Acceptance and Commitment Therapy An Experiential Approach to Behavior Change

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Edition: 1st
Format: Paperback
Pub. Date: 2003-07-29
Publisher(s): The Guilford Press
List Price: $37.33

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Summary

Most therapists and clients believe that a more vital life can be attained by overcoming negative thoughts and feelings. Yet despite efforts to achieve this goal, many individuals continue to suffer with behavior disorders, adjustment difficulties, and low life satisfaction. This volume presents a unique psychotherapeutic approach that addresses the problem of psychological suffering by altering the very ground on which rational change strategies rest. Acceptance and Commitment Therapy (ACT) focuses in particular on the ways clients understand and perpetuate their difficulties through language. Providing a comprehensive overview of the approach and detailed guidelines for practice, this book shows how interventions based on metaphor, paradox, and experiential exercises can enable clients to break free of language traps, overcome common behavioral problems, and enhance general life satisfaction.

Author Biography

Steven C. Hayes, PhD, is Nevada Foundation Professor in the Department of Psychology at the University of Nevada. His career has focused on the analysis of the nature of human language and cognition and the application of this to the understanding and alleviation of human suffering. Among other offices, he has been President of Division 25 of the American Psychological Association, of the American Association of Applied and Preventive Psychology, and of the Association for Advancement of Behavior Therapy (AABT).

Kirk D. Strosahl, PhD, is Research and Training Director for the Mountainview Consulting Group, where he provides consultation and training on integrative primary care medicine, outcomes management in applied delivery systems, clinical management of the suicidal patient, and Acceptance and Commitment Therapy (ACT). Dr. Strosahl began his career as the Director of the Suicidal Behaviors Research Clinic at the University of Washington, where, along with Marsha Linehan, PhD, and John Chiles, MD, he helped elaborate the use of acceptance and mindfulness strategies with suicidal borderline patients. From 1984 through 1998 he worked as a staff psychologist and as the Research Evaluation Manager for the Division of Behavioral Health Services at Group Health Cooperative of Puget Sound, where he became a recognized expert in integration of behavioral health services into primary care medicine, and in the dissemination of empirically supported therapies into managed care settings.

Kelly G. Wilson, PhD, is Associate Director of the Center for Contextual Psychology at the University of Nevada, Reno. He has directed a National Institute on Drug Abuse grant since 1993, examining both Acceptance and Commitment Therapy (ACT) and 12-Step facilitation treatment of substance abuse. An author of over 20 articles and chapters, his interests include the integration of basic and applied behavioral science, behavioral analysis of nontraditional behavioral topics, the interface of ACT and other acceptance-oriented traditions, and the application of acceptance strategies to substance abuse.

