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The Future of ACT…

The Future of ACT…. Brandon A. Gaudiano, Ph.D. Alpert Medical School of Brown University & Butler Hospital ACBS World Conference XII June, 2014 Minneapolis, MN. ACT Areas of Expansion. Expand the technology Expand the training of clinicians

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The Future of ACT…

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  1. The Future of ACT… Brandon A. Gaudiano, Ph.D. Alpert Medical School of Brown University & Butler Hospital ACBS World Conference XII June, 2014 Minneapolis, MN

  2. ACT Areas of Expansion • Expand the technology • Expand the training of clinicians • Expand the role of behavioral intervention in the healthcare system

  3. C T B Motivational Interviewing Many others Functional Analytic Psychotherapy Cognitive Therapy for OCD Beck’s Cognitive Therapy Exposure with response prevention Mindfulness Based Cognitive Therapy Metacognitive Therapy Prolonged Exposure Dialectical Behavior Therapy Barlow’s Unified Protocol Schema Therapy Mindfulness Based Stress Reduction Acceptance and Commitment Therapy Rational Emotive Behavior Therapy

  4. Enhancing ACT Technology • Potential Problem: • ACT’s distinctive techniques (metaphors/ exercises) can get in the way of the work • Related Problem: • Therapists forget to use traditional behavioral strategies that may be useful/essential

  5. Enhancing ACT Technology • Possible Solutions: • Better integrate standard cognitive/behavioral techniques that work well into ACT • Train therapists to conceptualize/employ CBT strategies in an ACT-consistent way linked to the model

  6. ACT-ifyingCBT • Exposure • Behavioral Activation • Skills Training • Stimulus-Control • Contingency Management • Homework • Cognitive Interventions (e.g., thought records)

  7. Psychological Flexibility

  8. Enhancing ACT Training • Potential Problem: • The complete ACT model can be too complicated for novice/less advanced therapists to learn at first • Related Problem: • Traditional CBT is easier to learn (at least initially at a superficial level) than ACT and so may achieve better “uptake” in community settings

  9. Enhancing ACT Training • Possible Solutions: • Develop a multi-tiered training system that can build from beginner to advanced knowledge over time • Meet therapists where they are at with ACT training just like we adapt our interventions to meet clients in need

  10. Outpatient Treatment Use at Mental Care Facilities “National Trends in Outpatient Psychotherapy” Mark Olfson, M.D., M.P.H. & Steven C. Marcus, Ph.D. Am J Psychiatry 2010;167:1456-1463.

  11. Enhancing ACT Impact/Reach • Potential Problem: • The Biomedical Model is growing stronger and stronger in mental health treatment settings • Related Problem: • Biological reductionism is becoming the dominant way of thinking about behavioral problems and their solutions

  12. Enhancing ACT Impact/Reach • Possible Solutions: • Steadfastly pursue functional contextual neuroscience to take back biology • Advocate strongly for the role of behavioral interventions and influence public policy

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