“The Psychologically Flexible Workplace”: London ACT Networking Event, March 11 2011, UCL

The next London Acceptance & Commitment Therapy Networking event is going to be held on Friday 11^th March from 2 – 5pm at UCL (Gustave Tuck Lecture Theatre, Gower Street, UCL, WC1E 6BT).

This event is titled “The Psychologically Flexible Workplace”, and our invited speakers are Jo Lloyd and Paul Flaxman, who will be presenting their research on ACT as a workplace training intervention.

The first half of the session will involve a comprehensive review of research on ACT and psychological flexibility in the workplace. Studies which have examined ACT as a workplace training intervention, and psychological flexibility as a predictor of mental health and behavioral effectiveness outcomes, will be presented.  The occupational contexts of the different studies range from large media organizations to local government services. As well as reviewing published research, findings from current investigations will be presented in order to allow attendees insight into the most recent developments in the field.

In the second half of the session, Paul will provide an overview of the three-session ACT at work protocol that he has been implementing and evaluating in recent years. Paul and Jo will also jointly discuss some of the challenges that can be faced when implementing ACT in the workplace.

Our speakers:

Jo Lloyd is a postdoctoral researcher and lecturer in work psychology at Goldsmiths, University of London.  Her PhD examined the effectiveness of ACT as a training intervention to improve health, performance, and attitudinal outcomes in human service workers, and how psychological flexibility related to these improvements. Jo is a chartered occupational psychologist and a member of the British Psychological Society (BPS), the British Association for Behavioural and Cognitive Psychotherapies (BABCP), and the Association for Contextual Behavioural Science (ACBS). Jo is currently the scientific sub-committee chair for the ACT special interest group with the BABCP.

Dr. Paul Flaxman is a senior lecturer in organisational psychology at City University London. Paul has been delivering and evaluating ACT as a worksite intervention for the past 10 years, and has personally delivered ACT training to hundreds of workers across the UK. In recent years, Paul has directed an ESRC-funded research programme which involved using ACT to improve staff well-being in various public sector organisations. In 2010, Paul and his collaborators (Joe Oliver and Eric Morris) were awarded additional funding from Guy’s & St. Thomas’ Charitable Trust to deliver ACT and mindfulness workshops for London-based NHS staff.

There will also be devoted time to discuss practice and network for peer supervision.

The event is free, and hosted jointly by UCL and the BABCP ACT Special Interest Group. Please RSVP to give us a sense of the numbers for the afternoon: morriseric@gmail.com .

We hope to see you there!

Addendum 16/3/2011

Thanks to everyone who attended this event: lots of great questions and discussion, with our speakers Jo and Paul bringing us up-to-date with the current research on ACT in the workplace.

Jo Lloyd’s presentation can be downloaded here.

Paul Flaxman’s presentation can be downloaded here.

The Future of Cognitive Behavioural Therapies Debate, 23rd September 2010 – Audio + presentations

Pictured: Prof Steve Pilling, Prof Steve Hayes and Dr David Veale.

On Thursday 23rd September the ACT Special Interest Group and University College London had the pleasure of hosting an evening debate on the “Future of CBT”, featuring three distinguished speakers: Dr David Veale, Prof Steve Pilling and Prof Steve Hayes. The debate was chaired by Eric Morris, Secretary of ACT SIG. The debate attracted an audience of 300, who had braved the wild weather to attend UCL that evening.

Each of our speakers presented their perspective on how CBT may change in the future, and what research strategies are likely to progress the scientific development of evidence-based behavioural and cognitive approaches. The evening resulted in some lively discussion, as our speakers debated the points made and commented on questions from the audience.

If you would like to listen to the debate the audio is available for download (50mb mp3: Future of CBT Debate).

The presentations from Dr David Veale and Prof Steven Hayes are also available: David Veale Future CBT.ppt Steve Hayes ACT CBT talk.ppt

Many thanks again to our speakers, University College London, and those who attended this unique event.

Third Wave CBT Approaches at the BABCP Conference 2010

Going to the 2010 BABCP Conference in Manchester next month? We’ve been looking over the conference programme, and there’s plenty of third-wave CBT on offer, with what promises to be some interesting presentations of new research and developments in the field.

