Psych108 Sem 1 Week 1-6

Psycholologists

• listed under Australian Health Practioner Regulation Agency

• diagnosis, treatment and clinical managment

• reoccuring issues

• long term

Counselors

• Therapeutic interventions with well functioning clients

• Early intervention

• Don’t need to do psychology degree - own undergrad

• Short term

• Focus on present issues

Psychiatrist and Social Workers

Psychiatrist:

• Use of medication and therapy

• Medical management

 

Social Workers:

• Case work and therapy to mediate relationships with schools, agency, health care

Why does counsellor/psychologist work

• Therapeutic alliance/relationship

• Client motivation and severity of problem

• Personal attitudes

• Therapeutic approach used

• High level of training standards

Challenges of being a psychologist

• Counter transference

• Loss of clarity and personal issues - described by Freud 1912

• Must handle opinions and values and personal biases - don’t discriminate against clients

Who were the first Psychiatrist?

• Hippocrates

• Homeostasis - natural balance of body

• Prognosis - prediction of outcomes based on current symptoms

• Importance of obtaining client history

• Trust building in therapy

• Acknowledge repressed feelings

Freud (1900s)

• Built credibility for talking out problems

Accomplishments:

• Plot anatomy of HNS

• Developed anesthesia

• Emphasized unconscious motives of behavior

• First generation of counsellors

• Underlie what psychologist and counsellors do

Early Psycholgists

• William James

• First professor of Psych

• Presented concepts of free will, consciousness, adaptive functions

• Believed humans are creatures of emotion and action

• Watson and Skinner - reinforcement influence behavior

• Wetheimer and Kohler - learning not always follow orderly progression

Different Eras

The guidance era:

• early 20th century

• WWW1 introduced standardised tests for abilities and personality

• WW2 help soldiers adjust to war

the counselling era

• Clifford Beers

• Mental patients in instuitions - being compassionate and understanding of patients

Medical Model (1940s)

• Diagnosis of psychopathy

• Treatments - shock therapy, frontal lobotomies, psychopharmacology

• Underlines clinical system in health care

Carl Rodgers

• Carl Rodgers (1902-1987) Argued doctor patient relationship through medical model was not adequate for most humans

• Emotional problems are not mentally ill - people needed safe environment

• 1960s Person centered counselling was focus of education in counselling

• 1970s Cognitive and behavior driven theories challenged person centered approach - Ellis and Beck

Foundations of client centered therapy

• Carl Rodgers

• Trust with clients - positive Centre and create constructive changes

• Therapeutic relationships - relationships with client fosters change

Core:

• empathy

• unconditional positive regard

• congruence authentic

Reading: first steps of counslling tasks

• understanding client history

• childhood experiences

• medical history

• family lineafe

what is different about counseling?

• Counselling is only helping discipline that has both preventative orientation and remedy model

• Means counsellors are trained to prevent problem and treat them

History of counseling

• Is a hybrid knowledge of philosophy, education, psychology, psychiatry, sociology and family studies

• In classic greek and roman eras early counsellors were philosophers, physicians or priests

• "talking cure" concept is what is around day - not accepted a century ago associated with witchcraft

• This cathartic method was pioneered by Sigmund Freud - took years for Freud to build credibility on technique

Influences from psychology

• Beginning with Rene Descartes (1596-1650) - first to study mind as separate from body and soul

• Continued through British Philosophers, John Locke (1632-1704), George Berkley (1685-1753), David Hume (1711-1776), John Stuart Mill (1806-1873) - gave rise to science of Psychology

• Discipline was born when Wilhelm Wundt (1832-1920) founded the first experiment laboratory in 1879

• However American Philosopher William James (1842-1910) was first "Professor of Psychology"

Parsons 1909 3 part model to counselling

• Analysis of ones personal interests

• An exploration of available occupations

• And application of systematic reasoning process to find a good match between the two

Gestalt therapy

transactional analysis (TA) values clarification strategies, reality therapy and other concepts and approaches all clamored for attention and vied for influence

Carkhuff

• Carkhuff and Berenson 1977; Truax and Carkhuff 1967 imposed systematic and generalist approach to task of helping

• Carkhuff suggests counsellors need to be skilled, reliable and capable of delivering core counselling skills

• Carkhuffs work is widely accepted - emphasised development of generic skills to provide base for helping relationships

What do we follow now?

