/
Jason A. Nieuwsma, PhD Associate Director, VA Mental Health and Chaplaincy Jason A. Nieuwsma, PhD Associate Director, VA Mental Health and Chaplaincy

Jason A. Nieuwsma, PhD Associate Director, VA Mental Health and Chaplaincy - PowerPoint Presentation

provingintel
provingintel . @provingintel
Follow
345 views
Uploaded On 2020-06-16

Jason A. Nieuwsma, PhD Associate Director, VA Mental Health and Chaplaincy - PPT Presentation

Associate Professor Duke University Medical Center Durham NC Opportunities in Acceptance and Commitment Therapy ACT for Enhancing Evidencebased Chaplaincy Objectives Describe how evidencebased principles in ACT can be highly synergistic with commitments in healthcare chaplaincy ID: 778213

acceptance act therapy present act acceptance present therapy commitment values amp psychological life moment care action patient human oakland

Share:

Link:

Embed:

Download Presentation from below link

Download The PPT/PDF document "Jason A. Nieuwsma, PhD Associate Directo..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.


Presentation Transcript

Slide1

Jason A. Nieuwsma, PhDAssociate Director, VA Mental Health and ChaplaincyAssociate Professor, Duke University Medical CenterDurham, NC

Opportunities in Acceptance and Commitment Therapy (ACT) for Enhancing Evidence-based Chaplaincy

Slide2

ObjectivesDescribe how evidence-based principles in ACT can be highly synergistic with commitments in healthcare chaplaincy.

Employ key practices from ACT to deepen the provision of patient-centered spiritual care.

Explore how using ACT principles can enhance capacities for participating as a member of integrated care teams.

Slide3

I undertook great projects: I built houses for myself and planted vineyards. I made gardens and parks and planted all kinds of fruit trees in them. I made reservoirs to water groves of flourishing trees. I bought male and female slaves and had other slaves who were born in my house. I also owned more herds and flocks than anyone in Jerusalem before me. I amassed silver and gold for myself, and the treasure of kings and provinces. I acquired male and female singers, and a harem as well—the delights of a man’s heart. I became greater by far than anyone in Jerusalem before me. I denied myself nothing my eyes desired; I refused my heart no pleasure…

Yet when I surveyed all that my hands had done and what I had toiled to achieve, everything was meaningless, a chasing after the wind; nothing was gained under the sun.

- Ecclesiastes

Slide4

The single most remarkable fact of human existence is how hard it is for human beings to be happy

.”

- Steven C. Hayes

Slide5

Why do we suffer?

Slide6

psychosociological underbrush. The physician should not be saddled with problems that have arisen from the abdication of the theologian and the philosopher”…I do not accept such a premise.George Engel,

Science (1977)

At a recent Rockefeller Foundation seminar on the concept of health, one authority urged that medicine "concentrate on the 'real' diseases and not get lost in the

Slide7

How do we stop suffering?

Slide8

Beck Depression Inventory-II

(BDI-2)

Slide9

What success looks like on BDI-2

Slide10

Acceptance & Action Questionnaire-II

(AAQ-2)

Slide11

What success looks like on AAQ-2

Slide12

What does “success” look like in faith?

Slide13

Control as a means to achieving success

CAN’T CONTROLExamples

13

CAN CONTROL

Examples

Slide14

Tug of War with a Monster

What to do?

Drop the rope!

Slide15

Paradox

ACTBeing accepting of negative leads to feeling more positive.

15

Faith tradition examples:

The last shall be first.

Lose your life to gain it.

Reality is not reality.

For neither is the aim “happiness” or “feeling good,” and yet that effect frequently occurs.

Slide16

Acceptance and Commitment Therapy (ACT)

What is ACT?

Related to CBT family of treatments

Acceptance

:

Willingness

to experience

Commitment: Living in line with values

Slide17

ACT Defined

The ACT care provider works to help the patient accept internal events (thoughts, emotions, memories, and sensations) while also helping the patient to make and keep behavioral

commitment

s

that reflect the patient’s personal values. Oversimplified, you might say: hold and move. “Hold” your experience, whatever it may be, and “move” forward in your life.

The objective of ACT is to foster

psychological flexibility

. Psychological flexibility can be summarized as contacting the present moment fully as a conscious human being, experiencing what is there to be experienced and working to change behavior such that it is in the service of chosen values.

Slide18

ACT: Is there “Value-Added?”

ACT challenges conventional cognitive-behavioral approaches to…The assumption of “healthy normality”

The patient/provider dichotomy

The role of thoughts

The significance of values

Measurement

Slide19

Why ACT for Interdisciplinary Care?

Evidence-based1,2

Over 250 RCTs show ACT ≥ TAU

3,4

Works for: Bio–Psycho–Social Health

Principle-based

Flexible theory, not fixed protocol

Not confined to particular disorderSynergistic with cultural perspectives/worldviewsValues-centricEmbraces major religious practices

Human flourishing, not absence of disease

A broad tent

Providers

Patients

Powers, M. B., M. B.

Zum

Vörde

Sive

Vörding

, et al. (2009). "Acceptance and commitment therapy: A meta-analytic review."

Psychotherapy and Psychosomatics

78

(2): 73-80.

