ACT II: Specific Examples from an ACT Trial - PowerPoint Presentation

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ACT II:Specific Examples from an ACT Trial

Jon Abramowitz, Laura Fabricant, & Ryan Jacoby

Clinical Lunch Spring 2014

Overview

ACT principles

O

ur study on exposure therapy and ACT

Techniques to foster

acceptance

Techniques to foster

defusion

Techniques to pursue

values

Discussion (applying ACT to other problems)

ACT Principles

My thoughts tell me how things really are, and determine what I do next

I constantly struggle with my thoughts and feelings

I spend

most of my time lost in thought about the past or future

I don’t know what I want from life

I don‘t manage to act on the things I care about

Deep down, my thoughts and feelings are the real me

I spend most of my time paying attention to what is happening in the present moment

I am clear about what I choose to value in life

I work out what I need to do about the things I care about, and

I see it through

My thoughts and feelings come and go, but deep down the real me doesn’t change

I see each of my thoughts as just one of many ways to think about things – what I do next is up to me

I willingly accept my thoughts and feelings even when I don’t like them

ACCEPTANCE SCALE

ATTENTION TO PRESENT SCALE

VALUES IDENTIFICATION SCALE

COMMITMENT & TAKING ACTION SCALE

DEFUSION

SCALE

SELF AS OBSERVER SCALE

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Our study: Exposure + ACT

Our Study

How did we get interested in ACT?

Our study

An ACT perspective on OCD: 3 parts

Exposure from an ACT framework

Similarities and differences (SUDS vs. willingness)Exposure therapy to facilitate the ACT processes

ACT Techniques

Acceptance

Willingness to experience internal events

Examples from OCD patients

Metaphors and techniques

“Jerk at the door”

ChessboardExposureHabituation vs. fear tolerance

Defusion

Distancing and disconnecting from thoughts

Seeing

thoughts and feelings for what they

are,

not what they say they areExamples from OCD patientsMetaphors and techniques

Milk, Milk, MilkPassengers on the bus

Imaginal exposure

Passengers on the Bus Metaphor

You’re the driver and the passengers are your OCD related thoughts, feelings, physiological sensations, etc.

The passengers try to direct where the bus goes

They are loud and bossy about what you do

They quiet down when you do what they want

If you drive the bus where you want to go, what will happen?

You can allow them to shout and keep your attention focused on where you want to go

Values

Choosing

what direction one wants life to take (not

letting OCD choose the direction life goes

)

Examples from OCD patientsMetaphors and techniquesBull's-eyeMoving through a swamp

Exposure

What do you value?

What do you want your life to be about?

What do each of these categories mean to you?

In what ways has OCD been getting in the way of living life in the direction of your values?

Moving through a swamp

Swamp =

OCD-related inner experiences and

triggers

Exposure = learning how to handle whatever comes up while still moving forward through

swampWillingness to go into the swamp without resisting (avoiding or using compulsive rituals)

Why are we doing this?

Getting dirty and muddy but for a purpose

Not wallowing in the swamp

Things you value are on the other side of the swamp (only way is through it!)

Exposures and values

Emotional moves vs. values moves

Motivation

Anxiety reduction is not an explicit goal

Successful outcome = you doing something important to you

despite having anxiety

Discussion

Discussion

How could we apply these techniques to other problems?

Similarities and differences with other therapies?

Questions?

Thank you!