Check out the following (highlighted from the programme):

At this year’s BABCP conference, we are delighted to be able to offer a range of workshops, keynotes and symposia relating to third wave approaches:

WORKSHOPS

Places on these full-day workshops, which take place on Tuesday 20^th July, are limited, please register early at www.babcpconference.com

Workshop 9. Distinctive Features of Dialectical Behaviour Therapy (DBT): Using DBT to treat clients with Personality Disorder, Multiple Comorbidities and High Risk

Michaela Swales, School of Psychology Bangor University & Betsi Cadwaladr University Health Board

Workshop 22. Acceptance, Mindfulness and Values for CBT Therapists

Eric Morris, South London & Maudsley NHS Foundation Trust/ King’s College London and Joe Oliver, South London & Maudsley NHS Foundation Trust

KEYNOTE

Third Wave Therapies for People with Intellectual Disabilities

Professor Chris Cullen

Keele University and North Staffordshire Combined Healthcare NHS Trust

SYMPOSIA

Mindfulness and Acceptance Approaches with people with Psychosis: New Research

Convenor: Joe Oliver, South London & Maudsley NHS

Clinical Roundtable: A case of Chronic Anorexia Nervosa: Can we offer something new?

Convenor: Lucy Serpell, North East London Foundation Trust & University College London

Panel Discussion: What should we use? NICE Recommended Treatments for Depression

Convenor: Heather O’Mahen, University of Exeter

Dialectical Behavior Therapy for Substance Abuse in Individuals

With Borderline Personality Disorder: State of The Art

Convenor: Thomas R. Lynch, University of Exeter

SKILLS CLASS

Teaching Core mindfulness skills in Mindfulness-based Cognitive Therapy (MBCT)

Mark Williams, University of Oxford

If you’d like to download the flier of what’s on at the conference third-wave wise, click here.

Also, the ACT Special Interest Group Meeting is on Thursday 22nd July at 5.15pm (listed in the conference programme also). It’d be great if members came along: we are announcing the results of the SIG elections for the new committee, discussing forthcoming events, and the strategic direction of the  SIG in promoting ACT in the BABCP. We’re also hoping that this will be an opportunity to meet up with other SIG members, and once the formalities of the meeting are over, we will move on to a suitable venue to socialise. If it is part of your valued direction, commit to coming to the meeting!  It’s your SIG, and what makes it work are the great contributions from members (all 1200 of them!).

Hope to see you in Manchester at the BABCP Conference.

Many more BABCP members in the ACT Special Interest Group

by Eric Morris, Chair – ACT SIG

The other day I checked in with the BABCP administration on the current number of members in the Acceptance & Commitment Therapy Special Interest Group (as part of  the preparations for the forthcoming Committee elections).

The ACT SIG now has over 1200 members, which is nearly 15% of the total membership of the BABCP.

Great news, particularly as the SIG started in 2006 with 20 members, and at the time of the last elections in 2008  had expanded to 200 members.

It seems like interest in ACT in the BABCP is increasing at a fast pace!

London ACT Networking Event – 7th May 2010

The next London Acceptance & Commitment Therapy Networking event is going to be held on Friday 7^th May from 2 – 4.30pm at UCL (Pearson Lecture Theatre – North East entrance, Pearson Building, Gower St, WC1E 6BT map: http://tinyurl.com/actldn1 ).

Our invited speaker is Mark Webster, who will be talking about “The Heart of ACT: Transformation of Functions”. There will also be devoted time to discuss practice and network for peer supervision. (please click here for details, .pdf)

The event is free, and hosted jointly by UCL and the BABCP ACT Special Interest Group.

Please RSVP to give us a sense of the numbers for the afternoon: actsig@babcp.com

We hope to see you there!

Rebuilding Trust

by Russ Harris     

Clients that have been hurt, threatened or abused by others often ask questions like, ‘How can I ever trust anyone again?’ There are several ways we can approach this from the ACT model.