Techniques of counselling likely follows Cormier and Hackney 2012, De Jong and Berg 2012, Egan 2014, Young 2012 - patterned after Carkhuff "core conditions"

Specalities in counselling

family and couples therapy, mental health counselling, school counselling, rehab counselling

what is a therapuetic relationship

• Relationship developed with clients - make people comfortable with us

• A space where people feel like the can discuss there most vulnerable parts of themselves

• Create a space that is safe - talk about emotions

• Bordin's (1979) model of working alliance suggest

• Quality of relationship - found to be twice as predictive of outcome as any client, therapist or service setting factor, separate or combined

• Negative evaluation of the client-therapist relationship was associated with drop out and poor outcomes

Factors of client change

• 40% Client - client motivation

• 30% Common - commmon elements by all approaches, goal setting, problem solving

• 15% Placebo - client being in treatment

• 15% Model - specific methodds or intervention

Basic Counsellig Skills

• Joining and Listening - inviting to talk, listen with interest, warm greeting

• Reflection of Content (Paraphrasing) - reflect what client has said, picking out most important details and rexpressign them

• Reflections of Feelings - reflecting feelings and emotions

• Summarising - smmarise main points, done time to time but at the end

types of listening

Non-verbal listening = using non-verbal cues to communicate that you are listening and understanding - head nodding

Reflective listening = key element is hypothesis testing. It asks "is this what you mean"

• statements rather than questions

• guessing what comes next

• giving voice to what client is saying

Thomas Gordans Model of listening

There are 3 places where communication can go wrong

1: the speaker does not say exactly what is meant

2: the listener does not hear the words correctly

3: the listener gives a different interpretation of what the words mean

how is summarising different from paraphrasing

• In paraphrasing counsellor focuses on one aspect of clients narrative

• When summarising the counsellor will put key aspects of clients story into a summary

Decidign when to reflext feelings or content

• emotions in character are linked to body sensations

• Reflecting feelings can be more powerful at helping someone own a feeling that they are avoiding

Case Management

• not about managing clients anymore

• a creative and collaborative process involving skills in assessment, communication, coordination, consulting, teaching, modelling and advocacy that aim to enhance the optimum social functioning of the client served and positive outcomes for the agency

• case managers perform responcibilites of case management

Case Mangment process

• Assessment - tries to understand what is happening and what client needs to do - intial contact and gathering and assessing information

• Planning - process of determining future services for client, client is primary source of information

• Implementation - when the service plan is carried out and evaluated

Goals of Case Management

• Integration of services - service work together

• Continuity of care - uniterupted

• Equal access to services/advocacy - free waivers

• Quality of care

• Client empowerment

• Self- determination - clients choose goals/interventios

• evaluation - collaborative decisions

Counselling Skills

• observing the person

• putting person at ease

• invitation to talk

• tuning in

• listen with intrest, minimal responses (can be used to convery conversation), brief invitations to continue, voice, silence

• bried invitationt to continue (tell me more)

non- verbal behaviour

• macthign non-verbal behaviour - mimif posture

• physical closeness - comfortable distance

• use of movement - can show joining in empathetic way

• facial expression - expression of interest, care, concern

• use of voice, clarity, volume, speed, tone

• silence

SOLER MODEL - Egar (2007)

• S - sitting at a comfortable angle and distance

• O - open posture; arms and legs uncrossed

• L - leaning forward from time to time; looking genuinely interested, listening attentively

• E - effective eye contact without staring

• R - remaining relatively relaxed

Wellbeing

• combination of feeling good and functioning well

WHO Wellbeing: a state of wellbeing in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and make a contribution to community

Wellbeing Theory Seligman PERMAH

P - Positive Emotions

E - Engagement

R - Relationships

M - Meaning

A - Accomplishment

H - Health

How to increase wellbeing?

