The book Acceptance and Commitment Therapy, The Process and Practice of Mindful Change, Second Edition, by Stephen Hayes, Kirk Strosahl and Kelly Wilson, is a good introduction to a type of therapy developed in the 1980s, which while the authors identified it as a form of behavior therapy, is different from other types of behavior therapy. The book is a presentation of the theory and techniques of ACT, pronounced as one word, which is a good introduction to therapists not familiar with this therapeutic approach.
The authors begin the book by discussing some statistics that indicate that psychological suffering is a basic characteristic of human life. The most popular models of psychological health and pathology, unlike most of the world’s major religions, barely touch upon human suffering. ACT is a departure from this omission in that it directly acknowledges this suffering and attributes it to normal rather than pathological processes, particularly those involving human language. The book elaborates this explanation in more space than this blog affords. Thus I will simply say that the authors state that one cannot be a good ACT therapist if you take words to be right, correct, and true rather than asking, “How effective are they?”
ACT presents psychological flexibility as an unfired model of human functioning. It identifies six core processes that contribute to psychological inflexibility and thus to psychopathology. These core processes are inflexible attention, experiential avoidance, cognitive fusion, attachment to the conceptualized self, the combination of inaction, impulsivity or avoidant persistence, and finally, disruption of values with the dominance of pliant, fused, or avoidant values. In contrast to these contributors to psychopathology, there are six core processes that contribute to psychological flexibility: flexible attention to the present moment, acceptance, defusion, self as context, committed action, and values. The model presents these six processes arranged visually in a hexagonal form so that the first four processes in the list can be represented as mindfulness and acceptance processes and the last four listed as commitment and behavioral activation processes. Thus self as context and flexible attention to the moment is in both groups of processes. It’s a lot easier to conceptualize when visualizing the hexagon with the processes written at each angle.
There’s a chapter devoted to each of the six processes further explaining them, illustrating clinical applications, discussing the interactions with the other core processes, offering therapeutic dos and don’ts, and describing signs of progress. Acceptance and Commitment Therapy uses many cognitive, experiential exercises and the book offers many of these embedded in clinical dialogues between therapist and client. This brief overview hardly does justice to a book of more than 350 pages that require a slow careful reading but which will offer a new model of therapy to those interested readers looking to expand what they have to offer to help reduce the suffering of their clients.
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