Acceptance and Commitment Therapy (ACT) is now widely recognised as an evidence-supported treatmentfor many forms of psychological distress. It’s simplicity, and experiential focus makes it appealing to many practitioners. Despite these strengths, ACT isn’t necessarily easy to apply.

In reality, human beings are complex. Built into our evolution, the urges to avoid uncomfortable experiences are strong. While human language can help you connect and work together, it also functions to pull both clients and therapists in unhelpful directions. Rigid patterns of avoidance and emotional control undermine well-being and perpetuate suffering. Acceptance and Commitment Therapy practised flexibly can overcome these challenges.

How do you become an effective ACT Therapist?

To be effective, ACT practitioners need to build their skills and competencies in psychological flexibility. This workshop will focus on helping therapists and psychologists move on from more formulaic ways of doing ACT, to working more flexibly and contextually sensitive.

What is Contextual Sensitivity?

There are a set of behavioural principles that underpin ACT, called Contextual Behavioural Science (CBS). The philosophical stance in CBS is functional contextualism. Functional Contextualismdescribes all behaviour as ‘acts-in-context’, which means that all behaviours operate within a context of what comes before it and what happens after it. Hence, the context of behaviours includes both the antecedents and the consequences of behaviour, because both help you to understand ‘why’ a person engages in certain patterns of behaviour.

Take this example of Stephen, who struggles to connect with people. When he is with a group of people, he tends to stay quiet and avoid direct eye contact. To understand why he does this, you would first need to explore his learning history. In doing so, it would reveal the complex relational networks (or stories) about ‘who’ Stephen is, how he manages his emotions and the social cues that influence his responses. In short, it would reveal the derived rules or instructions that guide his actions within group situations.

Similarly, if you were to discuss the consequences of his actions, you could clarify what it helps him to avoid or control. In ACT, the practitioner lasers in on the forms of experiential avoidancethat are maintaining suffering. While staying quiet and avoiding eye contact may ‘seem’ to protect him for feared judgements (at least in his mind), it also undermines his ability to connect – the very thing that gives his life meaning and fulfilment.

Utilising a Functional Behavioural Analysis

One useful tool at the ACT therapist’s disposal is a Functional Analysis of Behaviour. The functional analysis allows both the practitioner and the client to establish the purposes of any behaviour. Its strength is in its versatility because it helps you to understand any behaviour in any context. However, for much of the time, people are not aware of their actions, the rules that drive these actions nor important intentions. In essence, we are insensitive to the context or our behaviour.

Contextual sensitive is similar to the idea of ‘self-awareness’. However, it is also different in that contextual sensitivity involves a moment-by-moment attunement to your felt and sensory experience. It also captures the values that you want to live by because these too show up in any given moment.

To become an effective ACT therapist, you are required to develop a deeper understanding of behavioural principles that underpin the model. When you ‘know’ contextual behavioural science, it opens the door to working more flexibly.

In my experience, beginner ACT Practitioners often focus exclusively on the techniques of defusion, acceptance, present moment and values clarification. It is understandable and logical because one needs to learn the form of interventions before you can develop the fluidity that comes with experience and skill. Your effectiveness increases when you take the next step of using ACT more flexibly.

What can you expect?

You’ll get the opportunity to:

• Explore further the theory of Contextual Behavioural Science (CBS) in an interactive way.
• Observe demonstrations from the trainer to help you work through common stuck points.
• Practice in small groups and receive real-time feedback.

As part of the training, you’ll receive a Workshop Extra Booklet that contains useful guidance on deepening your practice. Naturally, you’ll also receive copies of handouts and slides.

The Head, Heart and Hands of Acceptance and Commitment Therapy (ACT)

An effective ACT practitioner is capable of using what they know about contextual behavioural science to influence the way they connect with and intervene to help their client. In other words, you are integrating theory with practice and delivering it in a way where you embody psychological flexibility. In the ACBS community, this is often called the head, heart and hands of ACT.

Will I learn about Relational Frame Theory (RFT)?

Relational Frame Theory (RFT) provides you with some useful knowledge about how language and human minds work. It teaches you ‘why’ you are targeting specific behavioural processes, and why it can be a trap to focus on the content of ‘thinking’. Both RFT and ACT suggest you focus on the functions of ‘what you do’ and it treats thoughts and emotions as forms of behaviour in their own right. For these reasons, this workshop will move beyond the very basics of RFT to give you a working knowledge so that you work with more precision.

The research into RFT continues to develop, and it is far from complete. It should give you cause for encouragement rather than a cause for concern. Our best therapies are effective for approximately one in two people, and they show no sign of becoming more effective. It is probably due to multiple factors, including a failure to focus on mediators of change, and inadequate theoretical assumptions about the nature of human suffering.

At present, Acceptance and Commitment Therapy (ACT) shows comparable effectivenesswith other evidence-based interventions. The ACBS community recognises this, and a supported position is that ‘we know ACT is wrong, we just don’t know where it is wrong’.

ACT and RFT have a close relationship, and one informs the other. It works both ways, and we have seen the emergence of RFT informed treatments like Clinical RFT. These approaches are not the same as ACT, and they do help the ACT practitioner to work with more depth and precision.

Given that RFT is new to many therapists and psychologists, it can seem different or ‘hard’. It takes time to comprehend how it works and how you can use it in the therapy room. Like many theories, you need to spend time reading, training, and trying out different exercises. As you persist and practice your understanding and skills develop.