Table of Contents

PART I. THE PROBLEM AND THE APPROACH 1(80)
1. The Dilemma of Human Suffering
3(10)
The Underlying Assumptions of the Psychological Mainstream
4(4)
The Assumption of Destructive Normality
8(5)
2. The Philosophical and Theoretical Foundations of ACT
13(36)
Why the Level of Technique Is Not Adequate
13(3)
The Need for Philosophy
16(2)
Functional Contextualism
18(8)
Relational Frame Theory and Rule Governance: The View of Language Underlying ACT
26(19)
Summary: Implications of Functional Contextualism, Rule Governance, and Relational Frame Theory
45(4)
3. The ACT Model of Psychopathology and Human Suffering
49(32)
The System That Traps People
51(7)
The Pervasiveness of Experiential Avoidance
58(2)
The Destructive Effects of Experiential Avoidance
60(5)
When Experiential Avoidance Can't Work
65(4)
How Humans Get Drawn into a Struggle
69(8)
ACT: Accept, Choose, Take Action
77(2)
ACT as a Contextual Cognitive-Behavioral Therapy
79(1)
Concluding Remarks
79(1)
A Personal Exercise for Therapists
80(1)
PART II. CLINICAL METHODS 81(184)
4. Creative Hopelessness: Challenging the Normal Change Agenda
87(28)
Theoretical Focus
87(3)
Clinical Focus
90(1)
Informed Consent
90(2)
Drawing Out the System
92(6)
Confronting the System: Creative Hopelessness
98(10)
Barriers to Giving Up the Unworkable System
108(1)
Letting Go of the Struggle as an Alternative
109(1)
Therapeutic Do's and Don'ts
110(2)
Progress to the Next Phase
112(1)
Personal Work for the Clinician
112(1)
Clinical Vignette
113(1)
Appendix: Client Homework
114(1)
5. Control Is the Problem, Not the Solution
115(33)
Theoretical Focus
116(2)
Clinical Focus
118(1)
Giving the Struggle a Name: Control Is the Problem
119(6)
How Emotional Control Is Learned
125(3)
Examine the Apparent Success of Control
128(4)
The Alternative to Control: Willingness
132(4)
The Cost of Unwillingness
136(2)
Therapeutic Do's and Don'ts
138(2)
Progress to the Next Stage
140(1)
Personal Work for the Clinician: Is Control the Problem?
140(1)
Clinical Vignette
141(1)
Appendix: Client Homework
142(6)
6. Building Acceptance by Defusing Language
148(32)
Theoretical Focus
148(2)
Clinical Focus
150(1)
Attacking the Arrogance of Words
151(3)
Deliteralizing Language
154(9)
Undermining Reasons as Causes
163(3)
Disrupting Troublesome Language Practices
166(2)
Evaluation versus Description
168(2)
Willingness: The Goal of Deliteralization
170(4)
Therapeutic Do's and Don'ts
174(1)
Progress to the Next Stage
175(1)
Personal Exercise for the Clinician: Your Views of Yourself
176(1)
Clinical Vignette
177(1)
Appendix: Client Homework
178(2)
7. Discovering Self, Defusing Self
180(24)
The Theoretical Focus: Varieties of Self
181(6)
Clinical Focus
187(1)
Undermining Attachment to the Conceptualized Self
188(1)
Building Awareness of the Observing Self
189(3)
Experiential Exercises with the Observing Self
192(6)
Therapeutic Do's and Don'ts
198(2)
Progress to the Next Phase
200(1)
Personal Work for the Clinician: Is Your Self Getting in the Way?
201(1)
Clinical Vignette
202(2)
8. Valuing
204(31)
Theoretical Focus
205(4)
Clinical Focus
209(1)
Valuing: A Point on the Compass
209(10)
Outcome Is the Process through Which Process Becomes the Outcome
219(2)
Values Clarification: Setting the Compass Heading
221(1)
Assessment of Values, Goals, Actions, and Barriers
222(7)
Willingness to Have Barriers and Barriers to Willingness
229(1)
Therapeutic Do's and Don'ts
230(2)
Progress to the Next Phase
232(1)
Personal Work for the Clinician: Taking a Direction
232(1)
Clinical Vignette
233(2)
9. Willingness and Commitment: Putting ACT into Action
235(30)
The Client's Quandary and the Way Out
235(1)
Theoretical Focus
236(2)
Clinical Focus
238(1)
Experiential Qualities of Applied Willingness
238(4)
Reconnecting with Values, Goals, and Actions
242(1)
Committed Action as a Process
243(1)
Committed Action Invites Obstacles
244(1)
A Map for the Journey: FEAR and ACT
245(4)
Primary Barriers to Committed Action
249(9)
ACT as a Behavior Therapy
258(1)
Termination and Relapse Prevention
258(1)
Therapeutic Do's and Don'ts
259(2)
Personal Work for the Clinician: Committed Action
261(1)
Clinical Vignette
261(2)
Appendix: Client Homework
263(2)
PART III. USING ACT 265(24)
10. The Effective ACT Therapeutic Relationship
267(14)
Positive Leverage Points in ACT
268(7)
Negative Leverage Points in ACT
275(4)
The Therapeutic Relationship
279(1)
Summary
280(1)
11. ACT in Context
281(8)
The Relevance of ACT in the 21st Century
283(6)
References 289(9)
Index 298

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