Firstly, we can distinguish between ‘blind trust’ and ‘mindful trust’. ‘Blind trust’ means trusting someone completely without bothering to assess whether they are deserving of your trust (i.e. going in with your eyes closed). ‘Mindful trust’ means seeing this person with your eyes open: assessing what sort of person they are. Are they generally honest, open, and truthful, or do they tend to lie, hide and deceive. Are they sincere (i.e. do they mean what they say)? Are they reliable (i.e. do they follow through on the things they say they will do)? Are they responsible (i.e. do they consider the consequences of their actions)? Are they competent (i.e. are they capable of doing the things they say they’re going to do)? As we get to know someone, and we assess that they are sincere, reliable, responsible, and competent, based on our direct observation of their actions, then we can establish a mindful trust rather than a blind trust.

Secondly, a general principle in ACT is to distinguish feelings from actions. While we have a lot of control over the actions of trust, we have very little control over the feelings of trust. So what does trust feel like? Well, usually it is a feeling of security, comfort, confidence, safety, calmness, relief – or some mixture thereof. So how likely is it that if you’ve been hurt or abused in a significant relationship, you are going to have such positive feelings when you start developing your next significant relationship? Highly unlikely, obviously. The feelings you are likely to have are those of anxiety, doubt, insecurity and vulnerability. So, the ACT question is, if developing meaningful relationships truly matters to you, are you willing to make room for these feelings, and take them with you into the new relationship?

Thirdly, remember that while you can’t control the feelings of trust, you can control the actions. So rather than leaping head first into a new relationship, you can do little actions of trust – just baby steps initially – and mindfully assess the consequences. As this other person starts to prove ‘trustworthy’, you can then take larger actions of trust (and continue mindfully assessing the consequences). And you keep on doing this – step by step – all the while making room for those perfectly normal feelings of anxiety, insecurity, and vulnerability (which will probably intensify as the size of your trusting action increases). And if the other person keeps on responding appropriately – then maybe, after a while, you will start to develop the feelings of trust. But this is not in your control. Only the actions are in your control.

Fourthly, it’s important to acknowledge that one thing you can never have is absolute certainty. If you want absolute certainty that you will never get hurt again in a significant relationship, the only way you can achieve that is to avoid ever getting into one. And is that the life you would really choose to have? If meaningful relationships are part of a rich and full life for you, then are you willing to make room for uncertainty; to thank your mind for the ‘I’ll get hurt story’, and breathe into that knot in your stomach, and make some space for that tightness in your chest?

Fifthly, it can be helpful to have the client notice all the ways in which they already do acts of trust on a daily basis. Taking a bus, train or taxi is an act of trust (we trust them to drive competently and responsibly). Eating cafe food, or take-away food is an act of trust (we trust them to cook competently and responsibly). Even eating supermarket food is an act of trust – (we trust it has been prepared safely and hygienically). Going to a doctor or dentist or physio are more obvious and dramatic examples. And of course, let’s not forget the therapeutic relationship. I like to say to clients, ‘Coming here to see me is a huge act of trust. What thoughts and feelings did you have to make room for in order to get here in the first place – and then, to open up to me like this?’

Sixthly, find a healthy balance between trust and self-protection. If you’ve met someone new, it may be wise to ask others what they know about this person. In some situations, it may be wise to check up on them – to see if they were telling the truth, or if they followed through on their promises. In some situations, it may be wise to wait a long time before you are ever alone together. Obviously as a genuine trusting relationship is established, these self-protective actions will become less necessary. The key is to find a HEALTHY balance. If it’s all about self-protection, you’ll destroy the relationship or prevent it form getting established; but if it’s all about trust and you neglect the self-protection, then you’re taking unnecessary risks. It’s about finding a balance that works, and expecting that balance to shift over time, assuming the relationship goes well.