Where does compassion fit into the ACT Model?

Compassion is a natural, evolved human behaviour. Hence, no one therapy owns the quality of relating what we call compassion. It is the central emphasis of Compassion Focused Therapy (CFT) and Mindful Self-Compassion (MSC).Within other therapeutic modalities, it may be implicit or absent at a theoretical level.

Within Acceptance and Commitment Therapy (ACT), compassion runs like a river through the individual processes:

• Values clarification indicates a set of motivations that have compassion in their intentions, i.e. they serve to increase purpose and fulfilment for the individual and their communities.
• Committed action indicates the retention of purposeful activity, which requires courage and persistence.
• Acceptance or Willingness invites a person to open the door to painful emotions, which is kind, courageous and wise.
• Cognitive Defusion focuses on disengaging from unhelpful worries and rules, which implores empathy and sensitivity to your experience.
• Present Moment Contact means slowing down to engage your senses and observational capacity, which is mindful and sensitive.
• Self As Context connects with the whole person who is suffering and seeking to alleviate that pain through kindness, warmth and common humanity perspective-taking.

The therapeutic stance in ACT is that ‘no person with psychological distress is broken’. It is more useful to say that they are stuck, they are whole and they can change. When the ACT Practitioner models this stance, they are better positioned to initiate self-compassion in their client.

The ACT Model and Compassion Focused Therapy (CFT) share an interest in evolutionary science. The models turn to what we know about the evolution of human minds and social groups. Many other psychological models have neglected to do this. There are many advantages to developing a knowledge of human evolution. Arguably one of the most useful benefits is the knowledge that evolution isn’t perfect. It has flaws, and while we’ve evolved in helpful ways, there are several powerful unintended consequences of evolution.

Language is a key example of how human beings have benefited and suffered. It is both a gift and a curse. Language allows a person to communicate efficiently and co-operate effectively. And, yet it’s also the source of incredible suffering and distress. To know that each of us was born with this flaw in our development supports our ability to take a compassionate stance on our suffering. It isn’t your fault!

Will I learn more about Self-As-Context and how to do it effectively?

When I’ve surveyed beginner ACT practitioners, they often report to struggle with the implementation of Self As Context more than any other process within the model. It is similar for clients too because self-as-context is the most abstract concept within psychological flexibility. The encouraging thing is that once you get into practising various perspective-taking exercises, it can be one of the most powerful drivers of flexibility.

Self-As-Context interventions aim to help a client connect with more flexible ways of relating to ‘who’ they are. From a young age, we begin to develop stories about who we are, what we like, dislike, want or need. We begin to learn that ‘I’ am different to ‘YOU’ and other people. We learn that MY thoughts, feelings and behaviours are not YOUR thoughts, feelings and behaviours. With age, it becomes clearer that these are parts of our experience and that they can change.

This process of knowing oneself is useful because it allows us to predict with accuracy what will happen if we do x y or z. For example, I know that I like to drink coffee more than tea. Therefore, I can predict that if I drink tea, I will often be less fulfilled than if I drink a coffee. This knowledge supports my decisions in this context.

The flip-side is that ‘knowing oneself’ also predicts future events with a high degree of inaccuracy. For example, your life experiences may have taught you that if you ask for help from a friend, then they will say no and you’ll feel hurt. Naturally, a person may ‘go along’ with this assumption and continually follow the rule “People will think I’m a burden if I ask for help. It is best to deal with matters on my own.” This type of rule-following is highly inflexible and can undermine a person’s well-being leading to incredible stress, loneliness and depression.

Rule-governed behaviours and the Self

‘Rules-governed behaviours’ operate under the influence of the ‘self’. That is what I have learned about ‘who’ I am, leads to a set of behaviours that are coherent or seem to fit the story of who I am. For example, if I see myself as “disgusting”, it would feel ‘right’ to get close to people or be kind to myself. Instead, I’d more likely keep my distance and treat myself with contempt. Although these responses undermine my health and well-being, they don’t seem awkward. They fit ‘who’ I am, whereas acts of intimacy and self-care would ‘go against the grain’.

When unhelpful stories about the self dominate a person’s experience and behaviours, it can be challenging to help them change their behaviour for the better. Self-As-Context is a useful tool in these circumstances because it helps a person to ‘try-out’ multiple perspectives on who they are: for example, by exploring being in other people’s shoes, by going forward or back in time and by practising a hierarchical relational-frame.

What is a hierarchical relational frame?

When our mind frame objects hierarchically, it means that they described as being part of something. For example, wheels are part of a car, and hands are part of your body. When a person has a tight grip on their self-story, they are no longer relating to their thoughts hierarchically. When this is happening, the ACT Practitioner might say to a client: “It seems like instead of you having these thoughts about who you are, it is like these thoughts have you.” The inference in this statement is that there is a reversal of the hierarchical relation. The story is the controlling force, not YOU the whole person.

Self-As-Context interventions attempt to reverse this hierarchical relation, not by erasing the language (that is impossible), but by flipping it. A useful metaphor is to say that ‘you’, the whole person, are the container for your thoughts and feelings – including the stories about who you are. You are the place where these stories get told. You are the whole book; the beliefs about you are merely words within that book.

How many days is this Level 2 ACT workshop?

Our ACBS peer-reviewed ACT Trainer, Jim Lucas, usually delivers ACT training at a fee of £850 per day (plus travel expenses and necessary accommodation).  Please get in touch to have a chat about what you would like.

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