• Mindfulness

• Creating hope

• Learned optimism

• Finding meaning

• Self care

Self Care and why its beneficial

WHO Self care: Is the ability of individual, families and communities to promote health, prevent disease, maintain health and cope with illness and disability with or without a health worker

Benefits of self care:

• Promotes wellness

• Manages stress

• Increase productivity

• Improves happiness

• Enhances self- esteem

• Self care requires consistence

Reflective Practice

Reflective practice is essential component of skill and professional development by psychologists through their career in psychology. It involves critical reflection on ones own practice

• makes changes to way we behave

Donald Schon (1983)

defined reflective learning as the exploration of experience, understanding its impact of on oneself and others, and learning from this to inform future actions

• Helps feelings of anxiety

• Clarify weakness of practice

• Clarity on next steps

• Search for evidence based knowledge

In action vs On action reflection

In action reflection:

• Is the process of being present in the moment and synthesising the current action being done, the available information and critically responding as the situation unfolds

• In Action- reflection assists you to respond curiously and learning on the job in flow of work

On action reflection

• Process of stepping back and reflecting on past scenarios, events and exploring why you and others responded in a certain way

• It is assessing how situation unfolded, what responses where chosen and how the result came about

• After this commitment is made to amend or continue the action

5 Pillars LSCMA

• Learning and Growth mindset

• self awareness

• critical thinking

• multiple perspectives

• action

Person Centreed Therapy:

• Client centered/humanistic/emotion focused

• Founded by Carl Rodgers

• Developed in 1940s/1950s

• Rodgers noted that traditional child-guidance methods in which he had trained did not work

Concepts:

• At core humans are trustworthy and positive

• Humans are capable at making changes and living productive, effective lives

• Humans gravitate towards self-actualisation

• Given the right growth conditions individual strive to move to fulfill their creative nature

• Represented movement towards order, complexity and interrelatedness

Basic Assumption

• Formative tendency

  • Basic tendency toward greater complexity, fulfillment of potential

• Self- actualizing tendency

  • Basic tendency of human beings to move towards completion or fulfillment of their potential

• "organismic valuing process"

  • People have innate sense of what they need

Overview:

• Therapists cultivate a positive, non-judgmental, accepting attitude toward client

• Therapists openly express feelings rather than hiding behind a mask

• The therapist experiences unconditional positive regard and empathic understanding and communicates this effectively

• The client will respond with constructive changes in personality organisation

Contrast with other the theraputic models

• Medical model of therapy views person as patients with problematic parts

• Other forms of treatment are directed by experts

• Client centered approaches focus on the clients inborn capacity for self healing

• Difference for the therapist is between using the self and being oneself

• The traditional view of an uncovering of hidden or denied feelings or experiences

• Question is how these hidden experiences exist and how they are resolves

• Listening to clients narratives are thought to be an avenue for helping client deal with internal conflicts

Challanges against Psychoanalytical

• Assumption that the counsellor knows best

• Validity of advice, suggestion, persuasion, teaching, diagnosis and interpretation

• The belied that clients cannot understand and resolve their own problems without help

• The focus on problem over person

Core Conditions - Client

• Self concept:

  • At therapy onset, self-esteem often low

  • Improvements correlated with therapy

• Locus of evaluation:

  • Pre- therapy focus on others opinions

  • Progress associated with internal locus-of-evaluation

• Experiencing:

  • At therapy onset, rigid

  • Success related to flexibility

techniques:

• No specific techniques

• Concerned with a way of being

• Skill of active listening

• Attending to clients verbal and non verbal cues

• Reflecting feelings

Criticisms

• Too much responsibility on the client

• Focus too narrow

• What about a client experiencing crisis?

• Does this approach consider cultural issues?

