Committed Action in Practice , livre ebook

“Committed action for specific behavior change is perhaps the most important piece of the acceptance and commitment therapy (ACT) puzzle, and it is all too often overlooked. Some of the true ACT pioneers and the brightest minds in behavior therapy have given you the perfect roadmap to take your clients from possibility to action. Highly recommended reading!”
—Dennis Tirch PhD , founder of The Center for Compassion Focused Therapy, associate clinical professor at Mount Sinai, and coauthor of The ACT Practitioner’s Guide to the Science of Compassion
“Years ago, as a young clinician trained in cognitive behavioral therapy (CBT), I was often flummoxed in the face of this situation: I knew what clients needed to do to improve their psychological well-being, but how could I get them to actually do it? Now, as a clinical director and supervisor who works with complex and treatment refractory clients, that same question continues to arise. Committed Action in Practice is a practical, pragmatic book, useful for clinicians across a range of presenting issues, in the clinic, in schools, or for life coaches. Its greatest strength is that it brings the evidence-based behavioral principles and strategies inherent in ACT to bear on this simple yet quintessential question: How do you help clients do what they need to do? This book distills ACT into elements of valuing and committed action—the core motivational framework of ACT that will assist clients to move forward in their lives whatever stage of change they are in. Clearly written, and easily consumed, this is a book I highly recommend and will reach for again and again when clients hit their stuck points in treatment.”
—Lisa W. Coyne, PhD , cofounder and director of the New England Center for OCD and Anxiety (www.newenglandocd.org), founder and senior clinical consultant of the McLean OCD Institute for Children and Adolescents, and an assistant professor at Harvard Medical School
“Moran, Bach, and Batten did it again! This book is a must-read for all ACT practitioners looking to optimize and augment their ACT skills by returning to core behavioral principles applied specifically to the process of committed action. This exciting new book shows us how to assess, enhance treatment outcomes, and troubleshoot potential obstacles—as they usually come in therapy—when facilitating values-based living. All chapters are clearly written, full of examples, and have clear explanations. You won’t get lost when reading this ACT book! Moran, Bach, and Batten also offer a fresh perspective about how to blend committed action with other empirically supported interventions capitalizing on the flexibility of the ACT model. This is a practical and powerful ACT book to read !”
—Patricia E. Zurita Ona, PsyD , founder of East Bay Behavior Therapy Center, author of Parenting a Troubled Teen and Escaping the Emotional Rollercoaster, and coauthor of Mind and Emotions
“This book is an essential tool for all professionals who apply evidence-based psychotherapies. It goes straight to the core of the ACT and all other evidence-based models: helping the patient to move in the chosen valued direction. It describes how to build flexible patterns of committed actions by creating and working inside a meaningful therapeutic relationship. As the therapist’s actions are the quintessential element of the therapeutic relationship, it also carefully addresses the obstacles in his or her own committed patterns to ease the process with the clients. A must-have, -read, and -practice for every ACT and non-ACT therapist.”
—Giovambattista Presti, MD, PhD , psychotherapist, associate professor in the department of general psychology at Kore University (Enna, Italy), and president of the Association for Contextual Behavioral Science
“A must-read for ACT practitioners! The crucial importance of committed action is evident, yet it is rarely illuminated how this core process is interwoven into the entire model. Considering how committed action functions within the context of one’s life can make the difference between intent and action, and Moran, Bach, and Batten give us the tools to do just that.”
—M. Joann Wright, PhD, peer-reviewed ACT trainer, and coauthor of Learning ACT for Group Treatment
“What a breath of fresh air! I highly recommend this original and much-needed book, which truly fleshes out the ACT model in a myriad of ways. If you think committed action is just goals, action plans, and problem-solving, think again. Committed action is an exciting and ever-expanding part of ACT, and the authors do a fantastic job of explaining the vast range of different interventions and strategies it covers, and teaching you how to quickly and effectively implement them. No two ways about it: if you’ve got stuck clients (and hey, who doesn’t?), you need this book!”