Ruiz, F. J. (2010). "A review of Acceptance and Commitment Therapy (ACT) empirical evidence: Correlational, experimental psychopathology, component and outcome studies."

International Journal of Psychology & Psychological Therapy

10

(1): 125-162.

Searches conducted on January 3, 2019.

ACBS keeps an ongoing count of published and “in press” RCTs on ACT (

https://contextualscience.org/ACT_Randomized_Controlled_Trials

). As of November 2018, there were 265 published RCTs on ACT.

Slide20

Premises of ACTPsychological pain is normal, it is important, and everyone has it.You cannot deliberately get rid of your psychological pain, although you can take steps to avoid increasing it artificially.

You can live a life you value.

Slide21

Six Aims of ACTFor patient/provider to:

Be in the present moment.Accept what is.Watch your thinking.

Be aware of yourself.

Know your values.

Carry out valued behavior.

Slide22

The ACT Model

Acceptance

Cognitive

Defusion

Values

Committed

Action

Contact with the Present MomentSelf asContext

Slide23

The ACT Model

Opening Up

Developing Awareness

Doing What Matters

Slide24

Acceptance Opening up and making room for painful feelings, sensations, urges, and emotions.

Slide25

Acceptance

In ACT, acceptance is not a passive resignation but an active acknowledgment.

Acceptance = Willingness

25

Slide26

Want to panic?

26

Levitt, J. T., T. A. Brown, et al. (2004). "The Effects of Acceptance Versus Suppression of Emotion on Subjective and Psychophysiological Response to Carbon Dioxide Challenge in Patients With Panic Disorder."

Behavior Therapy

35

(4): 747-766.

Slide27

Want to do it again?

27

Levitt, J. T., T. A. Brown, et al. (2004). "The Effects of Acceptance Versus Suppression of Emotion on Subjective and Psychophysiological Response to Carbon Dioxide Challenge in Patients With Panic Disorder."

Behavior Therapy

35

(4): 747-766.

Slide28

Cognitive Defusion Learning to “step back” and separate or detach from our thoughts, images, and memories.

Slide29

Don’t think about….

29

Slide30

30

CHOCOLATE CAKE

Slide31

Leaves on a Stream

https://www.mindfulnessmuse.com/wp-content/uploads/2011/09/Cognitive-Defusion-Exercise-1.pdf

Slide32

The ACT Model

Opening Up

Developing Awareness

Doing What Matters

Slide33

Contact with the Present Moment Consciously connecting with and engaging in whatever is happening in this moment.

Slide34

Contact with Present MomentAbout “therapist” as much as “client”Not just meditationMindfulness:

“paying attentionin a particular way:on purpose,in the present moment,

and non-judgmentally”

(Kabat-Zinn)

Nice, but…

Slide35

A Different Approach to Past, Present, & FutureInstead of…re-hashing the past

to make sense of the presentin order to predict the future…ACT seeks to…minimize the distraction of dwelling in the pastor fantasizing about the future

in order to live richly in the present.

Slide36

Self as Context Developing awareness of the “observing self” that is aware of what we’re thinking, feeling, sensing, or doing in any moment.

Slide37

Three Senses of SelfConceptualized selfSelf-concept; self-description“Who I am” as a person

Self-as-awarenessOngoing process of noticing our experienceContacting present momentSelf-as-contextSpace from which “noticing” happens (the “observing self”)

The “I” (as opposed to “me”)

Slide38

The Pieces and the Board

Slide39

The Continuous You

Slide40

The ACT Model

Opening Up

Developing Awareness

Doing What Matters

Slide41

Values Knowing and clarifying desired qualities of ongoing actions, or chosen life directions.

Slide42

ValuesIn ACT, values:are here & now.

are not about being justified.often need to be prioritized.are best held lightly.

are freely chosen.

Slide43

Committed Action Taking effective action, guided by our values, even in the face of pain and discomfort.

Slide44

Commitment

Values

Direction

Process-oriented

Intangible

Can’t check off

Goals

DestinationOutcome-orientedTangible

Can check off

Slide45

The Willingness & Action Plan

Slide46

Slide47

47

Trust no future,

howe'er

pleasant!

Let the dead Past bury its dead!

Act

, - act in the living Present!

Heart within, and God

o'erhead

!

Longfellow,

A Psalm of Life

Slide48

Slide49

Questions?

Slide50

Recommended ACT ReadingsHayes, S.C. & Lillis, J. (2012) Acceptance and Commitment Therapy. Washington, DC, American Psychological Association.

Hayes, S. C. (2005).

Get Out of Your Mind and Into Your Life: The New Acceptance and Commitment Therapy

. Oakland, CA, New Harbinger Publications.

Wilson, K.G. (2008).

Mindfulness for Two. Oakland, CA, New Harbinger Press.

Harris, R. (2009).

ACT Made Simple: A Quick-Start Guide to ACT Basics and Beyond. Oakland, CA, New Harbinger Press.Nieuwsma, J.A., Walser, R.D., & Hayes, S.C. (Eds.). (2016). ACT for clergy and pastoral counselors: Using acceptance and commitment therapy to bridge psychological and spiritual care. Oakland, CA: Context Press / New Harbinger Publications.

Worksheets available at:

http://www.thehappinesstrap.com/free_resources