Psychodynamic Therapy:

• Insight orientated approach

• Sigmund Freud (Psychodynamic theory in late 1800s)

• If we talk about things it helps us

• Defense mechanisms

• Levels of Awareness:

• Conscious: Phenomena Individuals are aware of at any given moment

• Preconscious: Phenomena individuals can become aware of if they attend to them. The preconscious sits on the threshold of awareness

• Unconscious: Phenomena Individuals are not, and usually cannot, become aware of

• Talk therapy bring forward things in unconscious

Structure of Psyche

• Id - part of us that wants and desires things, unconscious level

• Ego - how to be in life, behaviors, mediator, conscious and preconscious levels

• Superego - actually you have stuff to do, responsibility, all levels

Instics can be:

• Blocked from expression (temporarily)

• Repressed

• Expressed without modification (rarely).

• Freely expression

• Appear in altered expressions (commonly)

• Distorted by defense mechanisms

Defence Mechanism:

Repression - placing unpleasent memory in unconscious

Regression - reverting back to immature behaviour

Reaction formation - acting in exactly the opposite way to ones acceptable impulses

Rationalization - creating false exuses for unaccetable feelings

Displacement - redirecting unacceptable feelings fromt he orginal source to a safer, substitute target

Sublimiation - replacing sociall unaceetable impulses with socially acceptable behaviour

Projection - attributing ones own unacceptable feelings and thoughts to others

Role of early childhood: Psychodynamic

Psychodynamic therapists believe that early childhood experiences are crucial in shaping a persons personality and emotional wellbeing. Patterns of relating to others and coping mechanisms are often developed in response to early experiences

Free association: Psychodynamic

Clients are encouraged to freely express their thoughts and feelings without censorship or judgement. This process allows unconscious material to emerge and be explored in the therapeutic setting

Transference and counterference:

Psychodynamic therapy acknowledges the phenomena of transference, where clients may project feelings onto therapist based on past relationships.

Countertransference refers to the therapists emotional reactions to the client, which can also provide valuable insights. Patterns and conflict that exist in the real world are replicated with the therapist and explores

Criticisms of the Psychodynamic approach

• Complex

• Requires years of specialized training

• Time consuming

• Overemphasis on insight

• Difficult to support empirically

• Ignores social and cultural factors

• Not useful for clients in crisis

• Culturally and gendered biased

Contemporary Impact of Psychodynamic Theory:

temporary Impact of Psychodynamic Theory:

• the impact of psychoanalysis can not be overestimated

• Strong current interest in psychodynamic ideas and research

• Heavily informs understanding of psychopathology and trauma

Gestalt Therapy (1940s/1950s)

• Fritz Perls

• Focuses on facilitating the clients here and now experience

• The initial goal is for clients to gain awareness of what they are experiencing now

• Individuals must be understood in the context of their ongoing relationship with the environment

• It aims to promote direct experience rather than the abstractness of talking about situations

Built on

• Experiential present moment

• Everyone in web of relationships: only possible to know ourselves against the background of our relationship to the other

Feelings Gestalt Approach

• Feelings about the past may be unexpressed

• These feelings are associated with distinct memories and experiences

• Feelings not fully experienced linger in the background and interfere with effective contact

• Result:

  • Preoccupation, compulsive behavior, oppressive energy and self-defeating behavior

Gestalt Therapy Techniques

• Awareness through dialogue: therapists use open- ended questions to help clients become more present and attuned to their thoughts, emotions and bodily sensations in present moment

• Empty Chair technique: have clients imagine or interact with empty chair as if it is a significant person, part of themselves or unresolved issue. Can facilitate exploration of feelings and perspectives

• Role Playing: Clients may be encouraged to engage in role playing to express different aspects of themselves or interact with significant others in therapy room. Can provide insight into internal conflicts

• Body Awareness: Gestalt therapy recognizes the connection between mind and body. Techniques such as body scanning or paying attention to bodily sensations can be used to help clients connect with physical experiences

• Homework assignments: keeping a journal, practicing mindfulness, engaging in specific activities that promote self awareness and personal growth