—Russ Harris , author of ACT Made Simple and The Happiness Trap




Publisher’s Note
This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is sold with the understanding that the publisher is not engaged in rendering psychological, financial, legal, or other professional services. If expert assistance or counseling is needed, the services of a competent professional should be sought.
Distributed in Canada by Raincoast Books
Copyright © 2018 by Daniel J. Moran, Patricia A. Bach, and Sonja V. Batten
Context Press An imprint of New Harbinger Publications, Inc.
5674 Shattuck Avenue
Oakland, CA 94609
www.newharbinger.com
Cover design by Amy Shoup
Acquired by Catharine Meyers
Edited by Susan LaCroix
Indexed by James Minkin
All Rights Reserved
Library of Congress Cataloging-in-Publication Data on file
Contents
1 . What Is Committed Action?
2 . Perspectives on Commitment
3 . The Fundamentals of Contextual Behavioral Science for Supporting Committed Action
4 . Assessing and Planning Committed Actions with Contextual Behavioral Science
5 . Identifying Obstacles to Committed Action
6 . Addressing Obstacles to Committed Action on the Part of the Client
7 . Addressing Obstacles to Committed Action on the Part of the Therapist
8 . Reviewing Evidence- Based Psychotherapies
9 . Blending Evidence- Based Approaches with ACT
10 . Application of Committed Action: Case Examples
11 . Bringing It All Together
References
Index
Chapter 1
What Is Committed Action?
S ofia complains to her clinician that therapy isn’t helping her become the person she wants to be. After three months, she still doesn’t have a job, she still lives with her parents, she hasn’t lost any weight, and her English skills haven’t improved. In addition, she is still depressed and anxious most of the time, and isn’t sure she can change anything else in her life while feeling so depressed and anxious. At a casual glance, Sofia appears to be a dedicated therapy client, always arriving early to her sessions, completing detailed and neatly written behavioral logs between sessions, and able to articulate goals. However, when it comes to action, she frequently makes plans to do things, and rarely carries them out.
Sofia wants to move out of her parents’ house and live independently, and she’s acknowledged that she needs to earn an income in order to do so, yet she’s been unemployed since she completed training as a dental hygienist two years ago. At times, she says that she really wants to earn money, and at other times she says that her parents owe it to her to take care of her. Further, she recently stated that because she’s an immigrant from Mexico and speaks English with a heavy accent, she can’t apply for jobs until she improves her English. However, when her therapist invites her to brainstorm about opportunities to practice her English, Sofia balks at most of the suggestions because she doesn’t want to look stupid to others. She also reports that she believes she’ll have more success finding a job if she loses weight. Every few weeks she announces that she has a new diet plan and describes in detail why she thinks this one will work. She successfully follows each diet for five to ten days, then abandons it, giving reasons such as “It’s unbearable feeling hungry all the time,” “This week was really stressful, and I just can’t diet when I’m stressed out,” or “It was my mother’s birthday, and I had to eat the birthday cake my t í a made for my mom. Since I broke my diet, I just gave up.”
Sofia is like many clients in therapy. She wants her life to be different, yet she isn’t entirely clear about how she wants it to be different. Perhaps more importantly, she’s convinced that she must feel better before she can take action and that she can’t behave effectively when she feels distressing emotions. She gives up easily when obstacles arise, and she isn’t very open to exploring the multiple courses of action available to her. Sofia can sometimes describe what she wants in vague terms or articulate specific goals, such as getting a job; however, those statements don’t serve as commitments with which she follows through. And although she can come up with actions she might take that are consistent with her stated goals, that isn’t committed action either.
Committed action means engaging in behavior guided by personal values, even in the presence of unwanted thoughts or feelings and external hindrances that can impede such behaviors. Committed action is one of the six core processes in acceptance and commitment therapy (ACT). It is also both a process and an outcome of the therapy specifically, and of psychological flexibility more generally. The aims of this book are to aid clinicians in three key ways: developing and increasing a repertoire of interventions that build commitment; working with other core ACT processes