Finally, these same principles apply in long-established relationships where trust has been abused. If one partner has cheated or lied or deceived or manipulated or harmed the other, then the wronged partner has to make a choice about whether or not to continue with that relationship. If the wronged partner chooses to stay, they can expect to have plenty of thoughts and feelings of suspicion, insecurity, jealousy, anxiety, anger etc – all of which they will need to defuse and make room for, if they want their relationship to survive, recover, and thrive. Neither partner should expect feelings of trust to return for a long time. And again, the aggrieved partner will have to find a healthy balance between actions of self-protection and actions of trust. In other words, if your husband has cheated on you, it’s reasonable to call him at the office when he says he’s working late. If your wife has frittered the mortgage away on gambling, it’s reasonable to keep an eye on all her bank accounts. As genuine trust is gradually re-established, these self-protective actions will become less necessary.

Copyright: Russ Harris 2007

Russ Harris is an Australian ACT trainer, and author of The Happiness Trap, ACT With Love, and ACT Made Simple. For more information about his books, or free resources to use with them, or to subscribe to his quarterly newsletter, please visit www.thehappinesstrap.com

ACT & CBT: Bridging the Divide

The ACT SIG had an excellent turn-out for the first London networking event, "ACT and CBT: Bridging the Divide", hosted by University College London on Friday 29th January 2010.

Fifty people, made up of ACT SIG members as well as others interested in ACT, heard three speakers discuss how ACT fits within the CBT tradition, and incorporating ACT techniques within cognitive behavioural practice. The three talks looked closely at the theoretical and philosophical similarities and differences between ACT and CBT, while considering the actual practicalities and how these might play out in therapy and in the therapy relationship.

• Eric Morris presented a history of the development of ACT (.pdf), from radical behavioural roots and research on verbal behaviour, and some context for understanding the role of rule-governed behaviour in the development of Relational Frame Theory and the techniques used in ACT.
• Sue Watson discussed the similarities and differences between ACT and cognitive approaches (.pdf), outlining her development as a CBT therapist and discussing the advantages of cognitive defusion over thought challenging.
• Joe Oliver outlined an approach of using ACT within CBT, being clear about the function of the interventions you offer, and highlighting areas such as values work, which can serve to enhance goal-setting in CBT.

Time at the end of the afternoon was given to talking about future events. The consensus was that such events would be welcomed, particularly if there were opportunities for further practical training and supervision development.

Further networking events are being planned, with a view to making this a regular fixture in London.  Watch this blog, the UK ACT listserv and BABCP jiscmail for details.

Pen and Grid, the Client Manual

By Mark Webster & Kevin Polk

                       

Introduction

This manual is for use by clients who have attended a series of groups based on this model. It assumes that these exercises have been done with an experienced practitioner beforehand, and it is not for use as a standalone manual.

The Pen Exercise

Take out a pen, any pen, and just look at it with your five senses for about 30 seconds. Explore the pen with all the senses that you feel like. Then put the pen aside and close your eyes for about 15 seconds. If you are not comfortable with eyes closed then keep them open. Try and remember as much as you can about the pen.

How many pens are there?

Often we get confused between the pen in the hand and the pen in the mind. This can cause all manner of problems.

Story of the pen

When ‘you’ were born you were born into the world of the 5 senses. You could see, hear etc but there were no words back then. As time went by ‘you’ learned that objects had names like chair and door. With the passing of time you learned about colour and shape and the use of things, so that you could find a comfortable chair without thinking about it. Over time ‘you’ learned to move through the world based on words and what you had experienced, as if on Autopilot. This is really useful most of the time, except when it isn’t!

Values

When life is going fine then Autopilot is great, but when life starts going wrong then being like this is a problem as it leads to suffering. Suffering is the direction we talk about when life is going in the wrong direction, and values are what we call the right direction. All behaviour can take you in either direction so this is why we need to learn to use the Grid, so we can tell the difference.

For example I could avoid crossing a busy road for values, but I could avoid attending an important appointment for suffering. This is explained further in the Life Manual.

The Grid

We use the grid to help us make sense of where we are, by locating our behaviour in one of the four quarters:

Autopilot

This metaphor pulls the whole approach together:

Imagine that your life is like a ship (or other craft), and it is being controlled by an Autopilot. This is great so long as the ship is going in the right direction. Our Minds are like this Autopilot. Minds allow us to do all sorts of complicated actions without having to think.

In fact if we didn’t have this facility life would be really hard. For instance think of all the things you had to do to get here today, and then think about how long it would take if you had to think about all those things… Minds are really useful.

