Working group for scientific psychotherapy

Acceptance and Commitment Therapy

Acceptance and Commitment Therapy (ACT) according to Hayes does not assume that people are sick or “disordered”, but rather that people are not able to lead a fulfilling and value-oriented life within their inner individual contexts. ACT emphasizes that people who are trapped in their current contexts fight against unpleasant and aversive thoughts and feelings in the same way over and over again.

Acceptance and Commitment Therapy (ACT) was developed by Steven Hayes (e.g. Hayes at al., 2006) and is seen as a therapy model that does not treat the symptoms of individual psychological disorders, but rather teaches the patient skills to deal specifically with the symptoms and thereby promote your own behavioral flexibility and value-oriented actions in everyday life.

ACT therefore represents a prototypical procedure of the so-called “third wave” of behavioral therapy. Efficacy studies impressively show that these skills lead to a reduction in psychological symptoms without these always needing to be explicitly addressed (Powers et al., 2009).

For this reason, ACT can be used as a cross-disorder concept for secondary prevention in people who are already mentally ill or stressed. ACT attempts to balance the two essential dimensions of psychotherapy, “acceptance” and “change”: Numerous very intuitive exercises have been developed to promote tolerance even for higher intensity experiences of unpleasant emotions, to improve mindfulness for experiencing the moment, and to develop benevolent distance to become aware of one’s own thoughts and feelings, as well as one’s personal values, and to implement these in everyday life. Despite all the obstacles.

The 2-day course teaches the essential core components and exercises of ACT in a very practical way.

Introduction:

Acceptance and Commitment Therapy (ACT) according to Hayes does not assume that people are sick or “disordered”, but rather that people are not able to lead a fulfilling and value-oriented life within their inner individual contexts.

The acceptance and willingness to accept inner processes such as unpleasant thoughts and feelings and to open yourself up to them while at the same time defining personal life values ​​are the core of ACT.

ACT emphasizes that people who are trapped in their current contexts fight against unpleasant and aversive thoughts and feelings in the same way over and over again. Assuming that the occurrence of thoughts and feelings cannot be controlled, it is more about dealing with them sensibly.

“If you always do what you always did, you will always get what you always got” – the quote from Hayes describes the so-called autopilot of experience avoidance strategies that always kick in when typical unpleasant internal processes (thoughts, feelings, impulses to act, body reactions, etc Memories occur that do not want to be felt or perceived. As a result, the psychological flexibility to adapt to different contexts in which behavior (both mental and visible) takes place is significantly limited.

As a transdiagnostic therapy method, ACT can be used to treat a wide variety of disorders. Our everyday work with ACT, especially in group therapies, has also shown that groups with heterogeneous disorders benefit significantly from the experience-oriented approach.

Hayes, himself a classical cognitive behavioral therapist, developed ACT, a therapeutic method that expanded well-known and previously empirically effective traditions of psychotherapy to include elements from humanistic, existentialist and spiritual and “human potential” currents. The idea of ​​“open source” therapy has helped to refine, expand and spread this therapeutic approach. As more and more therapists become interested in this approach, Hayes and colleagues are interested in further developing ACT. ACT therapists and ACT patients are encouraged to add more techniques, develop metaphors, and try new things. Over the last few years, different versions of ACT have been established to suit different disorders and settings. Since 1999, many books to teach ACT methods and fundamentals have been further developed and the use of ACT in different populations with different problems has been adapted and modified. ACT has now been examined for its effectiveness in 50 controlled studies worldwide and is recognized as an empirically well-supported form of therapy.

 

Conceptual background:

Contents of the ACT:

The focus of therapy is the Hexaflex, a theoretical model with six therapeutic starting points, the so-called core processes. At the beginning of therapy, a case concept is used to define which of these core processes initially appear therapeutically relevant. The dance around the hexaflex describes how individual core processes in therapy are flexibly focused and linked to one another. The experience-oriented approach of ACT is at the center of the treatment. With the core processes

  • Acceptance (the ability to open up to inner processes and accept them as they are instead of avoiding them)
  • Presence (the ability to be present in the moment)
  • Defusion (the ability to understand thoughts as “products” of the mind and to view them from a distance)
  • Observer self (the ability to see oneself as the context of one’s own experience)
  • Values ​​(a person’s idea of ​​a satisfied and well-lived life)
  • Commitment (the inner commitment to values ​​and steps in a certain direction)

ACT goes into the respective inner context of a person in which a fulfilling life does not seem possible at the moment. The focus here is on promoting inner psychological flexibility.