• Creative Expression: drawing, painting or using other artistic forms to explore feelings and experiences that may be challenging to express verbally

Criticisms of Gestalt:

• Counsellors tend to be overly manipulative and controlling

• Cognitive factors ignores

• Viewed as gimmicky

• Little emphasis on acquiring behaviorally useful life skills

Psychotherapy

• Long part of treatment for psychiatric patients

• Can be both efficacious and cost-effective

• crucial for depression

• improves interpersonal and self essteem

• effective for children and adults with personality and anxiety

• can assist diabetic children

Summary:

• Psychotherapy is powerful and effective

• It is necessary for medical and surgical patients

• Can improve and extend life

• Is a tool for reducing medical costs

• Psychotherapy should be supported in all medical insurance policies

• Data shows psychodynamic psychotherapy is important

Focus of Psychodynamic psychotherapy

Psychodynamic focuses on the effect on past experience in molding patterners and behavior through cognitions, interaction and perception that interfere with health

Goal:

• to understand the defence mechanisms and transference responces of the patient, edludiate characterics of problems to have behavioural change

Technique:

• theraputic aliance

• free association

• defence and transference interpretion

• freuqent meetings

Duration:

• months to years

The setting of psychodynamic psychotherapy:

• breif of long term

• intermmitement

• no termination date

• mediations are used

The technique of Psychodynamic Psychotherapy

• Behavioral change occurs in psychodynamic psychotherapy through two processes of treatment

• Understanding the cognitive and affective patterns derived from childhood

• And understanding the conflicted relationships one had with ones childhood significant figures

• Treatment setting designed to facilitate the emergence of these patterns that enables them to be analyzed

• therapist foccusing on listening

Behavioural Therapy

• B.F Skinner

• Human control and manipulation

• Theory underlying this approach:

  • We are born empty headed

  • We are products of learned behavior, shaped by out environment and reinforced and modeled by the world around us (values, attitudes, thinking, styles, emotional responses, personality)

Behavioural Therapy techniques

• Operant Conditioning:

  • Client receives rewards by way of points or privileges when they cooperate or are compliant, they lose points for obstructing progress

• Reinforcement:

  • Produces the desired result remove a stimulus that a client perceives as aversive - positive reinforcement

• Extinction:

  • Removing the reinforcement for a behavior

• Contingency contracting:

  • A behavioral contract; define an event/goal work out how to achieve it

• Shaping:

  • Consistent reinforcement to work towards the ultimate goal

• Classical conditioning:

  • Or systematic desensitization - when a stimulus elicits an automatic response - using relaxation to help deal with anxiety in freighting situations

• Flooding:

  • Is when a phobia is extinguished by bombarding the client with a stimulus

Albert Ellis and REBT

• Based on logic and rational analysis

• We are born with the potential for rational and irrational thinking

  • Rational: self- constructing thinking

  • Irrational: self-defeating thinking

• Out culture and family experiences can exacerbate our irrational thinking

• We learn and invent disturbing beliefs and keep ourselves disturbed through self talk

ABC Theory of Emotions

A - Activating Emotional Experience

B - Belief/Interpretation of Expeirnce

C - Consequences

D - Disputing Irrational Beliefs

E - Emotional Effect

Aaron Beck and CBT

• Attempted to validate Freud found depressed clients to exhibit negative bias in how they cognitively interpreted life events

• In childhood we develop schemas including assumptions and beliefs that influence our interpretation of events throughout our life

• Self- critical belief systems can generate distorted cognitions, which negatively affect our mood and difficulties and problems arise

• The focus of CBT is to identify and modify these patterns of maladaptive thinking

• thoughts lead to feelings lead to behaviour lead to thoughts

Situation, Thought, Emotion, Behavior

Cognitive Distortions:

• CBT suggests that most maladaptive thoughts fit into a category of cognitive distortions

• Understanding what type of distortion your mind tend to focus on can help people notice their thinking, which is the first step to challenging their thoughts