However, if the ship is heading for the rocks then the Autopilot could be a bit of a problem. Sometimes you need to disengage it and take the wheel yourself so that you can change course. So that is what this program is about- you learn to disengage the Autopilot (show the Pen) through noticing, and then change course so that your life goes in a direction that matters to you.

This is the choice that noticing can give you.

To steer our craft successfully on the sea of life we need to be on watch (noticing) and know how to disengage the Autopilot and change direction (pen and grid).

University or Gym

This is pretty much all you need to know in order to move your life onto a course that you want it to be on. So this is not a University, we are not going to teach you loads of things, in fact we think you already possess all the resources you need. The approach is very simple.

This is much more like learning to play a musical instrument, or developing strength in the gym. You need to practice over and over again to get good at this stuff. Just like music or the gym it is practice that counts, and this will be hard work.

Just to make it more difficult you will encounter many obstacles on this path, so it is really important to be clear about your values. What are you going to do all this hard work for? What are you reading this for right now?

We are not going to make your pain go away, that is a promise. Just like the gym you may face the pain barrier in developing your new strengths. In fact we believe that humans need resistance in order to go strong, just like you need weights in a gym.

Demons on the boat

We have some creative people in the ACT SIG – London-based member Joe Oliver recently produced an animation of the "Demons on the Boat" metaphor, hosted on YouTube.

 

The Demons on the Boat metaphor originally appeared in Russ Harris’ book "The Happiness Trap", and helps to illustrate the cost in life vitality of engaging in experiential avoidance.

The video file is freely available to use in your setting, you can download it from here (in .avi format). 

ACT AND ME

  by DJ Moran                          

On a warm spring morning in 1994, I was at the Association of Behavior Analysis conference in Atlanta groggily attending to a panel discussion when the very attractive blonde woman on the dais winked at me. I immediately perked up and paid attention to the presentation topic, but it was completely over my head. I approached the bold woman after the event and asked, “So what was this session all about?” She proceeded to explain Acceptance and Commitment Therapy to me and I was hooked. I bought a bunch of Context Press books that afternoon and went back to Hofstra University the next semester and, as one supervisor once said, “openly scoffed at” the CBT materials being taught because I thought I discovered something better in ACT.

Fifteen years later, I no longer scoff at CBT (thanks in great part to my supervisory relationship with Albert Ellis and further understanding of RFT, functional contextualism, and the great effectiveness of cognitive-behavioral therapy interventions), and I am still friends with the woman who winked at me.

When I was establishing the MidAmerican Psychological Institute clinic in 2002, I also discovered Patty Bach‘s article describing the first randomized control trial with ACT. I hoped to someday to talk to her about her research at a convention, and found out that she actually worked less than a mile away from my office. We ‘did lunch’ and started working in the same private practice clinic. After discussing our cases together week after week, we agreed that we should write a book about how to put ACT in Practice. Our book came out on New Harbinger in 2008 during the same week that she and I co-chaired the Association for Contextual Behavioral Sciences convention in Chicago. We continue to present our ACT workshops and Demystifying Relational Frame Theory trainings together.

The picture of me wearing the hard hat is actually very ACT relevant. I‘ve recently been consulting with construction companies in an effort to increase safety behaviors. Teaching boilermakers and other blue-collar professionals mindfulness and values-directed committed action seemed like a big risk at first, but the construction workers actually embraced the ACT model very well and the safety managers have been ecstatic about the change in safety attitudes and behaviors around the work-sites.

I enjoy the camaraderie and ‘open-source’ attitude of the ACT community. It‘s been my pleasure to train other folks in ACT, RFT, and functional contextualism as an ACT Trainer, and enjoy being able to shape what the ACBS becomes as a board member. I‘ve also been fortunate to be able to sit down and interview lots of ACT researchers for my podcast Functionally Speaking (http://djmoran.podbean.com).

When I‘m not busy with all this ACT stuff, I‘m usually hanging out with my wife and children forcing them to listen to heavy metal music.

Daniel J. Moran, Ph.D., BCBA