1、Acceptance and Commitment Therapy: Advanced WorkshopJulian McNallyProgram OutlineReview Of ACT ModelGetting Stuck Into Getting Stuck7 Frequent Problems And How To RespondSweet Spot And Client DescendingMatrix For Case FormulationDeveloping Mastery In ACT“Hexaflex”ACT Model of Effective LivingValues,

2、 Purpose & MeaningDefusionCommitted ActionsContact with the Present MomentAcceptance & WillingnessTranscendent Sense of Self/ Self As ContextPsychologicalFlexibility“InFlexaHex”ACT Model of PsychopathologyLack of Values Clarity or ContactFusionInaction or Disorganised ActivityDominance of Conceptual

3、ised Past or Feared FutureExperiential AvoidanceAttachment to “Storied” or Conceptualised Self“Hexaflex”ACT Model of Effective LivingValues, Purpose & MeaningDefusionCommitted ActionsContact with the Present MomentAcceptance & WillingnessTranscendent Sense of Self/ Self As ContextMindfulness & Accep

4、tance ProcessesBehaviour Change ProcessesYour turn!Decide who will be client firstBrief your partner on presenting problem, but not whats tricky about this clientCounsellor: Notice yourself getting stuck. Observe thoughts and feelingsClient: observe and resist urge to be agreeable or make it easy fo

5、r counsellorIf counsellor is not getting stuck, brief “client” on what the actual client does thats tricky and try again. Switch.Pair up - one is “A” the other is “B”Getting Stuck Into “Getting Stuck”My experience is not authoritative because it is infallible. It is the basis of authority because it

6、 can always be checked in new primary ways. In this way its frequent error or fallibility is always open to correction. Carl Rogers, On Becoming a Person Bennet and CariNotice your reactions and make peace with themProvide an ACT-consistent responseWhere is the client on the Hexaflex?Where are you o

7、n the Hexaflex?7 Frequent ProblemsWhat do I do if I get stuck?Do I need to cover all 6 processes?What if they say “it didnt work”?What if they dont know/cant say what their values are or dont have any?What do I do with clients who are sceptical/concrete/psychotic?What if they (or I!) dont “get” Self

8、-As-Context?What do I do with clients who are fused with their beliefs or a sick or victim role?What do I do if I get stuck?General principles:Slow down!Be willing and acceptingHold your formulation and treatment trajectory lightlyStick closely to principles and loosely to techniquesListen to client

9、s experience before yoursListen to experience before models and ideasInvite a change in action rather than in understanding or feelingDo I need to cover all 6 processes?No!What if they say “it didnt work”? Is there a control agenda in place?Try another part of the modelTry a different technique from

10、 the same partWhat if they dont know/cant say what their values are or dont have any?How do they know they dont know?When was the earliest (last) time they remember having values?Make the therapy about discovering/creating values?Check for semantic problemsDetect values in the presentWhat do I do wi

11、th clients who are sceptical/concrete/psychotic? “Trust your experience, not my words or your thoughts”Workability of scepticismSideline “beliefs” and “being right” for a whileYou dont have to do “mindfulness” just pay attentionPsychosis ACT is not an EST other treatmentsMetaphor-imperviousness? Pre

12、sent-moment defusion and willingness with Self-As-ContextWhat if they (or I!) dont “get” Self-As-Context?Lets practise!Indicators Of Increased Capacity For Self-As-ContextDetecting and defusing from rules and storiesIncreased perspective taking and noticingNoticing own processes of fusion and unwill

13、ingnessNaming or joking about own scripts and storiesAble to dispassionately examine value-contradictory behaviours and thoughtsRecognising current choices and history as separate phenomenaRelating to multiple conceptualisations of self as determined by context and values-in-the-momentWhat if they a

14、re fused with their beliefs or a sick or victim role? Try Self-As-ContextBe curious and empathicAppeal to workabilityTemplate for Experiential ExercisesRecognise your mind will interfere, so slow down and acceptContact with present moment sounds and touchLocate the moment of choice or stucknessImmer

15、se in the moment (file cabinet or movie screen)Open eyes and express itHold the moment silently and appreciateThe Grid - Kevin PolkEven Simpler Model of ACT ProcessesSwSValued LivingSensory ExperienceMental Experience“I think that.”“Im having the thought that.”“I notice Im having the thought that.”This is unbearableI notice those thoughts are t