 

State of research:

There are a number of meta-analyses on the general effectiveness of ACT (Hayes2006 & 2013; Powers et al. , 2009; Öst, 2008; Ruiz, 2012; Smout et al. 2012) as well as disorder-specific meta-analyses and studies on affective, anxiety or obsessive-compulsive disorders, chronic pain (Forman et al., 2012; Swain et al. 2013, A-Tjak, 2015).

In summary, the study results to date indicate that ACT is an effective therapeutic method.

 

Bibliography:

 

  1. Hayes SC, Strohsal KD, Wilson KG (2014). Acceptance & Commitment Therapy. Paderborn: Junfermann. Eifert, GH, McKay, M, Forsyth, JP (2009). Dealing with anger and anger. Bern: Hans Huber.
  2. Törneke, N. (2010). Learning RFT. Oakland: New Harbinger
  3. Wengenroth, M. (2016). Accepting life, 3rd edition Bern: Hogrefe
  4. Wengenroth, M. (2017). Therapy tools acceptance and commitment therapy, 2nd edition Weinheim: Beltz

Basic literature

  1. Stephen Hayes, Kirk D Strosahl & Kelly G Wilson (2014). Acceptance & Commitment Therapy. Mindfulness-based changes in theory and practice. Junfermann Verlag.
  2. Niklas Törneke (2012). Frame of reference theory. An introduction. Junfermann Verlag.

Practical books

  1. Jason Luoma, Steven C. Hayes & Robyn D. Walser (2009). ACT training. Acceptance & Commitment Therapy: a handbook. A learning program in ten steps.Junfermann Verlag.
  2. Russ Harris (2011). ACT Made Easy: A Essential Guide to the Practice of Acceptance and Commitment Therapy. Arbor Publishing.
  3. Mathias Wengenroth (2017). Acceptance and Commitment Therapy (ACT). Therapy tools. With online materials. Beltz Publishing.
  4. Joseph Carriochi & Ann Bailey (2010). Acceptance and commitment therapy in CBT. With online material. Beltz Publishing.
  5. Matthew McKay, Avigail Lev & Michelle Skeen (2013). ACT and schema therapy. Changing interpersonal behavior through mindfulness, acceptance and schema awareness. GP Prost.

Selected scientific publications

  1. Forman, EM, Shaw, JA, Goetter, EM, Herbert, JD, Park, JA & Yuen, EK (2012). Long-term follow-up of a randomized controlled trial comparing acceptance and commitment therapy and standard cognitive behavior therapy for anxiety and depression. Behavior therapy, 43, 801 – 811.
  2. Hayes, SC, Luoma, JB, Bond, FW, Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behavior research and therapy, 44(1), 1-25.
  3. Hayes, SC, Levin, ME, Plumb-Vilardaga, J., Villatte, JL & Pistorello, J. (2013). Acceptance and commitment therapy and contextual behavioral science: Examining the progress of a distinctive model of behavioral and cognitive therapy. Behavior therapy, 44, 180 – 198.
  4. Ost, LG (2008). Efficacy of the third wave of behavioral therapies: A systematic review and meta-analysis. Behavior research and therapy, 46(3), 296-321.
  5. Powers, MB, Zum Vörde Sive Vörding, MB, & Emmelkamp, ​​PM (2009). Acceptance and commitment therapy: A meta-analytic review. Psychotherapy and psychosomatics, 78(2), 73-80.
  6. Ruiz, F. J. (2012). Acceptance and commitment therapy versus traditional cognitive behavioral therapy: A systematic review and meta-analysis of current empirical evidence. International Journal of Psychology and Psychological Therapy, 12(2), 333-357.
  7. Smout, MF, Hayes, L., Atkins, PW, Klausen, J., & Duguid, JE (2012). The empirically supported status of acceptance and commitment therapy: An update. Clinical Psychologist, 16(3), 97-109.
  8. Swain, J., Hancock, K., Hainsworth, C. & Bowman, J. (2013). Acceptance and Commitment Therapy in the treatment of anxiety: A systematic review. Clinical psychology review, 33, 965 – 978.
  9. A-Tjak, JGL, Davis, ML, Morina, N., Powers, MB, Smits, JAJ, & Emmelkamp, ​​PMG (2015). A meta-analysis of the efficacy of acceptance and commitment therapy for clinically relevant mental and physical health problems. Psychotherapy and Psychosomatics, 84(1), 30-36.
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