Categories of Cognitive Distortions

• All or nothing thinking  - I'm terrible at statistics

• Emotional reasoning: - feeling interpreted as fact "I'm not going to pass

• Mind reading: - "he thinks I'm boring"

• Catastrophizing: "nobody will love me"

• Fortune telling - "assuming you know what will happen"

CBT Techniques

• Brief model - 10/12 sessions

• Clients keep a thought diary/journal

• The counselor questions the clients cognitions/thoughts and challenges the thoughts

• Client eventually thinks about things in a more rational way

• Look for evidence (clients thought is often incorrect)

• Helping the client to break down their problem into manageable tasks

• Encourage the client to use relaxation techniques, exercise

REBT Techniques

• ABC theory helps explain the ways irrational beliefs lead people to negative emotional outcomes

• Can be used to help challenge these irrational beliefs

Both CBT and REBT

• Both approaches work at the level of irrational thoughts

• Both suggest we all learn thought patterns which influence how we interpret life and all its events

• However they use different terms to describe the thought - maladaptive (CBT) and irrational (REBT)

• Self critical belief systems can be activated by life events and generate distorted unrealistic thoughts that negatively effect mood

• CBT argued that the best way to help a client and modify feelings is by working with conscious thoughts

• CBT and REBT go about modify these automatic thoughts in different ways

Critisms CBT and REBT

• Too much emphasis on clients thought processes

• Less effective with clients who already have a problem over intellectualizing or don’t have the capacity to reason logically

• Repetitive for counsellors

• Counsellor perceived as being dominating, overpowerful

• Counsellor verba, active, directive

Characteristics CBT

• Theraptutic Style - Assumes that clinicians bring range of skills/ideas about intervenin, More than active listening

• Psychological formulation of problem - is the picture of why someone is experiencing the problem

• Collaborative Relationship - work together to build formation, transperent

• Structure to therapy - agenda, oppotunity for feedbacl

• Goal directed therapy

• Examination and questioning unehlpful thinking

• teching client to be their own therapist

• homework

• time limited

Limitations of CBT

• Gaudiano 2008 states CBT is too mechanistic and only focuses on one or two aspects of a person and their difficulties

• Research indicates that specific behavioral techniques are as effective as CBT in treating depression

• Richards et al 2016 suggests that behavioral activation is at least as effective at treating depression and can be delivered at a less cost by junior mental health staff

• Gaudiano discusses lack of connection between the theoretical basis of CBT and the science of human cognition which has led to need to adjust CBT so knowledge matches up

Mindfullness based cognitve therapy

• Developed by Segal et al 2002

• Aim of helping clients who experience episodes of clinical depression

• Used as relapse prevention approach

• MBCT is based on mindfulness based stress reduction MBSR - 8 week program that brings together mindfulness and CBT approaches

• Mindfulness is being in the moment and non-judgmentally

• MBCT proposes to enable clients to become aware of unhelpful thoughts and images, to label them and decenter themselves from these thoughts and images - move to present

Compassion-based therapy

• Draws from a number of different approaches:

  • Social

  • Developmental

  • Evolutionary

  • Neuroscience

  • Buddhist psychology

• One of its main concepts is the use of compassionate mind training to help develop inner safety, warmth and self soothing

• Targeted at people who struggle to feel relieved, reassured or safe

• Main aim it to enable people to develop self-compassion and research indicated that learning this skill can be valuable in both student and clinical populations

Automatic thoughts

thoughts that are instantaneous, habitual and non-conscious. Automatic thoughts affect a persons mood and actions. Helping individuals to become aware of the presence and impact of negative thoughts, and then to test their validity is a central task of CBT.

What is the aim of act?

