An Introductory Training in Acceptance and Commitment Therapy (ACT)
This introductory training in Acceptance and Commitment Therapy (ACT) will teach you the theory, practical skills and therapeutic stance that underpins this contemporary contextual Cognitive Behavioural Therapy (CBT).
What is Acceptance and Commitment Therapy (ACT)?
Acceptance and Commitment Therapy (ACT) is an evidence-based psychotherapeutic intervention rooted in the behavioural tradition. It has close to 300 RCTs demonstrating its effectiveness for many forms of psychological health problems including chronic pain, anxiety, depression, work-related stress, addictions, long-term health conditions (LTCs), traumatic stress and many more. For more detailed information about the research journey of ACT, I recommend this book by Nic Hooper and Andreas Larsson.
How does ACT work?
ACT aims to increase psychological flexibility, which is a scientific and empirically supported phenomenon in behavioural science. The research tells us that when a person increases their psychological flexibility, their well-being, their functioning and their mental health improves.
What is Psychological Flexibility?
We can understand psychological flexibility by first recognising that it has an opposite – psychological inflexibility. When a person is inflexible, they are more likely to suffer from emotional distress, ill-health and lower life expectancy. One can measure flexibility through the Acceptance and Action Questionnaire II (AAQ2). This short psychometric self-report measure captures the behavioural processes in psychological flexibility. It can also be measured qualitatively by tracking your own experience.
Psychological flexibility is made up of six interrelated and distinct behavioural processes. Broadly speaking, they include mindfulness, acceptance and behavioural change processes. More specifically, they are:
- Willingness or Acceptance
- Cognitive Defusion
- Contact with the Present Moment
- Perspective-taking through an Observing-Self
- Values Clarification
- Values-based Committed Actions
The Six Processes of Psychological Flexibility
Each behavioural process has a respective opposite that shows you how to identify inflexibility in that process. The list below corresponds to the list above with each number:
- Experiential Avoidance
- Cognitive Fusion
- Inflexible Attention and dominance of a past or future orientation
- Rigid attachment to a conceptualised self e.g. “I am weak, bad, a failure etc.”
- Disconnection from life purpose and meaning
- Avoidance, delay or inconsistent attempts of life-affirming activity
ACT aims to shape behaviour both inside and outside the therapy room. You can teach clients techniques (the hands of ACT) inside the session and invite them to practice them outside of the therapy in various and multiple contexts. This way, they get to build patterns of committed action.
It is important to help people understand the processes that underpin the techniques. It isn’t merely an intellectual process. It is an experiential one, which requires a person to ‘move their feet’. Hence, one needs to practice to understand willingness or acceptance. It’s why the ACT practitioner moves into experiential exercises quickly during the session.
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How do I become an effective ACT Practitioner?
To be effective, ACT practitioners require a firm knowledge of the basic science that underpins the application on the model. Without it, practitioners run the risk of going off-track.
One can attend a training workshop and feel invigorated. However, humans are complex, and once practitioners return to their places of work, they can easily feel lost after a few days or weeks of trying to apply what they’ve learned. Without a commitment to on-going continuing professional development and supervision, your development is likely to stagnate. The commitment to learn and improve is one that you can choose to make. You alone are the master of that choice.
Learn the Theory and Practice
As an ACBS peer-reviewed ACT Trainer, Jim Lucas recognises that he has a responsibility to ensure that what he teaches provides you with enough knowledge and skills to begin that journey. He could, if he chose to, show you a lot of techniques from ACT. If he were to do that and nothing else, you would not understand the theory and the science that tells you ‘why’ you are doing it.
Similarly, if you were only to learn the theory about ACT, you would not develop the skills you need to help people in your professional role. A combination of the ‘head’ (Knowledge and Concepts) and the ‘hands’ (ACT Skills Training) is necessary. However, even with these two components, you may still be left wanting.
Experiential Practice: The Heart of ACT
Therapy requires a true and deep connection between two or more humans. Jim’s own experience of being a therapist tells him that many of the problems that clients struggle with are rooted in painful and recurring interpersonal disconnections. When in the therapy room, you can impress a client with your advanced theoretical understandings. Similarly, you may have a remarkable arsenal of psychological tools at your disposal.
These abilities may make a useful difference but will likely be limited if a practitioner does not know how to embody the spirit of the model. In truth, one needs to know the ‘heart’ (Personal qualities and Experiential Practice) of ACT so that they may meet another person with empathy, courage and humility.
Who is this introductory workshop suitable for?
This workshop is suitable for therapists, counsellors, psychologists and other allied health professionals such as Physiotherapists and medics. You may already be familiar with other therapies such as Cognitive Therapy, REBT, DBT, Solution-focused Therapy, Person-Centred, Gestalt, Transactional Analysis or Psychodynamic psychotherapy. ACT can sit comfortably alongside your usual ways of working, and yet it offers something distinct and powerful.
