and distraction, which prevents clients from living a life of values