• Major element of ACT is go teach people how to handle pain more effectively through mindfulness

• Create a rich, full and meaningful life while accepting the pain that goes with it

• Everyone experiences frustration, disappointment, rejection, loss and failure

What is mindfulness

• Mindfulness means awareness on the present moment, focus on the present moment, acccepting without judgment

ACT Psychological flexibility

• Contacting the present moment:

  • Being psychologically present and consciously connecting and engaging with whatever is happening in this moment

• Defusion:

  • Stepping back and watching our thinking instead of getting tangled up in it

• Acceptance:

  • Making room to experience painful emotions rather than struggle, run from or fight them

• Self-as-context:

  • Although your body changes, your feelings changes, your roles changes, but they you that observes this never changes

• Values:

  • What do you want your life to be about? What truly matters to you? Values should act like a compass to guide you to a meaningful life

• Committed Action:

  • Taking effective actions, guided by our values

The ACT Triflex

• Both defusion and acceptance are about separating thoughts from feelings - seeing them for what they are

• Self-as-context and contacting the present moment involve making contact with verbal and non-verbal aspects if you’re here and now

• Values and committed action involve effective use of language to facilitate life enhancing action

• Thus psychological flexibility is to be present, open up and do what matters

 

ACT Acronym:

• A = Accept your thoughts and feelings, and be present

• C = Choose a valued direction

• T = Take action

Fusion vs Delusion State

Fusion State:

• the absoulte truth

• a threat you need to get rid of

• a command you have to obey

Defusion state:

• may or may not be true

• is not a command you have to follow

• not a threat to you

Workability:

is what you are doing working to make your life full and meaningful

How experiential avoidance increases suffering

•  Attempting to avoid unwanted thoughts and feelings can lead to participation in addictive behaviours. 

•  Anxiety disorders can arise from constantly trying to avoid unwanted thoughts 

•  Research shows high experiential avoidance associated with anxiety disorders, depression, poorer work performance, higher levels of substance use, lower life quality, borderline personality disorder, psychopathology (hayes, Masuda, Bissett, Luoma & Guerrero, 2004) 

• Rebound affect- increase in intensity and frequency of unwanted thoughts 

Psychologcal inflexibility

• Fusion - being stuck in your thoughts so much it affects awarness and behaviour

• Experiential avoidance - trying to esacepe unwated thoughts, feelings and memories

• Dominance of the conceptualised past and future/limited self knowledge - ruminating on past memories and worrying about the future

• Lack of valued clarity/contact - increased fusion within thughts or avoidance attempts = neglecting values

• Unworkable action - Patterns of behaviours that stop us from fulfilled lives and increase struggles

• Attachment to the conceptualised self - give sense of self by understanding you are you and where you come from, should be held lightly

Who is act suitable for?

• Anxiety, depression, OCD, social phobia, generalised anxiety disorder, schizophrenia and borderline personality disorders, workplace stress, chronic pain, drug use, epilepsy, weight control, stopping smoking, adjusting to cancer, management of diabetes 

• Benefits all

What is acceptance?

• Making room for unpleasant sensations, feelings, urges, thoughts

• Allowing them to come and go without trying to change them

• Acceptance is not resignation or tolerance

Struggle Switch

• Uncomfortable emotion means struggle switch goes on

• Anxiety - switch goes on now got anxiety about anxiety

• Angry about anxiety - then sad and guilt

• Emotions become amplified

• When switch off - anxiety shows up not struggle with it

Anxiety

• Everyone has anxiety, but people with anxiety disorders are when their lives revolve around controlling anxiety

• Panic disorder (anxiety about anxiety - avoid places that could lead to panic attack)

• OCD (elaborate rituals to get rid of anxiety)

• In Act Psychopathology is viewed as the result of experiential avoidance

  • Attempts to control unpleasant thoughts and feelings that do not work, and lead our lives away from actions that are meaningful to us

Values vs goal focussed life

• value clarification important for ACT

• Goal provide small bits of happiness

• Constant striving for achieving goals can be tiring

• Values - curiosity, adventure

• Appreciating the journey towards the goal

• Fulfilling a good life

• Define your values - no matter the circumstances still live your life based on values

• Things get in the way of achieving goals - get frustrated

• Long term goals can be problematic

• Live no matter the circumstance

Choice point

moved towards how you want to act effectivel