How many days training are there in this ACT course?
In the spirit of ACT, the number of days is not fixed. We are flexible! Our ACBS peer-reviewed ACT trainer, Jim Lucas is happy to deliver something that suits what you would like. There is scope to commission a one-day, two-day or three-day introductory training in ACT. Below, you can compare the three options:
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What is the scientific theory that underpins Acceptance and Commitment Therapy?
Contextual Behavioural Science (CBS) is the philosophy and empirical science that underpins the practice of ACT. Just as Cognitive Theory underpins Cognitive Therapy, CBS provides the roots to the practice and application of ACT. It is built on a philosophy of psychological science called Functional Contextualism.
What is Functional Contextualism?
The philosophy of ACT and CBS is Functional Contextualism (FC). As with all philosophy of psychological science, there exists a metaphor and truth criterion inside its assumptions that describe the way that it sees people and the world. FC believes that the truth of ideas and human beings is in whether it works. Hence, FC values usefulness above ‘truth’ in the conventional sense. For example, it doesn’t matter per se if a person struggling with depression has the belief “I am weak”. It only matters if ‘acting’ in coordination with this thought makes their life worse. If it does make it worse, then you can conclude that ‘it does not work’.
The metaphor in ACT is the ‘act-in-context’, which explains that you can only understand a person’s behaviour within a context. Behaviours make no sense whatsoever outside of a context. This worldview is distinct from conventional ‘abnormal psychology’ and psychiatry and the more traditional ways of understanding human suffering. For example, in the latter, if a person shares that they believe ‘people are watching me’, it may be concluded that the person is experiencing paranoia. However, if you were to investigate the person’s current life, including who and what is in their environment and what has happened in their past, then you may reach a different conclusion.
You can read more about the philosophy of psychological science in ‘The Philosophy of Science as it Applies to Clinical Psychology’by Sean Hughes in ‘Process-Based CBT: The Science and Core Clinical Competencies of Cognitive Behavioral Therapy (2018).
WTF? (What is the Function?)
Traditional CBT tends to focus on the ‘form’ of thought, i.e. the words that make up a NAT, assumption or core belief. These words are taken to be literal statements and cognitive re-structuring targets these thoughts and aims to change them. In ACT, this does not happen.
ACT is concerned with the function of thought, i.e. its purpose or consequences. A functional lens is held up to examine all behaviour. Thus, the ACT practitioner is always looking at the function of what is being said and done by the client.
In ACT, thoughts and feelings are treated as behaviours, too, which might sound a little odd. The reason is that a person learns patterns of thinking and ‘feeling’, which are forms of responding.
It is not true that ACT is only concerned with behaviour and not cognition. ACT believes that it is essential to target thoughts, feelings and behaviours. The biggest difference is that the ACT model believes that you can’t change a cognition. You can only add to it.
What is Relational Frame Theory (RFT)?
Relational Frame Theory is a theory of language based on behavioural analysis. It can often seem complex and difficult to understand. Jim doesn’t believe that it is essential to know RFT in-depth to be good at ACT. However, knowing something of the theory and its application to therapy will help you to be more precise in what you are doing.
A Very Brief Description of RFT
There is a basis in RFT called Derived Stimulus Relations. The way the human mind works is by building relations between different words, sounds and objects etc. These relations aren’t just associations; they are more specific than that. For example, ‘peas’ and ‘carrots’ aren’t just associated. They have a relation: they are both vegetables. Their relation is being ‘part of’ the group vegetables.
From a young age, our minds start to form these relations, and as you get older, they become increasingly sophisticated and complex. An adult mind can form an infinite number of relations between different stimuli. It’s like a sponge soaking up all this information, and then it organises the information into a network. For example, you might learn ‘anxiety is bad’. This ‘NAT’ (as it is labelled in Cognitive Therapy) leads to other sub-thoughts such as ‘I don’t like anxiety, it is harmful, I must get rid of it, I can’t control it, I am weak’.
The human mind is both a gift and a curse. Just as you can think things and use your words to connect with other people, to laugh with them and to support them, language can also take you to very dark places.
RFT shows us that there is no such process called ‘unlearning’. One cannot erase language. It can be temporarily forgotten, but that is not the same thing. Acceptance and Commitment Therapy doesn’t focus on ‘changing’ cognitions. It focuses on ‘adding’ helpful behavioural responses to unhelpful cognitions. When your interventions do this, they are altering the context in which the thinking and feeling take place. When you alter the context, you can increase psychological flexibility.
For a more detailed look at RFT, read ‘Learning RFT’ by Niklas Torneke.